Gunson Consult - Your opinion on my plan

[slysurfz]

Hi All

I consulted with Gunson. Seems like there is no rotation needed in my case and there is just linear advancement and bit of a downgraft.

However, When i got the final docs there is a Genio listed as possible. He also proposed HA paste cheekbone augmentation and  submental lipo if I wanted.

During the consult he focused a lot on restoring my teeth and the ortho treatment and referred me to a restorative dentist which he works with.

In light of the linear advancement and the case being relatively simple does it make sense in going with his expensive fees. It is a whopper as expected.

All things aside, I was really impressed by the consult.

Attached is the Ceph analysis.


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[whatdo]

Mine also has a genio listed as possible in the documentation and I was also told HA cheek augmentation is recommended

[Milli_Meters]

The plan sounds straightforward. Not really breaking ground here - you could take the plan to a less expensive/skilled surgeon.

How much is a "bit of downgraft" btw? < 5 MM?

[slysurfz]

So I just got told that that upper jaw moving down is a counterclockwise rotation. I can't understand it.

Can somebody who understands ceph analysis please help me in understanding this plan by looking at the attached ceph in the first post.


@milli_meters I don't know how much it is not very good at reading the analysis  from what I can tell it's 2-3mm for improving tooth show as I don't have any now.

[Milli_Meters]

Upper jaw moving down is not CCW.

If your whole maxilla is down grafted equally posteriorly and anteriorly , no rotation is involved as Gunson told you.

CCW is the back of the maxilla being moved down in relation to the front.

You can just ask him how much it is I guess. 2 - 3 mms will not improve teeth show if "you do not have any now"  .

[CCW]

You're getting a 2.8mm downgraft which is fairly typical. The maxillary incisor tip is advanced 10mm and moved down 2.5mm. The chin is advanced 8.7mm. This seems like a pretty standard Gunson plan.

[ditterbo]

Your airway looks terrible in that ceph analysis.  That's a lot of forward movement but no fancy CCW work (unless a total maxilla dropdown is also considered more advanced). Unless you go to like a sleep apnea concerned max fac, I'd wonder if other max facs would want to advance your jaws quite as much.  But I'd put Gunson's aesthetic above most run of the mill max facs.