That's A-OK, but that patient's result aside, I'm simply asking whether a rhinoplasty could make my paranasal area fill out in a similar manner? I'm genuinely wondering. I just don't know how to edit that type of change in frontal appearance into a photo of my face, but I hope that you get what I mean by making the paranasal area "fill out" now.
I wouldn't expect you to and I appreciate your help so far. I'm not arguing with you. I KNOW that many people would say it's close. I wasn't implying that they're wrong--it's just subjective. But look at the STILL photo overlay I made below (photo attached). For reference, the measured thickness of my lower lip is about 13 mm. To my eye, that makes the difference at the pogonion point in my morph around 10 mm of SOFT TISSUE change. To me, that says that even though genioplasty could be described as close to this, there would still be a difference, as the maximum for a genioplasty would be 6 mm of BONY CHANGE for me if not less.
I don't know if you agree with me, but I don't see anything wrong with going for the marginally better option if I have the finances, time and patience for the extra aesthetic and functional benefits. That's why I'm trying to figure out how to deal with those questions about CCW and width/extractions.
In the ABSENCE of referring to someone ELSE'S outcome, I convey that a (good) rhino surgeon can perform surgery to the anterior nasal spine area to better support the base of the nose. Of course, selective alteration of the ANS with aim of better support to the base of the nose does not involve advancing the entire Lefort 1 area of the maxilla forward, nor is it a procedure aimed at filling out the paranasal areas.
Your problem here is that you are STUCK on requiring communication based on your morph which is absent of the type of rigor in presentation which is needed for the viewer (here a scientifically inclined one if communication is with me) to cross reference what ever measurements you have 'exacted' or approximated. From my POV, communicative morph presentations involve 2 sets of SIDE BY SIDE presentations (present vs. desired goal). First set= 'mute' morphs which only show the visual changes. Second set shows RELATIVE LINES through landmarks which direct the viewers eye towards the displacements made. As to approximating mm measures of displacements, there needs to be reference on the diagrammed set as to the SCALE of the photo based on 'real life' measures of the distance between 2 distinct landmarks of the face in which lines are drawn between those 2 landmarks. For example, if you took a caliper to measure the distance between the ROOT of the nose and the BASE of the nose and found that distance was 'X'mm, then 'X' would substantiate other measures on the morph photo as to scale given that photos can appear as different sizes on different computer screens. Hence 'X' could be used for SCALE. So, the diagrammed morph would need to show the landmark lines passing through the point known as ROOT of nose to the point known as BASE of nose where the 'real life' distance of 'X' was noted on the diagrammed morph. In that way, 'X' can be used to adjust for the scale of the photo and also to substantiate other measures of displacement distances. Now, such a presentation is not hard to do. But it does resolve to a venue of a straight forward type of geometric proof to demonstrate to the viewer that what ever measures you approximated or 'exacted' are reliable.
NONE THE LESS, not even a more rigorous demonstration as stated above would duplicate the type of predicted outcome that specialized surgery design programs can do. In fact specialized surgery design (morph) programs (and the surgeons who use them) can come out SHORT of the desired soft tissue projection of the pogonian point as in short of the projected outcome you've defined for yourself (10mm) via your morph request. That's simply because desired soft tissue projection (here at pog point) is only PART of a complex MULTI-FACTORIAL EQUATION where other points, angles and planes need to be taken into consideration. Consider DISBANDING using your morph as a primary means of communication and consider INSTEAD having the doctors propose a plan for you (a VISUAL one that you can look at) and later compare to your own morph goal.
So, here, you've made what I call a 'mute' morph that resolves to EYEBALLING it where I see it as coming close to the look of a rhino and chin advancement. As to your 10mm figure, I'll accept that based on your word for it, like in the absence of my confirming or denying it's on the money. I also remind you that at NO TIME did I convey or imply to convey that the genio proposed to you by Gunson would replicate your morph. I told you that it would IMPROVE your profile; bring your chin CLOSER to the the TVL. So MOOT point (not to be confused with 'mute' morph) to point out that your 10mm measure is more than 6mm genio Gunson suggested. Although I don't deny that approx 10 mm advance to pog point would look better than a 6mm advance (based on your morph and your assessment of 10mm), I can't confirm that 10mm advance at pog point is going to be part of the MULTI-FACTORIAL equation (algorithm) where all the points, angles and planes, occlusion etc. play a role regarding where one can set the pog point WITHOUT OTHER things being shifted out of balance and function. Also, from my POV, (in your case) having to extract teeth to push the front of the face backwards, just so they can later push it forwards in a bimax surgery isn't the best reason to pursue bimax surgery for aesthetics. Instead, it's something to do if FUNCTION was the main issue and you were willing to accept FORM as playing second fiddle to that.
If improvement via Gunson's suggested genio is not enough for you, than there really isn't much to 'figure out' here because the preponderance of communication you got from the experts is that bimax surgery will involve 4 EXTRACTIONS and quite possibly some maxillary expansion to compensate for some 'shrinkage' that could arise from the extractions. Just don't expect that option to be on target with your morph goal, especially so if no doctor promised you such duplication.
As to CCW, CCW around the ANS will leave the ANS where it is but 'buck out' the incisors and PUSH the soft tissue of the lip FORWARDS. CCW around the incisor point won't move the incisors but will bring the ANS BACKWARDS. The former is on target for a patient who would benefit by the soft tissue of the lip being projected more forwards. The latter is on target for a patient who would benefit from having the ANS pushed BACKWARDS . So, I'll leave it up to you to cross reference those relationships for a person NOT needing their upper lip to move more forward and NOT needing their ANS to go more BACKWARDS.
As for self generated morphs, they are of LIMITED use as to 'talking turkey' with a surgeon. The main exception to that is when they look at them and tell you something like; 'That's quite like what I had in mind for you.' But that didn't happen here.
