Recommend a surgeon for CCW DJS

[GJ]

Having looked at thousands of cases and read textbooks on this subject, IMO (not a doctor of course), your jaws look to be close to an ideal position. It's possible you could advance the chin a bit more to get more prognathic. It's not recessed, but it's not pronounced. So that's the area I'd focus on if "no surgery wasn't an option." I think that would look much more good and natural than going with an anti-face look.

[jawsurgery029184]

Why do you think CCW is a good case for you? Usually this is done through impaction, but regardless of how it is achieved, it looks like your occlusal plane is actually fairly flat. What would you be trying to gain from CCW aesthetically, especially since your nose is normal (and possibly even on the shorter side depending on the lighting) from the frontal view? You say you want an improved smile — what does your smile look like now and what are your concerns with it? Can you show a picture of you smiling? That’s also going to determine whether you need downgrafting, impaction, expansion, etc.

Imo the only thing that’s disharmonious with your face is that your lips are thin, which also is ironically one of the only things about your face that you don’t have an issue with. Jaw surgery is not some easy miracle to fix incredibly minor issues, and can increase asymmetry either objectively (midlines off, increased cant), or by exaggerating existing asymmetries. What part of your face do you think is asymmetrical? If you’re talking about how one of your cheekbones is higher than the other, this is common even in celebrities, and can look even more noticeable if you get upper jaw advancement.

[Glassjaw]

Having looked at thousands of cases and read textbooks on this subject, IMO (not a doctor of course), your jaws look to be close to an ideal position. It's possible you could advance the chin a bit more to get more prognathic. It's not recessed, but it's not pronounced. So that's the area I'd focus on if "no surgery wasn't an option." I think that would look much more good and natural than going with an anti-face look.

It's definitely a bit recessed. You just have to look at the right side of my face (the left). I had a crossbite so the recession is very uneven. From the right side it may look like there is no issue. But on the left side you can clearly see the recession.

You should have seen my nose pre nosejob. It's still not symmetrical, but pre surgery it was a mess. There was a noticable bump on the LEFT side of the nose. My whole septum is located on the left side of my face due to the crossbit. My nostrils are still uneven when i smile, and the tip of my nose is curved to the left.

I was hoping that the jaw surgery could fix this problem too. Maybe a ever so slight rotation of the jaws to the right on top of the slight ccw movement? Maybe not realistic but one can dream.

[Glassjaw]

Why do you think CCW is a good case for you? Usually this is done through impaction, but regardless of how it is achieved, it looks like your occlusal plane is actually fairly flat. What would you be trying to gain from CCW aesthetically, especially since your nose is normal (and possibly even on the shorter side depending on the lighting) from the frontal view? You say you want an improved smile — what does your smile look like now and what are your concerns with it? Can you show a picture of you smiling? That’s also going to determine whether you need downgrafting, impaction, expansion, etc.

Imo the only thing that’s disharmonious with your face is that your lips are thin, which also is ironically one of the only things about your face that you don’t have an issue with. Jaw surgery is not some easy miracle to fix incredibly minor issues, and can increase asymmetry either objectively (midlines off, increased cant), or by exaggerating existing asymmetries. What part of your face do you think is asymmetrical? If you’re talking about how one of your cheekbones is higher than the other, this is common even in celebrities, and can look even more noticeable if you get upper jaw advancement.

My whole face, as it is, is slightly canted and my posture is bad mainly because of the crossbite i had. It doesn't appear to be that asymmetrical, because i had a crossbite, so the right side developed to look "okay", exluding the slightly downwards turned chin. The left side is more clearly recessed, the jawline also looks weaker from that side. As for my smile, my nostrils get completely crooked when i smile, as i understand due to the lack of bone support from the left side of my face. If you had seen my nose pre-rhino you would understand the amount of the recession better, the tip of my nose was pointing downwards because of lack of natural support.

My frontal teeth are quite bent outwards, that was the only way we could get my jaws to fit shut. My bite is still slightly crooked despite of years of orthodontics. I was hoping that maybe my lower jaw could be set slightly behind the upper jaw in the surgery, so that the jaws would fit into their natural position. Setting the front teeth back a bit is a quite fast operation really, a couple more months of orthodontics max.

I must say, im not 100% sure that surgery is going to fix the issues i have with my looks, but as i wrote before: The lines might say "there is no recession", but to the eye something is off, the skin around the midface is too saggy and the edges of the nostrils are too downward pointing, this would indicate that the problem is the position of the jaws being too backwards. Even if the lines don't concur.

