jawsurgeryforums.com
General Category => Aesthetics => Topic started by: Deformed_Human on December 15, 2016, 04:47:30 AM
-
Long story short, I look like a deep sea creature. I am a 2/10 and that's only due to being tall.
* long midface
* close-set eyes
* recessed mandible
* recessed maxilla
* receding chin
* long philtrum, like you could literally use it as a noticeboard; I could hire it out to CBSOutdoors to stick ads on
* no cheekbones
* big nose
* bimaxillary protrusion
* long skull/poor facial width to height ratio
* sparse eyebrows
* balding
* exzema
* porous as f**k skin, I look like swiss cheese; my skin is like sandpaper, I could sand down ships with my face
* no ramus
* downward grown jaw
I'd go UP in looks if I had Treacher Collins. I am constantly DEPRESSED. I could wake up feeling "okay", but then look in the mirror and BANG! My day is ruined. Obviously, women treat me according to my looks.
So here's the point. I am in talks with surgeons in London to get lower jaw advancement with a genioplasty. But I just feel like this will be a bandaid on a corpse when what is actually needed is resuscitation. Bringing my lower jaw and chin forward will make my face appear even longer. I think that maxillary impaction (CCW) would help, by shortening my downward grown maxilla. But I don't have upper gum show.
I am trying to get a lip lift early next year. Would a lip lift give some "leverage"? So my shortening my philtrum/soft tissue, this may also require maxilla impaction to keep the bones and skin in line? My maxilla is bordering on hypoplasia.
BTW, I had tear trough implants and blepharoplasty in the USA 2 years ago. All that did was make me look less tired and less old.
I am at my wits' end and am willing to do whatever it takes to at least make it to average-looking. If I were younger, I would push for a lefort3, but I'm too old for that now.
Can anyone weigh in, please?
-
It sounds as if you have long face syndrome. Most of your structural issues can be corrected or at least improved, but the proper treatment of LFS requires double jaw surgery with counterclockwise rotation. If you don't have a gummy smile, then the rotation has to be done via posterior maxillary downgrafting alone.
-
What a lifesaver you are, CCW.
Surgeons in the UK are pretty amateur and focus more on the minimum needed to fix your flaw rather than improve your appearance. If no surgeon in the UK does posterior maxillary downgrafting then, after all the money I've wasted so far on consultations, I'll have to look to Europe.
I have no idea what PMD is but I'll start researching it now...
-
What a lifesaver you are, CCW.
Surgeons in the UK are pretty amateur and focus more on the minimum needed to fix your flaw rather than improve your appearance. If no surgeon in the UK does posterior maxillary downgrafting then, after all the money I've wasted so far on consultations, I'll have to look to Europe.
I have no idea what PMD is but I'll start researching it now...
Buddy this is what you should do. You need to get a consultation with Dr Gunson in California. He's the best in the world for good reason. His consultation is only $250 and it lasts for 2-3 hours. During that time you can express all of your aesthetic concerns. If anyone is going to inform you correctly it will be him. He will draw up a complete treatment plan during that time. You can then take the treatment plan to a cheaper surgeon in Europe and use it to explain to that surgeon what you need. I would advise a surgeon experienced in CCW such as Dr. Zarrinbal who is also reasonably priced.
There's an action plan for you - so get on and get it done :)
-
What a lifesaver you are, CCW.
Surgeons in the UK are pretty amateur and focus more on the minimum needed to fix your flaw rather than improve your appearance. If no surgeon in the UK does posterior maxillary downgrafting then, after all the money I've wasted so far on consultations, I'll have to look to Europe.
I have no idea what PMD is but I'll start researching it now...
Take it from someone who knows about UK surgeons, don't even waste your time with them and go to a surgeon in Europe asap
-
Long story short, I look like a deep sea creature. I am a 2/10 and that's only due to being tall.
* bimaxillary protrusion
Can anyone weigh in, please?
Mate, if you've got bi-max protrusion, then go and see Dr Zarrinbal. I had surgery with him just over a month ago and he fixed my bi-max protrusion and long lower third
-
When you say this treats LFS, is it the case it vertically reduces the height of the maxilla? In which case, wouldn't this just be a 3-4mm midface reduction at most, which in turn requires a lip lift to compensate since there's no gummy smile for OP? Otherwise where does the excess flesh of the midface disappear too? It seems like a midface which is too long is OP's big problem.
If OP wanted to reduce his midface by 10mm what are his options?
Soft tissue wise a lip lift would help.
-
Reducing the actual length of the middle third is challenging. The options include maxillary impaction/rotation and lip lift. With significant shortening of boney structure, depending on the soft tissue, it may be useful to get additional procedures including lip lift and midface lift.
