Is 6mm forward advancement significant?

[Lazlo]

Okay, so this is what I want to know.

Originally Arnett had me scheduled for CCW and I remember that the forward movement on upper jaw would be something really minimal like 2-4 mm and the lower something like 9 mm and it would hugely open the airway blah blah. Arnett didn't think I needed a genioplasty at all and he was argumentative when I brought up the question of gonial angles and mandibular widening.

With Sinn I've had upper advanced 6mm and lower 6 mm as well (I"m uncertain how that is possible since with CCW it's supposed to make the lower jaw advance further no?).  Maybe MOLESTRIP
 you can explain this to us.


Anyway, so 6 uppe forward r, 6 lower forward, 6 mm upper jaw DOWN, and a bit of mandibular widening, plus a 9 mm genioplasty.

I guess what I wanted to know is the degree to which this surgery was well done as far as maximizing the movements I wanted?

[Lazlo]

Okay, so this is what I want to know.

Originally Arnett had me scheduled for CCW and I remember that the forward movement on upper jaw would be something really minimal like 2-4 mm and the lower something like 9 mm and it would hugely open the airway blah blah. Arnett didn't think I needed a genioplasty at all and he was argumentative when I brought up the question of gonial angles and mandibular widening.

With Sinn I've had upper advanced 6mm and lower 6 mm as well (I"m uncertain how that is possible since with CCW it's supposed to make the lower jaw advance further no?).  Maybe MOLESTRIP
 you can explain this to us.


Anyway, so 6 uppe forward r, 6 lower forward, 6 mm upper jaw DOWN, and a bit of mandibular widening, plus a 9 mm genioplasty.

I guess what I wanted to know is the degree to which this surgery was well done as far as maximizing the movements I wanted?

what the collective inteligence of this forum can't figure this one out?

[Rikenen]

Oh wow you had 6mm down? Nice - so you had vertical maxillary deficiency? Does your midface look a bit stretched out now? In a good way ofc....

[Lazlo]

Oh wow you had 6mm down? Nice - so you had vertical maxillary deficiency? Does your midface look a bit stretched out now? In a good way ofc....

I had it 6mm down and 6 mm forward. Yeah there's a graft. I think it looks like i have much more midface support (in a good way). My face doesn't look longer, just stronger --though of course a big part of that is swelling.

I'm gonna post my cephs and surgeon's notes and stuff when I get them so you guys can help me figure out how strong my advancement was. The chin is definitely apparent. Jawline is full of swelling and yeah nose and stuff looks good right now due to what Plosko suggested --again benefit affect of swelling.

[molestrip]

It's possible to downgraft and create a discontinuity in the mandible angle, which if small won't be noticeable. Most of us have them already anyway but 6mm seems large to me. Maybe he's recontouring it. In that case the teeth would move together the same amount so you're getting rotation in place. If I recall, your airway was pretty small to begin with (<5mm) so it seems grossly insufficient to me in terms of opening it up. I would think 10-15mm BSSO would be needed. I'm not a fan of SG either, particularly the larger ones. I feel they're used to cover up small jaws and if that's your problem for functional reasons you should really advance the jaws more. I have mixed opinions about the soft tissue effects, since movements are said to be 100% for SG, no thinning, but then I've seen people thin in practice. I think that's why surgeons do it anyway but sometimes looks unnatural to me since the underside tends to flatten out. Also, I feel like pushing them back in lol.