jawsurgeryforums.com
General Category => Aesthetics => Topic started by: jawprobs16 on July 09, 2016, 09:19:32 AM
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Hello everyone. I had lower jaw surgery (BSSO) for my underbite and crossbite 3 months ago. At first I was supposed to have double jaw surgery because my teeth were not leveled. My surgeon and ortho deemed a 3 piece lefort unnecessarily risky (that was the only way to level the teeth) so they said they could easily level the teeth with orthodontics. After that, my surgeon said my upper jaw didn't need to be touched because everything was fine with it. Now, I feel like my upper jaw should have been worked on. I feel it is recessed and I have vertical maxillary excess, though I'm not sure if the gums showing are just due to inflammation of having braces for so long because before braves I did not have a lot of gum show. Do you guys think I have a recessed maxilla/should have had my upper jaw advanced? need honest evaluations! first ceph is before, last ceph is after surgery
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If you have a Ceph X-Ray to share, it would be easier for people to evaluate?
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They keep saying my jpeg image is too big
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here is my lateral ceph after surgery
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here is a ceph of me before surgery
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How many millimetres did they setback your lower jaw?
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6 mm
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Your bite looks really good now and it doesn't look like you have maxillary excess from your pic. The reason you might feel you can see gum might be due to the protrusion of the teeth making your lips curl. Doing a Lefort 1 to reduce the maxillary would also mean you have to have lower jaw surgery as well to rotate the lower jaw ccw, so your bite fits again. This will also make your face slightly shorter. If you are going to do surgery again, I would get the maxillary rotated cw as well as reducing the height, to get correct the protrusion of the upper teeth and remove the support of it pushing your lips up and out.
How long left have you got to have braces on?
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Probably 2 or 3 more months. So my maxilla isn't recessed? I still have a bit of a long face, but I don't know if it's worth another surgery. My surgeon said he didn't do the upper forward becaus she felt that it would push my nose and lips too far out since they already push out naturally. Overall, do you think I should or should I just leave it how it is?
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Also does it look I need a genioplasty?
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I can't make that decision for you, but your maxilla doesn't need to go forward at all because it's already protruding. It all depends how unhappy you are about it really, if you feel that your face is too long and you really want to change it, then go for the surgery. But it all depends on how badly you want it.
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Is my midface flat though? Because when I smile or laugh my chin looks so bulky?
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Tooth show, profile look good. The chin is a bit rounded in profile, but it's normal for black people. You could probably make it sharper with genioplasty, but I'm not sure if it would look good (would not fit your lips). Was the frontal picture taken by a surgeon or orthodontist?
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No I took it
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No I took it
Bear in mind that I'm no doctor andd lens distortion from small cameras can make people look very different in selfies vs photos taken by a proper camera.
http://www.stepheneastwood.com/tutorials/lensdistortion/index.htm
I think your main problem is not that your face is long, but that it's narrow which makes you think that it's long. Your cheekbones look deficient and you look narrow jaw angle to jaw angle from the front..
The cheekbones can be addressed with a zygomatic osteotomy. It mainly gives width and a bit of forward projection under the eye (which you could do with as well). The jaw angles could be improved with a chin wing osteotomy (the chin could be narrowed a bit at the same time).
An alternative is implants. They can be made into any shape. The downside is quite a bit of foreign material in your face which could get infected even decades after surgery. With osteotomies, especially zygomatic, the result is highly predicated on your initial bone shape (but chin wings can be repeated multiple times to build up more and more bone where you need it, although resorption is a real risk). But the only foreign material with osteotomies are the plates, which are highly unlikely to get infected and are easy to take out and can even be taken out as soon as the bone heals (a year after surgery).
Your nose is quite wide from the front (it should be within the inner corners of your eyes). Narrowing it would make your face look wider. Rhinos are seriously hard to get right, so it would be the last thing i would do and only with the best possible surgeon. A bad nose job can absolutely ruin a face.
