Should I have had upper jaw done as well? (pics included)

[callmeUnicorn]

Hi there,

I am two weeks post-op a BSSO and Genioplasty (lower jaw/chin advancement) and am getting more and more depressed as the days go by. I had a deep overbite pre-surgery, but now I look like I have a slight underbite the way my teeth/lips touch. I have attached pics of me smiling with my teeth and without, and I can't help but feel like my upper jaw should have been brought either forward or down as well.

Pic 1: https://fi.realself.com/full/7efd53589ac2ea6c82cd57928212a8af/1/3/d/userimage-1482164.jpg

Pic 2: https://fi.realself.com/full/0618cf46e62660f48eb43b5583733b35/2/e/b/userimage-1482165.jpg

Pic 3 with me holding my tongue in between my teeth, I feel like this looks better but feels SO awkward: https://fi.realself.com/full/0618cf46e62660f48eb43b5583733b35/2/e/b/userimage-1482165.jpg

All my teeth touch and my ortho was the one who said I should be okay with a lower jaw/chin advancement, but my profile looks horrendous when I smile, I feel like an old lady or a witch with a squished middle face. I love how the chin turned out I mean I finally have a chin but because of the upper jaw it makes my chin look huge. At my first pre-op a week ago my OS said that I did look like I had a slight overbite but he didn't make a huge deal about it and thought it was just how I was biting. Have I made a huge mistake? I'm in Canada (Toronto) and see my surgeon tomorrow. Any suggestions on things I should be asking him?

[Picollo30]

i think a lefort 1 should have been done, for a bit of maxilla advancement. was this ever discussed pre surgery?

i like how the chin turned out, but it seems to me there's a loss of facial balance (upper lip in relation with lower lip). But dont worry, im sure you and your surgeon can sort it out. be sure to talk with him about what worries you. Be strong and dont give up. Also you can have an appointment with another surgeon to get a second opinion.

As for orthodontists i honestly dont trust them, most of them at least. They just care about how good teeth look in the end, and ignore functional problems (like jaw recession, facial assymetry, weak chin, etc).

[stupidjaws]

You are f**kin beautiful.

[callmeUnicorn]

Thanks for replying so far everyone. I've been so nervous but will definitely be bringing this up with my surgeon tomorrow and then update.. here are some more pics of me smiling normally with teeth showing and then mouth closed, and then another one where I'm holding my tongue in between my teeth (lower jaw feels better in this position as well) and I feel like my face looks balanced that way.

Do you guys think it's possible to do Lefort 1 (upper jaw) AFTER lower jaw/chin has already been done without touching the lower again?

Is there a reason I keep subconsciously placing my tongue between my teeth? It just happens without me even realizing it. Maybe I'm just crazy.... sorry guys I'll be asking my surgeon all these questions but it's comforting getting some opinions here as well... sigh

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[april]

I do think you look more balanced in your tongue pic above, but you are really pretty either way!

I used to do a similar thing with my tongue. I'm pre-op for deep bite & overjet, and would always stick my tongue between my teeth to push out my lower lip. It became second nature. But now that I have braces on I don't do it as much.

Good luck with your appointment tomorrow.

[callmeUnicorn]

So I had my appointment with the surgeon today and he was really casual about everything. He says since it's only 2 weeks I still have a significant amount of swelling especially around my chin, and gave me new elastics/showed me how to put them on to make sure my lower jaw doesn't want to jut forward (like I used to when I had an overbite). These elastics are PAINFUL and my jaw joints hurt... not sure if that's a good or bad thing but I'm kind of feeling better about everything knowing it's just swelling.

[Picollo30]

So I had my appointment with the surgeon today and he was really casual about everything. He says since it's only 2 weeks I still have a significant amount of swelling especially around my chin, and gave me new elastics/showed me how to put them on to make sure my lower jaw doesn't want to jut forward (like I used to when I had an overbite). These elastics are PAINFUL and my jaw joints hurt... not sure if that's a good or bad thing but I'm kind of feeling better about everything knowing it's just swelling.

have you talked to him about the possibility of a maxilla advancement in the future? i agree its early though.

[Tezcatli]

So I had my appointment with the surgeon today and he was really casual about everything. He says since it's only 2 weeks I still have a significant amount of swelling especially around my chin, and gave me new elastics/showed me how to put them on to make sure my lower jaw doesn't want to jut forward (like I used to when I had an overbite). These elastics are PAINFUL and my jaw joints hurt... not sure if that's a good or bad thing but I'm kind of feeling better about everything knowing it's just swelling.

It is probably swelling and you jutting your jaw. If not you will need upper jaw surgery and yeah you can have it by itself.