I guess i'm desperate enough to give it a shot. I do not think that a genioplasty would suffice in my case, i seriously considered it for years, but it wouldn't fix the main problem which is the canted and set back midface. It makes me look tired and old.

Also, i hate that f**king "beard". I only ever wore it because my face looks even more recessed without it.

[Glassjaw]

I have a question for you guys, everyone keeps saying my jaws are "close to the ideal position". So what? My whole face is quite clearly canted, so what difference does it make if the jaws are horizontally in position? Is it somehow required that there has to be this huge horizontal advancement of the jaws in connection to the surgery? The main thing for me would of course be the CCW rotation.

Besides, my jaws are not in an ideal position, they could definitely be slightly horizontally advanced without necessarily getting an overtly prognathic look.

I mean, i've seen much better looking people than me getting the surgery. Look at this guy https://www.youtube.com/watch?v=l_tnYd3VrbM

[Tomasjohn]

I have a question for you guys, everyone keeps saying my jaws are "close to the ideal position". So what? My whole face is quite clearly canted, so what difference does it make if the jaws are horizontally in position? Is it somehow required that there has to be this huge horizontal advancement of the jaws in connection to the surgery? The main thing for me would of course be the CCW rotation.

Besides, my jaws are not in an ideal position, they could definitely be slightly horizontally advanced without necessarily getting an overtly prognathic look.

I mean, i've seen much better looking people than me getting the surgery. Look at this guy https://www.youtube.com/watch?v=l_tnYd3VrbM

Let me repeat what you said and summarize. Correct me if i am wrong.
1. Everyone in this thread thinks your jaws are in an ideal position (speaking about horizontal lines when looking from the side)
2. You say your jaws are canted. I suppose we speak about frontal vertical asymmetry in this case (vertical line from the front in the middle of the face)
3. You want more horizontal projection.
4. More horizontal projection won't fix the vertical asymmetry.

Ask yourself: IF this assumptions are correct, would DJS for advancement be the optimal solution?

[kavan]

Let me repeat what you said and summarize. Correct me if i am wrong.
1. Everyone in this thread thinks your jaws are in an ideal position (speaking about horizontal lines when looking from the side)
2. You say your jaws are canted. I suppose we speak about frontal vertical asymmetry in this case (vertical line from the front in the middle of the face)
3. You want more horizontal projection.
4. More horizontal projection won't fix the vertical asymmetry.

Ask yourself: IF this assumptions are correct, would DJS for advancement be the optimal solution?

Excellent logic. I shall add that if the jaws are horizontal position there would be no (vertical) cant to be corrected.

Also, whether or not there is a cant is best established by getting a 'read out' from a surgery proposal which, for example, would give some info if one side of maxilla was planned to be elongated or shortened. At MINIMUM a consult with a maxfax to confirm or deny a cant. That would be preferable to insisting on its existence to people who don't see it.

[Glassjaw]

Let me repeat what you said and summarize. Correct me if i am wrong.
1. Everyone in this thread thinks your jaws are in an ideal position (speaking about horizontal lines when looking from the side)
2. You say your jaws are canted. I suppose we speak about frontal vertical asymmetry in this case (vertical line from the front in the middle of the face)
3. You want more horizontal projection.
4. More horizontal projection won't fix the vertical asymmetry.

Ask yourself: IF this assumptions are correct, would DJS for advancement be the optimal solution?

1. Most commenters seem to think so yes

2. I say my whole midface is canted. Everything below the eyebrows (Lefort 3)is recessed. If it was just the lower jaw, for example, it would be much easier to see. But since it's the whole midface, there is this certain "illusion" of symmetry looking from certain angles.

3. Slight horizontal projection wouldnt hurt. But the main thing im looking for is the ccw rotation, to fix the cant and the quite obvious asymmetry (the "long face") that comes with it.

4. More horizontal projection alone wouldnt fix anything. Horizontal projection that comes naturally with the rotating movement of the whole lower face, that is the key here. I haven't seen "thousands of cases" but I've seen enough and more importantly, looked into the mirror enough to understand where the problem is and how it can be fixed, IF it can be fixed.

[Glassjaw]

Excellent logic. I shall add that if the jaws are horizontal position there would be no (vertical) cant to be corrected.

Also, whether or not there is a cant is best established by getting a 'read out' from a surgery proposal which, for example, would give some info if one side of maxilla was planned to be elongated or shortened. At MINIMUM a consult with a maxfax to confirm or deny a cant. That would be preferable to insisting on its existence to people who don't see it.

