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General Category => Functional Surgery Questions => Topic started by: akvist1234 on February 14, 2014, 05:55:59 AM

Title: Need some jaw surgery advice
Post by: akvist1234 on February 14, 2014, 05:55:59 AM
First time poster here... i have a couple of issues with my jaw/face alligment that i can't quite wrap my head around  so i'm hoping for some feedback. also my english is not that great so i hope you understand me :D...anyway, i was in braces for 4 years (crowding, deep bite)....my teeth were extremly crowded and they were tinted inwards....while the ortodontic work did give me straight teeth my functional and estethic issues remain....

Functional :
have trouble chewing on the right side (it seems my jaw is slanted)
right side of my face seem to be less functional apparent whem smiling or talking-less bone support?)
mouth breathing during sleep
excess saliva
occasional clicking noises

Esthetic :
midface/paranasal flatness (dull/flat face expression)
lip incompetence (lower lip protrudes/also upper&lower lip don't quite match together)
fleshy/childlike apperance (even when BF is low)
dented mouth area/nasolabial  lines (funny enough this was less obvious during the ortodonthic work due to the bulk of the braces)

So my guess is retrognathic profile/recessed maxilla...would i be a good candidate for maxillomandibular advancement? I did some email consultation with dr yaremchuk in the past but he only mentioned midface deficiency ( he advised orbital rim/cheekbone implants). if my jaws are recessed i think i would get a more natural result with jaw surgery. would jaw advancment have a positive impact on the midface?

http://imageshack.com/a/img716/1596/7bav.jpg (http://imageshack.com/a/img716/1596/7bav.jpg)
http://imageshack.com/a/img703/281/yu0d.jpg (http://imageshack.com/a/img703/281/yu0d.jpg)
http://imageshack.com/a/img827/3961/dh15.jpg (http://imageshack.com/a/img827/3961/dh15.jpg)
http://imageshack.com/a/img196/9704/5xyp.jpg (http://imageshack.com/a/img196/9704/5xyp.jpg)
http://imageshack.com/a/img401/8693/513y.jpg (http://imageshack.com/a/img401/8693/513y.jpg)
http://imageshack.com/a/img268/8609/ka9d.jpg (http://imageshack.com/a/img268/8609/ka9d.jpg)
Title: Re: Need some jaw surgery advice
Post by: PloskoPlus on February 14, 2014, 11:09:50 AM
I don't see any obvious deformity.
Title: Re: Need some jaw surgery advice
Post by: sean89 on February 14, 2014, 01:30:16 PM
I don't see any obvious deformity.

Nor do I.

I can't see how jaw surgery would improve your face aesthetically.
Title: Re: Need some jaw surgery advice
Post by: nrelax11 on February 14, 2014, 01:42:36 PM
Yea I also dont see anything wrong. Yes your lower lip protrudes a little but I doubt anyone notices or looks at it.
Title: Re: Need some jaw surgery advice
Post by: akvist1234 on February 14, 2014, 01:48:52 PM
i was thinking that maxilla advancement would give me more paranasal/philtrum support. my upper lip hangs down at the corners giving me a kind of a frowning expression. there's also a lot of space beetwen my teeth and philtrum/upper lip so when i smile or talk my teeth are only 50% visible at most. Aesthetically speaking i was more satisfed while wearing braces due to to the added mouth/lips support.
Title: Re: Need some jaw surgery advice
Post by: Tiny on February 14, 2014, 04:12:26 PM
I see an everted lower lip.  However, it looks like you no longer have a deep bite so it's hard to say what's causing it

If you get an X-ray and you have a small airway and 2 recessed jaws then yes, you could get a bimax advancement.  It can be hard to tell from external pictures if the jaws are recessed.  There are people here who have posted pics that look OK but have 2 pretty recessed jaws
Title: Re: Need some jaw surgery advice
Post by: akvist1234 on February 14, 2014, 05:13:04 PM
Lower lip sticking out is really baffling since i didn't have that before braces. Also, my lips had a slight upward turn at the corners. So much for the orthodontics. 4 years of braces and my after photos look like before photos.

http://imageshack.com/a/img196/4673/buz5.jpg (http://imageshack.com/a/img196/4673/buz5.jpg)
http://imageshack.com/a/img542/801/xuxl.jpg (http://imageshack.com/a/img542/801/xuxl.jpg)
Title: Re: Need some jaw surgery advice
Post by: PloskoPlus on February 15, 2014, 08:02:00 PM
How much tooth and gum show do you have when smiling?  You look like you are forcing your teeth to show in those pics.  This could be indicative of a recessed maxilla.  Your lower jaw profile looks good, but I think it's mostly due to the long (horizontally, vertically it's good) chin, so your mandible could also be recessed (obviously you can have a good relative bite when both jaws are recessed).  You need to see a surgeon - a couple of them, in fact.

