Can someone please analyze my CEPH in detail? Appreciate any help and advice

[jaw_surgery_advice]

Picture of CEPH: https://imgur.com/uJ8F3YU

please help me analyze the image. in reality, i have a very weak chin. jaw that looks recessed, nose that is prominent and slight hooked.

was also curious about how my teeth rest and the occlusal plane?

[kavan]

Have you had prior ortho (braces) before for your bite?

When you got the ceph, didn't the practice run a ceph analysis on it? They all have automatic programs that chart out the points, lines angles and planes and then churn out the measures and deviations. Is it possible for you to get one of those from the practice who took the ceph?

[ArtVandelay]

Did you already have jaw surgery, those are BSSO plates ?

[kavan]

Did you already have jaw surgery, those are BSSO plates ?

Looks like there is some radio-opaque material (metal) in there. ceph is very over exposed , so hard to id what it is.

To the OP: You won't be getting a 'detailed ceph analysis here'. There are automatic programs that do that which is why you're being asked if the practice that took the ceph did that.

[Sergio-OMS]

Picture of CEPH: https://imgur.com/uJ8F3YU

please help me analyze the image. in reality, i have a very weak chin. jaw that looks recessed, nose that is prominent and slight hooked.

was also curious about how my teeth rest and the occlusal plane?

In my humble opinion, you remain bi-retruded

[jaw_surgery_advice]

In my humble opinion, you remain bi-retruded

can you please explain? and what would you suggest i do? for reference, physically, i have a very weak chin, my jaw looks swung back and not nice and projected under my face. my nose is large and a little hooked.

[GJ]

Your profile looks pretty good to me.
Bite looks slightly open - is it?

[jaw_surgery_advice]

Your profile looks pretty good to me.
Bite looks slightly open - is it?

Bite is not open.

Please refer to these images. Yes I know I have a beard. Im not asking for a perfect assessment. Just any advice at all

Right side: https://imgur.com/WMK5wJK
Left: https://imgur.com/9rzmFrb
Desired: https://imgur.com/wRPR1ZP

[jaw_surgery_advice]

can you please explain? and what would you suggest i do? for reference, physically, i have a very weak chin, my jaw looks swung back and not nice and projected under my face. my nose is large and a little hooked.

Thanks for the answer! Can you please refer to these images and help me out?

Left profile: https://imgur.com/9rzmFrb
Right profile: https://imgur.com/WMK5wJK
Desired results: https://imgur.com/wRPR1ZP
Surgeon treatment plan: https://imgur.com/aWC8eb2

Please analyze these and help me. What do I need to achieve max aesthetics possible in my case? My chin is very weak so is my jaw, underneath the beard. Nose is large/hooked a bit.

[kavan]

You're not going to get a detailed ceph analysis. I would say, GENERALLY speaking, you're probably in venue of CCW-r, bimax advance with MORE advancement to lower jaw than upper. You have a prominent anterior nasal spine that most likely should be reduced during the maxillary part of the surgery.

You have NOT answered the question about what hardware is already in your jaw. Nor the question as to whether or not the establishment that took the ceph also provided you with a ceph analysis.

[jaw_surgery_advice]

You're not going to get a detailed ceph analysis. I would say, GENERALLY speaking, you're probably in venue of CCW-r, bimax advance with MORE advancement to lower jaw than upper. You have a prominent anterior nasal spine that most likely should be reduced during the maxillary part of the surgery.

You have NOT answered the question about what hardware is already in your jaw. Nor the question as to whether or not the establishment that took the ceph also provided you with a ceph analysis.

They did not provide any analysis. Also the hardware was from a lower jaw advancement 3 years ago. It was to correct a bite, with no aesthetic regard whatsoever, it was simply for functionality. And recommended by orthodontist who have me on Invisalign.

[jaw_surgery_advice]

They did not provide any analysis. Also the hardware was from a lower jaw advancement 3 years ago. It was to correct a bite, with no aesthetic regard whatsoever, it was simply for functionality. And recommended by orthodontist who have me on Invisalign.

A prominent anterior nasal spine is a bad thing? I just googled it, I dont have much idea what it is. Isnt a prominent "anterior nasal spine" a sign of a forward grown maxilla, it seems?

Thanks btw. I know Ive been all over the place since joining.

[kavan]

They did not provide any analysis. Also the hardware was from a lower jaw advancement 3 years ago. It was to correct a bite, with no aesthetic regard whatsoever, it was simply for functionality. And recommended by orthodontist who have me on Invisalign.

OK. Thanx. Then you would be in venue of 'revision' surgery.

A prominent anterior nasal spine is a bad thing? I just googled it, I dont have much idea what it is. Isnt a prominent "anterior nasal spine" a sign of a forward grown maxilla, it seems?

Thanks btw. I know Ive been all over the place since joining.

