I actually haven't compared it exactly and meassured the degree of rotation with e.g Gunsons plan. All i know is that the Gunson plan was also significantly rotated compared to the raw ceph and at least very similar to the one from cephx. The other surgeon I think is known to rotate it even further than whats normal and by this being a bit more agressive with the rotations. So the conclusion was that regardless where I send the raw ceph, everyone agrees that this is not the format we work with and it deviates quite a bit in the same direction. Just by looking at the raw ceph it's not clear to me that I should have ccw. But by looking at the ceph when either the surgeons or cephx have stardardized it to their standard, it becomes more clear. So just by getting it in the right region of orientation it's much easier to look at it.
I think it's important to understand that cephs don't seem to be taken with a general standard and it can be very hard to just look at it out of box and in this case e.g know if ccw rotation is appropriate or not.
But yes, we agree. When rotating to a standard, the accuracy of the points used to define this standard defines the accuracy of the orientation.
Well, your cephs were rotated with reference to the Arnett analysis, also used by some Spanish doctors and others. The Nemo-FAB software company, designed around it, is in Spain.
The difference between your profile and Study Hacks is that IF I drop a PLUMB LINE vertical from the near the bottom of the nose bone pretty much close to where where Gunson drops his 'TVL' SH's, is pretty close already to the places where Gunson wants a reference vertical; one dropped near bottom of nose bone that passes through subnasa, near or close to upper lip and so chin point is posterior to it. He also looks to have what pretty much looks like he has an FH that is a 'pure' horizont. Basically, a situation where his ceph doesn't need to be rotated because his plumb line vertical (which is a 'true true' vertical) is pretty close to where Gunson would drop a 'TVL' after rotating someone ceph.
On your profile, it's pretty easy to see that you're compensating for recession by tilting your head up which is very COMMON position to hold head when someone has retrusion. The other tip off is the high SN line orientation. So, right there, they can tell they need to rotate downward.
Now, if I drop a PLUMB LINE vertical from the bottom of YOUR nose bone (or near that) where Gunson wants his 'TVL' to drop from, so it kind of intersects the base of your nose, your lips and chin are way AHEAD of that. So, in order to get a TVL dropped from near that part of the nose bone that also intersects with subnasa, runs along or close to upper lip and for the chin point is POSTERIOR to it, they had to rotate YOUR ceph by about 7 degrees.
So the difference is that a vertical reference line that is in the direction of real gravity (plumb line vertical which is same thing as vertical on the ceph stat) can be drawn on SH's ceph without having to rotate it AND what looks to be a pure horizont can be found. But on yours, the act of DROPPING a plumb line vertical from the bottom of your nose bone reveals subnasa, upper lip, lower lip and chin point is WAY AHEAD of that line. So, on YOU, they rotated about 7 degrees and by doing that, they constructed the 'TVL' from bottom of nose bone where the other parts of your face were more aligned with where they want them to be with reference.
SH's reference vertical is more of a 'true' TVL because it's aligned with a PLUMB LINE vertical.
Also, I don't think THEY put the red line you have on your ceph tracing. The line would be more along the vertical of your upper lip. Your red line is anterior to intersecting subnasa. Also, that red vertical line where you have it on your ceph tracing would convey your maxilla was to backward and to bring forward. So, I DON'T think the red vertical where you put it is the Gunson TVL (or anybody elses). If you drop the vertical from the BOTTOM of your nose BONE, THAT one would be the vertical that also passes through subnasa, runs along border of lip and for which the chin point is POSTERIOR to it but LESS so.
In essence, I don't think ceph X by DEFAULT rotates everyone's ceph and most certainly not 7 degrees as you rotated SH's. Having to rotate a ceph is not going to apply to everyone. If a PLUMB LINE vertical can be dropped from pretty much where Gunson drops his 'TVL' (near bottom of nose bone) which it can be on SH and that vertical happens to be oriented close to the places Gunson wants his TVL to be near, that person doesn't need their ceph rotated. (If they do, ceph X will know how much.)
It's not something where if they rotate person A's ceph by X degrees, then person A rotates person B's ceph by same X degrees. It's not like that.So, dropping a vertical from near bottom of nose bone on YOUR ceph, clearly revealed that the rest of your face was TOO AHEAD of it. Hence a rotation needed. But on SH's ceph, a vertical and mind you a 'true true' one aligned with the plumb line of gravity dropped from the bottom of his nose bone did NOT reveal that. That's a pretty salient difference where his profile was NOT like yours.
This is very hard to explain verbally because it's geometry. I just see WHY they rotated your ceph. But it's something to get a 'TVL' that's close to where SH's plumb line vertical already is pretty close to.
I wrote about similar to a post to April on this string as to what they call 'TVL' differing from the plumb line of gravity.
As to SH, he's just one of those people on Lookism who wants to 'mog' the others there and I guess someone from there must have told him his maxilla was 'recessed'. So, that's where he's operating from. Just so you know that.
