How come my orthodontist said i didnt need surgery?

[Picollo30]

5 years of my life wasted with a camouflage treatment that left me the same i was before i went there

look at my ceph

http://i1188.photobucket.com/albums/z416/Picollo30/PAULOMONTEIROCEFALO.png

now look at my front and profile pic, even with the beard you can see that the chin is ery retruded, the same with the jaws.its visible that i have an overbite. i even have a effin gummy smile, non existant cheeks and bad undereye area and facial assymetry, all symptoms of a mouth breather for christ sake.


http://i1188.photobucket.com/albums/z416/Picollo30/Clipboard07.png
http://i1188.photobucket.com/albums/z416/Picollo30/dsdsdd.png

lost money, time and youth 

a friend in another forum gave me an idea of what i would look like with bsso+lefort+genio

http://s9.postimg.org/zdxis6tnz/combined_dsdsdd.jpg

i think its way better than what i look now

[Picollo30]

i did he wants to do bsso+lefort 1, but he has doubts i need malar implants and the genio so i can have a stronger chin. he wants to wait till i do the surgery. i thought these procedures were done all at the same time?

it's 5 long years that i have my braces on. i'm tired of this.

[PloskoPlus]

i did he wants to do bsso+lefort 1, but he has doubts i need malar implants and the genio so i can have a stronger chin. he wants to wait till i do the surgery. i thought these procedures were done all at the same time?

it's 5 long years that i have my braces on. i'm tired of this.

5 years is insane.  I'd skip genioplasty and get a chin wing.

[triot]

Yeah, that morph looks great. But I honestly do not see much difference in the upper jaw from the original. I would just get a ching wing in your place. It would probably come very very close to the morph.

[golden280]

i highly doubt that you can get anything close to that morph, and if you do consider yourself lucky.

If your expecting anything more than that morph your setting yourself up for major disappointment, imo.

[Picollo30]

i highly doubt that you can get anything close to that morph, and if you do consider yourself lucky.

If your expecting anything more than that morph your setting yourself up for major disappointment, imo.

why do you say that?

i have crooked and weak jaws, assymetrical face, gummy smile, very weak chin and also hollow cheeks, you think i will still look the same?

[golden280]

I feel like morphs in general are a bad indicator to what to expect from surgery because it never turns out to be exactly like the picture. How your facial features "gel" with each other afterwards, where the soft tissue sits, the surgeons skill, how conservative he is etc.. that all plays into the final result (in addition to other major things).

My point was your morph looks great and if you can achieve that result with surgery thats fantastic and please keep us updated. But i have my doubts whether or not it can be achieved from your starting point (just my opinion others can disagree) and you even mentioned that you wouldn't be completely satisfied with the morph and thats why i replied like I did. Don't want you to be disappointed if thats the case.

[Picollo30]

here's what patrickb has to say about my case

Piccolo, i could do a more thorough analysis of your face, however from what i see these are my very quick remarks:

-First of all, you had a remarkable improvement from 2010. You say the fat did not take, however i see a huge improvement in your periocular and malar region. What did you do there? if it was just fat injections, it worked very well!!! photos in higher definition would be really appreciated.


-If i were you, i would avoid lefort 1 and bsso and consider Chin wing (maybe repeating it twice for optimal results) and from the photos you posted I DO NOT see the need for a malar osteotomy.

To make a more valid assessment i would need higher definition pictures but also pics of the current occlusion which seems ok to me.

However, i stand by the point that the lefort and bsso seems an overkill to me.

pb

picollo-my evaluation was only aesthetic. considering the functional issues (especially airway space) you might want to consider the surgery, although i really need better pictures.

Consider even if you'll do a lefort and BSSO you MUST have AT LEAST one chin wing, since the gonial angles won't change (probably worsen) after the bsso.

So, if you want to do the orthognatic surgery too, it will be a very very long road and i'm not so sure it's worth it after all these years of orthodontic camouflaging!


But i dont even know what a ching wing is, my max didnt told me about it or if he does it.

[Picollo30]

patrickb also adds this

Yes i see the recessed chin and the asymmetry in your face, and most probably being a mouth breather contributed to causing asymmetries to which already you may have been genetically predisposed.

The asymmetry of the jaw angles and of the mandibular contour MAY NOT be adressed by bimaxillary surgery (while the midlines and gummy smile are adressed by this surgery).

So you NEED chin wing FOR SURE, cosmetically speaking!

[Picollo30]

so what now guys, how do i approach my max fac with this new info? i dont even know if there are max facs that do chin wings in portugal or if chin wing is covered by insurance

[PloskoPlus]

I can understand orthos keeping children in braces for years and years, but I don't understand how they can do it with a straight face to adults.

[Picollo30]

I can understand orthos keeping children in braces for years and years, but I don't understand how they can do it with a straight face to adults.

you bet mate its been 5 years with the braces and maybe 1 more after MMA.

[Alue]

I can understand orthos keeping children in braces for years and years, but I don't understand how they can do it with a straight face to adults.

How can you understand it in children?  8 years during the period of time where the face grows the most is just ridiculous.  Just profiteering off of children.  I still regard having extractions, headgear, and braces when I was a kid as the worst thing that happened to me during childhood.  And my parents were just trying to do a good thing for me, they had the best intentions and were swindled.   

[PloskoPlus]

you bet mate its been 5 years with the braces and maybe 1 more after MMA.

I am not a doctor, but something tells me that camouflage orthodontics are not stable.  Your teeth will probably move back easily.  So you will probably have to get surgery for the sake of a healthy bite long term, let alone aesthetic reasons.

[PloskoPlus]

How can you understand it in children?  8 years during the period of time where the face grows the most is just ridiculous.  Just profiteering off of children.  I still regard having extractions, headgear, and braces when I was a kid as the worst thing that happened to me during childhood.  And my parents were just trying to do a good thing for me, they had the best intentions and were swindled.

Not condoning either, but you see children in braces all the time.  It's almost expected these days.  When I was in school I saw kids wear braces for practically eternity (OK, the younger we are, the slower were perceive time, but still).  That's why the very idea never entered my mind up until a few years ago.  Time flies as an adult, but there is no way I would've signed up if 5 years were on the cards.  In fact, I initially thought that 18 months was my ortho being conservative The first ortho I saw promised 6 months to operation.  LOL, just, LOL.  Ended up doing 13 months pre-op, and almost 6.5 post-op.