Analyze my ceph

[junebug90]

Hi guys,

If anyone is interested in evaluating my cephs and offering their opinions, I would greatly appreciate it.

I have always felt like something was “off” with my face after getting my braces off when I was 17. I felt like my smile (albeit straight) looked “dished in” and made me look “witchy” with expression and teeth show.

At rest, I have a very flat midface, and the lower 2/3 of my face looks almost like a pancake. It greatly lacks convexity.

I’ve consulted with several oral surgeons who feel their hands are tied due to my perfect bite, but are in agreement with my concerns regarding my facial appearance and have suggested correction via Lefort I w/ BSSO and cheek implants. Problem is affordability, although at this point I’m pretty sure I can make it work to have my face corrected. I ultimately  wouldn’t ever go with any of the surgeons I’ve seen as I understand the expertise needed behind an operation like this; hoping to consult with Posnick Andy Arnett & Gunson if I move forward. In the mean time, would appreciate some of your guys opinions!

Here is my ceph. I have cone beam CT images as well. https://imgur.com/a/uEERlEn

Below are IMGUR photos of a girl who has an almost identical face to mine, but she has greater chin projection and I have a large nose. (I’m uncomfortable sharing photos of myself on here)

https://imgur.com/a/GUwD

I appreciate all your feedback!

[kavan]

sna approx 78        norm range= 78 to 84
snb approx 75        norm range= 75 to 81
anb approx 3         within class 1 occlusion


What this indicates is that you could probably have plain old 'linear advancement' of both jaws by an equal amount (in addition to cheek implants) to kick up some more 'face space' and still be within the range of the jaw balance norms and also address flat cheeks via the implants. This is consistent with what the docs told you they could do. Since your case does not look like one needing  a lot of 'complex' rotations, it's most likely within the capacity of the docs you already consulted with. There's nothing about it that requires 'advanced expertise' of one of the top guys.



*Linear advancement: No rotations to Lefort 1 area. Just advancement and equal advancement to BSSO area; double jaw advancement along the same 'line' or 'plane' the maxilla is already oriented on; something within the realm of MOST maxfax docs because it's more straight forward to do because all they have to do is move both areas forward without having to balance specialized rotations to address deviations from the norm, imbalance of jaws or bite imbalances.

[junebug90]

Thank you Kavan. “Face space” and convexity is really what I need. I’m happy to hear your opinions parallel that of the surgeons I’ve consulted with.

[junebug90]

Also, Kavan, if I may ask — how would CW rotation and CCW rotation affect my profile if implemented? Is rotation only needed in the presence of a malocclusion?
 Despite reading about CW and CCW rotation on this board, I don’t think I precisely grasp the desired response of a CW or CCW rotation or why or why not a CW or CCW would be used.

[kavan]

Also, Kavan, if I may ask — how would CW rotation and CCW rotation affect my profile if implemented? Is rotation only needed in the presence of a malocclusion?
 Despite reading about CW and CCW rotation on this board, I don’t think I precisely grasp the desired response of a CW or CCW rotation or why or why not a CW or CCW would be used.

That would be a lengthy tutorial with diagrams/illustrations which I'm not up to the task of providing. However, IF a doc wanted to do that, it would be shown in a displacement diagram with a bunch of numbers on it. But even if that's the case, it's not a verbal explanation.