Author Topic: what do I need? (cephs)  (Read 2197 times)

Sajua

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what do I need? (cephs)
« on: July 26, 2019, 08:15:29 AM »
Hello everyone,

thanks a lot for looking into my post. I am a female in my 30ies and I really need some advice, as I don't know what to do.
The cephs attached were taken before and 6 months after BSSO surgery (was performed due to functional issues). The upper jaw was not touched. The surgery went well  and braces are supposed to be taken off this summer. However, I am still not sure if having only single-jaw surgery was the right decision. I feel like I am lacking bone support in my upper jaw as well which starts to show more as I am aging.

I would be very happy to hear your opinion about that, cause I have been having this topic on my mind for a while now, and I am also getting mixed opinions on it from the surgeons I've consulted.

thanks for your help


Sajua



« Last Edit: July 26, 2019, 08:28:48 AM by Sajua »

Post bimax

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Re: what do I need? (cephs)
« Reply #1 on: July 26, 2019, 08:44:12 AM »
Based on the soft tissue profiles in the CEPHs it looks like you got a nice improvement overall. Maxillary advancement carries some serious aesthetic risks, especially for women. I think you might have tolerated it well given the dimensions of your nose/lip, but there’s also a chance it could have come out much worse.

If your bite is good, any revision would have to be a bimax. I can’t say I’d recommend it in your case based on those pictures, but maybe we need to see more angles.

april

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Re: what do I need? (cephs)
« Reply #2 on: July 26, 2019, 09:12:48 AM »
You look great! I don't think you need anything more done. Your profile lines up perfectly and you have a good (short) philtrum with nice lips.

What are the surgeons saying?

kavan

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Re: what do I need? (cephs)
« Reply #3 on: July 26, 2019, 10:23:53 AM »
You look fine.
Please. No PMs for private advice. Board issues only.

GJ

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Re: what do I need? (cephs)
« Reply #4 on: July 26, 2019, 11:29:18 AM »
Need to see more records than those to know.
From what you posted, you look good and should move on with life.
Millimeters are miles on the face.

PloskoPlus

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Re: what do I need? (cephs)
« Reply #5 on: July 26, 2019, 04:01:31 PM »
Nothing has the potential to make one uglier than an inappropriate maxillary surgery. You look great. If your functional issues have been solved and you have no nerve damage, you've made out like a bandit.

GJ

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Re: what do I need? (cephs)
« Reply #6 on: July 26, 2019, 04:39:29 PM »
Yep. "Upper surgery not needed" would be music to most ears.

You get to keep your nose and not risk all the aesthetic downside.

Moving your upper jaw around is not going to have much, if any, effect on your skin. If it's lacking support due to age it's likely the skin itself losing elasticity and collegen. You're in your 30s and that's what happens to everyone except people with great skin. Don't be dumb and have jaw surgery for that.
Millimeters are miles on the face.

Sajua

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Re: what do I need? (cephs)
« Reply #7 on: August 16, 2019, 07:17:29 AM »
Hello everybody!

Many thanks to all of you for your helpful feedback which I really appreciate!

The opinions of the surgeons vary, as some of them say nothing is needed and two of them advised me of doing single upper jaw surgery.
the suggested plan is the following: advancing upper jaw vertically by about 2mm and downgrafting it by about 3mm, as I have almost no upper tooth show. Hence, the whole jaw will be rotated. Right now my upper teeth are also very flared outwards as I have a small jaw, and rotating the upper jaw is supposed to help this issue as well. as this would make my chin retruded (which already kinda is) some kind of chin enhancement would be needed (genioplaty, implant or HA-paste). 

according to the doctor, upper jaw surgery does not come with as many risks as lower jaw surgery. However, the reviews on that are very mixed and I would like to hear your guys' opinions as well.

Moreover, I've also read that the jaw tends to decrease in volume with age which also worries me, as I already have a small jaw.

Attached you find two pics that show also my face in proportion. Could it be that both my jaws are retruded, and I would ideally need bimax? My paranasal area is quite flat, so that is one of the reasons i am asking.

Many thanks again for your help.




kavan

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Re: what do I need? (cephs)
« Reply #8 on: August 16, 2019, 07:49:44 AM »
I think that what you 'need' is to realize you already look pretty good.
Surgery advice and/or encouragement for pursuit...DECLINED.
Please. No PMs for private advice. Board issues only.

GJ

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Re: what do I need? (cephs)
« Reply #9 on: August 16, 2019, 08:11:12 AM »
I don't think you need anything.
Millimeters are miles on the face.

ghiggson90

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Re: what do I need? (cephs)
« Reply #10 on: August 16, 2019, 12:26:50 PM »
You don’t need surgery. Shame on the surgeons proposing procedures on you.

Sajua

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Re: what do I need? (cephs)
« Reply #11 on: August 23, 2019, 08:41:03 AM »
I also dont have any upper tooth show at all which is really bothering me, hence i was suggested that plan.

I would be happy to hear if that plan would be feasible or if it would make things worse. And also how it would affect my lips.

Is upper jaw surgery related to many risks?
« Last Edit: August 23, 2019, 08:54:11 AM by Sajua »

ben from UK

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Re: what do I need? (cephs)
« Reply #12 on: August 23, 2019, 10:56:05 AM »
I don't think there is something wrong with your facial structure, based on these pics. Maybe your nose from the front isn't the best, but I have to see better pics.

Dogmatix

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Re: what do I need? (cephs)
« Reply #13 on: August 23, 2019, 01:13:18 PM »
Having jaw surgery is ultimately something you decide. Something that looks minor can be a big issue to someone else, jada jada.

Base on what I read you have no medical issues and it's a pure aesthetic concern. Your bite was corrected and you don't mention anything about airways. One important thing to understand about jaw surgery is that it alters your bite, and there's always a risk they don't get it right. For most people having jaw surgery that's a minor risk, because they go in with a malocclusion. Trying to fix something that is broken is necessary, while fixing something that is not, takes some balls.

Your aesthetic concern doesn't seem very established. You're not sure if lower jaw surgery was the right decission so you go consulting and get some proposals and we later get some concerns about tooth show. Tooth show is a concern that can be adressed with jaw surgery if it's a real concern. But you understand it makes little sense when you present your situation with profile photos and ask if you should have surgery for your consern about tooth show. You will get comments on what can be seen on the pictures you show.

Your surgical plan is not clear to understand at least for me. "advancing upper jaw vertically by about 2mm and downgrafting it by about 3mm". Vertical adjustments are normally not denoted as advancements, I can't read what these mm mean and how it's actually displaced. You talk about rotation and flaring teeth inwards, so probably clockwise rotation. If you already have a good bite, and you're doing only upper jaw surgery, it needs to be done in a way to maintain the bite.

You've been told upper jaw surgery is a minor surgery compared to lower jaw surgery. There's no way to meassure such thing, it's different fractures. I can tell you, lower jaw surgery is sometimes done under local anaesthesia, which upper jaw surgery is not. Go to youtube and watch some videos of "lefort I surgery" and "bsso surgery" and come back and tell us what you think is minor and major.

GJ

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Re: what do I need? (cephs)
« Reply #14 on: August 23, 2019, 01:18:52 PM »
Maybe your nose from the front isn't the best, but I have to see better pics.

What? Her nose is objectively fine.

Don't listen to people who are unhappy with their own issues and project it on to you.
Give zero weight to those types of comments.
Millimeters are miles on the face.