[kjohnt]

Right now it appears you have an underbite when looking at the soft tissue, so it appears the maxilla is recessed.  Given that your teeth are (or should be) in a class I position, your surgeon is absolutely correct in that you still have a lot of swelling in the lower jaw.  Once the swelling subsides, your chin and lower lip should align better with your upper lip.

I think you'll find that the surgeon should have advanced the maxilla some and the mandible further that same amount.

[kjohnt]

It is probably swelling and you jutting your jaw. If not you will need upper jaw surgery and yeah you can have it by itself.

Assuming her molars are now in a class I position, she cannot have maxillary advancement alone later as that would compromise her occlusion and give her an overjet.  She would need bimax advancement.

[callmeUnicorn]

Thanks so much for your replies so far everyone- and for the compliments

I'm actually feeling a lot better about everything since my appointment yesterday. To the previous poster, yes my bite is lining up perfectly, and my surgeon did say that I had a lot of swelling still. So if the maxilla was to be advanced, I'd be once again left with an overbite and the lower would have to be re-done but my OS is confident that everything is fine.

The one week where I had soft elastics, my bite changed for the worse temporarily- basically my jaw was jutting forward and my upper teeth sat right on top of my lower which gave in to the "underbite" look. With the new elastics I was given, my bite is now where it's supposed to be- upper teeth sitting slightly in front/over my lower teeth. It hurts like a b**** but this is how my teeth should be lining up together which fixes that slight underbite I thought I had going on.

If anyone cares to know, I will also be getting veneers on my front 4 or 6 teeth after my braces because of my peg laterals, and my short teeth. Can't wait..

I think I freaked out too early in the process. I am the definition of anxiety -_-

[JimmyTheGent]

Thanks so much for your replies so far everyone- and for the compliments

I'm actually feeling a lot better about everything since my appointment yesterday. To the previous poster, yes my bite is lining up perfectly, and my surgeon did say that I had a lot of swelling still. So if the maxilla was to be advanced, I'd be once again left with an overbite and the lower would have to be re-done but my OS is confident that everything is fine.

The one week where I had soft elastics, my bite changed for the worse temporarily- basically my jaw was jutting forward and my upper teeth sat right on top of my lower which gave in to the "underbite" look. With the new elastics I was given, my bite is now where it's supposed to be- upper teeth sitting slightly in front/over my lower teeth. It hurts like a b**** but this is how my teeth should be lining up together which fixes that slight underbite I thought I had going on.

If anyone cares to know, I will also be getting veneers on my front 4 or 6 teeth after my braces because of my peg laterals, and my short teeth. Can't wait..

I think I freaked out too early in the process. I am the definition of anxiety -_-

Should your jaw be hurting so much just to stay in the correct position?

[thinkingme]

i think its so early for say something. uare just two weeks post op and i think there is a lot of swelling. Just wait then open new thread

[kjohnt]

I'm not sure what I'm reading in this thread from some other members.

Yes you should have had Lefort 1, your maxilla looks recessed. Rather confuses me that your surgeon didn't think it was necessary.

Yeah this.

I was trying to be nice in my post as I think I've probably hurt some feelings on here, but I realize I personally want others to critique my features honestly and straightforward.

OP - ideally you'll need a revision with further bimax adancement.  It would help with projection as well as add some upper tooth show. Your surgeon's plan of attack was inadequate.

[callmeUnicorn]

Yeah this.

I was trying to be nice in my post as I think I've probably hurt some feelings on here, but I realize I personally want others to critique my features honestly and straightforward.

OP - ideally you'll need a revision with further bimax adancement.  It would help with projection as well as add some upper tooth show. Your surgeon's plan of attack was inadequate.

Thank you for being honest! I do agree with both of you. I think I would have gotten the BEST result if I had bimax. I feel like the easy way out was taken, just advancing lower jaw + chin to meet my upper jaw. If my upper jaw was brought down/forward a bit, I wouldn't have that pulling in look in the midface area. However, since I had taken the initial photos when I made this post, my bite has changed and it's beginning to feel a lot more natural and no pain at this point. The underbite look I had going on is gone as well, so I'm really starting to like my profile. But again a more aesthetically pleasing result would have been with a bimax in my opinion. I've never had much upper tooth show- mind you I used to grind my teeth so much so I have "short teeth" for which I will be getting veneers in the future. I'm finding that I used to grind a lot more pre-surgery, which was a surprising outcome of the surgery.

At this point I'm just waiting for the swelling to go down and judge after that. Physically, this is honestly one of the hardest things I've gone through