Nose Change (with images)

[Suchislife]

Hi guys,

I'd like some help predicting how my nose might change following jaw surgery.

The images show my current skull and the 'after' skull.

The 'after' skull is something I whipped up after 3d planning with a surgeon. It approximately shows the advancement we discussed. (8mm lefort 1, 10mm and 12mm bsso (on each side, asymmetry), 8mm genio).

8mm lefort seems kind of large and as you can see my nose looks OK with a slight upturn. I fear that with such a surgery my nose will become upturned in an undesirable way. My main concern is how far forward the nasal spine is going and what that might entail. As for widening, I am not too concerned as my nostrils are long and narrow. Another point I would like clarification on is how will the upper jaw downgraft change nose shape as well.

To limit the upper jaw forward movement, premolar extraction was also discussed as the teeth for my lower jaw can be brought back to create an overjet instead of moving everything forward and then doing a big genio. We are yet to plan for this however. I'm also interested for thoughts on this alternative if any1 has any.

Cheers,

[Vincent999]

Those movements for your face are a bit over the top imo. You dont want to risk an uncanny and harmony disrupting result from over advancing the jaws. The downgraft suggests your upper lip hangs over your upper incisors by several mms? Your straight nose will curve upwards. My nose widened a touch from 3mm advancement measured at the maxilla cut site. Check how far he has you coming forward at the cut site (the 8mm presumably measured at the incisor includes autorotation from the slight CCW rotation hes giving you). Advancement over 3mm will widen the nose noticeably.

[LeFort 3000]

Your surgeon needs to reduce the anterior nasal spine during the surgery to prevent as much nasal upturning as possible. Also I think advancement doesnt broaden the nose too much. I had 1cm SARPE and I cant even tell for certain if my nose has gotten bigger and to what extent. I think it might have a bit gotten bigger, but it didnt get anywhere close to the 1cm that I did in horizontal broadening. And this was direct, focussed horizontal broadening, not just accidental widening after a forward movement.