-
When you say this treats LFS, is it the case it vertically reduces the height of the maxilla? In which case, wouldn't this just be a 3-4mm midface reduction at most, which in turn requires a lip lift to compensate since there's no gummy smile for OP? Otherwise where does the excess flesh of the midface disappear too? It seems like a midface which is too long is OP's big problem.
If OP wanted to reduce his midface by 10mm what are his options?
No, the problem with this facial type isn't vertical maxillary excess but rather a lack of posterior facial height (i.e., the maxilla didn't grow enough in the back), which causes the jaws to rotate clockwise, and the anterior facial height increases because the mandible rotates downward and back. The volume in the midface increases when the jaws are advanced with counterclockwise rotation.
The midface is the area between the glabella and the subnasale, and you cannot shorten it. The length of the midface alone is pretty meaningless since it just has to be in balance with the other thirds.
Lip lifts often look weird and unnatural, and I don't like soft tissue operations in general. Fixing the underlying skeletal issues is usually enough to balance the features.
[attachment deleted by admin]
-
No, the problem with this facial type isn't vertical maxillary excess but rather a lack of posterior facial height (i.e., the maxilla didn't grow enough in the back), which causes the jaws to rotate clockwise, and the anterior facial height increases because the mandible rotates downward and back. The volume in the midface increases when the jaws are advanced with counterclockwise rotation.
The midface is the area between the glabella and the subnasale, and you cannot shorten it. The length of the midface alone is pretty meaningless since it just has to be in balance with the other thirds.
Lip lifts often look weird and unnatural, and I don't like soft tissue operations in general. Fixing the underlying skeletal issues is usually enough to balance the features.
Very hypothetical and different for each individual, but in general, wouldn't a large advancement basically cancel out the midface volume you would get from CCW?
-
Take it from someone who knows about UK surgeons, don't even waste your time with them and go to a surgeon in Europe asap
Why does there seem to be this culture with British jaw surgeons that it is virtuous to change the absolute minimum and that it is unethical to perform surgery for any reason other than function?
Its seems to me that if people went to consult with a UK surgeon and told them that they wanted jaw surgery just for aesthetics, then they would risk being labelled with BDD. Well then, clearly there is an epidemic of BDD sufferers and unethical surgeons in South Korea...
-
Hi,
thanks for the replies, guys. I am literally having a breakdown. Which I have almost EVERYDAY. At weekends I just sleep and don't leave the house much. I can't cope with this s**t anymore. I need surgery ASAP.
I can't afford to fly back out to California. I'm still paying for the last time I went. I can afford Europe though (well, if I cut back). I will email Dr Zarrinbal some pics tonight. I wonder if there are people too ugly for him to operate on?
Forget sex education: there should be JAW EDUCATION in school to give ugly guys a head start. What's the point in sex education for sub 5/10 looking guys who will rarely get sex and intimacy from a woman?
Sorry for the venting but I am so fkg depressed. :'(
-
Hi,
thanks for the replies, guys. I am literally having a breakdown. Which I have almost EVERYDAY. At weekends I just sleep and don't leave the house much. I can't cope with this s**t anymore. I need surgery ASAP.
I can't afford to fly back out to California. I'm still paying for the last time I went. I can afford Europe though (well, if I cut back). I will email Dr Zarrinbal some pics tonight. I wonder if there are people too ugly for him to operate on?
Forget sex education: there should be JAW EDUCATION in school to give ugly guys a head start. What's the point in sex education for sub 5/10 looking guys who will rarely get sex and intimacy from a woman?
Sorry for the venting but I am so fkg depressed. :'(
How can you not afford California it's a £400 plane ticket return from London?
-
No, the problem with this facial type isn't vertical maxillary excess but rather a lack of posterior facial height (i.e., the maxilla didn't grow enough in the back), which causes the jaws to rotate clockwise, and the anterior facial height increases because the mandible rotates downward and back.
Sorry in advance for the newbie-style question, but what is the etiology of the maxilla failing to grow enough in the back? Mouth breathing? But this view still isn't consensus, right? Because I've seen authors write that the directionality is the opposite - it's the posterior deficient maxilla that causes mouth breathing and not the other way around.
The volume in the midface increases when the jaws are advanced with counterclockwise rotation.
Does this therefore correct some scleral show in a similar manner as a LeFort I?
The length of the midface alone is pretty meaningless since it just has to be in balance with the other thirds.
OP is a man and it's generally a more attractive/masculinized feature for the midface to be slightly shorter.
-
OP is a man and it's generally a more attractive/masculinized feature for the midface to be slightly shorter.
