jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Aleina8586 on November 17, 2015, 02:14:49 AM
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Hi,
At the moment I live and work outside the U.S. but want to have surgery with Dr. Gunson. How does it work for people who want to have surgery abroad? Ortho and surgeon have to be on the same page... So if I get my braces in an other country is that going to be a pain for Dr. G? Has anyone done this? Also, can a steep occlusal plane be corrected with double jaw surgery?
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If I were you, I'd do nothing. Gunson will probably advise the same. If you want surgery at any cost (pardon the pun), see wolford in dallas. He invented CCW rotation. You may also be able to achieve the same effect with a chin wing (triaca is the best).
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can't see difference.
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If I were you, I'd do nothing. Gunson will probably advise the same. If you want surgery at any cost (pardon the pun), see wolford in dallas. He invented CCW rotation. You may also be able to achieve the same effect with a chin wing (triaca is the best).
Wolford was also in my radar, I didn't know he invented CCW rotation, will definitely check him out.
I kept reading "chin wing" in post titles here but never bothered to look it up, now that you brought it up I did and I think this could actually do the trick. I am impressed with some of the results. My only concern would be needing jaw surgery in the future.. Right now I don't have complications but this could change. Do you know if it can be performed after a chin wing?
Thank you for your reply, you have given me a lot of valuable information!
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Chin wings are impressive, yes. But I suspect that in a lot of the cases they camouflage the underlying problem of a steep occlusal plane. Fwiw, I have the same problem. Imo fixing this underlying problem can really rebalance the face. The CCW cases I saw in Wolford's office were IMPRESSIVE. Although he must've done so many cases, it's easy for him to cherry pick I guess.
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You're extremely attractive as you are, your features are quite striking! I can see you have a strong jawline, I think this looks youthful and fits your face very well. I'm no expert, but your facial structure looks good to me. I know beauty is subjective though, and you should do whatever makes you happy, so good luck!
By the way, I don't think there would be a problem as an out of town patient with Dr Gunson... that's my plan. You can even do a paper consultation first to get an idea of whether it's worth making a visit to their office.
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Chin wings are impressive, yes. But I suspect that in a lot of the cases they camouflage the underlying problem of a steep occlusal plane. Fwiw, I have the same problem. Imo fixing this underlying problem can really rebalance the face. The CCW cases I saw in Wolford's office were IMPRESSIVE. Although he must've done so many cases, it's easy for him to cherry pick I guess.
Exactly. I feel like fixing the position of my jaws should help rebalance the face, I guess I'm just a little worried it won't. In that case I can get a chin wing after everything is 100% healed. I will ask about this one, both are hardcore procedures and I don't want my face to fall off.
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You're extremely attractive as you are, your features are quite striking! I can see you have a strong jawline, I think this looks youthful and fits your face very well. I'm no expert, but your facial structure looks good to me. I know beauty is subjective though, and you should do whatever makes you happy, so good luck!
By the way, I don't think there would be a problem as an out of town patient with Dr Gunson... that's my plan. You can even do a paper consultation first to get an idea of whether it's worth making a visit to their office.
Thank you sj594! I've always felt uncomfortable with the shape of my jaw so your comment definitely made me smile. it's true beauty is subjective but in my case I feel like the abnormal position of my jaws is what is causing the steepness of the occlusal plane I dislike so much.
Didn't know about the paper consultation, that is awesome. Their website is kind of weird, mostly info of the courses they teach. I emailed them a few days ago but didn't hear back, will contact the staff directly, hopefully will have better luck.
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We would need to see pics of your bite before giving opinions but based upon looks alone I wouldn't do anything. Quite honestly, you look like a model. You're gorgeous and do not need any changes to your appearance.
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it looks like your maxilla is slightly recessed resulting in a paranasal hollowing
how is your sna and snb angle?
however i agree that if you only want to get a lower gonial angle and your bite is fine chin wing might be the best choice.
My bite looks normal to the naked eye, but it's not. I feel like my maxilla is slightly recessed (like you said) and my lower jaw should be pushed back. Also, my orthodontist managed to close my open bite but it still doesn't close ALL the way down like a normal bite. He was able to get a good result but the underlying problem is still there.
