jawsurgeryforums.com
General Category => Aesthetics => Topic started by: Mrtn on October 18, 2020, 07:28:43 PM
-
I just got an X-ray to gather more information about possible surgery or treatment to improve my aesthetics.
-
There is a lot of information to gather about aesthetics as they apply to maxfax on the EDUCATIONAL section of this board. Anything I posted there is with that aim. Here's a link to a few of the articles I recommend for self study:
https://www.sciencedirect.com/science/article/pii/S2395921516300575
https://onlinelibrary.wiley.com/doi/pdf/10.1002/9781118925225.app1
-
I came to this forum to look for help from people who already has more knowledge in this. Otherwise why would I ask for help if I already knew how to read the x-ray?
-
This is not going to end well.
-
This is not going to end well.
Maybe I'm totally clueless about this place, but isn't it a forum for people to get help/recommendation for jaw surgery based on pictures? I mean I read quite a few threads and they were pretty similar to mine, except they got some helpful replies and recommendation against/pro surgery. What did I do wrong or what did they do differently?
-
Just a gut feeling.
But anyway, you should post photos as well. Based on that x-ray CCW of both jaws, or linear of both jaws + (ccw) genio would make sense.
-
Just a gut feeling.
But anyway, you should post photos as well. Based on that x-ray CCW of both jaws, or linear of both jaws + (ccw) genio would make sense.
Thanks! That's all I wanted to know. One of the surgeon I asked only told me to get genio because double jaw in my case wouldn't really make a "dramatic difference".
Non x-ray pictures: https://imgur.com/a/aHIufNN
-
I came to this forum to look for help from people who already has more knowledge in this. Otherwise why would I ask for help if I already knew how to read the x-ray?
I've given you help before and it proved fruitless.
-
I've given you help before and it proved fruitless. Same demonstrated again when I gave you self study that gives directions on basic how too as to cephs.
And you told me I should post my ceph for further details. So I did, and I just wanted to know if your previous recommendation changed after seeing my ceph, that's all.
-
And you told me I should post my ceph for further details. So I did, and I just wanted to know if your previous recommendation changed after seeing my ceph, that's all.
and I just wanted to know what your response would be after giving you educational material for self study. I needed to validate past interaction which I felt was fruitless. But no problem with your getting help from others.
-
and I just wanted to know what your response would be after giving you educational material for self study. I needed to validate past interaction which I felt was fruitless. But no problem with your getting help from others.
I wish I had time to look through all of this stuff and I appreciate your recommendations for self study. What I know is that my face is a bit "off" (f**ked up) and I'd like to improve that. What I don't know, is how exactly should I improve it, because I got different insights, recommendations from different places, including from surgeons, and the more I read about this the more confused I get.
-
I wish I had time to look through all of this stuff and I appreciate your recommendations for self study. What I know is that my face is a bit "off" (f**ked up) and I'd like to improve that. What I don't know, is how exactly should I improve it, because I got different insights, recommendations from different places, including from surgeons, and the more I read about this the more confused I get.
In a prior post, you wanted to know why some people get a lot of help and others don't.
My help is best reserved for people who come here demonstrating some prior knowledge and/or capacity to 'digest' the info I give them. That's what I look for and those are the types who benefit the most from my help. I gave you plenty of help in the past (http://jawsurgeryforums.com/index.php/topic,8062.0.html ) and even told you in no uncertain terms WHY not to just get genio as a doctor suggested to you. But there was little to no demonstration from you as being able to 'digest' that info.
-
In a prior post, you wanted to know why some people get a lot of help and others don't.
My help is best reserved for people who come here demonstrating some prior knowledge and/or capacity to 'digest' the info I give them. That's what I look for and those are the types who benefit the most from my help. I gave you plenty of help in the past (http://jawsurgeryforums.com/index.php/topic,8062.0.html ) and even told you in no uncertain terms WHY not to just get genio as a doctor suggested to you. But there was little to no demonstration from you as being able to 'digest' that info.
Fair enough. I'll dig in a bit more, it's just so contradictive. Two doctors told me to get genio. I don't know them, I don't know you, so I'm just trying to use what information I have online and from real doctors so far. Those doctors could perform double jaw but they didn't suggest it. I don't know why, or why not, but I need to consider their opinion too against yours.