A prominent nasal spine (ANS) is not an indicator of a forward grown maxilla.  BUT, sometimes a jaw surgeon might hold back in bringing the maxilla forward BECAUSE of the prominent ANS. The prominent nasal spine (ANS) is, in part, what is projecting out the base your nose out too much. It's also responsible for the type of 'tethering' you have to the philtral area below the base of nose. Although the ANS is also brought FORWARD in bimax surgery,  a prominent ANS when brought forward during a bimax surgery would NOT look aesthetically pleasing. Taking it down during a maxilla advancement aspect of a bimax surgery, COULD necessitate another rhino technique during same surgery (ANS cut down is a rhino technique). But the surgeon
 would need to be conversant in rhino.  Given you would be in venue of 'revision' surgery since you had a past surgery to lower jaw, you would need a pretty good maxfax who could also cut the ANS down as part of the maxillary advancement and also be poised to compensate with other rhino techniques to bridge and tip area. In RHINOPLASTY, the act of cutting the ANS down is often referred to as 'deprojection' (of the nasal base). However, along with the deprojection of the ANS, other maneuvers are done in addition.

The GENERAL rule of thumb is to have the bimax surgery BEFORE a rhino. However, a prominent ANS is the only exception to this where the rhino can be performed before the bimax.

Here is a link to a very good tutorial about prominent ANS as it relates to rhinoplasty techniques and how it 'tethers' to philtral area.  http://www.facialsurgery.com/ClkoffTPgt3_2011_09_01bh.html

[jaw_surgery_advice]

OK. Thanx. Then you would be in venue of 'revision' surgery.

A prominent nasal spine (ANS) is not an indicator of a forward grown maxilla.  BUT, sometimes a jaw surgeon might hold back in bringing the maxilla forward BECAUSE of the prominent ANS. The prominent nasal spine (ANS) is, in part, what is projecting out the base your nose out too much. It's also responsible for the type of 'tethering' you have to the philtral area below the base of nose. Although the ANS is also brought FORWARD in bimax surgery,  a prominent ANS when brought forward during a bimax surgery would NOT look aesthetically pleasing. Taking it down during a maxilla advancement aspect of a bimax surgery, COULD necessitate another rhino technique during same surgery (ANS cut down is a rhino technique). But the surgeon
 would need to be conversant in rhino.  Given you would be in venue of 'revision' surgery since you had a past surgery to lower jaw, you would need a pretty good maxfax who could also cut the ANS down as part of the maxillary advancement and also be poised to compensate with other rhino techniques to bridge and tip area. In RHINOPLASTY, the act of cutting the ANS down is often referred to as 'deprojection' (of the nasal base). However, along with the deprojection of the ANS, other maneuvers are done in addition.

The GENERAL rule of thumb is to have the bimax surgery BEFORE a rhino. However, a prominent ANS is the only exception to this where the rhino can be performed before the bimax.

Here is a link to a very good tutorial about prominent ANS as it relates to rhinoplasty techniques and how it 'tethers' to philtral area.  http://www.facialsurgery.com/ClkoffTPgt3_2011_09_01bh.html

Thanks! Gonna read up on that link. My surgeon is.  Would you happen to know anything about him?

Also here is our treatment plan: https://imgur.com/aWC8eb2

And here is my profile: https://imgur.com/9rzmFrb (I know I have a beard, but Im too insecure to shave. Was hoping you can analyze the ANS here)

What do you think overall of the plan?

[jaw_surgery_advice]

OK. Thanx. Then you would be in venue of 'revision' surgery.

A prominent nasal spine (ANS) is not an indicator of a forward grown maxilla.  BUT, sometimes a jaw surgeon might hold back in bringing the maxilla forward BECAUSE of the prominent ANS. The prominent nasal spine (ANS) is, in part, what is projecting out the base your nose out too much. It's also responsible for the type of 'tethering' you have to the philtral area below the base of nose. Although the ANS is also brought FORWARD in bimax surgery,  a prominent ANS when brought forward during a bimax surgery would NOT look aesthetically pleasing. Taking it down during a maxilla advancement aspect of a bimax surgery, COULD necessitate another rhino technique during same surgery (ANS cut down is a rhino technique). But the surgeon
 would need to be conversant in rhino.  Given you would be in venue of 'revision' surgery since you had a past surgery to lower jaw, you would need a pretty good maxfax who could also cut the ANS down as part of the maxillary advancement and also be poised to compensate with other rhino techniques to bridge and tip area. In RHINOPLASTY, the act of cutting the ANS down is often referred to as 'deprojection' (of the nasal base). However, along with the deprojection of the ANS, other maneuvers are done in addition.

The GENERAL rule of thumb is to have the bimax surgery BEFORE a rhino. However, a prominent ANS is the only exception to this where the rhino can be performed before the bimax.

Here is a link to a very good tutorial about prominent ANS as it relates to rhinoplasty techniques and how it 'tethers' to philtral area.  http://www.facialsurgery.com/ClkoffTPgt3_2011_09_01bh.html

Also my surgeon specifically said he does not feel comfortable doing a rhinoplasty at the same time as the revision bimax. He also said its best to see what the nose looks like after the advancement, as it will look smaller. I was thinking of getting rhinoplasty after jaw surgery if need be, can the whole ANS issue be sorted with a rhinoplasty surgeon afterwards?