I honestly don't understand why i would need to "insist" anything. Why would anyone have the need to presume that i come to this forum to lie about my condition? As i wrote before, i had a crossbite from 2 to 25 year old, and had a nosejob some years back. Those are the is reasons my face now looks as it does. 1+1=2

The bone structure i have is not genetic, aside from the bite problem itself of course. There are signs of mild recession caused by it all over the place (the downwards pointing chin, the overall vertically round shape of the face, the recessed cheekbones, the protruding eyes) if someone honestly can't see it after looking at all the photos i posted then i have to question their ability to see much anything. I have already visited a professional in my country, who confirmed the recession. But it's really not something i ever needed to get confirmed by a "professional", any person who has any eyes in the first place can see that something is not quite right with the symmetry... That right there is the whole problem.

[Tomasjohn]

I honestly don't understand why i would need to "insist" anything. Why would anyone have the need to presume that i come to this forum to lie about my condition? As i wrote before, i had a crossbite from 2 to 25 year old, and had a nosejob some years back. Those are the is reasons my face now looks as it does. 1+1=2

The bone structure i have is not genetic, aside from the bite problem itself of course. There are signs of mild recession caused by it all over the place (the downwards pointing chin, the overall vertically round shape of the face, the recessed cheekbones, the protruding eyes) if someone honestly can't see it after looking at all the photos i posted then i have to question their ability to see much anything. I have already visited a professional in my country, who confirmed the recession. But it's really not something i ever needed to get confirmed by a "professional", any person who has any eyes in the first place can see that something is not quite right with the symmetry... That right there is the whole problem.

I don't think anyone said that you are lying.

"That would be preferable to insisting on its existence to people who don't see it."

This just means that some people don't SEE the problem the same way you do.
It's obvious that it is a severe problem for you personally, don't worry.

[kavan]

I honestly don't understand why i would need to "insist" anything.

That is beyond my venue to explain that need. I would suggest (psyche) SELF introspection on your part because it's something in the venue of self introspection.What you clearly don't have the need for is what you (ostensibly) came here for; some facial maxfax feedback from others. When the feedback you got didn't correlate with your OWN assessments, that is when you went about INSISTING you had things others did not observe.

Why would anyone have the need to presume that i come to this forum to lie about my condition?

No one here suggested you came here to 'lie about your condition' and not my task to deal with a paranoia playout when rendering feedback.

As i wrote before, i had a crossbite from 2 to 25 year old, and had a nosejob some years back. Those are the is reasons my face now looks as it does. 1+1=2

No one here is denying you wrote that. So YES. You wrote that.

The bone structure i have is not genetic, aside from the bite problem itself of course. There are signs of mild recession caused by it all over the place (the downwards pointing chin, the overall vertically round shape of the face, the recessed cheekbones, the protruding eyes) if someone honestly can't see it after looking at all the photos i posted then i have to question their ability to see much anything.

Again, NO ONE here is denying that YOU see what YOU see. They are just conveying what they see. But when they don't see what you see or point out maxfax relationship that you have which can be considered good ones or ANYTHING ELSE that does not reflect your own opinion, THAT is EXACTLY when you start INSISTING they see what you see and if they don't, you 'question their ability to see much of anything.

In closing I shall say that what I observed in the first place is that you want your OWN OPINION reflected back to you by others and indeed you come off as INSISTING they see what you see. So, let's resolve to I'm 'BLIND', can't see what you see and lack the capacity to render anymore 'questionable' advice/feedback. GOOD and thank you for giving me an EXIT from providing any more. I'm OUT OF HERE with you.

[Glassjaw]

Again, NO ONE here is denying that YOU see what YOU see. They are just conveying what they see. But when they don't see what you see or point out maxfax relationship that you have which can be considered good ones or ANYTHING ELSE that does not reflect your own opinion, THAT is EXACTLY when you start INSISTING they see what you see and if they don't, you 'question their ability to see much of anything.

In closing I shall say that what I observed in the first place is that you want your OWN OPINION reflected back to you by others and indeed you come off as INSISTING they see what you see. So, let's resolve to I'm 'BLIND', can't see what you see and lack the capacity to render anymore 'questionable' advice/feedback. GOOD and thank you for giving me an EXIT from providing any more. I'm OUT OF HERE with you.