-
Have you considered a chin wing? Or even a jaw implant? Your bite and upper jaw area look good to me (but I might be completely wrong).
-
Have you considered a chin wing? Or even a jaw implant? Your bite and upper jaw area look good to me (but I might be completely wrong).
Jaw implant no, I think it's not a solution for my problem. I was looking at chin wing surgery but honestly I don't know why should I choose it over double jaw with genio? What are the benefits?
-
I was looking at chin wing surgery but honestly I don't know why should I choose it over double jaw with genio? What are the benefits?
It's a lot less invasive and a lot less can go wrong. Might be cheaper too, depending on where you would get it done.
-
It's a lot less invasive and a lot less can go wrong. Might be cheaper too, depending on where you would get it done.
I'm not sure if it's the ideal solution for me because I'm hoping to get a bit better philtrum to chin ratio and a little bit of better upper lip support with double jaw, but maybe it's just a dream.
-
Thanks! That's all I wanted to know. One of the surgeon I asked only told me to get genio because double jaw in my case wouldn't really make a "dramatic difference".
Non x-ray pictures: https://imgur.com/a/aHIufNN
This is one of those rare cases where I think extracting two lower bicuspids and advancing the lower jaw only, could work...
Upper jaw looks to be in the proper place, face is short, etc.
-
This is one of those rare cases where I think extracting two lower bicuspids and advancing the lower jaw only, could work...
Upper jaw looks to be in the proper place, face is short, etc.
I think Kavan told me the same when I posted my pictures for the first time without x-ray, as an alternative. So I have a stupid question. I supposed to tell this plan to the surgeon and tell him what I exactly want? Because when I communicate with them, they would never even consider the option you mentioned, I only heard this here on this forum before. I mean I'm not an expert and I shouldn't tell (should I) tell the surgeon the method of the whole operation.
And something that really bothers me is my philtrum area which could be a bit improved by double jaw, but maybe I'm wrong. My philtrum looks long and I think my face also would benefit if the philtrum chin ratio could be improved somehow. (Example: when I smile, my lower third looks way more appealing, and I wish to have that ratio.)
-
The surgery isn't nuanced enough to create the exact philtrum that you want.
You shouldn't tell the surgeon what to do, but you can sure ask him if what Kavan and I see is viable, and get their reasoning as to why it isn't (i.e. if they're not recommending it, ask why). Maybe there's good reason we're not thinking of.
-
The surgery isn't nuanced enough to create the exact philtrum that you want.
You shouldn't tell the surgeon what to do, but you can sure ask him if what Kavan and I see is viable, and get their reasoning as to why it isn't (i.e. if they're not recommending it, ask why). Maybe there's good reason we're not thinking of.
Something that I also found that could be an option (maybe I'm totally wrong) is maxillary setback. On the picture I attached the lady shows a little bit similar profile like mine. So what if my maxilla gets a backward movement instead of my mandible a forward one? I thought about this because I have noticeable nasolabial folds around it from really young age. However, I can't see how this works, especially on the attached picture.
-
Fair enough. I'll dig in a bit more, it's just so contradictive. Two doctors told me to get genio. I don't know them, I don't know you, so I'm just trying to use what information I have online and from real doctors so far. Those doctors could perform double jaw but they didn't suggest it. I don't know why, or why not, but I need to consider their opinion too against yours.
That is exactly why a prior existing capacity for grasping concepts along with a basic FOUNDATION to build on is needed to digest or make order out of information. Without a basic capacity to process information along with that already being built on, somewhat via education, people who lack that won't be able to identify which answer makes the most logical sense or otherwise make order out of conflicting information.
Concepts in maxfax are NOT 'rocket science'. Conceptually, it's in the venue of elementary geometry; points, lines, angles, planes, rotations, distance relationships etc. If someone has that under belt, it's the BASIS for grasping the material in the educational links as to which lines are used to evaluate basic distance, angle relationships etc in a ceph X ray. It's needed to have some kind of basis in order to resolve and put into perspective maxfax types of info and relationships. Explanations from me will beyond them to 'digest' or put other feedback into perspective and it will then beyond me to UNCONFUSE them. I can give people information but I can't provide what ever capacity is needed to PROCESS it.