I will consult with at least three oral and maxillofacial surgeons before taking the next step (Gunson and Wolford are on my list), hopefully soon I will have a clearer view of what's wrong with me and what are the steps I need to take to fix it. I'm 27, it's time to bite the bullet, this has been bothering me for too long.
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We would need to see pics of your bite before giving opinions but based upon looks alone I wouldn't do anything. Quite honestly, you look like a model. You're gorgeous and do not need any changes to your appearance.
Wow thank you treevernal, what a nice thing to say. Im honestly surprised that you don't think it looks off... I'm always looking at people's jaws (since I dislike mine) and I feel like my jaw angle is crazy steep and throws everything off. If my bite was perfect I would probably just accept it but i think fixing it might help making it better. I am consulting a few doctors before going forward, if they think it's not worth the pain then I will just learn to accept my face as it is and move on.
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My advice is not to do anything. Your jaw looks good now. The amount you might gain with surgery is small and you risk making it worse. This stuff is not an exact science. If you do decide to proceed with surgery, use the search function and read about the risks and failed outcomes forum members have written about so you go into it fully informed.
That is actually very good advice, thank you FaceNit. I have to admit I have focused on the good transformations and not so much on the complications because we tend to think it won't happen to us. I haven't read anything bad about Gunson so far, that's kind of why I want to go with him, but I know that even the best doctors can have a bad outcome. Thank you for the reminder, I appreciate it :)
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Wow, you look stunning already! What's your opinion on married men ten years older with facial deformities? :P
I have a steep mandible too so I understand your concern but you should know that you don't just change the gonial angle. To do that you'd need to alter the ramus height, which isn't possible today. To change the gonial angle you need to advance both jaws which alters facial balance. Can't tell just from the pics you posted (need imaging) but I'd be more concerned about any long term health implications if any, steep angles and female are generally not a good combo and I've read some literature suggesting jaw surgery to prevent TMD is indicated. I'd also like to see your airway. I'm not thrilled about compensatory orthodontics, all this evaluation should have been done first, but it's done already. Surgery out of country shouldn't be an issue btw but there are many good surgeons out there. Dr G is a wonderful man with a great reputation and an easy choice but by no means the only one.
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Very stunning and sexy. I would be careful. Perfect is the enemy of good. When you have a not good looking starting point there is room for improvement. If you have such good looks already, there is much more chance to see little improvement or to make a mistake. Not many surgeons can make such a goodlooking face look better. Much more chance to not look better afterwards or even worse.
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Wow, you look stunning already! What's your opinion on married men ten years older with facial deformities? :P
Hahah that made me laugh, you forgot to add great sense of humor.
I'm not going to lie, my main goal is to achieve a nice looking jaw and reduce some of the height but future health problems are also on my mind.
Wait, did you have an anterior open bite before? That changes things! Do you have teeth pics from before ortho to share?
Well I started my treatment really young, I want to say 9 years old?
I've read that ortho sometimes can make it impossible (or very difficult) for someone to have jaw surgery in the future, especially if they extracted teeth... That scared me because I remember I had 2 extractions. I guess I'll just have to wait for my consults and see what's up. I had my treatment done so long ago that I barely remember what was done.
The fact I had an anterior open bite before changes things? For the worse or for the better?
I live in Dubai at the moment so unfortunately I have zero options locally, any surgeon I choose will be out of the country.
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you look perfect already don't have surgery
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Very stunning and sexy. I would be careful. Perfect is the enemy of good. When you have a not good looking starting point there is room for improvement. If you have such good looks already, there is much more chance to see little improvement or to make a mistake. Not many surgeons can make such a goodlooking face look better. Much more chance to not look better afterwards or even worse.
Thank you for your lovely comment Schrodinger :) I loved what you said about "perfect is the enemy of good", you are very wise. However I do feel I have a lot of room for improvement in my jaw area haha but I do know what you mean... After going through the forum and reading about some of the complications (scary stuff) I am not feeling 100% sure about my decision, I think I will only go ahead with it if the OMS says it's something that untreated will bring me problems in the future. I think going into this only for the aesthetic aspect is a bit too risky. Thank you for the advice!
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I think you look better than Barbara Palvin 8)
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Thank you for your lovely comment Schrodinger :) I loved what you said about "perfect is the enemy of good", you are very wise. However I do feel I have a lot of room for improvement in my jaw area haha but I do know what you mean... After going through the forum and reading about some of the complications (scary stuff) I am not feeling 100% sure about my decision, I think I will only go ahead with it if the OMS says it's something that untreated will bring me problems in the future. I think going into this only for the aesthetic aspect is a bit too risky. Thank you for the advice!
