jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: ababc on July 27, 2014, 01:02:29 PM
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Hi jawsurgeryforums! I am 25 years old and have a very unique problem that has bothered me for years and I want to get around to finally consulting / getting surgery to fix it. I have prominent cheekbones and a recessed and extremely wide posterior maxilla making my midface seem very dented in with deep nasolabial folds while the outer corners of my face seem very prominent. It also creates weird contour a pan smashed midface with concave cheeks (which actually looks fine in top down lighting). However, my nasal base is behind my orbital rim in profile. (Think of my facial profile from the eyes to maxilla like this: /) On top of this I also have slight bimaxillary protrusion of my incisors. I did have braces when I was younger which I think proclined my upper incisors like \ to meet with my lower incisors. Overall, my face appear extremely weird with this combination of prominent cheekbones, recessed maxilla, and bimaxillary protrusion and I want to get braces and move my maxilla forward to correct this problem. My quest is mostly cosmetic, as I do not have any serious functional issues except maybe teeth grinding and some joint pain near my jaw joints. I used to have extreme masseter hypertrophy but I stopped eating super hard foods / do not chew hard foods all the way because I would redevelop the extreme masseter hypertrophy that really hurts my jaw joints. I also know for a fact that my airway is also tiny as I have had asthma my entire life and I snore despite being relatively skinny. I have read a little about jaw surgery and leforts and I was wondering if anyone knew more about this and of any reputable surgeons in the Northern New Jersey area.
Thanks!
I'll try to show a profile later to clarify my situation
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Fantastic cheekbones!
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Well, should be easier than for most class 3s then! Regular Le Fort 1 does not touch the cheekbones :)
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Can you post a profile pic? (as in directly from the side). It reveals more about jaw relationships than the frontal shot can.
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Can you post a profile pic? (as in directly from the side). It reveals more about jaw relationships than the frontal shot can.
Check above post
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Check above post
Post a picture of yourself smiling hard.
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Your Maxilla isn't recessed, for instance the nasolabial angle is acute and not obtuse. You have a normal asian face.
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Your Maxilla isn't recessed, for instance the nasolabial angle is acute and not obtuse. You have a normal asian face.
I believe the nasolabial angle is not always indicative of if the maxilla is recessed or not. My front teeth are just extremely angled like this \ on my maxilla. If you look at the base of my nose you will see that it is behind the outermost point of the orbital rim. And yes asian faces are flat but even flat faces should have the maxilla lined up to the eye like this: |. When I had braces when I was younger, it only masked my maxilla by moving the teeth forwards like \. When I smile, my nose actually droops downwards because there is less support from my incisors
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Your Maxilla isn't recessed, for instance the nasolabial angle is acute and not obtuse. You have a normal asian face.
This is how I feel too. I can't see how advancing the maxilla would result in anything but some serious bimax protrusion relative to the rest of the face.
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IANAD, but you look normal to me.
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Take this for what it's worth; I'm still learning. You look completely fine, and in your case I would not recommend doing anything for aesthetic reasons alone, but I think there are a few things to consider.
You're really young to be snoring, and that unfortunately usually only gets worse with age. Like you said, that's probably not a good sign, but before doing anything I would address why you're snoring. If you have a deviated septum (or whatever) just fix that without ripping your entire face apart. It sounds like you're either having joint pain, or muscle pain, from chewing and surgery can either make that better or WORSE. Also, if your top front teeth were flared outward by your orthodontist, and that's the only reason your bite is alright, I would be cautious of the long term stability. If that was the case, then I guess I would consider surgery. If you do go ahead with this I would be super conservative. You have a good face, and good bone structure, and I would be afraid an aggressive movement would give you a bit of a 'chimp' look. I don't mean that in a bad way, at all, it's just something that can happen so plan accordingly.
Cheers!
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This is how I feel too. I can't see how advancing the maxilla would result in anything but some serious bimax protrusion relative to the rest of the face.
