Indecisive on surgery

[txiña]

Hi everyone,
My name is Montse, I have open bite, over bite and slight asymmetry.  I am guessing I will probably need upper and lower jaw surgery. I am having my first surgeon appointment next month. I know I should go through with the surgery for functional reasons but the main fear is the change of my face and if won't be happy with the results..... any advice?

P.D. sorry about my english, but I am spanish.

[attachment deleted by admin]

[attachment deleted by admin]

[neferkitti]

Hi txina,

Welcome! I see the asymmetry, a set back lower jaw, but I'm not sure whether there's a gummy smile there or not. Is there? Also, in the last photo, is that where your jaw naturally rests?
I'm in no way an expert -- just a post-surgical patient. I would ask your surgeon about the potential for lower face lengthening. Surgical forward movement of the mandible tends to widen and lengthen. The degree of which would depend on how many millimeters it's moved, however.

With upper jaw movement, I'd ask questions like: affects on "tooth show" and changes to nose (widening and upturning).

I had some asymmetry, as well, but this was not addressed by my surgeon. On me, it is more pronounced post-surgery. I would make sure yours is corrected and not overlooked.

You look good now, so I understand your aesthetic concerns.

Good luck. 

[tdawg]

It is amazing how similar our cases are. Im also an open biter who is indecisive. You actually look like my sister.

Anyway, I have decided that jaw surgery isnt worth it for me. The reason being the cost, risk(you only see the good results online) and down time adversely effecting my career. However another big factor is that for us open biters maxillary impaction is usually indicated. As I have a fairly long upper lip that leaves me with a normal non gummy smile, I am worried about pre mature aging which is a risk if the maxilla is impacted too much.

So instead I am going to have invisalign and possible TADs with the goal being to intrude the posterior segment of teeth, allowing the mandible to auto-rotate up. There are some impressive results of this online. I figure that if I am not happy I can always get a genioplasty later. However my problems arent worth the risk of a bad jaw surgery.

If you DO decide to go through with surgery, I urge you to go to the best and most experienced surgeon you can afford. If you do this surgery, you should go all out and not cut any corners.

[neferkitti]

Neferkitti, thanks for your advices and sorry to hear that your asymmetry is worse now. About your questions, yes, there's a gummy smile, not too much. About the last photo, yes is where my jaw naturally rests... as you can see I have a prominent chin, so if they are going to make a forward movement of my lower jaw... my chin will be even worse??... this question worry me and the changes to nose too.

Hi. Yes, I would ask about the chin. Mine was prominent before braces. Pre-surgical orthodontics made it more pronounced relative to my labiomental fold (horizontal crease between lip & chin), so now I have an overly prominent chin post-surgery. This outcome was due to bad planning by my doctors, so you may not have the same experience. But, definitely push them to address this issue just to be safe.

[Cmonster]

Hello fellow overbiter

I can see an overbite and some mild asymmetry BUT if it does not bother you and you are not at risk for joint deterioration or pain then forget it, its not worth it to you.
If it is something that you think about every day, is bothering you and you feel that changing it will improve your life then move forward.

It all depends on what you want, and what is best for you. Its impossible with surgery to guarantee an outcome ,BUT if you communicate clearly with your surgeon about your expectations/wants they should try to work with you.

I have the EXACT same fears as you, but this problem has been bothering me for 11 years, I need to get over with it, instead of spending the rest of my life thinking 'what if'

I found this surgeon in Spain who looks like he's handled a number of cases might be worth a consult
http://en.institutomaxilofacial.com/orthognathic-surgery-facial-deformities/clinical-cases%20/class-ii/
Good luck !

[tdawg]

I tried posting my pics but it said the upload folder was full.

However I disagree with the last poster.

I actually see the opposite of an overbite, an openbite. Your overjet looks to be in normal range(but its hard to tell). IMO your problem is caused by the vertical excess in the posterior region of your maxilla. Depending on the severity and how much it bothers you treatment will probably consist of an attempt to intrude the back teeth, or a lefort impaction.

[txiña]

 Maybe with this picture you can see my openbite

[attachment deleted by admin]

[txiña]

Cmonster, thanks for your advices. I am overbiter, openbiter, i have asymmetry and gummy smile  All of this bother me, obviously it's difficult don't think about it everyday when you look at the mirror, also I have strong headaches. The Spanish surgeon that you mentioned in your post is Dr. Alfaro, he is very famous in Spain cause he was surgeon in a TV show Extreme Makeover, now it's the most expensive in Spain. I have an appointment next month with other surgeon that it's the president of SECOM Spanish Society of Oral and Maxillofacial Surgery. My ortho say that this surgeon is good. 

Tdawg, can help  if you edit your pics using Paint, you have to go to IMAGE click on stretch-skew and choose 50-50 in horizontal and vertical. 

[Cmonster]

I can definitely see an open bite with that picture.... Good luck with your consults (go to more than 1) !!!  and more important go with the surgeon you feel most comfortable with !