Glad to hear your re-thinking it a bit. I don't need to tell you that you look attractive already and that your jaw looks good. Definitely have a consult with Dr. G, in person if possible, I suspect he'll point out some minor issues but say you don't need it. I don't recommend consulting with Wolford, he is a pioneer and one of the best however he will push for completely joint prosthetic replacement if you have even minor tmj issues.
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I have only one question: are you single?
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I'm not going to lie, my main goal is to achieve a nice looking jaw make @molestrip babies.
FTFY. For your convenience, I happen to be on the way too.
I've read that ortho sometimes can make it impossible (or very difficult) for someone to have jaw surgery in the future, especially if they extracted teeth... That scared me because I remember I had 2 extractions :( I guess I'll just have to wait for my consults and see what's up. I had my treatment done so long ago that I barely remember what was done.
Not necessarily, it just has to be undone. At your age, probably not an issue. But you can't get those teeth back. You could get implants. Ultimately, your goal would be to re-center teeth in the alveolar bone. If you do have an underlying facial deformity, then there may also be thinning of cortical bone, adding insult to injury. Still, that stuff is very common in society these days, 25% of Americans lose all their teeth by 60.
The fact I had an anterior open bite before changes things? For the worse or for the better? :-\
Depends on your perspective. It means you do indeed have a steep incline and, as a woman, you'd be at high risk for joint problems down the line. I don't know if surgeons will want to make that prediction, if they did many of us would never get to this point. At a minimum, you'd want to watch for sleep apnea as you age. By my observation, AOBs often pass as normal, attractive even, despite notable skeletal abnormalities. You'd get something close to the jaw you wanted at least.
I live in Dubai at the moment so unfortunately I have zero options locally, any surgeon I choose will be out of the country.
Syria isn't far and surgeons probably not too busy this time of year.
Surgery in general is nasty, avoid it like the plague. This one in particular comes with a lot of cost, risks, and compromises. The vast majority turn out well but you have so much to lose and even a good outcome for others might be terrible for you. Many of us don't mind losing feeling to lips, gums, palate, etc if it means keeping our teeth in the long run for example or not dieing of a heart attack in a decade because we can't sleep. Joint and airway problems are terrible, if your mandibular plane angle is over 40deg then I say go for it.
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I think you look better than Barbara Palvin 8)
Lol @chinnychinchin even though that's definitely not the case, your comment made my day. Thank you!
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FTFY. For your convenience, I happen to be on the way too.
Haha @molestrip you crack me up ;D
Not necessarily, it just has to be undone. At your age, probably not an issue. But you can't get those teeth back. You could get implants. Ultimately, your goal would be to re-center teeth in the alveolar bone. If you do have an underlying facial deformity, then there may also be thinning of cortical bone, adding insult to injury. Still, that stuff is very common in society these days, 25% of Americans lose all their teeth by 60.
Phew! Good to hear it can be undone, probably more complicated though... I need to find an excellent orthodontist. How did you find yours?
Depends on your perspective. It means you do indeed have a steep incline and, as a woman, you'd be at high risk for joint problems down the line. I don't know if surgeons will want to make that prediction, if they did many of us would never get to this point. At a minimum, you'd want to watch for sleep apnea as you age..
Yes, that is always on my mind. The right side of my jaw makes a clicking sound when I open really wide and it worries me. That's also why I feel I should just get it over with now rather than later, but man reading about some of the complications got to me, it is such an invasive procedure.
Syria isn't far and surgeons probably not too busy this time of year.
Hahah that's true
Surgery in general is nasty, avoid it like the plague. This one in particular comes with a lot of cost, risks, and compromises. Many of us don't mind losing feeling to lips, gums, palate, etc if it means keeping our teeth in the long run for example or not dieing of a heart attack in a decade because we can't sleep. Joint and airway problems are terrible, if your mandibular plane angle is over 40deg then I say go for it.
I agree. It makes sense when your life is on the line. This forum has helped me a lot, I was SET on having the surgery but now I do want to know if it's actually necessary to avoid future health issues. Will be updating ;)
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I don't recommend consulting with Wolford, he is a pioneer and one of the best however he will push for completely joint prosthetic replacement if you have even minor tmj issues.