That said, I'll give you the most likely choice based on NOW looking at your X rays and the options suggested to you prior by some surgeons. But if it's something you don't understand or is confusing because you got/get different feedback elsewhere, I'm not going to take this any further as to clarifying all the confusion you have. That's because the interaction in the prior thread: http://jawsurgeryforums.com/index.php/topic,8062.0.html was not one I found fruitful.
The protrusive area seen to the philtal region confirms a prior suggestion you got for an ASO to move back only the protrusive area affecting the nose to lip angle (philtral area). The X ray confirms an excessively high SNA angle and a normal SNB angle. Of the suggestions you got which you listed on your first post to this board, of those choices, the suggestion that includes the ASO along with double jaw and chin is the one to consult further about.So, you'd be looking to consult with maxfax surgeons who ALSO do the ASOs. ASO is not 'total maxillary set back.
-
That is exactly why a prior existing capacity for grasping concepts along with a basic FOUNDATION to build on is needed to digest or make order out of information. Without a basic capacity to process information along with that already being built on, somewhat via education, people who lack that won't be able to identify which answer makes the most logical sense or otherwise make order out of conflicting information.
Concepts in maxfax are NOT 'rocket science'. Conceptually, it's in the venue of elementary geometry; points, lines, angles, planes, rotations, distance relationships etc. If someone has that under belt, it's the BASIS for grasping the material in the educational links as to which lines are used to evaluate basic distance, angle relationships etc in a ceph X ray. It's needed to have some kind of basis in order to resolve and put into perspective maxfax types of info and relationships. Explanations from me will beyond them to 'digest' or put other feedback into perspective and it will then beyond me to UNCONFUSE them. I can give people information but I can't provide what ever capacity is needed to PROCESS it.
That said, I'll give you the most likely choice based on NOW looking at your X rays and the options suggested to you prior by some surgeons. But if it's something you don't understand or is confusing because you got/get different feedback elsewhere, I'm not going to take this any further as to clarifying all the confusion you have. That's because the interaction in the prior thread: http://jawsurgeryforums.com/index.php/topic,8062.0.html was not one I found fruitful.
The protrusive area seen to the philtal region confirms a prior suggestion you got for an ASO to move back only the protrusive area affecting the nose to lip angle (philtral area). The X ray confirms an excessively high SNA angle and a normal SNB angle. Of the suggestions you got which you listed on your first post to this board, of those choices, the suggestion that includes the ASO along with double jaw and chin is the one to consult further about.So, you'd be looking to consult with maxfax surgeons who ALSO do the ASOs. ASO is not 'total maxillary set back.
Thank you Kavan, I appreciate your suggestion. I will look into this, I also believe this would bring the best results for my particular case. In reality it looks a bit scary, it's basically the most invasive surgery a person can get for the jaw (I assume), so there are a lot to consider here. I will consult with the doc who suggested me this, and get back if I have any new information.
Do you know anybody who got this surgery before (here on the forum or generally)? Because it's something I only saw in Korea done on Asian people (which is fine for me), but I have never seen any before-afters on Caucasians. Is it because the problem is so unique or they use different approach in western countries to address the issue?
-
Thank you Kavan, I appreciate your suggestion. I will look into this, I also believe this would bring the best results for my particular case. In reality it looks a bit scary, it's basically the most invasive surgery a person can get for the jaw (I assume), so there are a lot to consider here. I will consult with the doc who suggested me this, and get back if I have any new information.
Do you know anybody who got this surgery before (here on the forum or generally)? Because it's something I only saw in Korea done on Asian people (which is fine for me), but I have never seen any before-afters on Caucasians. Is it because the problem is so unique or they use different approach in western countries to address the issue?
It's not really a 'unique' problem. It's just that that sort of protrusion is more common in Asian countries. you would have to google around to find articles with photos.
-
It's not really a 'unique' problem. It's just that that sort of protrusion is more common in Asian countries. you would have to google around to find articles with photos.
The doctor who recommended ASO, seems to change his mind only to CCW rotation after seeing my ceph.
I contacted the places that do ASO but they all seem to not recommend it, based on my ceph and pictures. I asked them the reason and they said that a jaw rotation alone (that you recommended me in the first place) is enough with genioplasty, because my protrusion is not severe enough to have ASO for it. As far as I understand correctly, my protrusion will remain the same after CCW (should not be worse I assume), which will look 'less protruded' due to the balanced mandible, however there is a chance that my lower third will look too much 'forward' with only CCW and genioplasty.
