Info regarding Recessed Maxilla w/ Prominent Cheekbones

[ababc]

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

[Modigliani]

Fantastic cheekbones!

[Tiny]

Well, should be easier than for most class 3s then!  Regular Le Fort 1 does not touch the cheekbones 

[dantheman]

Can you post a profile pic? (as in directly from the side). It reveals more about jaw relationships than the frontal shot can.

[ababc]

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

[PloskoPlus]

Check above post

Post a picture of yourself smiling hard.

[notrain]

Your Maxilla isn't recessed, for instance the nasolabial angle is acute and not obtuse. You have a normal asian face.

[ababc]

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

[Optimistic]

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.

[PloskoPlus]

IANAD, but you look normal to me.

[LoveofScotch]

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!

[dantheman]

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 

[PloskoPlus]

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.

[Optimistic]

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 

I thought "proclined teeth" don't really affect soft tissue by any noticeable amount. At least that's what orthos say.

[LoveofScotch]

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.