Double jaw surgery with CCW-r ?

[Nietzsche77]

Hey there ! I plan to do a DJS/bimax soon - for aesthetics reasons only since I have a normal bite (I had braces when I was fifteen). As the pictures show, having a small skull, a recessed jaw, a narrow face, a very little lower third and a weak chin (arguably due to my mandible being set back in my neck), I’d expect bimax to lengthen my lower third/ramus, provide forward growth to my maxillary and my mandible and widen to some extent my face - those are my three cosmetic purposes, from the most important to the least important. In this regard, from what I’ve seen here and there, bimax with CCW-r seems to be the best solution. What are your thoughts about this ? Are you those objectives achievable, realistic ? How carefully should I pick my surgeon ? And can I also expect bimax with CCW-r to improve both my eye area and my cheekbones ?

(The last pic I share, with a genioplasty involved, is a bimax forward growth result I'd want my surgeon to emulate)

[GJ]

Yeah, I think you answered your own question. CCW should do all of those things, and I think it's all realistic providing you get a good plan. I disagree your face is narrow, but either way, CCW should make it appear wider from the front.

Post any plans you get here so we can look 'em over.

[InvisalignOnly]

You are so handsome already, why don't you just get a chin wing or similar work in the chin / mandible area instead of a bimax? I honestly do not think you need a bimax for aesthetic reasons.

[kavan]

Twisting the head is not a correct profile pose. So, I decline to opine on assessments based on that pose.

Some basic info to incorporate into your expectations: 

Having braces prior often requires 'decompensation' or otherwise to undo what the prior braces did in order to prepare for the planned displacements in a surgery. CCW-r does not improve areas that are above the Lefort 1 cut. Areas like the cheeks, bones below the eyes and forhead STAY where they are. They don't move with the L1 cut. So if those areas are already recessive, they can look relatively more recessive with bimax advancement. CCW-r does not elongate the lower 1/3rd. It can give a SHORTER look to the lower 1/3rd for those who are visually long in that area. CCW-r bimax advancement is a great technique for those with true bimax recession, little to no recession above the L1 cut and who have long lower 1/3rds.

[Nietzsche77]

Thanks for your replies. Kaven, tomorrow I'll try to take a better profile picture but I don't there will be significant differences since I actually did my best not to twist my head. As for CCW-r, I've concluded (perhaps mistakenly) that for those like me with a relatively recessed lower jaw, it would provide the most aesthetically pleasant results by lowering the occlusal plane while bringing the mandible forward and making the ramus less steep - two things I wish for. But I may be wrong. By the way, assuming that pose is correct, what would be your assessments considering my expectations ?

[kavan]

Thanks for your replies. Kaven, tomorrow I'll try to take a better profile picture but I don't there will be significant differences since I actually did my best not to twist my head. As for CCW-r, I've concluded (perhaps mistakenly) that for those like me with a relatively recessed lower jaw, it would provide the most aesthetically pleasant results by lowering the occlusal plane while bringing the mandible forward and making the ramus less steep - two things I wish for. But I may be wrong. By the way, assuming that pose is correct, what would be your assessments considering my expectations ?

Well, I won't 'assume' the pose is correct because it's not a correct profile pose. A profile pose is a shot from the side where the head and neck are in neutral position and not twisted from the neck. I think I gave you enough basic info to cross reference it with your expectations.

ETA: CCW-r doesn't exactly 'lower' the OP, it decreases it's angle of inclination via a rotation. Ceph is needed to look at the inclination of the OP. So, for example, if someone had a 'flat' OP (about 0 degree inclination relative to a horizont) a decrease in the angle of inclination would give a NEGATIVE OP inclination. OP norms can be looked up.

ETA: PROFILE pose: