Opinions based on ceph

[TIG]

Hello everyone,
I am not satisfied with the aestetics of both of my jaws and search for opinions on how to improve them. Soon i will have an appointment with a jaw surgeon to discuss this and make a treatment plan. From what i read and understand so far an advancement of both jaws could lessen my skeletal type II profile.

My questions:
- I dont think i would benefit from a genioplasty on top of the bimax since this would only make my deep mentolabial angle even deeper. But what is your opinion on that?
- Do you think i should get a CCW? I have a narrow jaw and a relatively wide chin. A linear advancement of both jaws could maybe result in making my face look too long. A chin wing is probably not a good solution too because it would make my chin too wide and would result in my face loosing overall harmony.
- What can you say about my airways when you look at the ceph? Do they look alright or too small?

https://imgur.com/C1fuhwO

Thank you in advance!

[GJ]

I'm only seeing on image (a ceph), but based off that, I think your self-assessment about genio is accurate. I'm not sure I agree you couldn't move linearly. Your mandible angle doesn't look particularly steep.

Do you have breathing issues? Airway looks on the small side.

[kavan]

I think you might be able to get away with a single jaw surgery via increasing your overbite and bringing out just the lower jaw. Your mandibular plane angle is not high, so a downward and out genio could help and be added to single jaw. It's only the sliding genios that go UP and out that deepen the chin groove. The down and out ones make the chin groove more shallow.

[TIG]

I dont have breathing issues that i am aware of. Only a very deviated septum which i need to fix in the future. Is linear advancement of the jaws somewhat comparable to jutting the jaw forward? Because if so my face would appear too long despite having a low mandibular plane angle.

[GJ]

Is linear advancement of the jaws somewhat comparable to jutting the jaw forward? Because if so my face would appear too long despite having a low mandibular plane angle.

Not exactly, but it can give you some idea.

Looking at that ceph it's hard to image any situation where your face would be too long. You look to have a brachycephalic facial pattern.

[TIG]

I actually have a more dolichocephalic skull but i can see that only based on the ceph it looks brachycephalic. Thanks for the answers so far. I will discuss my case with the surgeon soon and keep you updated.
I have one more question. My orthodontist said i could decide between surgery or braces only. If i would take the braces only route he would move my upper teeth back with elastics using the space of my already removed wisdom teeth. Could this when you look at my ceph result in a negative aestetic outcome like loss of nasolabial angle, make my lip less curled, give me a larger philtrum area etc. by changing the alveolar bone part of the maxilla? Is this exaggerated by me or is this something that could THEORETICALLY happen?

[GJ]

I have one more question. My orthodontist said i could decide between surgery or braces only. If i would take the braces only route he would move my upper teeth back with elastics using the space of my already removed wisdom teeth. Could this when you look at my ceph result in a negative aestetic outcome like loss of nasolabial angle, make my lip less curled, give me a larger philtrum area etc. by changing the alveolar bone part of the maxilla? Is this exaggerated by me or is this something that could THEORETICALLY happen?

Yeah I'm not seeing that facial pattern in that ceph. It looks normal to brachy.

Regarding ortho, based on how you write it, I'm skeptical that can even work - he wants to move the entire upper arch back and fill in wisdom teeth space? What will be the anchor to do that, and how will he moved double rooted molars? Does he intend to place a tad as an anchor? Your aesthetic concerns would be real if that's even a possible movement, which I don't think it is.

[kavan]

I dont have breathing issues that i am aware of. Only a very deviated septum which i need to fix in the future. Is linear advancement of the jaws somewhat comparable to jutting the jaw forward? Because if so my face would appear too long despite having a low mandibular plane angle.

This question reflects you are not observing what you're doing.

You ask if linear advancement of the JAWS (both of them, as in PLURAL) looks like what you are doing when you jut out the lower jaw.

Observe, on your OWN face if you are moving the UPPER jaw when you are moving the lower one.

Observe how you are moving your lower jaw to jut it out.

a: Are you able to move your lower jaw outward without also having to move it down? Usually, jutting out the lower jaw involves moving it down in order to move it out.

In the event you're not able to SELF observe, which jaw you are NOT moving and/or which jaw you ARE moving and how you are moving it, the short answer is: NO. Jutting out the lower jaw isn't that comparable to advancing out BOTH jaws via linear advancement.