Need OPINION on underbite

[jb2908]

Hi

I'm a 22 year old from Australia. I had braces, top and bottom, for about 4 years during my childhood, which were used to camouflage a deficient maxilla. I originally went to a plastic surgeon, with concerns about a large chin, where it was pointed out to me that I had a deficient maxilla. I went on to see 2 maxillofacial surgeons a few years back, and the gist of both was that my maxilla needed an 8mm advancement, and a slight CW rotation. I never ended up proceeding on anything, but have come back to seriously considering jaw surgery.

I was hoping the members of this forum could give me some advice on what operations may potentially help. I'm concerned not only about the receded maxilla, but also the flatness under my eyes, and asymmetry of the lower jaw and chin. And input would be greatly appreciated

See the pictures here

https://imgur.com/gallery/glzvQ

[kavan]

For now, flatness under eyes is the least of your problems. Put it on the back burner.

It does look like you are good candidate for surgery to maxilla and mandible, former being moved forward, latter back and with specialized chin osteotomies to remove excess.

Some of the specialized bone cuts to chin to reduce it are done in Korea which is about 1/2 the travel distance Europe is in the event you need to travel for surgery.  You might be a candidate for surgery first (which they do there too) as class 3 cases are often good candidates for that.

Hi

I'm a 22 year old from Australia. I had braces, top and bottom, for about 4 years during my childhood, which were used to camouflage a deficient maxilla. I originally went to a plastic surgeon, with concerns about a large chin, where it was pointed out to me that I had a deficient maxilla. I went on to see 2 maxillofacial surgeons a few years back, and the gist of both was that my maxilla needed an 8mm advancement, and a slight CW rotation. I never ended up proceeding on anything, but have come back to seriously considering jaw surgery.

I was hoping the members of this forum could give me some advice on what operations may potentially help. I'm concerned not only about the receded maxilla, but also the flatness under my eyes, and asymmetry of the lower jaw and chin. And input would be greatly appreciated

See the pictures here

https://imgur.com/gallery/glzvQ

[GJ]

Before reading your post I clicked the pictures and thought your maxilla needed slight advancement and slight CW rotation. Went back to read it, and see that's what the doctors recommended. So, I agree. Not sure I agree with 8mm, though...seems excessive.

[jb2908]

For now, flatness under eyes is the least of your problems. Put it on the back burner.

It does look like you are good candidate for surgery to maxilla and mandible, former being moved forward, latter back and with specialized chin osteotomies to remove excess.

Some of the specialized bone cuts to chin to reduce it are done in Korea which is about 1/2 the travel distance Europe is in the event you need to travel for surgery.  You might be a candidate for surgery first (which they do there too) as class 3 cases are often good candidates for that.

Do you believe the maxilla should be addressed without considering the under-eye/cheekbone element? One of the things I am concerned about is the asymmetry due to lesser structural support under one eye. Considering the maxilla and cheekbone complex are connected, should both not be considered at the same time?

[kavan]

Do you believe the maxilla should be addressed without considering the under-eye/cheekbone element? One of the things I am concerned about is the asymmetry due to lesser structural support under one eye. Considering the maxilla and cheekbone complex are connected, should both not be considered at the same time?

Well, IF you have a max fax who can  make specialized cuts to the orbital rim/cheekbone complex to bring that area out ALSO during the same time, then yes.

[jb2908]

Well, IF you have a max fax who can  make specialized cuts to the orbital rim/cheekbone complex to bring that area out ALSO during the same time, then yes.

Do you know some names of surgeons who are able to?

[kavan]

Do you know some names of surgeons who are able to?

Keep in mind that there are many more max fax docs than those who's names are frequently dropped.

If addressing the midface area is important to you to be done during same bi-max, than you should bring that up DURING your consult about bi-max.

My advice was to put it on the back burner for a later surgery after the jaw and chin areas were addressed.

[Ben30]

Some photos when your smiling would be useful that would reveal the extent of your problem.

You have had the abnormality disguised then you will need to have it uncovered with orthodontic de~compensation prior to surgery.

Your lower incisor teeth will be tipped back making your chin appear pointy. Orthodontic de compensation will improve your chin and allow for a larger upper jaw advancement.

[Tati]

Congrats on finding surgeons who do advancements and downgrafts simultaneously, mine wanted nothing to do with that.