Kavan I am worried lefort advancement will make me look worse as I already have prominent anterior nasal spine. My upper lip would protrude even more. Can max fax do anything about it or is it rhino work?
CCW rotation via anterior impaction:
You will get some CCW auto-rotation of the mandible with the CCW anterior impaction of the maxilla which will put your mandible in a better position. = 1 good thing which is almost CERTAIN
You will reduce your gummy smile with same CCW anterior impaction of maxilla. = 1 good thing which is almost CERTAIN.
Advancement of the maxilla:
Advancement of the maxilla should allow MORE advancement of the mandible. = 1 good thing which is almost CERTAIN.
Advancement of the maxilla in order to kick up the good thing of more advancement of the mandible could possibly result in unfavorable changes to the base of the nose which includes the top of the upper lip area. = 1 bad thing that is possible but highly UNCERTAIN.
NOTE: It's highly uncertain that maxillary advancement would be a 'bad' thing for you BECAUSE there is NO INFORMATION as to 'how much' advancement there will be there. That's DIFFERENT from the the mandible advancement because even if if HOW MUCH is unknown, we know, with certainty, that even a modest advancement to the mandible would be an improvement.
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Tally:
3 good things that are pretty certain VS 1 bad possible bad thing (a 'trade-off) that's uncertain.
IF the bad thing were certain, then 3 certain good thing vs 1 certain bad thing would mean a 75% 'pay-off' or over all improvement.
But since the bad thing you are worried about is UNCERTAIN, the potential 'pay-off' or IMPROVEMENT is MORE than 75%.
A 75% potential for over all improvement is pretty good and since the bad thing is uncertain, the potential for over all improvement gets higher.
Highly IRRATIONAL to think that something that could possibly happen (an unwanted aesthetic trade-off from maxillary advancement) would make you look worse in a circumstance where the maxillary advancement might be needed for an overall 75% improvement in your appearance.
Although the bad thing is NOT certain, IF it's something that you would not want to risk possibly happening IN EXCHANGE for a 75% over-all improvement, then don't get the surgery. Stay as you are.
There are no 100% certainties in these surgeries. So don't expect it to be 100% certain that you will be 100% improved. Learn to accept uncertainty and work with the ODDS or at least enough to know they are in your favor.