Thoughts On This Sub-Par Result

[sanddunes]

This happened to pop up in my instagram feed.

Aesthetically, the result is so far from what an excellent surgeon could have achieved.

They moved his mandible WAY too far back and now he looks retrognathic!  They should have advanced his maxilla forward more instead.  If you draw a line down from his lips, his chin now sits well behind his bottom lip, resulting in a convex profile. 

If I was the surgeon I would be embarrassed by this sub-par result, not bragging about it or using it to advertise.  The caption of "What an amazing result!" really irritated me.

How do some surgeons have such a bad eye for aesthetics?  It's shocking and sad.

[ghiggson90]

Looks like a great result to me.

[dvfan]

Hmm yea mandible seems a bit set back too much. Would be interesting to see his ceph in addition to just this one pic though.

[ditterbo]

Not sure how you figure. His lips look pretty well aligned now. If anything the inward flare of his bottom incisors makes me wonder if the doc could've technically moved the mandible even further back to make the bite more 'correct'.  But then he'd suffer with the airway and aesthetic consequences. Maybe he could've had a stronger SG, just maybe.

[PloskoPlus]

Not sure how you figure. His lips look pretty well aligned now. If anything the inward flare of his bottom incisors makes me wonder if the doc could've technically moved the mandible even further back to make the bite more 'correct'.  But then he'd suffer with the airway and aesthetic consequences. Maybe he could've had a stronger SG, just maybe.

Probably needed CCW to minimize the setback.

[Austinou88]

The jawline still looks nonexistent to me.

[kavan]

Maxilla advancement was probably significant given the amount of retrusion you see to it. The case looks to be one where there was significant max retrusion and also significant over growth of lower jaw and chin. So, not a thing where they can OVER ADVANCE maxilla to get 'monkey muzzle' look to match lantern chin and jaw. So, the result looks like the best that could be done for that case given there was a LIMIT as to how much the upper jaw could be advanced before it became monkey muzzle and also constraint of getting the bite right. He now has a normal jaw to jaw balance and a functional bite.

IF you WERE a surgeon,--or let's just say someone  who knows there are limitations-- you would know there are limitations involved. It looks like you are critiquing the doctor based on a male model aesthetic you see in GQ magazines.

This happened to pop up in my instagram feed.

Aesthetically, the result is so far from what an excellent surgeon could have achieved.

They moved his mandible WAY too far back and now he looks retrognathic!  They should have advanced his maxilla forward more instead.  If you draw a line down from his lips, his chin now sits well behind his bottom lip, resulting in a convex profile. 

If I was the surgeon I would be embarrassed by this sub-par result, not bragging about it or using it to advertise.  The caption of "What an amazing result!" really irritated me.

How do some surgeons have such a bad eye for aesthetics?  It's shocking and sad.

[Lefortitude]

This patient was hyperdivergent class 3.  This is a GOOD result given the diagnosis. A GREAT result could have been achieved, either with some sort of segmenting and CCW, or with additional mandibular osteotomies like a mandibular wing osteotomy. However, very few maxillofacial surgeons practice this technique.

Given the condition, this is a GOOD result.

[GJ]

I wouldn't call it sub-par. What if the guy loves it?
He looks within normal now.

[Greek21]

That's exactly what they did to me :/