Not true at all. In fact, males can get away with an average or slightly long midface much better than females can. A compact midface is desirable on females. A slightly longer midface can be desirable on males, (look at golden ratio masks, look at photos of male models etc.) and in fact a longer midface is somewhat dimorphic. Some males can get away with a compact midface though. Recent research suggests that there is no correlation between dimorphism and the FWHR, which is equally a function of facial width as it is midfacial length anyway. Confusions over fwhr's role in dimorphism can be explained by the dimorphic quality of lateral zygomatic projection. Strong lateral zygomatic projection coupled with a slightly long midface is the 'most' dimorphic configuration. See the attachments that I've posted for the best examples of this.
This isn't to confuse dimorphism absolutely with male aesthetics as numerous studies have demonstrated that femininity in male faces is desirable. However, what these studies fail to do is to distinguish between different parts of the face when coming to that conclusion. No study has tested the dimorphism of individual variables (aside from fwhr) and that variable's dimorphic quality's impact on attractiveness. Nevertheless, we cannot exclude the conclusion that a range of midfacial lengths are acceptable for males, so long as those lengths are not too long or short.
[attachment deleted by admin]
[attachment deleted by admin]
-
Very hypothetical and different for each individual, but in general, wouldn't a large advancement basically cancel out the midface volume you would get from CCW?
No, not really. One of the benefits of counterclockwise rotation is that you don't have to do a large maxillary advancement since most of the movement comes from the rotation. This way you avoid getting too much fullness at the base of the nose, which you often get if you do a straight advancement when counterclockwise rotation is indicated. You want to be conservative with maxillary movements, and more midface volume is not better.
This girl was advanced 42mm (Wolford).
[attachment deleted by admin]
-
Sorry in advance for the newbie-style question, but what is the etiology of the maxilla failing to grow enough in the back? Mouth breathing? But this view still isn't consensus, right? Because I've seen authors write that the directionality is the opposite - it's the posterior deficient maxilla that causes mouth breathing and not the other way around.
Genetics mostly, I think. It's my understanding as well mouth breathing is caused by the jaws and not the other way around. The breathing pattern corrects itself when the skeletal issue is fixed.
Does this therefore correct some scleral show in a similar manner as a LeFort I?
Yes, better soft tissue support, so the lower eyelid moves up.
OP is a man and it's generally a more attractive/masculinized feature for the midface to be slightly shorter.
Yeah, I figured OP was a man, but it doesn't matter and the figure still applies. I don't really care about "midface length" because I think it's all about balance and harmony.
-
No, not really. One of the benefits of counterclockwise rotation is that you don't have to do a large maxillary advancement since most of the movement comes from the rotation. This way you avoid getting too much fullness at the base of the nose, which you often get if you do a straight advancement when counterclockwise rotation is indicated. You want to be conservative with maxillary movements, and more midface volume is not better.
This girl was advanced 42mm (Wolford).
The stuff I saw in Wolford's office was the best I've ever seen.
-
The stuff I saw in Wolford's office was the best I've ever seen.
No wonder. I was like if she went from that to there, then why the hell does my mandible still look recessed. Well I was advanced like 6mm (plus 9mm genioplasty) --Should have been advanced like 12mm bsso, plus 10 genioplasty for a total of 22mm.
-
No wonder. I was like if she went from that to there, then why the hell does my mandible still look recessed. Well I was advanced like 6mm (plus 9mm genioplasty) --Should have been advanced like 12mm bsso, plus 10 genioplasty for a total of 22mm.
She had a massive CCW rotation - her upper lip hardly changed at all, so probably minimal advancement of the maxilla. Wolford invented CCW, so little wonder he can do them.
-
She had a massive CCW rotation - her upper lip hardly changed at all, so probably minimal advancement of the maxilla. Wolford invented CCW, so little wonder he can do them.
She was rotated from 34 degrees to 8. It makes me laugh when some some run-off-the-mill surgeon, who makes his living pulling wisdom teeth, says CCW isn't a stable movement, and this girl has remained stable for 22 years after such a huge rotation.
-
She was rotated from 34 degrees to 8. It makes me laugh when some some run-off-the-mill surgeon, who makes his living pulling wisdom teeth, says CCW isn't a stable movement, and this girl has remained stable for 22 years after such a huge rotation.
Do you have more details? The picture says she was stable after a year, not 22 years. Interestingly enough no mention of TJR.
-
Do you have more details? The picture says she was stable after a year, not 22 years. Interestingly enough no mention of TJR.
It says that on picture.
At 22-years post surgery the patient maintains good facial balance and function.
This 15 year-old patient (Figures 21 A-C, 22 A-C, 23 A) developed severe juvenile idiopathic arthritis, diagnosed at age 11 years with milder effects in multiple other joints, had severe sleep apnea, but was relatively pain free. Incisal opening was 42 mm.
