jawsurgeryforums.com
General Category => Aesthetics => Topic started by: castaway123 on February 02, 2022, 12:22:47 PM
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Hey all, new member here. I have a upcoming consultation for a bimax operation with possible genioplasty, was wondering if bimax with linear advancement or CW rotation would be possible to achieve the result wanted, the pic with me jutting jaw shows the asthetic result I would kike achieve with regards to adding height and projection to my lower jaw, i realize that jutting the lower jaw out and down isnt an accurate way to show how I would like the result to look but the overall height and projection gained from simulating a jaw jut is what I would want from the bimax. Please let me know if this is a realistic amount of verticality and projection I could achieve, I’m willing to advance the upper jaw forward if it means I can get the desired amount. But let me know you opinions please.
Thank you.
Pics will be posted below as im on my phone and the picture sizes are too large
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Having trouble posting pic lol says file size for 1 pic is too large lol
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Do you have any medical records we can look at?
It's going to be impossible to say much based on those photos.
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DECLINED:
Reason: The OP already knows jaw jutting is not a realistic expectation to have as to outcomes that can be predicted for him from here. Yet he's wanting to know how realistic it is (and with a beard mind you).
It's impossible to advise someone like that. But based on the very QUESTION being illogical.
The translation of the question is: 'I know this isn't realistic way to convey what I want but I need to know how realistic it is to get it.'
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Thank you for the replies.I actually do have a ct scan record along with scans of my upper and lower palate that were mailed to the surgeon as trying to get the images to display on my laptop was giving me a headache. I will get the ct side view and frontal view. What are some medical records that would prove helpful besides the ct scans and dental arch scans?
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What are some medical records that would prove helpful besides the ct scans and dental arch scans?
Those should be good, but front and side x-rays showing the TMJ are also nice. If the surgeon gives you a plan post that, too.
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@GJ @Kavan
Here are some topographs I was able to get to display, I ended up getting the whole file list of the ct so there are some other Coronal, Saggital, and axial views although I don't know much about them. I also am not sure if the TMJ is clear here in regard to what GJ suggested for but let me know.
Thanks
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Also yes, the two white teeth are implants
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Looks more like a rhino case to me than a maxfax case. When you say tooth 'implants', you mean tooth (and its root) extracted and being replaced by implants implanted into the bone right (as opposed to CAPS over the teeth but nothing screwed into the bone).
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Yep drilled into the bone, the ortho and surgeon have decided to work around the implants during pre surgery orthodontics. The case itself isn't really a case, I mean I have a class 2 malocclusion on the left side of my face but the right is normal, I forgot what kind of class 2 it was but I'll get back to that with more details and the surgeons preposed plan. I've had TMJ in the right side of my jaw since i was 15 and there used to be pain, but over the years its just evolved into annoyance..popping, locking and clicking at random times when I eat but thankfully no pain, the primary reason though is for a improvement in side profile and a taller lower third of the face like the pics show when i jut, I basically want as much lower third height as the pic of me jutting.
Would I be better doing a procedure without any CW rotation just to bring the jaw forward and them improve the verticality with implants/genio?
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Doesn't look like a situation where I would advise in favor of maxfax. If your doctor is, then ask him how he emulates jutting.
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One of the few times I disagree with Kavan here. Your jaw “structure” looks super solid (ramus length, angles, etc) but it does look a bit recessed given your overbite, lip position and deep labiomental fold.
I would guess, and I’m no doctor, that lower jaw surgery would give you a better profile, fix your overbite, but wouldn’t change your look from the front at all.
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One of the few times I disagree with Kavan here. Your jaw “structure” looks super solid (ramus length, angles, etc) but it does look a bit recessed given your overbite, lip position and deep labiomental fold.
I would guess, and I’m no doctor, that lower jaw surgery would give you a better profile, fix your overbite, but wouldn’t change your look from the front at all.
There's actually nothing to 'disagree with Kavan' about because I didn't actually advise him other than to ask his doctor. But be my guest and advise him on the questions he's asked.
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Can you upload a larger version of the images to imgr? If those are the actual size, there are free AI enlargers out there that will make the image bigger and clear.
I wouldn't touch the nose, btw...very solid, masculine nose.
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Here are the ct Scans resized by about 400% let me know if this is clear enough. @Kavan Regarding the maxfac he acknowledged my jutting question and said he would be able to achieve the desired vertical height in lower third and said that the movement itself wasn't drastic or too much. I think he said something in the realm of 4 mm of upper advancement and 6-8 for the lower jaw but I'll get the definite numbers today when I speak to him so take that with a grain of salt for now. Don't plan on touching the nose as in person it looks more proportioned than the ct scan shows.(beard helps)@GJ. @eastcoastasian1 I believe even a BSSO movement by itself would change the front view at least in a small way as the surgeon showed me how advancement linearly would in of itself add some verticality due to the angle the upper and lower jaws but of course aesthetically I desire some more so thats where the upper jaw movement might come in, or like I suggested maybe implants combined with a genio. (He plans on doing the genio anyways for the chin).
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Here are some 3d views, if too small I'll resize, if these or the other resized scans are also too small let me know Ill end up posting em on imgur
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That helps.
