What are your honest impressions regarding my profile? (Aesthetically speaking)

[strongjawman]

Hi everyone,

Long time poster but please allow me to provide a brief preamble: I have mild bilateral asymmetry of the mandible (right side larger and chin deviates slightly to the left). I have soft tissue asymmetry which exacerbates the appearance of boney asymmetry.

I have a class i tooth relationship on the right and class ii on the left causing wearing/flattening. My incisors are edge to edge with zero overbite.

In 2012 as a broke 21 year old when I first joined this forum I had a series of investigations done by a surgeon and he concluded that orthodontics alone would not correct my bite.

In 2018 I saw Dr Birbe in Barcelona and he too recommended surgery (he did no oral inspection, but looked at the 3D print of my skull that I brought with me).

A couple of weeks ago I returned from Barcelona having consulted with Dr Alfaro and he advised that orthodontics COULD POTENTIALLY correct my bite, and if it couldn't, surgery could be an option afterwards. However he didn't think my asymmetry or lack of facial projection was too bad.

On the one hand I was happy to hear that orthodontics may be able to resolve my teeth from wearing and finally be able to bite through a pizza properly without tearing the toppings off. On the other I was sad that I had spent 10 years of my life obsessed and depressed over my appearance.

First impressions of Dr Alfaro's staff is that they are great - professional, friendly and caring. I received this email from one of his assistants following my consultation:

"I spoke again with Dr. Hernandez Alfaro about your case and below you can find his answer and I am also enclosing a 2D simulation.

Maxillo-mandibular advancement plus counterclockwise rotation would definitely improve your jawline and neck definition as well as your chin projection and lips/nose support.

My point is that you are already quite balanced facially, and not having any clear functional issues its basically up to you to decide whether  if you want to go through this process.

Said that, we have a lot of patients with similar facial traits who seek and get surgery done by us for pure aesthetic reasons. To understand the potential facial changes, you can check on similar cases in our social media.

Please, find below a gross simulation of potential changes that could be achieved with this surgery. If this somehow fits your desires/expectations, we could proceed with a combined ortho-surgical treatment.

 

I remain at your disposal for any further information you may need.
"
 

Please see a link to image provided by Dr Alfaro here: https://i.imgur.com/MD3WoIV.jpg

Link to GIF https://imgur.com/a/gJjySUO (I altered my nose and kept the original laxity in my neck. (right click to stop loop)

Link to GIF (only altering nose): https://imgur.com/a/Ew2Csfb

I would appreciate outside opinions. I can't be competely objective with myself when it comes to how I look. Do I look substantially better with more forward projection? My projection looks slightly less from the left side profile (not shown here) due to mandibular asymmetry too.

Is a septo/rhinoplasty sufficient to balance the top and bottom of my face? Maybe a slight genio? This with orthodontics might be a happy medium.

Thank you for your time.

[strongjawman]

Imo, you definitely would benefit aesthetically from surgery, but I don’t think your profile appears abnormal at all. It’s really up to you how important your appearance is to you.

Thank you, this seems to be what most people are telling me.

[Tomasjohn]

I would appreciate outside opinions. I can't be competely objective with myself when it comes to how I look. Do I look substantially better with more forward projection? My projection looks slightly less from the left side profile (not shown here) due to mandibular asymmetry too.

I agree with the previous answer that the side-view does not look abnormal at all.
And i also think the simulation looks good as well.
Are you as bothered with how you look from the front?

[strongjawman]

I agree with the previous answer that the side-view does not look abnormal at all.
And i also think the simulation looks good as well.
Are you as bothered with how you look from the front?

I'll post the front photos here soon once I've received them from the office.

The asymmetry is apparent from the front, so yes a bit. If a septoplasty and genio to straighten my chin is sufficient I would probably do that. Then unilateral fat transfer to correct the soft tissue asymmetry.

Whenever I gain weight (lifting weights/buking) my chin looks like it joins my neck from the side though. So when I'm lean it's less obvious.

Do you thin the morph looks better though? I understand that moving the maxilla can also mess with the Ogee curve though.

[mediumdrinkofwater]

Did your surgeon mention how many mm movements he wanted to do?

[strongjawman]

Did your surgeon mention how many mm movements he wanted to do?

No, this is just a crude morph he provided. I'm going to get a ceph and then ask him to do a mock up if possible.

[Tomasjohn]

Do you thin the morph looks better though? I understand that moving the maxilla can also mess with the Ogee curve though.

Yes I think the morph looks better. And yes, if we just speak about the side view I think a genio and septo would be sufficient. Obviously any plan regarding jaw surgery has to be assessed again after these procedures because the baseline will change. 

[strongjawman]

Yes I think the morph looks better. And yes, if we just speak about the side view I think a genio and septo would be sufficient. Obviously any plan regarding jaw surgery has to be assessed again after these procedures because the baseline will change.

Thank you.

I've been reading a lot on jaw surgery relapse so I'm not sure if the risk is worth the aesthetic reward.

[Tomasjohn]

You are welcome.
Could you explain how the bite on one side is class l and on the other is class II with zero overbite and edge to edge bite? It is just for personal interest. Could you explain how this manifests (i have a hard time comprehend this). 

EDIT: Nevermind, found it online. Class 2 subdivision.