NHS Consult Advice

[Eilerson]

 I had a consultation with an NHS orthodontist who mentioned a probable upper expansion and, maybe, lower expansion followed by double jaw surgery.
 
 He was reluctant to go into details before the consult with the surgeon (this week)

 I'm 30 yeards old.  Had my upper 4s removed in my teens, other than that I've got all my teeth including fully erupted wisdom teeth. I've got a crossbite and open bite., front teeth are practically edge to edge but don't make contact.
   
 The primary reason is functional but obviously I want the best aesthetic result. What should I be looking out for/need?

 Self done profile below, couple of x-rays attached.

[triot]

Expansion (upper/lower)
CW-Rotation
Both jaws horizontally advanced by a bit.

Your Zygomas aren't as bad as I would expect. But you have a retruded upper midface. No easy fix for that.

I'm not an uber-expert but that would be my guess.

Get your jaws done before. You will greatly benefit healthwise.

[JimmyTheGent]

Expansion (upper/lower)
CW-Rotation
Both jaws horizontally advanced by a bit.

Your Zygomas aren't as bad as I would expect. But you have a retruded upper midface. No easy fix for that.

I'm not an uber-expert but that would be my guess.

Get your jaws done before. You will greatly benefit healthwise.

How do you expand the lower jaws to coincide with the upper palate expansion???    My only uneducated guess would be something like wilckodontics which would expand the dental arch but not the jaw bone.  Can they do a horizontal cut to the chin during a genioplasty to make the mandible look wider???

[Eilerson]

 Had the joint ortho/surgeon clinic today.

 Preliminary plan.

 Expansion with braces only as they decompenstate the bite in preparation, no extractions... 12-18 months
 
 BiMax surgery involving impacting and bringing forward the Maxilla,  clockwise rotation.
 
 Said something about having to careful of the relation between the nose and the glabella. They explained that my mandible was a little large but the real problem was how the maxilla had developed..

[Eilerson]

 What type of lefort do you think is most likely to be used?

[triot]

What type of lefort do you think is most likely to be used?

Probably LeFort I + BSSO. If they would do a higher Lefort level you'd know by now. Ask your surgeon.