Any Suggestions?

[ProsfeR]

Also I think my face looks kinda short. I have a big forehead. Do you guys think I would benefit from down genio or just forward genio? SARPE?

[kavan]

Also I think my face looks kinda short. I have a big forehead. Do you guys think I would benefit from down genio or just forward genio? SARPE?

The genio usually depends on what they can do to the lower jaw.  The chin definitely needs forward advancement. But I would hold off actually asking for a downward drop with that (which would take a bone buttress or a graft to actually make the chin LONGER in addition to advancing) and just WAIT until the maxfax shares his plan with you which is usually in form of profile contour change diagram.

[dvfan]

Hello everyone!
What can I do to fix my face? x-ray is old from 2015 before braces. I had braces for almost 2 years, but I knew it wouldn't fix anything. Lip incompetence, gummy smile, nonexistent jawline and small chin.I just wanna look normal. I've been on consultation with local surgeon and he said I need counterclockwise rotation. What do you guys think?

Agree with the CWW with posterior downgraft advice. Kavan gave you some very good advice in addition.

Dunno if you're interested in other aesthetic comments, but in the side view your superior lateral browbones seem recessed too making your lateral brows look droopy. It affects your orbital area and takes away from a masculine look. My point of view anyhow. Not too easy to fix though and most maxillofacial surgeons seem to ignore the orbital area. Imo it means they don't look at the entire picture.

[ProsfeR]

Agree with the CWW with posterior downgraft advice. Kavan gave you some very good advice in addition.

Dunno if you're interested in other aesthetic comments, but in the side view your superior lateral browbones seem recessed too making your lateral brows look droopy. It affects your orbital area and takes away from a masculine look. My point of view anyhow. Not too easy to fix though and most maxillofacial surgeons seem to ignore the orbital area. Imo it means they don't look at the entire picture.

So how to fix it anyway?

[ProsfeR]

Did a new ceph today with a normal head position(compared to my old ceph, they also confirmed is was wrong) and it looks different and I don't see how to advance my lower jaw it is almost already in line with my forehead. Could you guys take a look?
https://imgur.com/aEecFRl

[Dogmatix]

Did a new ceph today with a normal head position(compared to my old ceph, they also confirmed is was wrong) and it looks different and I don't see how to advance my lower jaw it is almost already in line with my forehead. Could you guys take a look?
https://imgur.com/aEecFRl

I think normally the ceph tracements are normalized to FH-plane when doing the 2-d planning, which would rotate your picture clockwise and set your chin behind the forehead more.

Just to give you an idea of how it would work below.

https://imgur.com/a/DUCaRTP

[kavan]

Did a new ceph today with a normal head position(compared to my old ceph, they also confirmed is was wrong) and it looks different and I don't see how to advance my lower jaw it is almost already in line with my forehead. Could you guys take a look?
https://imgur.com/aEecFRl

First  ceph with head tilted down, shows jaw retrusion and chin recession with what looks to be a small airway. It is consistent with the suggestion for CCW and chin advance.

Second ceph with head more upright, shows jaw retrusion and chin recession with what looks to be a small airway. It is also consistent with the suggestion for CCW and chin advance.


Conclusion: Both cephs show jaw retrusion and chin recession with what looks to be a small airway. Both cephs are consistent with suggestion for CCW and chin advance to address what bothers you, ("Lip incompetence, gummy smile, nonexistent jawline and small chin.").

[ProsfeR]

First  ceph with head tilted down, shows jaw retrusion and chin recession with what looks to be a small airway. It is consistent with the suggestion for CCW and chin advance.

Second ceph with head more upright, shows jaw retrusion and chin recession with what looks to be a small airway. It is also consistent with the suggestion for CCW and chin advance.


Conclusion: Both cephs show jaw retrusion and chin recession with what looks to be a small airway. Both cephs are consistent with suggestion for CCW and chin advance to address what bothers you, ("Lip incompetence, gummy smile, nonexistent jawline and small chin.").

Thank you! Much appreciated.

[ProsfeR]

A lil update. My ortho (who works with my surgeon) said she counted everything and it will be CCW as we discussed with her earlier. +-1 year in braces, then surgery. BUT she said it will be only anterior impaction without posterior downgrafting. (Gap will close itself?) Dunno if it is enough rotation? +Some maxillary advancement. Tbh I don't know what to do. I'm 25. I live in a third world country. Not so many options here. My surgeon is like the best in our country. Should I go for it or look for another surgeon? Thx

[ben from UK]

Should have been something like this I guess?

Besides jaw- and chinwork this could maybe be achieved with browridge implant + lowering hairline + nosejob + forehead shave. Jaw + chin if done well will bring you up though.

[kavan]

That might be sufficient to address the gummy smile and for some auto rotation of the lower jaw and allow you to get genio with it.

[ProsfeR]

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?

[Post bimax]

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?

How many millimeters of LF1 advancement?

[jusken]

Should have been something like this I guess?

Besides jaw- and chinwork this could maybe be achieved with browridge implant + lowering hairline + nosejob + forehead shave. Jaw + chin if done well will bring you up though.

I'll probably be downvoted for this but, with all due respect, that morph looks like a freakshow.  I would suggest more the opposite of this, as few procedures as possible to bring lower third into a more favorable place.  No disrespect intended...

Prosfer: some amount of CCW + advancement would probably not cause much (if any) disruption to your nose.

[Post bimax]

I'll probably be downvoted for this but, with all due respect, that morph looks like a freakshow.  I would suggest more the opposite of this, as few procedures as possible to bring lower third into a more favorable place.  No disrespect intended...

Prosfer: some amount of CCW + advancement would probably not cause much (if any) disruption to your nose.

The distance between the lower lip and pogonion in that morph is extreme so I think that's what's causing the odd look. I think the rhino is an improvement though. Your morph on pg 2 plus the rhino and slightly more chin projection would be ideal IMO.