-
I am Caucasian and had a 4mm total maxillary setback 3 months ago (ASO was originally discussed as an alternative). There are very few non-Asian people that would truly benefit from moving the maxilla back and I really do not think you are one of those. I attached my old ceph so you can see what my maxilla looked like - it truly 'jumped out' of my face plus I had vertical maxillary excess and lip incompetence. Moving the maxilla back was an alternative to over-impaction in my case, but you do not have any of these issues so it would be totally unnecessary for you.
Even for me, I feel like 4mm was too much, it looks okay but if I could go back in time, I would probably ask for 2mm or so and my starting point was 'extreme', unlike yours. In short, based on personal experience, I would not recommend maxillary setback for you (in fact I would not recommend it to anybody unless it is truly an exceptional case).
-
I am Caucasian and had a 4mm total maxillary setback 3 months ago (ASO was originally discussed as an alternative). There are very few non-Asian people that would truly benefit from moving the maxilla back and I really do not think you are one of those. I attached my old ceph so you can see what my maxilla looked like - it truly 'jumped out' of my face plus I had vertical maxillary excess and lip incompetence. Moving the maxilla back was an alternative to over-impaction in my case, but you do not have any of these issues so it would be totally unnecessary for you.
Even for me, I feel like 4mm was too much, it looks okay but if I could go back in time, I would probably ask for 2mm or so and my starting point was 'extreme', unlike yours. In short, based on personal experience, I would not recommend maxillary setback for you (in fact I would not recommend it to anybody unless it is truly an exceptional case).
Thanks! I'm wondering why didn't you get ASO? Maybe it's better for less severe cases or something else?
Btw, the surgeon told me the following for my case about ASO: "Your columella philtrum angle is very obtuse angle. It is not good for ASO." Maybe he is worried if my nasolabial angle will get bigger with ASO? I thought it can improve that angle (make it smaller in my case) but it seems not. I'm wondering if CCW will (could) close the angle a little bit at least.
-
Thanks! I'm wondering why didn't you get ASO? Maybe it's better for less severe cases or something else?
Btw, the surgeon told me the following for my case about ASO: "Your columella philtrum angle is very obtuse angle. It is not good for ASO." Maybe he is worried if my nasolabial angle will get bigger with ASO? I thought it can improve that angle (make it smaller in my case) but it seems not. I'm wondering if CCW will (could) close the angle a little bit at least.
My doctor thought the setback was the best option for me instead of ASO - it's not like you can pick and choose, they have their own reasons why they choose one over the other, considering all aspects of the surgery. I do not understand a lot of these technical terms about angles etc. but attached a before-after picture of a girl; that's pretty much the way my maxilla changed from profile, you can see for yourself. I still do not think this would look good on you but I do not have the terminology to explain why.
-
My doctor thought the setback was the best option for me instead of ASO - it's not like you can pick and choose, they have their own reasons why they choose one over the other, considering all aspects of the surgery. Why do you think the nasolabial angle would get smaller with ASO? Mine got much bigger after the setback which is a good thing in my case as it used to be extremely small (acute, I think they call it?) before. Of course it would get bigger, they are moving the maxilla backwards compared to the base of your nose.
Well I supposed to get a smaller angle (so totally opposite your case), because it's already big. So ASO itself wouldn't do the trick for me, because I need a smaller angle or to not make it bigger at least. I'm not sure if ASO combined with double jaw why not better than only double jaw alone, but the doctor told me ASO is not recommended anymore. CCW with genio was recommended by two surgeons so far after my ceph x-ray. My other option to make the angle smaller is nosejob or philtrum shortening surgery, but it's also a bit complicated. Would be nicer to make it better with jaw surgery but not sure if it's be possible. CCW should make the angle smaller based on my research.