If the maxfax relationships that i had were good ones i certainly wouldn't be on this forum. There was a time period when those relationships were (somewhat) good ones, back when i was a teenager, the difference is quite striking and that is why i will never be satisfied with my face as it is. I can post some pics from those days if i can find them so that you can see what i mean.

Nobody certainly HAS to comment anything. It is quite frustrating telling my side of the story again and again and then just get the same old "but the horizontal lines".

Once more:

I say my whole mid/lower face is canted. Everything below the eyebrows (Lefort 3)is recessed. If it was just the lower jaw, for example, it would be much easier to see. But since it's the whole midface, there is this certain "illusion" of symmetry looking from certain angles. And it makes sense, i had a crossbite after all.

The main thing im looking for (in the DJS surgery) is the ccw rotation, to fix the cant and the quite obvious asymmetry (the "long face") that comes with it. More horizontal projection alone wouldnt fix anything. Horizontal projection that comes naturally with the rotating movement of the whole lower face, i believe that COULD drastically improve my looks.

Your, whoever's, opinion on THIS assessment? A sound plan, a complete crock of s**t, something from the between? I'm all ears. Just don't tell me again that you don't see anything wrong with my face, if you don't then get glasses and take an another look at the pics that i posted. Just pretend for a sec that i have at least some clue on what i'm talking about and i'm not just planning to throw away 20k and my health for nothing. And if you still have no idea what i mean then perhaps it is indeed better that you don't say anything.

Excellent logic. I shall add that if the jaws are horizontal position there would be no (vertical) cant to be corrected.

If the natural position of the jaws would have been more horizontally protracted if not for the recession, as it seems it would have been the case here, then naturally there can also be a vertical cant included. There is no "one horizontal position" that is optimal for all people. Again, don't get fixated on the lines, look at the big picture.

[Glassjaw]

https://imgur.com/a/DDo1NuS?

I added some pics from back when I was 19 years old at the end. Pre nosejob. See the difference?

There’s already a bit of recession, but just a bit. See how different my lips look? See how symmetric the midface is? No long face at this point yet.

I don’t mean I’m trying to get this back, because it’s impossible, i can't get my whole face down from the Lefort 3 line moved around after all. But the DJS with the CCW rotation could nevertheless get me closer to looking like this again. Opinions?

[kavan]

I see that you have a 'negative vector' relationship meaning  recession to the upper midface below the eyes. But that has little to do with cants or cross bites. It has more to do from lack of orbital rim projection/support. Negative vector is evidenced by dropping a straight line vertical from the surface of the eyeball. When the upper midface, orbital rim region is behind the line, which yours is, that is a negative vector relationship.

So, I see where your recession is. But I can tell you that CCW DJS does not address that area. It won't advance where your recession is located. CCW DJS will advance the area BELOW where your recession actually is and would stand to make where your recession actually is look more recessed when the jaws are advanced but the recessed area is left behind.

[Glassjaw]

I see that you have a 'negative vector' relationship meaning  recession to the upper midface below the eyes. But that has little to do with cants or cross bites. It has more to do from lack of orbital rim projection/support. Negative vector is evidenced by dropping a straight line vertical from the surface of the eyeball. When the upper midface, orbital rim region is behind the line, which yours is, that is a negative vector relationship.

The situation has everything "to do with cross bites", since i had a cross bite for 25 years and that's where the whole problem is derived from..

So, I see where your recession is. But I can tell you that CCW DJS does not address that area. It won't advance where your recession is located.

I think that's a pretty weird comment to make, since my jaws are very much a part of the recessed area. It's not like my "upper midface" alone is somehow recessed, but my jaws are right where they were supposed to be all along. CCW DJS would absolutely address a part of the recessed area. I think that at this point you are just incapable of admitting that you were wrong.

CCW DJS will advance the area BELOW where your recession actually is and would stand to make where your recession actually is look more recessed when the jaws are advanced but the recessed area is left behind.

Sure, but advancing the jaws in itself was never the point, rotating the jaws was, as i think i already stated once or twice. A part of the recessed area will get left behind, and that's a shame. But CCW DJS absolutely wouldn't make me look "more recessed", i don't know what you are talking about. Notice how you are not presenting any solutions, just making problems where there aren't any. Once again, i do NOT intend to advance my jaws with the surgery, i intend to rotate them.

CCW DJS is the way to go for me, if such a thing exists. I will consider a genioplasty after this, but i doubt it will be needed. Even if i just wanted to have cheek implants, in order to counter the "upper face recession", i would have to have the CCW rotation first, in order to not make the side profile appear round(er).