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So if my cheekbones are deficient does that mean my maxilla is recessed? That is my main concern. I'm not too concerned about my nose or anything like that. My chin does feel a bit wide. I don't know if that's because the upper jaw should have been brought forward or I'm swollen or that's just how my bone structure is
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So many people keep telling me my upper jaw is fine and that advancing it would adversely affect me. So I don't know what to tjink
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Your maxilla definitely is not recessed. Why do you think it is?
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Because I feel like my upper set of teeth don't project forward a lot. I think that may be due to the braces. I also feel like when I smile or laugh, my jaw and chin look really bulky so I think it's due to my maxilla being recessed but I may be wrong.
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They project forward more than enough
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Do braces just tend to retract incisors a bit? And what about my chin and jaw looking bulky? Do u think that's just my bone structure??
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For example in these photos I feel like everything looks setback. I keep comparing myself to other people I'm around.
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It doesn't look setback at all. Your smiling in the pic so when you smile the muscles around your mouth tighten and pull the soft tissue closer to the bone. You look fine though, you've not actually got a gummy smile. Have you got a profile pic exactly side on without you smiling?
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Yes I do
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I think your projection is fine. As for your chin, I have a similar problem when I smile my chin seems to get wider. I think its the muscles as Vic pointed out. Maybe Botox to help relax muscles would help, but I dont know how it would affect smiling. Also Botox is expensive since you have to keep getting it to maintain results. A genioplasty might help if its a bone issue, but if its soft tissue I dont know. Maybe you should consult a PS? Im hoping that my Lefort 1 will help solve my issue with my chin but now I dont think it will. Im not too worried with it, I think that no one really notices it as much as I do. Im just worried that after jaw surgery is done Im going to focus more on my other flaws and want to get them fixed as well. Seems like everyone on this board is obsessed with perfection (so am I) lol.
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What malocclusion do you have now? See that's why I was thinking that my upper jaw would fix that issue, but then again I feel like that doesn't make a difference. I know a woman who had double jaw surgery and she still had the same issues with her chin. I'm just hoping that it's swelling. I plan to ask my surgeon about it soon. It's not so much chasing perfection, I just want this all to be worth it and for me to be happy in the end. I feel like I've lost confidence since this surgery and I honestly would rather look how i looked before to be honest. Something just seems off about my face to me.
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Your profile is right for you ethnicity. What do you feel is the issue with your chin? do you think its too flat and doesn't have the
curve around it? Having upper jaw surgery won't do anything to your chin only a sliding genioplasty can change it.
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I feel like it is very bulky and round when I laugh or smile. It makes the Lower half of my face look huge.
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Well I had an underbite but got it corrected with elastics when I was from 11-17yrs. My bite now is almost class I after 2 1/2 yrs 2nd roumd braces. I still have stubborn crossbite on my right which makes my whole face assymetrical (esp when I smile). This is what bothers me most, as my ortho flared out my teeth and made the assymetry worst than prior to my 2nd round. Which is why I am now on a mish to get jaw surgery (although my ortho thinks i dont 'need' it). My jaw itself may be a class III. You have a nice bite and beautiful smile, which Im sure everyone notices and not your chin. However if it would make you happier I would def look into genioplatsy. Im thinking of that myself if the final results arent good enough. Korea seems to have nice results with chin feminization. I mean they have a technique that makes the jaw softer and less prominent. One other thing I was reading about was buccal fat removal, but I dont think it applies to you.
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I don't know something just doesn't look quite right about my face. That's why single jaw surgery sint very common. It's not aesthetically pleasing.
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I think you look good. The only suggestion would be a genioplasty to give you more projection and shape of the chin, but I wouldn't touch anything else other than that
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Ok I agree with that. I want my chin to be less round and softer on the edges into a point. What exactly would I tell my surgeon for me to obtain that
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Just tell them exactly what you just said and what you want, from that they'll know exactly what needs to be done
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Ok. Another point of mine is even when I talk it looks like you can barely see my teeth