Do I have short facial growth patterns?

[griffin616]

Hey, longterm lurker here. I think I've finally learned enough to articulate my thoughts on my situation.  It would mean a lot to me if you guys told me what you thought of my situation and if my thoughts and theories are remotely plausible. I had tried discussing this with my parents(I'm 17), but they laughed at me and told me I was handsome, so here's to hoping you guys can be a little more honest.

As the title points out, I think my face has followed some short growth patterns. Here are some pictures.

I'll prefice my monolouge by pointing out that most of what I know I learned from here. This might be a bit scattered, but it feels good to atleast get it written out.

So, to jump right in, I believe I was a "victim" of camoflouge orthodontics. Prior to having braces (and afterwards technically) I had a retruded mandible, resulting in a class 2 malocclusion. My orthodontics "fix" to this problem was to pull and restrict growth of the maxilla through use of elastics to make the mandible and maxilla meet. This fixed the dental occlusion, but created facial disharmony.

To my knowledge, the way to fix this would be to have a clockwise rotation of the maxilla as well as bring it forward and down. And to also bring the mandible forward to meet the maxilla where it was originally supposed to. Additionally, I have developed a deviated septum (I believe as a result of this maxillomandibular deficiency). So having that corrected should improve airflow as well correct?

Going back to this paper, I went down the list of "symptoms" and "characteristics" and was able to relate to virtually all of them. (I think it might be worth noting that I think my profile reflects a lot features seen in the last girl on that paper.) In addition to what you can see in my pictures, I have sleep apnea, lower back  and knee problems (caused by compensating posture), tinnitus, ADHD and constant fatigue(This is all that I can think of atm). So, while yes having a more attractive face would very much be a plus for me, I am more interested in fixing these issues as I believe they're all correlated to the facial disharmony.

Sooo, now that I have it all written out and if you stuck with it, What do you think of my thoughts? Am I seeing something my Mom isn't or am I looking too far into it? And if I am right, is my case at all severe enough to warrant any kind of action(Surgery?) Thank you if stuck with me this far haha.

TL;DR: Facial disharmony(and several other ailments, physiological and physcological) caused by camoflouge orthodontics manifests in short facial growth. Or I am very, very wrong.

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[Optimistic]

Hard to say without scans.

I think you could solve your problem with a simple sliding genio, honestly.

[notrain]

Your self diagnosis is pretty accurate. From your profile shots it indeed looks like a mild class 2 deep bite (Angle II/2) skeletal malocclusion.

Do you have money or insurance in order to fix it? If so, go ahead and consult with some surgeons.

[needadvancement]

I think you are good looking and would advise against surgery but those are some serious issues you are describing. My 2  cents is that to go along with your functional bsso, get a vertical genioplasty for some added facial height.

[TMKA]

It looks like you have an overbite. It's hard to tell from the pictures whether its both jaws or just the mandible. I would find a very experienced orthodontist and oral surgeon to have a consultation with. I will probably cost you a couple hundred dollars or so to get a full plan with xrays, computer imaging, measurements, graphs and etc made, but it's worth it. It's pretty neat to see all of it and then you'll know exactly what you need. 


I wish orthodontists wouldn't do the camoflauge treatment without fully explaining the pros & cons of it. I think they think most parents and patients would be scared of the surgery and also wouldn't want to wait till they quit growing to do treatment.

[griffin616]

Hard to say without scans.

I think you could solve your problem with a simple sliding genio, honestly.

You look good to me dude. Just young and you are still gonna see some developments/changes in the maxilla/mandible for the years to come. Aesthetically I don't see what's bothering you. Perhaps a genio as Optimistic said indeed would help you achieve what you want to achieve but you look very good already. Aesthetically I don't see the need for jaw surgery. Functionally? Couldn't say of course.

From just a quick glance at google, a sliding genioplasty is just the advancement of the chin by cutting it at a certain angle (angle determining vertical/horizontal projection) and screwing it in? If that's the case, wouldn't it just further project the chin, increasing the already deep labiomental fold? Even if adding vertical length shallowed the fold, wouldn't there still be excess protrusion of the upper lip as well? It seems to me that this might be more "camouflage" treatment.

Your self diagnosis is pretty accurate. From your profile shots it indeed looks like a mild class 2 deep bite (Angle II/2) skeletal malocclusion.

Do you have money or insurance in order to fix it? If so, go ahead and consult with some surgeons.