@ForeverDet thank you for the heads up! it is always good to know about these things in advance, I really appreciate It :) did you have surgery already?
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Haha I'm not, but I might be in a few months if I decide to go ahead with surgery lol he thinks I'm insane for wanting to cut my jaws :-\ people with normal bites never understand :'(
Well then I say do it. By the way I'd go with Sinn. What you want is your ramus dropped. Blus the other stuff.
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Seeing someone as beautiful as this dissatisfied with their appearance... aaand now I feel like jumping off of a cliff. I would legitimately kill to have jaw structure as normal looking as yours. :/ I hope you can sort out any functional issues you have, because honestly your cosmetic issues are minor at worst. Good luck
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Phew! Good to hear it can be undone, probably more complicated though... I need to find an excellent orthodontist. How did you find yours?
Another orthodontist refused to work with me when he heard the surgeon name and gave me names of big guys in town. Not sure my ortho was good though. I've had better experiences with younger guys actually.
Yes, that is always on my mind. The right side of my jaw makes a clicking sound when I open really wide and it worries me. That's also why I feel I should just get it over with now rather than later, but man reading about some of the complications got to me, it is such an invasive procedure.
Sucks :( Very common though. It may resolve on its own. Surgery can worsen joint problems too. The one to watch out for is progressive ICR, that is arthritis of the joint. Once it starts, you won't be a great surgical candidate anymore. The key is to see what your imaging looks like and if you can kill a few birds with one stone while it's still fixable. Hopefully, everything will look good. Honestly near you, see if you can get to Dr Alfaro in Spain or someone in Israel to be closer. Get some imaging done and post it here. Look near dental schools, ideally professors with side practices. Anyone who does a lot of surgeries.
I agree. It makes sense when your life is on the line. This forum has helped me a lot, I was SET on having the surgery but now I do want to know if it's actually necessary to avoid future health issues. Will be updating ;)
Aesthetics and health are often related. We're all very intrigued by your case but we need more pictures, xrays, nudes, whatever. Or at least /r/gonewildsmiles.
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@ForeverDet thank you for the heads up! it is always good to know about these things in advance, I really appreciate It :) did you have surgery already?
No prob. Yes I did, I have a thread in the overbite forum.
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I'm new to this so take this for what it's worth.
After analyzing your photos, I think perhaps the women in your "desired "photos have more forward projection (i.e. more distance between the ear and lips). And perhaps more square jaw angles, but I honestly don't think it's the result of your maxilla's downward projection (or bad/clockwise rotation) since your features line up nicely in profile view. I could be incorrect. But you have a nice chin and labiomental sulcus (plus perfect forehead height IMO). If you look at my profile picture in my thread, you'll see a difference between you and me in those regards.
Honestly, I tend to analyze people's facial features a lot given my insecurities about my own, and if I saw you in real life, your needing any form of surgery (aesthetically speaking) would not cross my mind at all.
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Seeing someone as beautiful as this dissatisfied with their appearance... aaand now I feel like jumping off of a cliff. I would legitimately kill to have jaw structure as normal looking as yours. :/ I hope you can sort out any functional issues you have, because honestly your cosmetic issues are minor at worst. Good luck
+ 1. What Icy says.
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Seeing someone as beautiful as this dissatisfied with their appearance... aaand now I feel like jumping off of a cliff. I would legitimately kill to have jaw structure as normal looking as yours. :/ I hope you can sort out any functional issues you have, because honestly your cosmetic issues are minor at worst. Good luck
You are so sweet @Icy, thank you for your kind words :) I haven't seen your jaw but trust me, we are our worst critics. We look at ourselves with a magnifying glass and think others do too. I'm clearly not the person to be preaching about self acceptance but hopefully you won't feel alone in this. Everyone has problems. His are as big to him as mine are to me and yours are to you. I'm trying not to obsess about it anymore because life sure as hell won't be perfect after surgery either (even though it feels like it sometimes). Wishing you the best of luck!