I guess it depends. If the maxillary incisors are as proclined as the illustration depicts them, then that might cause the illusion of maxillary prognathism...
I snore too man, not every night, but some nights it gets pretty horrific. Not a good feeling when you are skinny. Well skinny fat, who am i kidding :o
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I see what you're getting at better from your profile view. See a bunch of max fac surgeons, see what they say. But you look above average as it is.
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I guess it depends. If the maxillary incisors are as proclined as the illustration depicts them, then that might cause the illusion of maxillary prognathism...
I snore too man, not every night, but some nights it gets pretty horrific. Not a good feeling when you are skinny. Well skinny fat, who am i kidding :o
I thought "proclined teeth" don't really affect soft tissue by any noticeable amount. At least that's what orthos say.
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If I were in your shoes, and had both snoring issues (caused by airway stuff), and my upper front teeth had been flared outward to give me a proper bite, then I would have surgery. Snoring seems to get worse with age (and weight), and teeth that have been flared outward seem to ultimately want to find their original 'home' again. I have an impossibly low risk tolerance, but in your case, for the two reasons listed above, I think surgery may make a lot of sense.
Stuff like this gets way more difficult to plan/find the time for as we get older.
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I think you're over-estimating by an extreme amount the degree to which proclined teeth affect soft-tissue.
To me you just look like a very typical asian. By that I mean an overwhelming majority of asians would look better after a le fort iii. Flat faces and bimaxillary protrusions are common traits amongst that race.
Admittedly I haven't followed the entirety of this thread, though I will say if your concerns are aesthetic I'd agree with what others have mentioned regarding paranasal implants and such. Especially given that your bite is class I. Only if it would solve some other issue such as snoring would it be worth it.
You won't look better after surgery.
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To me you just look like a very typical asian. By that I mean an overwhelming majority of asians would look better after a le fort iii. Flat faces and bimaxillary protrusions are common traits amongst that race.
That's a bold claim. Le Fort III can make the eyes look smaller.
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"Asians" don't need le fort III that is crazy talk. lol. And don't be racist and stereotype all asians in the same category. Some asians actually have VERY well developed mid faces, SO DON'T BE JEALOUS.
So what am I jealous of again? I didn't catch that part.
Calm down with the political correctness. Believe it or not we aren't all the same. Asians DO have flatter faces.
My point about the lefort III was simply that so many asians have flat faces to the point where you could look at them and say "Yea, they'd look better after invasive surgery", but ultimately they are within the confines of what is considered normal for their race. So unlike a European, a flat face wouldn't be a compelling justification for jaw surgery. Especially when it'll make their bimax protrusion even stronger.
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Asians don't all have the same faces, stop being a f**king idiot. How's that for not being politically correct?
Asians are actually known for having higher and more prominent cheekbones and also more developed maxillas and arches and that doesn't qualify as having a flat face. The flatness perhaps is mainly due to the nasal bone not being as forward as on a Caucasian face.
Once again not all asians have the same problems, japanese tend to have longer flatter faces, whereas a south east asian would have a more of a rounder face etc but even this is stereotyping because there's many varieties of facial types and dental occlusions.
Also i didn't say we are all the same, but we can definitely have the same or similar occlusion problems.
And you are WRONG about asians looking better le fort iii, because it would make their already prominent cheekbones even more forward (and not to mention wider) and also make their eyes smaller. East asians tend to have flatter foreheads, so bringing the cheeks and mid face out by surgical means would look even more weird. I suppose now you will say they would look better if the entire frontal cranial base was brought forward ::) I'd say that in reality there is no need for invasive surgery for non medical reasons, even if they have flat faces by your standards. Asians faces look damn good as they are. By asian standards, a standard caucasian face look "abnormal" but ultimately they are within the confines of what is considered normal for their race.
Your post is reminiscent of the radical feminists and progressives who spout logical fallacies and makes straw man arguments to justify their positions.
What I said:
"Asians do have flatter faces."
"Flat faces and bimaxillary protrusions are common traits amongst that race."