Good to know I might not be that far off haha. If I can get my parents on board money isn't an issue, they currently think I'm crazy to even suggest that there might be something wrong with my face. What kind of surgeons should I consult with? I'm now weary of approaching any kind of orthodontist. And what kind of surgeries/treatment do you think might be needed?

I think you are good looking and would advise against surgery but those are some serious issues you are describing. My 2  cents is that to go along with your functional bsso, get a vertical genioplasty for some added facial height.

Thanks, I guess I do have that "cute" teenager look and not really considered ugly, but I'm more interested in improving the functional aspects of my body. Improved aesthetics would just be a bonus for me.

It looks like you have an overbite. It's hard to tell from the pictures whether its both jaws or just the mandible. I would find a very experienced orthodontist and oral surgeon to have a consultation with. I will probably cost you a couple hundred dollars or so to get a full plan with xrays, computer imaging, measurements, graphs and etc made, but it's worth it. It's pretty neat to see all of it and then you'll know exactly what you need. 


I wish orthodontists wouldn't do the camoflauge treatment without fully explaining the pros & cons of it. I think they think most parents and patients would be scared of the surgery and also wouldn't want to wait till they quit growing to do treatment.

This is the part that confused me in my search to find what was wrong, I have some features that are associated with an overbite, but I have good dental occlusion. It's my assumption now that I have a skeletal occlusion(always did technically), as notrain stated I seem to have a deep bite caused by the retrusion of the mandible and now the maxilla. So I guess skeletal occlusion was sacrificed for dental occlusion.

Yup, I definitly agree with getting all the info because I'm just scrambling to figure this out myself haha.

I don't understand this and it frustrates me so much! If my parents were warned of the ramifications, I don't think they would have pursued the treatment for me. So are these orthos ignorant or selfish? Do all these orthodontists purposefully ruin faces just to get their paycheck? I have a hard time believing that someone who goes to school for 10 years to specialize in the field can be ignorant to the implications of their treatments. And in the case of my old ortho, how would they still not notice after the hundreds of people they've treated?

Sorry about the rant. 


Btw thank you for your responses so far

[PloskoPlus]

How's your tooth show? Cute is good,but can age badly.

[griffin616]

How's your tooth show? Cute is good,but can age badly.

Not quite sure on how to measure tooth show, but I'll try. I have almost no tooth show when face i.e. jaw, lips is relaxed. When I smile my upper lip curls up(I think that's what it is doing) and is pretty strained, well actually my whole face feels slightly strained I guess. When I smile my top teeth show, and no gingiva shows.

Yeah I've heard about that too. From what I've read about aging in short facial growth patterns is that from pre-pubescence-early adulthood the faces appear younger, but a edentulous look quickly takes its place.

[Icy]

Not quite sure on how to measure tooth show, but I'll try. I have almost no tooth show when face i.e. jaw, lips is relaxed. When I smile my upper lip curls up(I think that's what it is doing) and is pretty strained, well actually my whole face feels slightly strained I guess. When I smile my top teeth show, and no gingiva shows.

Yeah I've heard about that too. From what I've read about aging in short facial growth patterns is that from pre-pubescence-early adulthood the faces appear younger, but a edentulous look quickly takes its place.

That sounds like my situation after camouflage orthodontics with an overbite and slightly short facial growth pattern. Reversing the retroclined incisors has helped my situation, but I also have to strain my face a lot to show my teeth when I smile and I show no gum. Have you consulted with an ortho before at all? I have another appointment tomorrow to discuss these issues and the only bit of advice I can offer is this: if you do decide to pursue treatment make sure that your orthodontist is willing to take facial harmony into account, as my previous one did not and I paid the price (literally) for it. My current orthodontist works with several surgeons and is also very face-focused so I feel I can trust her. Your features do not look terribly unbalanced to my eye; your overall appearance is attractive. I'm certain that if you do decide to pursue treatment for your functional issues that the aesthetic gains will be a bonus on top of the functional improvements surgery would afford.

[TMKA]

quote " are these orthos ignorant or selfish? Do all these orthodontists purposefully ruin faces just to get their paycheck? I have a hard time believing that someone who goes to school for 10 years to specialize in the field can be ignorant to the implications of their treatments. And in the case of my old ortho, how would they still not notice after the hundreds of people they've treated?"

I think thats the way they are trained. The problem is, if I'm an orthodontist and I suggest to a parent that they wait until their child is 16 and then we will do this scary sounding surgery, most likely they will go to some other orthdontist who will tell them that an appliance can make the jaw grow and then they won't need surgery and they can get started right away. Hard to stay in business treating only adults and older teenagers.