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Sucks :( Very common though. It may resolve on its own. Surgery can worsen joint problems too. The one to watch out for is progressive ICR, that is arthritis of the joint. Once it starts, you won't be a great surgical candidate anymore. The key is to see what your imaging looks like and if you can kill a few birds with one stone while it's still fixable. Hopefully, everything will look good. Honestly near you, see if you can get to Dr Alfaro in Spain or someone in Israel to be closer. Get some imaging done and post it here. Look near dental schools, ideally professors with side practices. Anyone who does a lot of surgeries.
@molestrip you have been so helpful, I really appreciate you taking the time to share your expertise!
I'm actually going to be in Madrid the second week of January so I'm taking a train to Barcelona to see Dr. Alfaro. They confirmed my appointment via text, but did not send any information to my email, which was annoying. It's going to be a long ass train ride so I expect a full evaluation and a plan, not a 10 min consultation. I sent them an email with my questions and waited 2 days, I sent them another one and the customer service person finally replied. Apparently she forwarded my email to the person in charge.. I literally asked 3 basic questions.. It's been 2 days and still no answer, so we'll see what happens, so far I'm not impressed. Arnett/Gunson are definitely more professional in this regard.
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Maxilla looks recessed, so I would bring that forward.
jaw angles can be improved with chin wing yes, but good luck finding anyone in america who does that with any degree of proficiency. Best option there would be custom ramal implants. You'll be done in one operation.
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Maxilla looks recessed, so I would bring that forward.
jaw angles can be improved with chin wing yes, but good luck finding anyone in america who does that with any degree of proficiency. Best option there would be custom ramal implants. You'll be done in one operation.
If the surgeons I'm consulting don't think double jaw surgery is worth it, I would look into it for sure. I was reading that Dr. Yaremchuk is the wizard of face implants.
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If the surgeons I'm consulting don't think double jaw surgery is worth it, I would look into it for sure. I was reading that Dr. Yaremchuk is the wizard of face implants.
Look into CT Bone. That's been posted around here and has a bit of hype behind it.
As for your face, firstly, you are attractive. Your profile is aesthetic. HOWEVER, your upper lip is positioned behind your lower lip. This would indicate the maxilla is recessed. The options are either advance maxilla and create a more ante face (good) or bring lower jaw back and flatten the face (very bad, just f**k my s**t up type stuff). Please do not bring the lower jaw back. Such a bad idea no matter what the surgeon tells you.
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How's your tooth show? Can you post a picture of your smile from the front?
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You are so sweet @Icy, thank you for your kind words :) I haven't seen your jaw but trust me, we are our worst critics. We look at ourselves with a magnifying glass and think others do too. I'm clearly not the person to be preaching about self acceptance but hopefully you won't feel alone in this. Everyone has problems. His are as big to him as mine are to me and yours are to you. I'm trying not to obsess about it anymore because life sure as hell won't be perfect after surgery either (even though it feels like it sometimes). Wishing you the best of luck!
Thank you, though I'm an artist and I call it as I see it. My facial problems are likely impossible to fix considering my entire facial structure is messed up, regardless of possible future surgery. You look completely normal and attractive. If you can let go of your obsession before you do something cosmetically regrettable, then do what you can to reduce the risk of later health problems and let it be. I'm sure it impacts your life to be psychologically focused as intensely inwards as one must be when confronting such problems, I know it impacts mine quite severely. I hope you can get the results you wish for nonetheless.
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Okay I'm reading all of this over again and listen, why are you going to see Dr. Alfaro??
Listen, go see Gunson/Arnett and they will give you a proper, honest assessment of what needs to be done. They will also print you out a plan. They'll suggest HA paste for the jaw angles and rotating the lower jaw.
That said, I would then take that to see Dr. Sinn and have him do the surgery because he will drop your ramus to give you the square jaw and angles you want (in addition to the CCW along G/A's lines). But if Gunson/Arnett discourage you from sugery just don't do it. If they actually think your health will benefit from it, then proceed on your own account.
You're already around the 10 zone appearance wise (can't see you body which plays a factor obvs but still). You are legitimately a stunner and I don't use that term often. Beauty and G/A's analysis wrote about is so holistically related to skin quality and hair lustre and other factors --you have all that in spades. You're the complete package. If they discourage you from it, or say you're not in the health risk zone, walk away from this forum and enjoy your life. Honestly, I even find the steeper angle of your jaw aesthetically more compelling and striking than the square jaw you want. You're a beauty.
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please put your pics back up for research purposes :P