Your smile change is not just one of upper tooth show (or lack thereof) but also one LOWER tooth show, especially if it's now harder for you to move your lower lip UP when closing your lips than it was before. 'Lip incompetence' is mentalis strain (muscle moving the lower lip). For example, when the lower jaw, including the chin is too far back or even too far forward, lifting the lower lip UP gets harder to do the more the mentalis muscle is kind of stretched out over a long diagonal path. From my perspective mechanical efficiency of ease of moving the lower lip UP is a shorter path to do so. Even if there is no direct surgery on the chin itself, I think that the more it goes outward with the ride of the jaw advancement, the muscle used to lift the lower lip up can lose some mechanical efficiency where it gets harder (takes more effort) to lift it directly 'up'.
That said, your chin looks to be somewhat 'on the stretch' as in a little too far forward and I think that could factor in to the lower tooth show. I think the lower tooth show is more visible issue than is upper tooth show being 'invisible'.
Although anterior downgraft (CW-r) would stand to reverse CCW-r of the impaction and thereby give more upper tooth show and perhaps result in some auto rotation of the lower jaw in CW-r direction to move the chin point backwards, you might need the BSSO along with it (double jaw surgery) for stability and/or more mechanically efficient lower lip 'up' movement.
When your lower jaw was too far backwards for your aesthetic liking subsequent to the first surgery, did you have the same lower tooth show and difficulty moving your lower lip upwards as you now have? What I'm getting at here is that not only do you have to think about the lack of upper tooth show but also the presence of the lower tooth show. Like you need to think in terms of a surgery that would rectify both.
Hi kavan, thanks once again for all your feedback and insight. It is very much appreciated.
So for one, my lip incompetence issue was not developed by this second surgery, I'm sorry if it seemed like I alluded to that. I would say my lip incompetence issue was worst prior to my first surgery, and while improved after that surgery, not eliminated by it. I would say there's not been much of a noticeable change in lip incompetence prior to and after my second surgery - maybe even improved slightly (but still present).
Secondly, my lower tooth show is definitely something I've only really noticed after this second surgery, and not prior to it. I'm definitely still a bit confused as to what caused it - I initially thought it was rather straight-forward and because I was over impacted, thus losing upper length in my jaw, when everything was stitched back (ie. inside top lip under nose and bottom lip above chin) naturally it was stitched back in different locations on my jaw (lower on top and bottom, thereby exposing less top teeth and more bottom teeth). So I simply assumed that my exposure of more bottom teeth was the exact same problem and went hand-in-hand (or was a byproduct) of the over impaction mistake - ie. if he didn't impact at all, things would have been stitched back higher on both jaws, yielding more top tooth show and less bottom tooth show. I'm not sure if this makes sense, but I'm learning here that perhaps the bottom tooth show problem is a different problem/cause all together..?
Anyhow, I will certainly be mindful of this lower tooth show problem when I start back seeing OS' for consultations (hopefully within the next couple months).