[PloskoPlus]

Not quite sure on how to measure tooth show, but I'll try. I have almost no tooth show when face i.e. jaw, lips is relaxed. When I smile my upper lip curls up(I think that's what it is doing) and is pretty strained, well actually my whole face feels slightly strained I guess. When I smile my top teeth show, and no gingiva shows.

Yeah I've heard about that too. From what I've read about aging in short facial growth patterns is that from pre-pubescence-early adulthood the faces appear younger, but a edentulous look quickly takes its place.

Your maxilla is vertically short then if you don't show 1m of gum when smiling hard (and your upper lip is short too - That's a good thing BTW)

Sounds like you may need down grafting your maxilla.  That's the least stable maxillary surgery.  You need a very good surgeon for this.

[terry947]

I think at 17 years old you should wait a couple of years. If it makes you feel better than get some consultations. I think you are correct with your assumptions towards your facial growth. Genio might be enough, but like plosko said, you might need a CCW rotation. Forum member Tumerican could probably help you out since he's in a similar boat.

[buzzhead]

Hello all.  I haven't been visiting the forum for quite some time.  I guess now that the surgery is behind me I am obsessing on other life issues.  I never imagined actually being on the other side of this whole process.

To recap, I also was blessed with the dreaded "Short Face Syndrome" and suffered camouflage orthodontics when I was your age.  The ortho PULLED AND REMOVED four perfectly healthy teeth and moved my face backwards greatly harming my facial aesthetics.  I actually had more upper incisor show prior.  The so called treatment also still left me with a deep bite.  Only thing accomplished was no crowding of the arches.  I remember voicing my concerns with the orthodontist and they simply got pushed aside and ignored.

To be fair, that was back in the stone age (1978) when apparently all of the knowledge and treatment science was not at all what it is today.  So I have forgiven him. 

Over the years, living my life unhappy with my appearance,  I developed severe sleep apnea which caused me to seek solutions to treat it.  One great eye opening day in conversation with my new young dentist,  she brought up this whole idea of orthodontic surgical treatment.  She certainly got my attention!  Soon I was on my way for a consultation with my current Orthodontist and subsequent Surgeon which brought me to where I am today. 

Basically,  my maxilla was brought forward 9 mm, and down grafted 5 mm.  Lower jaw moved forward 14 mm.  All with CW rotation.  Currently I am under going the finishing orthodontics.  My recovery is going very well with most of the numbness going away which is great seeing that I am almost 57 years old now.  I am only six months out of surgery and if this is as good as it gets then that is all good with me.  I hardly even notice the residual numbness any more.  Although I definitely do not qualify as a "babe magnet", (I am already married  to a babe),  I like better what I see in the mirror and I finally don't have sleep apnea.  All is good.

I sometimes get a little down wishing these things were possible back when I was 17 but oh well,  life's journey takes us all where ever and however it takes us.  By all means I would recommend you to continue investigating your issues, perceived or real, but don't do anything surgical until you are beyond any growth spurts that you as a male could experience up to your mid twenties.  Love all you guys!

[buzzhead]

Oh, and my maxilla was widened 5 mm and I am a male.

[griffin616]

My current orthodontist works with several surgeons and is also very face-focused so I feel I can trust her. Your features do not look terribly unbalanced to my eye; your overall appearance is attractive. I'm certain that if you do decide to pursue treatment for your functional issues that the aesthetic gains will be a bonus on top of the functional improvements surgery would afford.

Yes I will definitly only be consulting with face-focused orthos, learned my lesson from the last one too. This new "world" has opened my eyes to how important the proper development of the face is in all matters of life.

Thanks for considering my face attractive  I feel as if I was handed the right blueprints for a nice face, but some of the construction went wrong along the way if that makes sense. I think if I didn't get lucky with some genetics my face could have turned out a lot worse from this situation. But yeah, I am looking into this mostly to fix the functional issues as those have the biggest effect on my quality of life, especially the fatigue.

I think thats the way they are trained. The problem is, if I'm an orthodontist and I suggest to a parent that they wait until their child is 16 and then we will do this scary sounding surgery, most likely they will go to some other orthdontist who will tell them that an appliance can make the jaw grow and then they won't need surgery and they can get started right away. Hard to stay in business treating only adults and older teenagers.

That does seem like the most likely scenario. I hope at some point these trends change so less people are affected by these medieval treatments.

