(UPDATE+PICCS)Consult with a dr in Belgium (overbite, HA paste, jawline shaving)

[jawsurgeryadvice]

I had a consultation with a dr (dr J.D) in Belgium this week.

I have a little overbite and a steep mandibular plane angle with a strong chin.

This is the plan he made for me:
1. Moving my lower jaw +- 4 mm forward.
2. shaving of a bit of the side parts of my jawline (the parts next to the chin).
3. a little bit sliding genioplasty

Now I also thought my upper jaw should be more advanced and some members here who saw my pictures said I should do a CCW rotation. The doctor didn't say anything about CCW and he didn't want to do an advancement and/or impaction because that could age me.
Instead of that he wanted to:
4. fill in my nasolabial fold area with HA paste. He said I lack bone support there and that's one of the reasons I have a little too much gum showing when I laugh.
5. I have low cheekbones and a negative orbital vector, so he wants to put some HA paste on the higher parts of my cheekbones and orbital rim area.

Could you guys give your opinions about his plan. Especially the HA paste. I read a few stuff about it here, but im still not really sure about it yet.
And I'm also a bit skeptical about the jawline shaving, because what will happen to the soft tissues in that area? Will it hang, because there is a lack of bone support? Or will the advancement compensate the lost of bone support?

I could PM some pictures if anyone wants.

[MyTimeIsNow]

PM me pics.

I had consultation with Dr. Df too. I liked the consultation, but I didn't like his suggested options, so I won't be choosing him.

[Lestat]

Could you guys give your opinions about his plan. Especially the HA paste. I read a few stuff about it here, but im still not really sure about it yet.

You went all that way and you didn't ask for photos just to see what he could achieve with the methods he in fact used!?

[jawsurgeryadvice]

He has a lot of before and after pics on his website, so I actually did. My next appointment will be in July and I'll ask him some more specific pictures. But of course he is positive about the HA paste, since he uses it so often. Just wanted to know your guys' opinion since some are very knowledgeable in this forum.

[ditterbo]

Now I also thought my upper jaw should be more advanced and some members here who saw my pictures said I should do a CCW rotation. The doctor didn't say anything about CCW and he didn't want to do an advancement and/or impaction because that could age me.

Did he say why or how that would age you?  I've been wondering about this as well.

[jawsurgeryadvice]

@ditterbo I dont know what he exaclty did, but he did measure how much of my front teeth was showing (in height) when i opened my mouth (and that was good already). And also I dont really have gum showing when I smile only when I have a good laugh. So I think based on these 2 things he thought an upper jaw surgery would age me, especially an impaction since there is less bone support for the soft tissues. Also he was scared that my nose will change in a negative way.

[asphyxia]

What did he say exactly about the HA ? How does he want to use it ?

[whatdo]

@ditterbo I dont know what he exaclty did, but he did measure how much of my front teeth was showing (in height) when i opened my mouth (and that was good already). And also I dont really have gum showing when I smile only when I have a good laugh. So I think based on these 2 things he thought an upper jaw surgery would age me, especially an impaction since there is less bone support for the soft tissues. Also he was scared that my nose will change in a negative way.

Interesting.  I have no gum show and my orthodontist says upper jaw surgery will give way to some gum show for me too.

That's also a huge worry of mine, the aging, but wouldn't a ccw do the opposite? Tighten the skin/bone support and give a more youthful appearance?

[Milli_Meters]

I have little teeth showing when smiling/talking.I would rather have moderate gum show over no teeth showing  any given day.

Some gum show looks youthful. Teeth covered while smiling looks old.

[UKMaxfac]

He offers a 3d mapping of your face and skull with a simulation of what jaw surgery can achieve. This is only after you pay the hefty fee for all the x-rays etc to be taken though. He then detracts some of that payment out of the final cost of the surgery.

I found that actually seeing a proper simulation of the changes extremely helpful - it might help you as well.

[CCW]

I don't like Defrancq and here are three examples why. He doesn't do CCW and uses a posterior impaction to close an open bite. This makes the OP steeper, puts more strain on the joints, doesn't fix the airway, or the face. He then does a huge ugly genio to camouflage the recession, which would be unnecessary if he did CCW. If you don't routinely do CCW when it's indicated, you're not a good surgeon in my opinion. I wouldn't have surgery with him.

[Milli_Meters]

I don't like Defrancq and here are three examples why. He doesn't do CCW and uses a posterior impaction to close an open bite. This makes the OP steeper, puts more strain on the joints, doesn't fix the airway, or the face. He then does a huge ugly genio to camouflage the recession, which would be unnecessary if he did CCW. If you don't routinely do CCW when it's indicated, you're not a good surgeon in my opinion. I wouldn't have surgery with him.

That was a bad result.  What do you think he did here - http://www.facialsculptureclinic.com/en/case/all-cases/169/   moved the whole maxilla down?

[jawsurgeryadvice]

I don't like Defrancq and here are three examples why. He doesn't do CCW and uses a posterior impaction to close an open bite. This makes the OP steeper, puts more strain on the joints, doesn't fix the airway, or the face. He then does a huge ugly genio to camouflage the recession, which would be unnecessary if he did CCW. If you don't routinely do CCW when it's indicated, you're not a good surgeon in my opinion. I wouldn't have surgery with him.

Yeah I also noticed that. Most of the outcomes aren't spectacular. And most of the pictures on his site are from people who had a very noticeable deformity, so its easier to make them look normal. I think I look okay already, but I just want that extra, and idk if he can help me with that 
My ortho told me a few days ago that there are actually quite some Dutch surgeons who perform a rotation of the jaws. But they are just not so worldwide famous like these other surgeons mentioned in this forum. So maybe I should see a local surgeon? (Im from the Netherlands).

Or does anyone know any good surgeons from the Netherlands or Belgium who do perform CCW rotation?

[CCW]

I can't give surgeon recommendations in BENE, but I think you should travel if you want the best result. The prices are similar everywhere in Europe. Schedule a consultation with Alfaro, Raffaini and/or Marianetti.

[jawsurgeryadvice]

I can't give surgeon recommendations in BENE, but I think you should travel if you want the best result. The prices are similar everywhere in Europe. Schedule a consultation with Alfaro, Raffaini and/or Marianetti.

Have you heard of dr De Jonge? I Think he did a really great job in this case: http://cindyskaakoperatie.blogspot.nl/2015/09/re-post-voor-en-na-fotos-kaakosteotomie.html