-
Well I supposed to get a smaller angle (so totally opposite your case), because it's already big. So ASO itself wouldn't do the trick for me, because I need a smaller angle or to not make it bigger at least. I'm not sure if ASO combined with double jaw why not better than only double jaw alone, but the doctor told me ASO is not recommended anymore. CCW with genio was recommended by two surgeons so far after my ceph x-ray. My other option to make the angle smaller is nosejob or philtrum shortening surgery, but it's also a bit complicated. Would be nicer to make it better with jaw surgery but not sure if it's be possible. CCW should make the angle smaller based on my research.
I think your upper jaw is fine as is, I do not understand what bothers you about it - yes, CCW should make the angle smaller but as GJ told you before, jaw surgery isn't that nuanced. If you do not like the way your upper jaw looks now, I honestly think you will not like the way it will look after because there is no way to predict down to the millimeter what it will exactly look like. In terms of aesthetics, jaw surgery is mostly about making people look 'normal', not to make an already normal looking person slightly different exactly the way they want it - it simply does not work that way. Honestly, you should just be happy you have an upper jaw that already looks nice / normal - not everyone is quite so lucky.
By the way, you know the picture of the woman you posted earlier - do you happen to have a PDF copy of the whole study? I would be interested in reading it and tried to download it but didn't work for me.
-
I think your upper jaw is fine as is, I do not understand what bothers you about it - yes, CCW should make the angle smaller but as GJ told you before, jaw surgery isn't that nuanced. If you do not like the way your upper jaw looks now, I honestly think you will not like the way it will look after because there is no way to predict down to the millimeter what it will exactly look like. In terms of aesthetics, jaw surgery is mostly about making people look 'normal', not to make an already normal looking person slightly different exactly the way they want it - it simply does not work that way. Honestly, you should just be happy you have an upper jaw that already looks nice / normal - not everyone is quite so lucky.
By the way, you know the picture of the woman you posted earlier - do you happen to have a PDF copy of the whole study? I would be interested in reading it and tried to download it but didn't work for me.
You're totally right about this. I just want to make my mandible look 'normal' compared to my upper jaw, without making my upper area looking worse, that's my expectation of this whole surgery which seems to be achievable. Anything else is plus and hoping not making worse.
About the file, I just downloaded it for you, uploaded here: https://gofile.io/d/atdsXC
Not sure if I can attach this here or share the link, the mods will decide. If not, I'll share with you privately later.
-
You're totally right about this. I just want to make my mandible look 'normal' compared to my upper jaw, without making my upper area looking worse, that's my expectation of this whole surgery which seems to be achievable. Anything else is plus and hoping not making worse.
About the file, I just downloaded it for you, uploaded here: https://gofile.io/d/atdsXC
Not sure if I can attach this here or share the link, the mods will decide. If not, I'll share with you privately later.
Thanks a lot for the link! I managed to download it and just finished reading it. I think it's a realistic goal that you are trying to advance your mandible / chin area without making the upper jaw area look worse, which is why I am saying - as the surgeon told you as well - that maxillary setback or anything along those lines would probably not be a good move in your case. In my case, one of the reasons they wanted to move the upper back was that advancing my chin too much would have given me a too strong chin, but I am a woman with a small face, with you being a man, I do not think they have to worry about advancing your mandible / chin too far forward. If you read the study, you will notice that all patients included were female, and the authors explain - illustrated with pictures - that in their cases, bringing the mandible / chin forward to meet the protruding maxilla would not have looked good, but there should be nothing wrong with bringing the mandible / chin forward on a male (within limits obviously, but your maxilla is not that far forward at all).
-
The doctor who recommended ASO, seems to change his mind only to CCW rotation after seeing my ceph.
I contacted the places that do ASO but they all seem to not recommend it, based on my ceph and pictures. I asked them the reason and they said that a jaw rotation alone (that you recommended me in the first place) is enough with genioplasty, because my protrusion is not severe enough to have ASO for it. As far as I understand correctly, my protrusion will remain the same after CCW (should not be worse I assume), which will look 'less protruded' due to the balanced mandible, however there is a chance that my lower third will look too much 'forward' with only CCW and genioplasty.
Please disclose the answers to the following questions:
---------------------------------------------------------
WHEN did you ascertain a follow up response from the doctor/s who initially suggested ASO but who now doesn't/don't recommend it any more?
a: BEFORE you engaged (recent) feedback from me and subsequent to a CHOICE/decision to OMIT this information.
b: AFTER you got recent feedback from me to consult with doctor/s who do the ASO. For example, you ascertained this NEW info from them within a time span of approx less than 2 hours subsequent to my feedback.