Sounds like you may need down grafting your maxilla.  That's the least stable maxillary surgery.  You need a very good surgeon for this.

Why is it the least stable? Is it due to the need of a bone graft/or some kind of filling to fill the gap? Do you know of any good sources where someone could learn more about this type of surgery?

I think at 17 years old you should wait a couple of years. If it makes you feel better than get some consultations. I think you are correct with your assumptions towards your facial growth. Genio might be enough, but like plosko said, you might need a CCW rotation. Forum member Tumerican could probably help you out since he's in a similar boat.

What is the reason for waiting? I hear from some places that the sooner the better for these types of surgeries and some that say that the surgeries should be delayed until after full growth.

I don't mean to be nitpicky here, but I'm fairly certain this kind of situation would be treated with a clockwise rotation of the maxilla, as a CCW would be used to treat someone with a "long face type."

Hi.

You look pretty good as is. However if I was in your shoes I would wait a couple of years then go ahead and get the surgery, but bear in mind I'm only saying this because I have short jaws so am a little biased - when I see a short face I have this inherent bias within me that causes me to be more critical because I dislike my own, whereas the regular joe probably wouldn't even notice.

I also had a deviated septum which was fixed 3 and half weeks ago - I can strongly recommend atleast getting this done if you dont want to do the jaws, I can finally breathe through both nostrils again which is very nice. But obviously make sure you only get a septoplasty not a rhino since your nose looks great otherwise, mine was severely deformed in comparison 

Since you are younger you stand to get a greater benefit from the surgery - but the risks are certainly there. I've not had jaw surgery yet and despite my excitement over the possibility even I am still not sure whether having potentially permanent numbness of the chin etc is worth it in the long run just for looking better...

Just make sure you see atleast a couple of surgeons and get a full diagnosis and take everything said on this forum with a pinch of salt.

I definitly want to fix the deviated septum as I can pretty much only breath out my left nostril  I think I have a good nose structurally, but its size is enhanced by the recessed/tilted maxilla, so definitly no rhino for me.

It seems to be a huge matter of weighing pros and cons. If doing jaw surgery meant my functional issues were fixed, but there was a chance I couldn't feel parts of my chin, thats a great deal for me.

Hello all.  I haven't been visiting the forum for quite some time.  I guess now that the surgery is behind me I am obsessing on other life issues.  I never imagined actually being on the other side of this whole process.

To recap, I also was blessed with the dreaded "Short Face Syndrome" and suffered camouflage orthodontics when I was your age.  The ortho PULLED AND REMOVED four perfectly healthy teeth and moved my face backwards greatly harming my facial aesthetics.  I actually had more upper incisor show prior.  The so called treatment also still left me with a deep bite.  Only thing accomplished was no crowding of the arches.  I remember voicing my concerns with the orthodontist and they simply got pushed aside and ignored.

To be fair, that was back in the stone age (1978) when apparently all of the knowledge and treatment science was not at all what it is today.  So I have forgiven him. 

Over the years, living my life unhappy with my appearance,  I developed severe sleep apnea which caused me to seek solutions to treat it.  One great eye opening day in conversation with my new young dentist,  she brought up this whole idea of orthodontic surgical treatment.  She certainly got my attention!  Soon I was on my way for a consultation with my current Orthodontist and subsequent Surgeon which brought me to where I am today. 

Basically,  my maxilla was brought forward 9 mm, and down grafted 5 mm.  Lower jaw moved forward 14 mm.  All with CW rotation.  Currently I am under going the finishing orthodontics.  My recovery is going very well with most of the numbness going away which is great seeing that I am almost 57 years old now.  I am only six months out of surgery and if this is as good as it gets then that is all good with me.  I hardly even notice the residual numbness any more.  Although I definitely do not qualify as a "babe magnet", (I am already married  to a babe),  I like better what I see in the mirror and I finally don't have sleep apnea.  All is good.

I sometimes get a little down wishing these things were possible back when I was 17 but oh well,  life's journey takes us all where ever and however it takes us.  By all means I would recommend you to continue investigating your issues, perceived or real, but don't do anything surgical until you are beyond any growth spurts that you as a male could experience up to your mid twenties.  Love all you guys!

Seems you've had quite the journey so far, and it's amazing that you've kept up such a positive outlook on your life!

And dang, that is quite the big movement there, bringing pretty much your whole face forward a cm I guess I am lucky to not have had any teeth extracted, though it seems the wisdom teeth may have to go as they're pretty impacted(which I assume is because of the retraction of everything else.)