Hi everyone,
I'm a 23 year old male with a number of chronic lifelong health issues to go with aesthetic concerns that I believe jaw surgery may be the fix for; I've just been left unsure of what specific surgical approach should be undertaken following a recent consult with my maxillofacial surgeon.
I don't have a lot of knowledge like many users on this forum so I'm looking to gain insight on what options I should be considering for my situation and what questions I should be asking my surgeon.
BACKGROUNDI've had orthodontics through childhood including extractions for tooth alignment due to overcrowding. This includes most recently the removal of a central incisor on the lower jaw followed by orthodontic braces to pull teeth back to fix my front teeth touching when trying to bite.
Functional symptoms:
- Lifelong sufferer of allergies paired with a deviated septum leading to chronic mouth-breathing from nasal/airway blockage/restriction that persists to this day.
- Chronic fatigue and poor concentration. Recently diagnosed with ADHD so these symptoms can be masked with stimulants.
- Anxiety
- Forward head posture and forward slanting upper body posture.
- Issues swallowing with an upright head posture (very difficult/uncomfortable).
- Can't place my tongue on the roof of my mouth without either restricting or completely blocking my airway.
- Bad snorer
- Wake up with dry mouth
- Experience sleep apnea if I sleep on my back with my head up.
- Adenoid/mouth-breather face
- Vocal projection issues; because I can't push air through my upper airways and nasal passage my voice sounds nasally and it takes a huge effort energy-wise so it's quite draining therefore I often try to avoid speaking whenever possible.
I've been undergoing regular allergy desensitisation treatment over the last 18-24 months which marginally improved my nasal breathing ability initially but I haven't had any further improvement since.
I recently saw a highly experienced maxillofacial surgeon in my city for an initial consult and expressed these symptoms to him. He's told me I require a bilateral osteotomy involving straight advancement of both jaws in combination with a septoplasty. He uses 3D planning technology and I respect his abilities having seen him before in 2017 for a genioplasty.
Images:
https://imgur.com/a/u1IDUfA__________________________
GOING FORWARDI have aesthetic concerns about this surgery since I don't know what I'm going to look like post-op. These concerns strictly come from the maxilla advancement, as the only issue I have with my appearance is my weak lower jaw.
Looking at my side profile in the attached image(s), my mandible is already set back in relation to my maxilla. I'm concerned I might be at risk of ending up with the infamous 'chimp look' I've seen people mention here that comes with straight advancement, given my lower jaw is already weak in comparison to the upper jaw and that moving both jaws forward equally would put me at risk of this.
If I proceed, do I need to be looking at cheek implants to offset the jaw advancement and maintain facial balance?
Should I be pushing for CCW rotation? I'm not sure my surgeon or anyone in my state (Perth, Western Australia) does CCW rotation, and since travel is not an option these days I don't know if it'd even be possible.
How much am I rolling the dice here when it comes to an aesthetic outcome, be it positive or negative?
What other questions should I be asking my surgeon?
I'm quite nervous over this since it is a big decision and I don't know what I'm going to look like post-op, so please excuse me if any of the questions come across a bit stupid because again my knowledge on this topic isn't as rich as many people here.
Any suggestions or feedback is a massive help so thank you.