WHICH ONE?
IF 'a', then that would resolve to a decision/choice on your part to engage me in giving feedback in the ABSENCE of information that could have/would have factored into my feedback. So, if 'a',now the ball is in your court to re-adapt or otherwise process my prior response (given in the absence of this information) in accordance to the presence of this information.
IF 'b' then my suggestion to CONSULT with doctor/s who perform the ASO should be sufficient for you to process the 'new' information from them. Also, all the information I provided to you prior http://jawsurgeryforums.com/index.php/topic,8062.0.html should be sufficient.
Best of luck in what ever decision you make.
-
Please disclose the answers to the following questions:
---------------------------------------------------------
WHEN did you ascertain a follow up response from the doctor/s who initially suggested ASO but who now doesn't/don't recommend it any more?
a: BEFORE you engaged (recent) feedback from me and subsequent to a CHOICE/decision to OMIT this information.
b: AFTER you got recent feedback from me to consult with doctor/s who do the ASO. For example, you ascertained this NEW info from them within a time span of approx less than 2 hours subsequent to my feedback.
WHICH ONE?
IF 'a', then that would resolve to a decision/choice on your part to engage me in giving feedback in the ABSENCE of information that could have/would have factored into my feedback. So, if 'a',now the ball is in your court to re-adapt or otherwise process my prior response (given in the absence of this information) in accordance to the presence of this information.
IF 'b' then my suggestion to CONSULT with doctor/s who perform the ASO should be sufficient for you to process the 'new' information from them. Also, all the information I provided to you prior http://jawsurgeryforums.com/index.php/topic,8062.0.html should be sufficient.
Best of luck in what ever decision you make.
I asked the doctors after you suggestion to get ASO. Only one doctor recommended me ASO way before our conversation about it, and then I sent him my ceph (after your suggestion for ASO) and then he changed his mind about it. After this, I specifically asked other docs if they suggest ASO (bigger clinics in Korea), and they did not. So the answer is B. (Btw the 2 hours correct, most Korean clinics have a fast response rate.)
I assume you're a person who's trying to give the 'best' advice possible for people here for the 'best outcome' for their surgery based on your current knowledge in this field, and I assume doctors want the same thing for their patients, especially in a places where most people get maxillofacial surgery only to improve their aesthetics. I'm just curious of your opinion, why do you think doctors so against the plan you suggested me about ASO?
Edit: one of the clinics told me, (a new one I asked) they don't recommend ASO for my case because I might end up look like a 'grandpa'. I assume they mean that my maxilla would too flat after the extraction. They said, they only perform this kind surgery for severe protruded cases. What I don't understand, if they did ASO, they could just move my maxilla more forward to a less protrusive (but still not 'grandpa flat') position to achieve the best results. Anyways, I just wanted to share this, none of the clinics would perform ASO on me so far in combination with DJ/genio.
-
I asked the doctors after you suggestion to get ASO. Only one doctor recommended me ASO way before our conversation about it, and then I sent him my ceph (after your suggestion for ASO) and then he changed his mind about it. After this, I specifically asked other docs if they suggest ASO (bigger clinics in Korea), and they did not. So the answer is B. (Btw the 2 hours correct, most Korean clinics have a fast response rate.)
I assume you're a person who's trying to give the 'best' advice possible for people here for the 'best outcome' for their surgery based on your current knowledge in this field, and I assume doctors want the same thing for their patients, especially in a places where most people get maxillofacial surgery only to improve their aesthetics. I'm just curious of your opinion, why do you think doctors so against the plan you suggested me about ASO?
Edit: one of the clinics told me, (a new one I asked) they don't recommend ASO for my case because I might end up look like a 'grandpa'. I assume they mean that my maxilla would too flat after the extraction. They said, they only perform this kind surgery for severe protruded cases. What I don't understand, if they did ASO, they could just move my maxilla more forward to a less protrusive (but still not 'grandpa flat') position to achieve the best results. Anyways, I just wanted to share this, none of the clinics would perform ASO on me so far in combination with DJ/genio.
