I am seeking to understand what the most appropriate move may be for my current situation.
As it stands my bite/occlusion is fine. I could probably do with braces but really just to straighten up my two front teeth which are very slightly crooked.
I do have a slightly gummy smile which I would like to improve.
My main issue is with my gonial angle. It is quite steep which gives the impression of a longer face as well as I believe giving the perception of a lack of projection from side profile. This being said, by mandible is by no means retrognathic, however I believe the steep angle creates a smaller weaker looking jaw.
I am a no on implants therefore I consider, from my research, that there are two options...
Lefort 1, to impact the maxilla/move it upward to eliminate the gummy smile and in doing so also allow the mandible to rotate CCW Joan's out, making the gonial angle appear less steep and hopefully giving some perceived better mandible projection. My concern is I am unsure as to whether I really have anywhere near enough excess for any surgeon to do a lefort 1 on me and also how much CCW rotation could actually be achieved and would it really be worth it in terms of the perceived gonial angle change. Also the procedure seems very invasive considering I have no dental occlusion problems.
Second option would be chin wing or side wing osteotomy. I say side wing as I already have a relatively well pronounced chin it's just at the wrong angle so to speak, but I wonder if some advancement of it would be a good thing? Either way would you say the perceived gonial angle change from a chin or side wing osteotomy would be better than that of a lefort 1 with CCW rotation? Finally is a chin or side wing osteotomy less invasive than a lefort 1. I.e. which has more down time, pain, recovery time etc?
Pros and cons of each given my situation?
I realise I need to do some actual consultations with some decent surgeons but I was hoping the knowledgeable individuals on this site may be able to help in the interim.
Thank you in advance.
