Author Topic: gummy smile: is it possible to have upper jaw surgery only?  (Read 2474 times)

ahamis

  • Newbie
  • *
  • Posts: 29
  • Karma: 0
gummy smile: is it possible to have upper jaw surgery only?
« on: December 04, 2019, 09:37:34 PM »
Hello all,
I have GUMMY SMILE (and Long lower face) but NORMAL occlusion. (I had Le fort 2 surgery along with lower jaw surgery to correct occlusion in the past).

I went to a orthognatic surgeon recently to address the gummy smile that bothers me. He said in order to do the upper jaw impaction he would also have to operate the lower jaw "to move the jaws together" and coordinate occlusion. He said it was NOT possible to just cut the upper jaw because that would create an occlusion problem. But I don't want to cut my lower jaw again. 

Is it possible to have just upper jaw impaction without cutting the lower jaw? Orthodontic treatment wouldn't be enough to correct any occlusion problem that result from the upper jaw impaction?

Thank you

PloskoPlus

  • Hero Member
  • *****
  • Posts: 3044
  • Karma: 140
Re: gummy smile: is it possible to have upper jaw surgery only?
« Reply #1 on: December 05, 2019, 02:12:38 AM »
Depends on the case, but yes. Who was your original surgeon?

ahamis

  • Newbie
  • *
  • Posts: 29
  • Karma: 0
Re: gummy smile: is it possible to have upper jaw surgery only?
« Reply #2 on: December 05, 2019, 09:39:04 AM »
Original surgeon was in Brazil.
Now I live in SF area and I would need to find a surgeon that could operate upper jaw  without having to cut lower jaw (CCR).

The surgeon that I consulted with wanted to do upper jaw along with Lower jaw CCR surgery.
However, he said that my lower jaw bone was too thin and could be dangerous to cut the bone on the lower jaw again...

kavan

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4029
  • Karma: 426
Re: gummy smile: is it possible to have upper jaw surgery only?
« Reply #3 on: December 05, 2019, 12:40:39 PM »
Anterior impaction as a SOLE procedure to reduce gummy smile area works ONLY IF auto-rotation of the lower jaw would be the ONLY thing the lower jaw needs to move into place where the bite will also be right. If the lower jaw also needs to be adjusted to accommodate the displacement done to upper jaw to reduce gummy smile, then the case resolves to bi-max surgery meaning a BSSO also needs to be done.

Depending on the extent of the gummy smile, IF the extent is MODEST--and I don't know the exact amount of what qualifies as modest--a GUM REDUCTION SURGERY can be done to provide MORE tooth show and LESS gum show. Since doing so will also EXPOSE the NON-enamel parts of teeth, the tooth surfaces exposed by the gum reduction surgery would need to be protected with some bonding material or maybe veneers.

ETA: I just saw your photos. Since your teeth are already LONG, gum reduction surgery would NOT work for you. So, it's looking like you would need the bi-max with BSSO along with the L1 impaction. However, it never hurts to get a SECOND OPINION from another maxfax to confirm or deny the need for the BSSO to go along with the Lefort 1.
Also, if you absolutely DON'T WANT the BSSO that would need to go with the L1 to reduce gummy smile (and excess long teeth show), then it doesn't hurt to OPT OUT of ANY surgery for a WHILE and in the interim, look into getting BOTOX with objective of REDUCING the extent you lift the smile muscles to show the excess gum and teeth.

« Last Edit: December 05, 2019, 12:49:56 PM by kavan »
Please. No PMs for private advice. Board issues only.

PloskoPlus

  • Hero Member
  • *****
  • Posts: 3044
  • Karma: 140
Re: gummy smile: is it possible to have upper jaw surgery only?
« Reply #4 on: December 05, 2019, 01:42:29 PM »
I think you’re fretting over nothing. You will get old, your upper lip will get longer, you will have less gum show.

GJ

  • Administrator
  • Hero Member
  • *****
  • Posts: 1493
  • Karma: 215
Re: gummy smile: is it possible to have upper jaw surgery only?
« Reply #5 on: December 05, 2019, 06:55:50 PM »
You look good and have a normal bite. Don't do surgery.
Millimeters are miles on the face.

ghiggson90

  • Private
  • Full Member
  • *****
  • Posts: 107
  • Karma: 14
Re: gummy smile: is it possible to have upper jaw surgery only?
« Reply #6 on: December 08, 2019, 12:16:21 PM »
I agree with the rest here. No surgery, please.

ahamis

  • Newbie
  • *
  • Posts: 29
  • Karma: 0
Re: gummy smile: is it possible to have upper jaw surgery only?
« Reply #7 on: December 08, 2019, 08:50:31 PM »
Thank you for your explanation Kavan!

Does anybody know a good jaw surgeon to recommend in the bay area or nearby?

kavan

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4029
  • Karma: 426
Re: gummy smile: is it possible to have upper jaw surgery only?
« Reply #8 on: December 08, 2019, 09:50:11 PM »
Thank you for your explanation Kavan!

Does anybody know a good jaw surgeon to recommend in the bay area or nearby?

Honestly, I would FIRST  just try some BOTOX to lower the smile to show less gum. 
Please. No PMs for private advice. Board issues only.