What kind of surgery was used here

[Freddie54]

I came across this result from a retired french surgeon on youtube and was blown away from the result does anyone knows what kind of surgical procedure was operated on the women here ?


Looks like Clockwise rotation to me but I’m not sure, here’s the video if you wanna check there’s subtitles the patient case is around 13:00 https://youtu.be/JlR_-sOcZPM?si=Nr1VyTfnN5P9orL2

[kavan]

Her lower 1/3 of her face is longer in the after, she starts with little upper tooth show and maxillary recession. So, most likely an overall graft to the maxilla with net CW-r in addition to maxillary and mandible advancement.

[Freddie54]

Her lower 1/3 of her face is longer in the after, she starts with little upper tooth show and maxillary recession. So, most likely an overall graft to the maxilla with net CW-r in addition to maxillary and mandible advancement.

Where the graft was used ? Isn't graft used only in CCW ? Why would a CW need a graft ? Also do you think the same method could be used on someone with relative normal upper teeth show ?

[kavan]

Where the graft was used ? Isn't graft used only in CCW ? Why would a CW need a graft ? Also do you think the same method could be used on someone with relative normal upper teeth show ?

My prior statement conveyed where an OVERALL maxillary graft would be used which means spanning the entire maxilla with purpose of vertically elongating the entire maxilla. That is HOW the lower 1/3rd of face gets LONGER and gets more upper tooth show on a person with a vertically short maxilla who has little to no upper tooth show.

NO. Grafts are not 'only used' in CCW. If that were the case, then 'only' people needing a CCW graft could get a graft and people needing a CW graft couldn't get any. Your question of: 'Why would a CW need a graft ?' assumes that 'only' people needing a CCW graft are candidates for any grafts and you ask after I explained the type of graft the person had. Let me put it this way: If the person in the photo who started with lack of upper tooth show and short lower 1/3rd ended up with a longer lower 1/3rd and more tooth show didn't have the the graft I told you she had, she wouldn't have had the improvement seen in the after.

Different types of grafts for different needs:

ISOLATED:
a: Posterior downgraft ISOLATED to posterior maxilla = CCW posterior downgraft
b: Anterior downgraft ISOLATED to anterior maxilla= CW anterior downgraft.

OVERALL DOWNGRAFTS:

Overall downgrafts span the entire maxilla to elongate the maxilla.
Candidates= people who have a short lower 1/3rd because of a short maxilla and also who have LACK up upper tooth show.

Rotation of Overall downgrafts:

If the anterior part of downgraft is longer than the posterior part, the NET rotation is NET CW

If the posterior part of the downgraft is longer than the anterior part, the NET rotation is NET CCW.

If the downgraft to the overall maxilla is uniform throughout, then there is no NET rotation.

QUIZ for you:

1: Are grafts 'only' uses in CCW? Yes____. No___

2: What type of graft did the person in the photo (who ended up with a longer lower 1/3rd and more tooth show) most likely get?

a: an isolated CW anterior downgraft
b: an isolated CCW posterior downgraft
c: an overall downgraft to elongate maxilla with NET CW-r
d: an overall downgraft to elongate maxilla with a NET CCW-r

3: As to the question of: CAN the 'same method could be used on someone with relative normal upper teeth show ? Let's see if you can answer that yourself now that I gave you the basic relationships.

Would an overall downgraft to elongate the lower 1/3rd (whether or not it's net CW or net CCW rotation) that INCREASES upper tooth show be a method to use in a person who had normal upper teeth show and didn't need any extra upper teeth show?  Yes____. No____.

[tie]

Hi Kavan, long time.
Its took me a bit so see the change its seems so subtle but yes makes a different and, and i hate to upgrade people but upgraded her. But seemsso subtle. 
Just wonder , more philosophiclly - do you feel auch surgeries are needed  does doctors do them ? I looked at the cases before in this video all girls looked beautiful even as thwg werd "before" .

And dont get me wrong, im a guy to see subtle changes.  Didnt knlw doctor do surgeries in such cases.

Her lower 1/3 of her face is longer in the after, she starts with little upper tooth show and maxillary recession. So, most likely an overall graft to the maxilla with net CW-r in addition to maxillary and mandible advancement.

Her face also looks more lifted and i get it why. I winder if she could get rhis cheek bone lifted and skin stretched look with plastic surgery instead (just wondering, alsso for myself)

[kavan]

You would have to refer to the video if you wanted to find out which doctor did the surgery. In general, the point I was making is that clockwise rotation GRAFTS are possible and were most likely used in this particular case.