I told you that of the PRIOR choices you listed from doctors (in your very first post on this board), the one with ASO option and the double jaw surgery with chin was the closest choice. (kind of like a multiple choice question I also told you to consult with such doctors. You did. (It's always needed to cross reference advice from non-doctors--I'm not a doctor--with advice you get here.) They re-evaluated. I have nothing against their re-evaluation. As to my suggesting the ASO, it was in reference to a doctor telling you PRIOR that would be how to address the protrusion you had and also the SNA angle of the ceph was very high to an area that could be pushed backwards via the ASO.
Did you address your curiosity to doctor/s who initially suggested the ASO as to why THEY suggested that?
That said, the ASO now being ruled out, your choices resolve to a type of surgery that does NOT move the protrusive area any more forward than it is now which could either be CCW double jaw surgery with chin advance OR single jaw surgery with pre-molar extraction to the lower jaw to accommodate a BSSO and chin advancement along with it. You may cross reference either option with what ever surgeons you choose to consult with further.
-
Did you address your curiosity to doctor/s who initially suggested the ASO as to why THEY suggested that?
Interestingly the doctor who suggested me ASO as an option in the first place, didn't really answer why he changed his mind after seeing my x-ray. He told me my columella philtrum angle makes me a bad candidate for ASO (after seeing my x-ray and some new pictures I sent).
What I suspect is that the pictures I sent that time were with a bit longer beard and that might alter his view on my upper jaw area, and now it cleared out with the x-ray and pictures with shaven face.
-
Interestingly the doctor who suggested me ASO as an option in the first place, didn't really answer why he changed his mind after seeing my x-ray. He told me my columella philtrum angle makes me a bad candidate for ASO (after seeing my x-ray and some new pictures I sent).
He did answer you (angle etc.), and other doctors also explained to you why this pretty extreme procedure to bring the maxilla backwards is not for you. You should be grateful that they are being honest with you - they could just agree to do anything for money if they wanted to. ASO cannot be done in 'degrees', they remove teeth and bring the whole maxilla back quite a bit, maybe as much as 7-8mm? I am telling you from my own personal experience that bringing my maxilla back 4mm changed my face lots and I feel it was slightly too much, and look how much more protruded my maxilla was compared to yours - I attached a before-after picture of my profile (no I was not smiling in the before photo, that was my face at rest). ASO would be a disaster on your face, be happy people are telling you that now so you do not have to find out the hard way when it's too late.
One of the reasons ASO is common in some parts of Asia is that their beauty ideal is very different from Western ideals; they tend to dislike a strong jawline / chin even on males, so they prefer to bring everything back instead of advancing the lower part to match the protruding maxilla. You are a Western guy living - presumably - in a Western country, why would you want a flat face and a weak chin / jaw to match? Does not make any sense.
-
He did answer you (angle etc.), and other doctors also explained to you why this pretty extreme procedure to bring the maxilla backwards is not for you. You should be grateful that they are being honest with you - they could just agree to do anything for money if they wanted to. ASO cannot be done in 'degrees', they remove teeth and bring the whole maxilla back quite a bit, maybe as much as 7-8mm? I am telling you from my own personal experience that bringing my maxilla back 4mm changed my face lots and I feel it was slightly too much, and look how much more protruded my maxilla was compared to yours - I attached a before-after picture of my profile (no I was not smiling in the before photo, that was my face at rest). ASO would be a disaster on your face, be happy people are telling you that now so you do not have to find out the hard way when it's too late.
One of the reasons ASO is common in some parts of Asia is that their beauty ideal is very different from Western ideals; they tend to dislike a strong jawline / chin even on males, so they prefer to bring everything back instead of advancing the lower part to match the protruding maxilla. You are a Western guy living - presumably - in a Western country, why would you want a flat face and a weak chin / jaw to match? Does not make any sense.
You're absolutely right and I agree with you about western/Asian beauty standards too. And yes, the docs also told me that ASO is mostly used in severe cases, and mine is not in that category. Thanks for your replies and that you shared your story with me!
-
Thanks for your replies and that you shared your story with me!
No problem, I thought it might be useful for others reading this too, in case they are interested in total maxillary setback - it is quite uncommon so there isn't much information available about it. I am grateful for the study you shared, very interesting for me. Hope you find a doctor that can recommend the most suitable surgery for you and that you will be happy with the result.