Thanks, I actually was thinking about my nose as well, I have a consult scheduled. Does the rhino guy need to know I may get bimax surgery and alter plans accordingly, or are they relatively independent procedures in my case?
Could rhino + genioplasty give me a reasonable result? I'm still on the fence with regards to bimax (although, I do have mild sleep apnea that I believe to be related)
Ah, I had 2 removed in Mexico when they were bothering me. In retrospect I don't know why I didn't get them all out.
Look/study the tutorial I provided so you are prepared to consult with a rhino guy about deprojection rhino. (I don't know what area you are in.). Bring your ceph along so he can look at the ANS. You can also broach topic of rhino experience capacity, prominent ANS with any maxfax you consult with.
Your angle measurements look to be those where you would aesthetically benefit from what the other posters told you which is CCW rotation (posterior downgrafting type). They are also such that your maxilla (the part of it that does not include the prominent ANS) is within the norm but closer to the lower side of the norm. Angle measures relative to the mandible DEVIATE from the norm which is indicator of clear cut RECESSION of the mandible. So, it's very likely that in YOUR case, in addition to the type of posterior downgrafting they do to assist mandibular advancement, it is very likely they would have to move your maxilla FORWARD to ALSO ASSIST with a good aesthetic mandibular advancement. BUT, BUT, BUT....the protrusive ANS could LIMIT the aesthetic benefit of the WHOLE bimax IF the surgeon was NOT in capacity to do the rhino technique of deprojection rhino along with the bimax surgery. Hence, you should either get the deprojection rhino BEFORE maxfax or find a maxfax who can do the deprojection rhino WITH a BIMAX surgery.
As to your question of could rhino and genio work: NOYour angle measures reveal your MANDIBLE is RECESSIVE. Also, with bimax the CHIN goes forward with the mandible forward displacement and with the docs who do the CCW posterior downgrafting, they often don't need to do a genio (or they just do a small one) because they can bring the mandible forward enough so the chin point is in the best place. A plastic surgeon (rhino docs) would probably want to put in a chin implant or do a genio. But for the most part they DONT do maxfax surgery.
That said, my advice is in favor of the BIMAX, either after a deprojection rhino or with a surgeon who could either do a deprojection rhino OR just cut a V notch under the ANS so that does not come forward with the rest of the maxilla.
The situation is such that you would need to tell the rhino guy (a plastic surgeon) NOT to do anything to your chin. They will WANT TO. Just tell them you will later be getting bimax where the bimax surgery would bring your chin out along with the mandible advancement.
