Bimax. protrusion opinions needed - pictures + X rays

[carli]

Hello everyone! For half a year now I have been obsessing about what I need to do about my looks which I am really not satisfied with. I have been to 9 orthodontists and one max. fac. surgeon. Still i am not quite sure what is the best route to go for me.
My concerns are my convex protruding profile and my lip incompetence. All that is accompanied with a chin deformity in which the chin is very crooked to one side.
I had braces when younger and they made my bite functionally good but didn't fix my aesthetic facial issues.

What I have concluded for now is that I have bimax. protrusion, some vertical maxillary excess and possibly a weak chin. All the orthodontists and the max. fac.  surgeon (although he didn't see the x rays as I didn't have them yet) said that they don't recommend double jaw surgery as the improvements would be minor. Some orthodontists think I am a good candidate for teeth extractions while others disagree. I personally think extractions would be beneficial since it would improve the puffiness of my mouth and lip incompetence which really look bad on a western European male.

I still don't know what to do and I am running out of doctors to consult in my region. What I know for sure is that one day I will fix my crooked chin issue as I don't want to hide it my whole life with my patchy beard. However, I feel I should first fix my dental/skeletal jaw issues one way or another.

What do you think is my main issue and what would be the best way to treat it? Do I have any major upper/lower jaw deficiencies and is the relationship of my jaws bad in a skeletal way? Should I go for extractions and braces to fix protrusion or should I insist on some kind of jaw surgery? I will be very grateful to hear as many opinions on this forum as possible.

p.s. My nasolabial angle is too big, but I had a septorhinoplasty for a very crooked nose 2 months ago and the healing is still in process.

Thank you!

Profile closed lips:
https://www.dropbox.com/s/hfpij5peg4xdimf/file6.jpeg?dl=0
Profile open lips(relaxed):
https://www.dropbox.com/s/adzylrwd8dxhkcb/file4.jpeg?dl=0
Front view:
https://www.dropbox.com/s/yhi3oat9o9gtjt8/file.jpeg?dl=0
Ceph(open mouth):
https://www.dropbox.com/s/aj5z5xmzesevvtc/MARKOVI%C4%86_KARLO_10052018_200818%20%281%29.jpg?dl=0
Ceph(closed mouth):
https://www.dropbox.com/s/n2fd97ndyn0v98p/Markovi%C4%87_Karlo_04052018_174546.jpg?dl=0
Front x ray(you can see the chin deformity here):
https://www.dropbox.com/s/86ilo31q8do584o/MARKOVI%C4%86_KARLO_13022018_184449%20%281%29.png?dl=0

[kavan]

Just to let you know:

Others might have FASTER computers than me or might be more tolerant of opening up a BUNCH of different links to look at multiple photos. But personally, my preference for looking at photos is when the person puts them ALL on the same photo link and gives a description under each photo. I find IMGUR preferable to 'drop box'.

Again, that's just ME (can't speak for others) where if I have to WAIT for EACH separate photo to load on a separate link, I'm going to be disinclined to give feedback and more inclined to give it when photos are presented altogether in one place.

[carli]

Just to let you know:

Others might have FASTER computers than me or might be more tolerant of opening up a BUNCH of different links to look at multiple photos. But personally, my preference for looking at photos is when the person puts them ALL on the same photo link and gives a description under each photo. I find IMGUR preferable to 'drop box'.

Again, that's just ME (can't speak for others) where if I have to WAIT for EACH separate photo to load on a separate link, I'm going to be disinclined to give feedback and more inclined to give it when photos are presented altogether in one place.

I made a folder that contains all the pictures, and renamed them all to describe what they show. I hope it is more convenient now.
-------


Note from Kavan: Upon your satisfaction with the morph and illustrations made with your putting all your files in one place BUT also with your desire to REMOVE them, I've removed my illustrations and the photo link with all the photos in one place.

[kavan]

I would not fret about possible bi-max protrusion because sometimes, that can give a youthful look and give GOOD lip support with aging. Not to mention that they sometimes to often need to pluck the pre-molars to push back the protrusion and for WHAT???-- just to get the lips to line up closer to vertical. NOT worth it in your case IMO.

I think you would look better with a sliding genio to both advance out the chin and vertically shorten it.

Your other aesthetic issues; nose, under eye area, are more in the venue of plastic surgery rather than maxfax.

[PloskoPlus]

A narrow nose makes the midface look longer.