With regards to facial fleshiness.  I have an underbite.  My maxilla is definitely retrognathic, my mandible is most likely prognathic.  I lost a bunch of weigh recently and have been the leanest possibly ever (six pack not far away).  Yet my skin is fleshy around the lower jaw.  Could be just the s**tty way body fat is distributed.
Title: Re: Need some jaw surgery advice
Post by: akvist1234 on February 16, 2014, 01:58:21 AM
I have zero gum show and only my upper 4 teeth are visible unless i go for a forced joker-like smile. There's just a lot of space beetwen my teeth and lips, dental arches provide minimal support for the lips. I guess i could build up maxilla projection with some veneers but probably only by a 1mm and anyway that wouldn't solve my structural issues.

http://imageshack.com/a/img198/2373/sjpw.jpg (http://imageshack.com/a/img198/2373/sjpw.jpg)
Title: Re: Need some jaw surgery advice
Post by: joesun on February 16, 2014, 01:46:15 PM
A lot of people chimed in and I agree that you do not need jaw surgery.  You look fine.  If you are seeking perfection through jaw surgery then you might be disappointed.

Title: Re: Need some jaw surgery advice
Post by: Kristen on February 18, 2014, 07:25:21 PM
No jaw surgery... You look great.. Be happy
If you have to get a filler to mid face o give more volume in that area
Title: Re: Need some jaw surgery advice
Post by: PloskoPlus on February 19, 2014, 12:48:32 AM
No jaw surgery... You look great.. Be happy
If you have to get a filler to mid face o give more volume in that area
Nothing beats bone.  Filler may work for women.
Title: Re: Need some jaw surgery
Post by: PloskoPlus on February 19, 2014, 12:54:53 AM
I have zero gum show and only my upper 4 teeth are visible unless i go for a forced joker-like smile. There's just a lot of space beetwen my teeth and lips, dental arches provide minimal support for the lips. I guess i could build up maxilla projection with some veneers but probably only by a 1mm and anyway that wouldn't solve my structural issues.

http://imageshack.com/a/img198/2373/sjpw.jpg (http://imageshack.com/a/img198/2373/sjpw.jpg)
There are people who have normal occlusion, but do double jaw surgery for sleep apnea.  I read a blog of this red haired girl who did this.  To be honest I think she looked better or no worse before the surgery.  He jaws look a bit protrusive after (maybe it was the swelling, can't find her blog anymore).  Don't remember her smile.  But a very weak smile usually means the maxilla is recessed.  Since your occlusion is normal, you'd have to advance both jaws, and maybe shave down the chin to keep your profile in check.
Title: Re: Need some jaw surgery
Post by: overbiter on February 19, 2014, 04:18:06 PM
There are people who have normal occlusion, but do double jaw surgery for sleep apnea.  I read a blog of this red haired girl who did this.  To be honest I think she looked better or no worse before the surgery.  He jaws look a bit protrusive after (maybe it was the swelling, can't find her blog anymore).  Don't remember her smile.  But a very weak smile usually means the maxilla is recessed.  Since your occlusion is normal, you'd have to advance both jaws, and maybe shave down the chin to keep your profile in check.

You mean this girl? http://unrulyslumber.wordpress.com/2013/04/12/8-month-time-lapse-profile-swelling-changes/ (http://unrulyslumber.wordpress.com/2013/04/12/8-month-time-lapse-profile-swelling-changes/)
I think she looks good after. Her jawline is super strong in the after pics, it would look terrible if it was slightly longer but it's still aesthetic. Maybe she had a big chin before the surgery and that's what made her jawline look normal, even though it was recessed.
Title: Re: Need some jaw surgery
Post by: PloskoPlus on February 19, 2014, 11:36:12 PM
You mean this girl? http://unrulyslumber.wordpress.com/2013/04/12/8-month-time-lapse-profile-swelling-changes/ (http://unrulyslumber.wordpress.com/2013/04/12/8-month-time-lapse-profile-swelling-changes/)
I think she looks good after. Her jawline is super strong in the after pics, it would look terrible if it was slightly longer but it's still aesthetic. Maybe she had a big chin before the surgery and that's what made her jawline look normal, even though it was recessed.
Thats her.  I didn't know about scleral show when I first saw her blog last year.  I can see now that the surgery fixed hers.  Good stuff.
Title: Re: Need some jaw surgery advice
Post by: Ben on February 20, 2014, 07:33:33 PM
Anyone know how much her upper jaw was advanced? What method was used.. was it by leforte 1 method with the use of surgical plates? I think her results are great.
I'm going to have another advancement surgery since my last one only moved me 2mm and I need about 4mm and I was wondering how it would effect my nose.