The treatment plan (Figure 23 B) in a single stage surgery included:
Bilateral TMJ reconstruction and mandibular advancement in a counterclockwise direction with TMJ Concepts/Techmedica total joint prostheses
Bilateral coronoidectomies.
Multiple maxillary osteotomies to move the anterior aspect upward and posterior aspect downwards.
Genioplasty with a 14 mm alloplastic implant.
Bilateral partial inferior turbinectomies.
The traditional C-TJR-OS protocol was used to prepare this case for surgery with the surgery performed on the sterolithic model by the surgeon for manufacture of the TMJ total joint prostheses, then duplicated on the articulator mounted dental models for construction of the intermediate and final palatal splints.
With the counter-clockwise rotation of the maxillo-mandibular complex and the genioplasty, pogonion advanced forward 42 mm. The patient is seen at 1-year post surgery (Figures 21 D-F, 22 D-F) with good facial balance, no pain, skeletal and occlusal stability, and an incisal opening of 33 mm. At the age of 37 years (22 years and 3 months post surgery), she maintains good facial balance and stability, no pain, and an incisal opening of 37 mm with no dietary limitations (Figures 21 G-I, 22 G-I).
http://www.drlarrywolford.com/tmj-temporomandibular-joint-disorders/total-temporomandibular-joint-tmj-replacement-2/
She did have TJR. Wolford also had to build her a chin since she literally didn't have one.
[attachment deleted by admin]
-
Sorry didn't see that. f**king amazing. I asked him about the horrendous reviews. He said a couple of unhappy patients create all the bad reviews and he basically does cases that nobody else will. Most people are happy and just move on with their lives. He wished that they would actually let their good experience be known.
-
I am literally having a breakdown. Which I have almost EVERYDAY. At weekends I just sleep and don't leave the house much. I can't cope with this s**t anymore.
Suicide is cope.
Life has many great pleasures, even without society.
-
Suicide is cope.
Life has many great pleasures, even without society.
Agreed, for all you know there is nothing after you die, your existence and potential in this life is too great to throw away.
-
Sorry didn't see that. f**king amazing. I asked him about the horrendous reviews. He said a couple of unhappy patients create all the bad reviews and he basically does cases that nobody else will. Most people are happy and just move on with their lives. He wished that they would actually let their good experience be known.
What did they concern? The only negative things I have heard about Wolford have been about the Mitek anchors. By all accounts when it comes to jaw surgery, Wolford is one of the best in the world and a legit artist.
-
What did they concern? The only negative things I have heard about Wolford have been about the Mitek anchors. By all accounts when it comes to jaw surgery, Wolford is one of the best in the world and a legit artist.
Perhaps the TJR horror stories cast a pall on his reputation for me. But if you look on his site, his preop photos have the patient basically looking down and post op looking horizontally as if to over emphasize the effect of CCW. Fwiw he had me basically staring at the ground in his photos.
-
Perhaps the TJR horror stories cast a pall on his reputation for me. But if you look on his site, his preop photos have the patient basically looking down and post op looking horizontally as if to over emphasize the effect of CCW. Fwiw he had me basically staring at the ground in his photos.
On his site, he explains the correct head position in which patients should be evaluated. The pictures seem to follow his guidelines.
http://www.drlarrywolford.com/tmj-jaw-surgery-diagnosis-treatment/patient-evaluation-tmj-dentofacial-abnormalities/
http://www.drlarrywolford.com/tmj-temporomandibular-joint-disorders/total-temporomandibular-joint-tmj-replacement-2/
-
On his site, he explains the correct head position in which patients should be evaluated. The pictures seem to follow his guidelines.
http://www.drlarrywolford.com/tmj-jaw-surgery-diagnosis-treatment/patient-evaluation-tmj-dentofacial-abnormalities/
http://www.drlarrywolford.com/tmj-temporomandibular-joint-disorders/total-temporomandibular-joint-tmj-replacement-2/
Look more carefully. He has the preops staring at the floor.
-
A lot of surgeons do that though, I don't think it's relevant to his skill.
-
How can you not afford California it's a £400 plane ticket return from London?
London, UK not London, Canada. lol
It's not £400 dude. More like £1200 + hotel from £1000.
Can you link me to where it costs £400 please? Also, I would need multiple consultations. I can't be flying to california 4 - 5 times a year.
-
London, UK not London, Canada. lol
It's not £400 dude. More like £1200 + hotel from £1000.
Can you link me to where it costs £400 please? Also, I would need multiple consultations. I can't be flying to california 4 - 5 times a year.
https://www.google.co.uk/flights/#search;f=LHR,LGW,STN,LCY,LTN,SEN,QQS;t=LAX;d=2017-01-10;r=2017-01-17;q=flights+london+to+los+angeles