And your response:
"Asians don't all have the same faces, stop being a f**king idiot."
Seems like you're the f**king idiot for not understanding what was very clearly a generalization. I didn't say 100% of asians without fail have flat faces, just that it is common for asians to have flatter faces and bimax protrusions. Context is a powerful thing. There is no need to go beyond what I said. To any reasonable reader it should be clear, yet you insist on twisting it to be that I made a hard and fast rule concerning every asian and therefore am racist, jealous, and wrong.
Strangely enough you then went on to write at length about generalizations concerning asian facial morphology. Whatever.
I stand by what I said which is that him having a flat face is not particularly abnormal for an asian, just as his bimax protrusion is not abnormal.
I'm not going to post anymore in this thread as everything that needs to be said has. OP just needs to see someone to find out if jaw position is related to any of his non-aesthetic concerns and go from there.
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Le Fort III also widens the face.
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Just had a consultation with a maxfac near my house and he said that I actually have extreme skeletal bimaxillary protrusion -- meaning the shape of my maxilla is basically flared outwards this way: \. Apparently I have the opposite of what I thought i did -- maxillary prognathism lol. The reason I have kind of poor support around my nose is because the back of my maxilla is too wide compared to the front of the maxilla?? <-- I was kind of confused when he told me this. My airway is kind of small due to a slightly recessed mandible but it shouldn't affect my breathing at night. So the snoring is being caused by something else. No idea what yet but there you have it. I have extreme maxillary prognathism and slight mandibular recession.
P>S. max fax also said that 99% of people with prominent cheekbones have prominent maxillas because they grow together as a unit
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So what does he propose? Don't tell me extract teeth and pull the rest back to reduce the protrusion.
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So what does he propose? Don't tell me extract teeth and pull the rest back to reduce the protrusion.
He proposed that I do nothing as the position of my maxilla/mandible was pretty much in an optimal position already. The arches were a little different though; my maxilla is like a V while my mandible was like a U. He said my orthondotist flared the teeth on the front of my maxilla laterally to account for this. I had diastema, which is a gap between teeth caused by uneven teeth/jaw size. My occlusion plane also starts flat, then descends a lot, then arches back upwards. He said it was good to have slightly recessed mandible and that it was not contributing to the snoring
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He proposed that I do nothing as the position of my maxilla/mandible was pretty much in an optimal position already. The arches were a little different though; my maxilla is like a V while my mandible was like a U. He said my orthondotist flared the teeth on the front of my maxilla laterally to account for this. I had diastema, which is a gap between teeth caused by uneven teeth/jaw size. My occlusion plane also starts flat, then descends a lot, then arches back upwards. He said it was good to have slightly recessed mandible and that it was not contributing to the snoring
What about SAPRE to widen your maxilla?
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Just had a consultation with a maxfac near my house and he said that I actually have extreme skeletal bimaxillary protrusion -- meaning the shape of my maxilla is basically flared outwards this way: \. Apparently I have the opposite of what I thought i did -- maxillary prognathism lol. The reason I have kind of poor support around my nose is because the back of my maxilla is too wide compared to the front of the maxilla?? <-- I was kind of confused when he told me this. My airway is kind of small due to a slightly recessed mandible but it shouldn't affect my breathing at night. So the snoring is being caused by something else. No idea what yet but there you have it. I have extreme maxillary prognathism and slight mandibular recession.
P>S. max fax also said that 99% of people with prominent cheekbones have prominent maxillas because they grow together as a unit
tl;dr I was right.
This is for goodlookingmaxilla ---
(https://img.4plebs.org/boards/tg/image/1373/97/1373972602741.jpg)
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Get a room you two 8)
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P>S. max fax also said that 99% of people with prominent cheekbones have prominent maxillas because they grow together as a unit
Well that's super interesting about cheekbones and maxillas growing together as a unit. So prominent cheekbones = prominent maxillas. Hmm, it seems like that isn't always the case? ???