Author Topic: Before/Afters of maxillary impaction on people with no gummy smile  (Read 16184 times)

fedfan

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Before/Afters of maxillary impaction on people with no gummy smile
« on: September 08, 2013, 08:25:14 PM »
Are there any pics out there of people who underwent maxillary impaction that didn't previously had a gummy smile or just greater than average tooth show at rest? I'm really curious about how this turns out. It's well known that surgeons refuse to perform such surgery on people who don't possess gummy smiles, and also that it ages the face considerably. I wonder if the trade off between looking a little older and shortening the lowerface (for people with long philtrums) is worth it.

falcao

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Re: Before/Afters of maxillary impaction on people with no gummy smile
« Reply #1 on: September 09, 2013, 12:54:17 AM »
Sorry I don't have any pics I can link to for you.

Maxillary impaction will not help you with a longer philtrum as you assume in your post. As a matter of fact it can exacerbate the look overall, if a long philtrum is the problem. Maxillary impaction looks good on people who have a shorter to normal length philtrum to start with. They are also likely to show more teeth or even have a gummy smile. The length of the philtrum should be evaluated relative to the remaining part of the lower face (if you measure from the base of the nose to the bottom of your chin, 1/3 should go to the philtrum and the upper lip, 2/3 to the lower lip and the chin - but you probably know this). Also, the lower third of the face should be evaluated relative to the face overall.

If you shorten your lower face significantly by way of maxillary impaction but the philtrum length stays the same (and it will, unless you have a lip lift of some sort), you may find yourself with an altered lower third ratios in an unfavourable way. I've seen this in people with maxillary impaction - their philtrum APPEARS to be longer even though strictly speaking it's not. It's all about ratios.

I had been considering impaction because I will have BSSO (advancement) and I feared that without any rotation to accompany the BSSO this will make my face look longer (and it probably will, I'm trying to prepare myself for this). But then when I considered how the lower third of the face ratio is altered by impaction and how less bone in the lower third of the face will mean less support for the soft tissue there (what you referred to as possible ageing effect), I decided against it.

I hope my explanation makes sense...

If you have a problem with a long philtrum, the only way to help it surgically is a lip lift. Or dropping your chin down during a lower jaw surgery with genioplasty, which will give an illusion of a shorter philtrum. But this will mean a longer face overall - it could work for some men, but not for all. If your face is on the longer side, definitely not a good idea. Mine isn't, fortunately.

fedfan

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Re: Before/Afters of maxillary impaction on people with no gummy smile
« Reply #2 on: September 09, 2013, 06:11:09 PM »
falcao, thanks for your reply.

I don't think a lip lift would be of any help at all in my case, since what I'm interested in reducing is the length between lowerlip and bottom of nose (and by undergoing maximpaction  the lower jaw would rotate CCW which is definitely a plus). A lip lift would only increase the teeth show but the length of the face would remain the same. This is why I want to see examples of this procedure on people with normal teeth show, to determine if it's worth it looking a little older in exchange of having a slightly shorter lowerface.

pekay

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Re: Before/Afters of maxillary impaction on people with no gummy smile
« Reply #3 on: September 09, 2013, 06:25:15 PM »
VME without a super gummy smile?

there a couple here

http://institutomaxilofacial.com/casos-clinicos/ortognatica/clase-2
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fedfan

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Re: Before/Afters of maxillary impaction on people with no gummy smile
« Reply #4 on: September 09, 2013, 07:49:27 PM »
VME without a super gummy smile?

there a couple here

http://institutomaxilofacial.com/casos-clinicos/ortognatica/clase-2

Great link, thanks. About Juan's case, I wonder if he's still swollen in the after photo. Because if not and that's the final result, he got butchered. And he indeed look older.

I notice in some of the bimax patients their faces got longer and in other they remained the same. Maybe he's using CCW advacenment in some and linear in others.

Check out Ana. Her philtrum length is longer than her chin. That looks pretty bad.

pekay

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Re: Before/Afters of maxillary impaction on people with no gummy smile
« Reply #5 on: September 09, 2013, 08:59:15 PM »
Juan looks better (profile and 3/4th) and about the same from the front, probably saw a massive improvement in his quality of life though (snoring/mouth-breathing)

Ana looks slightly better nothing drastic (imo)

the most popular result from institutomaxilofacial, the one that is used to bring in patients is this one



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Lazlo

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Re: Before/Afters of maxillary impaction on people with no gummy smile
« Reply #6 on: September 10, 2013, 12:56:35 AM »
Juan looks better (profile and 3/4th) and about the same from the front, probably saw a massive improvement in his quality of life though (snoring/mouth-breathing)

Ana looks slightly better nothing drastic (imo)

the most popular result from institutomaxilofacial, the one that is used to bring in patients is this one






what happened to her chin!?

pekay

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Re: Before/Afters of maxillary impaction on people with no gummy smile
« Reply #7 on: September 10, 2013, 09:25:20 PM »

what happened to her chin!?

it was already asymmetric before the surgery
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overbiter

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Re: Before/Afters of maxillary impaction on people with no gummy smile
« Reply #8 on: September 11, 2013, 12:30:12 PM »
it was already asymmetric before the surgery

But why not just straighten the chin when doing the genioplasty. If they can straighten jaws why not chins?