Aesthetics advice

[Dogmatix]

This is really weird to see, from where I'm sitting. You had a similarish starting point to me, maybe 4mm better just off the planned pogonion change (Gunson wants like 18-19mm for me where I see your plan called for 14mm).  But then your actual pogonion advancement was like 2-4mm shy of plan, and now you look a lot like me with my 12mm chin implant, albeit with a better labiomental crease. So Gunson's plan is a 6mm advancement from where I'm at, but in reality... could end up quite close to the same chin advancement I already got with the implant.

https://imgur.com/iDCdf9v

Still looks like a great aesthetic improvement, for you, and hopefully without the unique lip drama I'm forever suffering from my first go-around with a chin implant (current is a revision). I'm probably staying put until I make a lot more $$, TMJ tech improves, and/or bimax improves.

I think that's a great result, didn't knew such big advancements as 12mm could be done with implant, and also look as natural. You're right, you could have more projection to optimize further if that's what you like. I don't think a good surgeon will be 4mm off, some people only have 4mm advancement for the entire surgery. It's however probably more complicated if it's gonna be done in one procedure, remove the implant and perform bimax. Can imagine it's hard to plan the outcome with an implant that's going out.

[ditterbo]

I think that's a great result, didn't knew such big advancements as 12mm could be done with implant, and also look as natural. You're right, you could have more projection to optimize further if that's what you like. I don't think a good surgeon will be 4mm off, some people only have 4mm advancement for the entire surgery. It's however probably more complicated if it's gonna be done in one procedure, remove the implant and perform bimax. Can imagine it's hard to plan the outcome with an implant that's going out.

Agreed, just a lot of diminishing returns from here for more work in that area. I grew a tight beard (thicker than in that pic) and I probably improved another 1-2 points with that alone. If anything I want jaw angle implants but those are a crap shoot and can't be considered before bimax.
To be fair, a chin implant 6-7mm+, especially silastic, runs the risk of burring down the chin bone with micromovements. I should get a ceph x-ray done in a year or so to make sure nothing's changing there. I'm not too concerned though since mine appears positioned somewhat properly low, and a massive screw should be stabilizing it. Pretty sure a chunk of muscle got scraped off/disturbed by the screw head in the first implant, causing a unique incompetence in that dead center spot in my lower lip, vertical to the screw head. There's a consistent 'black' irregular line in my chin, in my ceph and ct scan, where the screw head used to stick out more 

[dammit_daniel]

Thanks for the comments on the results guys. I'm happy with the result, the result looks more similar to the full face morph

https://imgur.com/a/tRDfrGr

I just didn't understand why I was given the other inaccurate MAIN morph. More importantly at week 10 I'm finally seeing a positive impact on my sleep and I'm not tired as hell recently.

Sorry to hear about your lip problems diiterbo but your result looks very good and and natural like Dogmatix said. Yes we do have quite similar profiles before and after!

So your plan is to remove your implants and possibly do bimax do the road? Yeah you might end up looking quite similar to how you already look? Idk it sounds more complicated than what I know.

[Dogmatix]

Thanks for the comments on the results guys. I'm happy with the result, the result looks more similar to the full face morph

https://imgur.com/a/tRDfrGr

I just didn't understand why I was given the other inaccurate MAIN morph. More importantly at week 10 I'm finally seeing a positive impact on my sleep and I'm not tired as hell recently.

Think this looks very good as well, I can see now that last picture I saw contained pretty much swelling which has gone down now. Also interesting how much your labiomental fold has improved.

Glad to hear your breathing is finally improving as well. Seems like a success to me. I'm following your case closely as it has similair movements as mine. If you really got 14mm, it calms me down as it doesn't seem like as big deal as I thought.

[dammit_daniel]

Think this looks very good as well, I can see now that last picture I saw contained pretty much swelling which has gone down now. Also interesting how much your labiomental fold has improved.

Thanks Dogmatix, the last pic I linked is a morph as well.

I saw on your post that you mentioned you were looking into ADD. I was diagnosed with ADD a few years ago before I discovered my sleep issues. I am nearly 100% sure that my attention issues were due to my disturbed sleep because of my airways. This is because through trying CPAP and mandibular advancement devices I noticed my attention issues improved and finally my attention is getting much better of late due to the surgery. I found ADD medication never really helped me properly. I am not saying you have the same problem but thought I would share my experience.
I actually cut wheat/diary out of my diet as well and found that it helped my focus, I'd say that's probably quite specific to the individual though...

[Dogmatix]

Thanks Dogmatix, the last pic I linked is a morph as well.

I saw on your post that you mentioned you were looking into ADD. I was diagnosed with ADD a few years ago before I discovered my sleep issues. I am nearly 100% sure that my attention issues were due to my disturbed sleep because of my airways. This is because through trying CPAP and mandibular advancement devices I noticed my attention issues improved and finally my attention is getting much better of late due to the surgery. I found ADD medication never really helped me properly. I am not saying you have the same problem but thought I would share my experience.
I actually cut wheat/diary out of my diet as well and found that it helped my focus, I'd say that's probably quite specific to the individual though...

Wops, sorry, thought it was a real picture.
I read a paper where they found that 80% of the patients with OSA, also had AD(H)D. As the psychiatrist said, most people have some of these issues, the trick is finding out if it's enough to call it a disorder.

I don't have severe obstruction, but as we've discussed earlier, it's well outside the normal range. There was also another user on this forum who had surgery for sleep apnea, and got off her ADD medication post surgery. It's like finishing a puzzle, things connect in a way that makes sense and motivates me to continue with this. Chances are I'll have more than aesthetic improvements.

Had my visit with the orthodontist, seems like he wants to keep me for a while before surgery. He did an estimate maybe for late summer.

[dammit_daniel]

I read a paper where they found that 80% of the patients with OSA, also had AD(H)D

Wow that's a huge number. You are lucky you  have a therapist who understood there is sometimes a link, ones i have spoken to looked at me like i was crazy, i don't think its completely accepted by all health professionals. You're right it is like a puzzle. I've seen so many  doctors, had heaps of blood tests and multiple surgeries to finally find some answers and get where i am. That's  great you have an idea of the time frame now. All the best on your journey.

[Dogmatix]

Wow that's a huge number. You are lucky you  have a therapist who understood there is sometimes a link, ones i have spoken to looked at me like i was crazy, i don't think its completely accepted by all health professionals. You're right it is like a puzzle. I've seen so many  doctors, had heaps of blood tests and multiple surgeries to finally find some answers and get where i am. That's  great you have an idea of the time frame now. All the best on your journey.

Nono, don't misread me, no one else than me is thinking about these links, they all think I'm crazy. Evaluating and treating the ADD is a separate investigation, the surgery etc is something I pay from my own pocket and have had to fight pretty hard for. I've had orthodontists lie straight to my face, refuse sending me to a surgeon and refuse appropriate x-rays. I had to fly abroad to arrange this.

The obsession about this is actually part of the ADD investigation 

I don't find the paper I've read earlier, but found this. Here they say 20-30% have full blown ADHD, and attention deficiency in 95%.
https://www.ncbi.nlm.nih.gov/pubmed/21808754

Edit: Maybe I didn't read this correctly. Can it be the other way around that 20-30% of ADHD patients have OSA? Then it's a huge number.