Let's talk about lips

[ArtVandelay]

Very informative talk by Gunson

https://www.pathlms.com/pcso/events/979/video_presentations/91349

I'm still amazed that my surgeon (Dr. David Behrman) could say with a straight face that leaving a patient with 6mm lip incompetence is a complete success because the open bite was closed.

[april]

should be required watching for all surgeons and orthodontists.

[kavan]

There is actually somewhat of a 'divide' or 'spectrum' amoung maxfax docs. On one end you have docs like Gunson who want to get not only the bite right but also the form and function of the FACE right with that. On the other end, or somewhere near that part of the spectrum, you get types like your guy who stop at getting the bite right.

Also, with your guy, you have the 'double damning' of his being the head of a teaching hospital where a lot of the work is given to the residents who are just learning. I mean, who knows? When you're allocating some surgery to residents, depending on where they are on the learning curve, you don't want to give them TOO MUCH to do. Like maybe they need to start (and stop) with just getting the bite right.

The good news is that they eventually got the bite right and you have a VIRGIN chin that was not touched by a resident. So, now your free to pursue an isolated (sliding) genio to reduce chin strain and make it easier for you to close your lips (address the residual lip incompetence).

[ArtVandelay]

So the resident thing was a big concern of mine since it's a teaching hospital. Paraphrasing his response, as I still have my original pocket book I brought it to all my appointments: "They'll just cut open your gum line and stitch you + band you up; I do all the actual bone cutting and placement". We then had a bit back and forth about it but he was adamant about the previous point.

At this point it wouldn't surprise me to hear that he just flat out lied and told me what I wanted to hear.

[kavan]

So the resident thing was a big concern of mine since it's a teaching hospital. Paraphrasing his response, as I still have my original pocket book I brought it to all my appointments: "They'll just cut open your gum line and stitch you + band you up; I do all the actual bone cutting and placement". We then had a bit back and forth about it but he was adamant about the previous point.

At this point it wouldn't surprise me to hear that he just flat out lied and told me what I wanted to hear.

Well, if he did the actual bone cutting and there was a mistake or unplanned occurrence the first time that necessitated a revision, the good news is that maybe he quit while he was ahead and kept things at getting the bite right.

[GJ]

Excellent lecture.
Elongating long patients is criminal.

[Lefortitude]

outstanding lecture. Thank you for sharing. I love this medium for sharing information, as i find it really easy to watch and learn.

[CloudyAngel]

There is actually somewhat of a 'divide' or 'spectrum' amoung maxfax docs. On one end you have docs like Gunson who want to get not only the bite right but also the form and function of the FACE right with that. On the other end, or somewhere near that part of the spectrum, you get types like your guy who stop at getting the bite right.

In my opinion, any doctor who is NOT getting the form and fu toon of the FACE  right is BEGGING to be sued. 

Let me say that again, BEGGING to be sued

[kavan]

Cloudy,
NEXT time you use the QUOTE function, make sure your comments are OUTSIDE of the closing brackets.

[GJ]

One thing I disagree with from the lecture is that long or open mouth is never good. I live in a college town, and see plenty of girls with both those issues who look good simply because they have good features. Also, Popeye had a short face and looked bad. If the point is never to make long longer that's probably true yes, but never make short shorter should follow, and I don't think he mentioned that.

[april]

I'm with you on that. Like function totally aside and all, i think in general class 2 features can look good on the right girls. A recessed chin and some lip incompetence can be feminine and youthful. I've seen a few class 2 before/afters (even one A&G result) where I thought to myself they looked better beforehand. More youthful, more fun, wheras when they were corrected they looked serious and older. Not sure if I've just developed an odd aesthetic-sense though.

[GJ]

I'm with you on that. Like function totally aside and all, i think in general class 2 features can look good on the right girls. A recessed chin and some lip incompetence can be feminine and youthful. I've seen a few class 2 before/afters (even one A&G result) where I thought to myself they looked better beforehand. More youthful, more fun, wheras when they were corrected they looked serious and older. Not sure if I've just developed an odd aesthetic-sense though.

No, I've seen that, too. Not sure if it was on an AG patient or not, but I've come across those types of photos.
The bottom line is sometimes that youthful/recessed look is "cute", and the correction is (as you say) more serious/old, and somehow off. It happens. In general what Gunson said is true, but to speak or think in absolutes is never a good idea.

But also as you mention, maybe it's our aesthetic sense? I don't like those huge anchorwoman jaws on ladies. Too masculine.

[some1afterall]

I agree with the last few comments here-regarding youngish youthful look of open bite and recessed chin. I was always insecure about my profile, but best believe men approached me/flirted with me wayyy more prior to my djs and genioplasty. My upper lip is unsupported now/philtrum elongated, it’s aged me. Face looks long and sad. With my open bite, my upper lip was fuller and more flirty, smile appeared bigger and more inviting.