Author Topic: Advancing the upper lip?  (Read 4657 times)

Gregor Samsa

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Advancing the upper lip?
« on: December 26, 2013, 02:33:09 PM »
I had upper jaw surgery some time ago to correct an underbite and I'm not happy with the result. For some reason my upper lip did not get advanced or enlarged when the upper jaw was moved forward so now there's a downward slope near it when you look at my face from the side. Because of this, it still looks like I have a bit of an underbite even though my occlusion is now good. Anyone have any ideas of what went wrong or what could be done?

Gregor Samsa

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Re: Advancing the upper lip?
« Reply #1 on: December 29, 2013, 03:42:35 AM »
It looks like the upper jaw was not advanced enough even though the occlusion now looks good. I'm not sure how that is even possible...

Kristen

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Re: Advancing the upper lip?
« Reply #2 on: January 06, 2014, 12:05:48 PM »
Easy fix.....fillers or fat in upper lip

Tiny

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Re: Advancing the upper lip?
« Reply #3 on: January 06, 2014, 02:19:46 PM »
Easy fix.....fillers or fat in upper lip

Yes will probably help.  Will fill the lip and rotate it outwards.

Gregor Samsa

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Re: Advancing the upper lip?
« Reply #4 on: January 08, 2014, 01:36:52 PM »
Fat injections in the lips seem to be controversial. I looked at Realself.com and most of the surgeons there said that fat injections will either go away entirely with time or even worse, cause lumps. I haven't seen any good results from lip enlargement to be honest and this definitely sounds like something that could end up looking plasty and fake.

Modigliani

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Re: Advancing the upper lip?
« Reply #5 on: January 08, 2014, 03:17:04 PM »
Yeah, not a good look on a bloke.

Gregor Samsa

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Re: Advancing the upper lip?
« Reply #6 on: January 08, 2014, 05:18:43 PM »
I have no idea what can be done to be honest. I spoke to my orthodontist and she said that the teeth are in a good position and can't be moved much more without ruining the bite (i.e. decompensation to allow more jaw movement is not possible). I haven't seen any x-rays since the surgery but it certainly looks like there's a skeletal imbalance. It's quite a strange situation...

I wonder if placing hydroxyapatite on the upper jaw would be possible? I'm not sure how you could do that without affecting the teeth though...
« Last Edit: January 08, 2014, 05:33:54 PM by Gregor Samsa »

notrain

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Re: Advancing the upper lip?
« Reply #7 on: January 09, 2014, 09:18:33 AM »
were you on a nonextraction plan for decompensation?

you can always get more decomp if you extract premolars. In case of your underbite, if you extract upper premolars and retract the upper front segment, you can advance the upper jaw much further afterwards than without extractions. You would also have had a truly massive underbite after decompensation right before surgery. Judging from the pictures you provided, Mommaerts didn't have enough room to put the maxilla in an aesthetically pleasing position. So he moved it forward as much as possible while retaining proper occlusion. That's not really a surgical error but rather poor planning between ortho and surgeon - if you needed extractions for decomp and didn't have them.
Of course such things require good teamwork between the ortho and surgeon, not sure how this would work with a belgian surgeon and a swedish ortho. I know the general consensus in this forum regarding extractions, but I have come to believe that for optimal results they are (sadly) necessary. At least in the jaw that's deficient, i.e. class 3s need upper premolar extractions + bimax and class 2s need lower premolar extractions + bimax.

Gregor Samsa

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Re: Advancing the upper lip?
« Reply #8 on: January 09, 2014, 09:24:46 AM »
I haven't had any extractions and no one has suggested it either. The surgery itself went well and like I wrote above, I don't think he's made any surgical errors except perhaps my genioplasty that has left me with saggy skin under the chin/neck. The surgical plan however was just wrong considering what I had requested so I have no idea why no one even discussed extractions with me if that would've made it possible to advance the upper jaw further.
« Last Edit: January 09, 2014, 09:37:02 AM by Gregor Samsa »