Straight vs CCW rotation cosmetic results in MMA. Please give your opinions.

[Picollo30]

what are the major differences? Arnett & Gunsons says while straight MMA for OSA cure treats it completely its aesthetic results are very weak but they dont elaborate much more.

Who has done a straight MMA procedure and what did you think of the results when you saw yourself in the mirror?

[terry947]

Straight advancements  are for people who have close to horizontal oclussions related to the Frankfurt plane. If someone with a horizontal oclussion got a CCW rotation then they'd look like they have a scrunched in mid face from the side profile. Any kind of advancement helps with sleep apnea. But if you have a really steep jaw angle a straight advancment by will look "off"

[notrain]

I had a straight bimax (4mm/15mm) advancement for sleep apnea and my occlusal plane was/is naturally flat.

Problems with straight LeFort 1 advancements only arise if it is a big movement (i.e. 1cm+). Your nasal base will become very full in profile and the nose very wide from the front.

In my case, my upper lip advanced 2mm and my nose got 1mm wider - if at all. My cheeks look better in profile. It was a solid improvement overall, but it's not like a live changing transformation (not that ccw would have been one either). The biggest improvement came from the 15mm BSSO anyway.

[Sinsajo]

Hello one question!! with whom you had the CCW am very interested to let me because my face is very long ... thank you very much !!

[molestrip]

I had a straight bimax (4mm/15mm) advancement for sleep apnea and my occlusal plane was/is naturally flat.

Problems with straight LeFort 1 advancements only arise if it is a big movement (i.e. 1cm+). Your nasal base will become very full in profile and the nose very wide from the front.

In my case, my upper lip advanced 2mm and my nose got 1mm wider - if at all. My cheeks look better in profile. It was a solid improvement overall, but it's not like a live changing transformation (not that ccw would have been one either). The biggest improvement came from the 15mm BSSO anyway.

From a technical standpoint, maxillary advancements over 5mm are riskier I recall reading. Regarding aesthetics, I think you're right unlikely to notice much of an impact on the nose, especially with ANS shaving and alar cinch. Even then, it surprises me that surgeons would expose patients to surgical risk over 1-2mm of changes to the nose, within the noise floor of surgery in general. As notrain said, CCW rotation is more about correction growth deficiencies and establishing normalcy than anything else. Normalcy is aesthetic typically of course but in some cases may be counter-aesthetic, as we don't surgically change the rest of the skull so a big deviation between different parts of the face can be an aesthetic disaster. What I don't understand about these straight advancements is how the geometry works out. To keep the teeth in contact seems like the mandible would need two different angles, granted the first angle is only a few cm long.