BSSO+Le Fort 1 w/ CCW rotation but no Sliding Genio? Surgery Question

[Picollo30]

Max fac surgeon is not doing sliding genio he says he wants to see how the first surgery goes without it, and if needed he will do it in a second intervention. is the 2 jaw advancement sufficient to bring the chin forward or it depends on the degree of retrusion that the patient have?

I wont lie i'm scared that the jaws advancement is not sufficient and by advancing the maxilla through the lefort he overcorrects my problem, and i end up looking like a chimpanzee, with a flat face. In these cases where there's OSA involved but no gummy smile, is the maxilla moved much? I want him to be conservative with the lefort but i want him to give me more chin projection even without a sliding genio.

Is this achievable?

[molestrip]

If you're got no gummy smile and a weak chin, then sounds like you've got a steep occlusal plane. CCW rotation can bring forward the mandible a lot. SG adds a little, often not worth it IMO, especially when the midface remains in place. I've seen an MMA in person, the chimp look is overdone IMO. 90% of people love the aesthetic result. The only surgeries with real bad outcomes I've seen are those with straight advancements where CCW rotation was needed.

[TMKA]

I think the chimp look is only a concern for people who have an underbite and are only having a lefort without the bsso, but thats just my opinion.

[Picollo30]

If you're got no gummy smile and a weak chin, then sounds like you've got a steep occlusal plane. CCW rotation can bring forward the mandible a lot. SG adds a little, often not worth it IMO, especially when the midface remains in place. I've seen an MMA in person, the chimp look is overdone IMO. 90% of people love the aesthetic result. The only surgeries with real bad outcomes I've seen are those with straight advancements where CCW rotation was needed.

yes i have a steep occlusal plane. but it depends how much of the maxilla is advanced right? another question molestrip i have mandibular assymetry  that makes one side of the face fuller than the other which looks flat, do you think the bsso will minimize it (knowing of course that everyone has a small amount of assymetry) ?

[molestrip]

I can tell you're an anxious patient like me lol. Detials for the surgeon but yes, they can advance each half of the mandible different amounts.