You have a bit of a Morgan Dollar profile. It's not a bad thing at all, and it's pretty classic, but at the same time your labiomental grove is very deep and maybe giving an illusion of recession. I think the best thing would be to get a genio only and fill in the labiomental grove with either a bone graft or HA, and then maybe elongate it slightly (gain vertical height). I think all of your "problems" can be addressed via genio. I don't see anything on those scans that warrants double jaw surgery. I'm not even seeing bite problems in those scans. It's hard to tell, though. Even though you enlarged them, it's just hard to see detail in the bite.
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Thanks for the insight, I do have a slight overbite. Hopefully I could gain the desired height through genio work and gain slight projection through a bsso only movement. My ortho said minor movements tend to have a higher rate of relapse so I'm a little conflicted on that and any opinions on relapse would be appreciated. I had subpar oral posture my whole life but have been practicing good tongue posture over the last 2 years so hopefully my chances of relapse are low, the issue was always keeping the tongue up near the front/tip of my mouth near the incisors and that COULD be why the front portion of the face looks slightly recessed. The maxfac himself suggested a bsso only movement after the incisors were de compensated after pre-surgery braces as a possibility. The aesthetic result I want isn't drastic as many have told me. But whatever gets me the vertical height I desire is what I plan on going with.
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Let me make clear that the reason/s I am NOT advising the OP to pursue maxfax surgery regarding the AESTHETIC reason he's pursuing it, in particular, any advice as to what he should ask his surgeon to do toward aim or reproducing the look of a 'jut out' jaw, is because I SEE that any PERCEIVED jaw or chin recession is actually an ILLUSION directly attributable to the nose being OVERLY PROJECTED. As a knowledgeable information provider on here, it is as CLEAR to me that the nose has an overly projected ANS and also an overly prominent dorsal hump. As to how 'solid' his nose may be, it is the reason his lower jaw area looks RELATIVELY recessive to him and the reason he's jutting out his jaw in an attempt to 'balance' an IMBALANCE coming from the nose itself. So, from an AESTHETIC perspective, the act of wanting to 'balance' the jaw with an IMBALANCE coming from an overly projected nose stands to result in more aesthetic imbalance. So, I'm electing to play NO PART in giving any aesthetic advice as to how to achieve his aesthetic goal OTHER than conveying that the goal of trying to reproduce the look of a jutted out jaw is a misdirected one when there is neither recession nor lack of chin length and that it's all an ILLUSION coming from the nose. The illusion (of recession) is NOT coming from the overly acute lip to chin groove.
Other reasons include a less than 'long' chin and overly acute lip to chin groove is PERFECTLY NORMAL for someone with a LOW MPA , a very SOLID mandible and an AMPLE projected CHIN. Aesthetically, this is often referred to FAVORABLY as 'SQUARE JAW' and is something many pursue. Also, the tooth IMPLANTS don't allow for moving the implants via braces in prep for a surgery that requires moving the teeth. Add my not actually seeing bite issues.
All that said, from my POV, he's asking for advice on how he can achieve a misdirected aesthetic goal which is why I'm electing to not give him any toward that goal. Others may...as long as I'm on record here for discouraging it.
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@kavan Just looking at a glance it looks like I have a shorter lower third in proportion to the rest of my face, the pics have most of my face blurred out but I could show you what I mean with better pics(Would have to PM tho). This has nothing to do with the nose since you cant even see my midface in the frontal pics. The lower third doesn't quite match my face or rather is not in proportion. This doesn't mean that I have any underlying skeletal issues but it does mean i have room for aesthetic improvement to balance out the way my lower third/chin is. AGAIN not in width, gonial angle, or any other vector but purely vertical projection. NOW, I've already said I am considering a genio/maybe implants to add verticality. To reiterate, its clear to me that my face could do with a little vertical height increase aesthetically, key words being "A LITTLE". Forget the jaw surgery in this case as I've said I would consider genio/implants. I AGREE reducing the nose would help in a profile view but the nose has no effect on how MY lower third looks in relation to the rest of the face from a FRONTAL view. Now...if you think I shouldn't look for an aesthetic goal because you think I look fine (forget the nose) then thats your opinion and I appreciate it but I've already made up my mind that I'm not just gunna sit here grow a beard out and train neck 3 days a week. You could give me a nose job but my chin/lower third would still look slightly short compared to the rest of my face from the front.
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@kavan Just looking at a glance it looks like I have a shorter lower third in proportion to the rest of my face, the pics have most of my face blurred out but I could show you what I mean with better pics(Would have to PM tho). This has nothing to do with the nose since you cant even see my midface in the frontal pics. The lower third doesn't quite match my face or rather is not in proportion. This doesn't mean that I have any underlying skeletal issues but it does mean i have room for aesthetic improvement to balance out the way my lower third/chin is. AGAIN not in width, gonial angle, or any other vector but purely vertical projection. NOW, I've already said I am considering a genio/maybe implants to add verticality. To reiterate, its clear to me that my face could do with a little vertical height increase aesthetically, key words being "A LITTLE". Forget the jaw surgery in this case as I've said I would consider genio/implants. I AGREE reducing the nose would help in a profile view but the nose has no effect on how MY lower third looks in relation to the rest of the face from a FRONTAL view. Now...if you think I shouldn't look for an aesthetic goal because you think I look fine (forget the nose) then thats your opinion and I appreciate it but I've already made up my mind that I'm not just gunna sit here grow a beard out and train neck 3 days a week. You could give me a nose job but my chin/lower third would still look slightly short compared to the rest of my face from the front.
Than do what you are going to do anyway. I just wanted to make clear WHY I'm electing not to advise you.