General Category > Aesthetics
Aesthetic outcome of my jaw surgery
kavan:
--- Quote from: VincentGT on November 09, 2023, 07:13:25 AM ---I asked him about the premolar extractions. He told me there is not enough place in my mouth to bring back the frontal teeth (which are leaning forward too much), so I needed those extractions. In theory I could have had just more CCW rotation, but that would not fix the forward leaning frontal teeth. These are prone to more gum recession and earlier loss if left with that much flaring outwards. Also, he told me my lower lip position is not ideal because those teeth are pushing it a bit outwards. With the extractions and braces they can bring back these teeth and advance the mandible more, which would be ideal.
I did not ask about the upper wisdom teeth extractions, but I always understood from my ortho this is the case because my mandible will be brought forward MORE than my mandible and so the upper wisdom teeth would not have 'matching' lower teeth.
I also asked about lower wisdom teeth loss during surgery, but my surgeon said he's never had this in his whole career and he's confident I wouldn't lose more teeth.
Thanks for this very clear explanation. Would this mean I'm one of the rare cases where I only need advancement in both jaws, without any CCW rotation? I do fear a lengthier philtrum in that case...
Would you say, based on my pictures, that I have rather a long face or short face? I always thought my facial thirds were (frontal) kind of in balance.
And does CCW rotation always mean your face (or chin) gets shorter?
Oh and if I can avoid a genioplasty, I would.
--- End quote ---
I told you the similar about the pre-molar extractions to the lower jaw. They need to be removed to make room for the BSSO advancement and also that lower mandibular teeth flaring too much forward is an unfavorable angle for them to be in. So, ya, since the inclination of the lower teeth have a bearing on the inclination of the lower lip, your sugeon told you right.
I told you similar to what your ortho said about the upper wisdom teeth to the MAXILLA; It would have no opposing tooth. I told you that (in GENERAL), they like to remove the wisdom tooth to the MANDIBLE to avoid a bad break. So, if your surgeon told you something SPECIFIC to your particular case such that you didn't need your lower wisdom tooth removed, well we can say there are GENERAL reasons surgeons like to remove the lower wisdom tooth and reasons highly SPECIFIC to a particular person's case where they don't need to be removed.
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I told you that your upper lip would tend to be UN-FURLED with maxillary advancement. You stated you did not like the 'curl' to your upper lip. So the term 'unfurled' can be taken as uncurled as in straightened out somewhat or having less of a CURVE to it. Upper lip area= PHILTRUM + the upper LIP.
Maxillary advancement will tend to straighten out the upper lip area, make LESS the curl or the furl-up it has to that area which includes the philtrum. OK.
Your request to have your upper lip (area) uncurled because you don't like that in profile perspective but also don't want the philtrum to look longer is a self negating request. Although your upper lip area which includes the philtrum will not be made physically longer, the more of a conCAVE curve one sees in profile is made straighter, the more it will look longer in frontal perspective. So, nothing can be done about that very fundamental principle when the specifics of what you want vs. what you don't want are self negating.
I would say you have a short face and I already told you the principle of looking at a conVEX area in profile (under chin) and it projecting (visibly) longer in frontal and you liking the extra 'length' of your chin in FRONTAL was due to the convex curve under chin giving the illusion of a longer chin when viewed in frontal.
The conCAVE CURVE to your upper lip area you don't like in profile when made less via maxillary advancement, when straightened out, could make your philtral area look longer to you. The fundamental principles of curves seen in profile projecting differently in frontal when straightened out can't be changed in accordance to not liking how something looks in profile but liking how it looks in frontal or not liking how it looks curled in profile , wanting it to be uncurled but not wanting it to look any longer in frontal. What someone wants to see or doesn't want to see on their face after maxfax surgery does not always conform to how things actually work.
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CCW-r does not 'always' mean the face or chin will get shorter or look shorter. Although it can make the angle of inclination of both the maxilla and mandible less (because a decrease in the angle of inclination of the maxilla will have a proportional decrease in the angle of inclination of the mandible), the angle of inclination the mandible has with the horizont is still going to be a downward diagonal even though made less of one by the CCW-r done to the maxilla. So, a BSSO will still have it that the mandible will move in downward diagonal; vector displacement of horizontally outward and vertically downward. CCW-r can make the lower face shorter but a significant BSSO along with it still is displaced along a downward diagonal would tend to compensate for that.
Anyway, all this depends on the rotation of a triangle formed by 3 landmarks to the face: ANS, PNS and Pog and the extent of both the Maxillary advancement and the BSSO. So, I would defer you to your surgeon and his PREDICTIVE SOFTWARE given you seem to need to know in advance specifically, how your face is going to look to you if you do or don't get CCW.
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