Hello,
I would like to get some insight on my orthodontist's treatment plan. I have a class II bite and a hypo-divergent face growth pattern. The orthodontist suggested that I should perform a mandibular advancement surgery (BSSO) along with a genioplasty. I was not prepared to hear about the genioplasty, as most talks with other orthodontists in the past focused around the mandibular advancement only. I questioned its necessity and the doctor remained firm about it. I told him something along the lines that "I would like to fix the occlusal problem and I don't want my face to be changed too much" and he responded that the genioplasty would not change my face too much as it will be performed to move my chin where it was previously. I suppose this is because the mandibular advancement includes a clockwise rotation which would move my chin further back. His focus is to make the lower third of my face longer, as you will see in the plan.
In the past I've also been told that I have a prognathic maxilla, based on a measurement of 85 deg. SNA angle (my SNB angle is 80 deg) and proposed a treatment that involves maxillary distalization (with carriere motion). I told my current orthodontist about it, whether we should retract the maxilla a little bit (with elastics) and then follow with the mandibular advancement surgery, which he refused. "The teeth will not touch" he said. I thought that by retracting the maxilla a little we would also get some clockwise rotation (more height). I fear a little that if we advance the mandible so that I have a class I bite, both jaws will be slightly prognathic.
Below you can see my cephalometric x-ray and the treatment plan.
Thanks in advance
