Relevant surgery for my issues?

[toddstratt]

Hi, I was a member on this forum and active on it many years ago. After a long absence I've accumulated better finances in my life and am in a place where I am much better able to finance a jaw surgery out of network. I was previously told by my ortho, and then follow up appointment with Dr. Gunson in Santa Barbara, CA, that my lower and upper jaw were both set back. I have an overbite with my jaw, and also an overjet of my front top teeth. They also told me I had a narrow palate and that would need to be widened.

On consultation there was a certain amount of movement they wanted to do with my bottom and top jaw to bring them both forward which would prevent me from losing teeth as I get older from the lack of pressure on my bottom front row of teeth now , as well as helping to improve my sleep apnea issues due to structural issues of my jaw and tongue rolling back when I sleep as a result.

I posted in another section about the best surgeons to find, but posting here because in curious what people's opinions are on good options just from the outside perspective of my face itself? I don't have access to my old x rays at the moment which makes the issues much more obvious. Also another thing to note is my face is very thin. To the point most sunglasses and glasses (don't wear glasses), most largely hang off the sides of my face where as with people compared to most people. My cheekbones are also set back alongside my lower and upper jaw which they noted as well, but didn't offer suggestion on part of thar surgery.

 Just that it would look a bit strange after if I didn't have something done with my cheekbones at same time. I then looked into lefort 3 as an option for that.  Anyways rambling aside with the picture here and info provided what do yall think would be some good options? Excuse my goofy stretched mouth last photo for weirdness lol , just needed to show the overbite

[GJ]

It's hard to tell from photos, but their diagnosis does seem right based off what I am looking at.

What is your overjet, like 4 or 5mm? Looks about that. So you could move the lower jaw alone linearly and get that advancement. That would be one way to go if you want to reduce some risk. CCW of both jaws would also be an option and get more projection of the lower jaw. This would probably be best if everything goes well, but you introduce risk to the nose widening, nasal base/philtrum perception issues, etc.

[toddstratt]

It's hard to tell from photos, but their diagnosis does seem right based off what I am looking at.

What is your overjet, like 4 or 5mm? Looks about that. So you could move the lower jaw alone linearly and get that advancement. That would be one way to go if you want to reduce some risk. CCW of both jaws would also be an option and get more projection of the lower jaw. This would probably be best if everything goes well, but you introduce risk to the nose widening, nasal base/philtrum perception issues, etc.

I don't remember the exact numbers but it's quite severe it's actually interesting how my upper lip is far forward despite both recessed manilla because of the overjet holding it there. Good aggressions and was what I wanted to look into ccw with both jaws brought forward. As for nasal changes not a big concern. My health is priority after all. Slight nose changes I can handle. I just want to maximize my aeathetic results alongside the functional surgery. Because it has potential to make me look a bit off if not. It's hard to tell in these pics but with some angles I can do with my face especially if I tuck my chin, and tilt my head down or down to the side and etc. My face can look really weird and off. I'm assuming the jaw issues are a big cause. I'll post a pic of what I mean in a bit

[mediumdrinkofwater]

It's hard to tell from photos, but their diagnosis does seem right based off what I am looking at.

What is your overjet, like 4 or 5mm? Looks about that. So you could move the lower jaw alone linearly and get that advancement. That would be one way to go if you want to reduce some risk. CCW of both jaws would also be an option and get more projection of the lower jaw. This would probably be best if everything goes well, but you introduce risk to the nose widening, nasal base/philtrum perception issues, etc.

He seems like a classic shortface, where cw rotation would be the venue? Not sure why ccw rotation is being discussed for aesthetic purposes here.

[Tomasjohn]

Just that it would look a bit strange after if I didn't have something done with my cheekbones at same time

I agree on this if your lower jaw gets wider posterior. It could look a bit weird from the front because there is an inward curve between your zygo and jaw angle that could be exaggerated.

But why do u think it could look weird with only forward movement?

[GJ]

He seems like a classic shortface, where cw rotation would be the venue? Not sure why ccw rotation is being discussed for aesthetic purposes here.

I don't see him as having a short face. Looks normal/average to me.

And I said linear lower jaw only would be a good option for that reason. He probably won't get the projection to have a classic profile going that route, but it would be an improvement with less risk involved. Could move the chin to finish either movement and refine face length, but he'd probably need grafting given the deep LMG.

[toddstratt]

I don't see him as having a short face. Looks normal/average to me.

And I said linear lower jaw only would be a good option for that reason. He probably won't get the projection to have a classic profile going that route, but it would be an improvement with less risk involved. Could move the chin to finish either movement and refine face length, but he'd probably need grafting given the deep LMG.

Don't know what half these terms mean to be honest. But that being said I am in NY and wanted to ask if y'all have a good reference for the best surgeon I can see in regards? I was going to see Dr Sinn in Texas back in 2016. I don't think he is practicing it any longer though.

[toddstratt]

I agree on this if your lower jaw gets wider posterior. It could look a bit weird from the front because there is an inward curve between your zygo and jaw angle that could be exaggerated.

But why do u think it could look weird with only forward movement?

It would look okay with movement forward, but if my cheekbones stay in the same place I will have it looking strange by contrast when it's brought forward maybe? I think overall my face is just extremely thin, so it would be nice to just have more bone structure in the jaw and cheekbones itself. It is to the point that most sunglass frames can't even fit the profile of my face, they are all too big. I don't really know what exactly that would require additionally. If possibly I'd just like to have more width/ definition to my cheekbones and jaw by association.

[Tomasjohn]

It would look okay with movement forward, but if my cheekbones stay in the same place I will have it looking strange by contrast when it's brought forward maybe? I think overall my face is just extremely thin, so it would be nice to just have more bone structure in the jaw and cheekbones itself. It is to the point that most sunglass frames can't even fit the profile of my face, they are all too big. I don't really know what exactly that would require additionally. If possibly I'd just like to have more width/ definition to my cheekbones and jaw by association.

I understand. I personally find it difficult to recognize the thinness of your face without a comparison. But comparing to the cheekbones you don't need a wider jaw imo.

[toddstratt]

I understand. I personally find it difficult to recognize the thinness of your face without a comparison. But comparing to the cheekbones you don't need a wider jaw imo.

That's true. I just mean that the overall dimensions of my face It's very thin but I'm not sure what to do for comparison sake. I can upload a picture in regular size sunglasses. These ones aren't the best example because I tried to get something that looked okay, but it's also especially noticeable if I ever try on someone's glasses, or most sunglasses. My face is so thin it often just hangs off the sides.

[Tomasjohn]

Ah ok, yes definitely noticable with sunglasses.
BUT: Within its own dimensions i think your face looks balanced from the front.

Does your head fit your body or is it small in comparison?

[toddstratt]

Ah ok, yes definitely noticable with sunglasses.
BUT: Within its own dimensions i think your face looks balanced from the front.

Does your head fit your body or is it small in comparison?

It fits my body I'd say in over all skull size and stuff. It just feels like my facial dimensions are smaller than a normal adults in some ways. I'm also 6'1 so it's not that I'm a tiny person in general. It just seems over all too thin, especially with certain angles or if I wear a hat or sunglasses etc. I always wondered if I just naturally had a thinner face or if it was related to my other jaw issues and stuff together. I thought if my cheekbones and jaw were a bit wider I would feel like I have more normal range proportions and such. Overall my face just feels like it doesn't have enough bone structure. But I don't feel like I'm bad looking or anything. Just feels like it lacks any noticable features aside from my nose and eyes.