i can't figure out what is not in balance

[aristidine]

Hey there, I'm a 28 year old female and there are a few things which have been bothering me for quite some time.
I recently had a consultation with a plastic surgeon about these things, and he was the one to suggest consulting with an orthognathic surgeon, so I've been reading all I can in the past week.

I have normal occlusion, and I wasn't a mouth-breather as a kid. That said, my upper and lower jaws seem to be too small for my face, making it look "short" somehow. My face seems to have changed after I had braces as a kid. Before, I had a great facial contour and good incisor show upon parting my lips slightly. When I smiled, the entire top row of the teeth showed. Now, when I part my lips, my upper lip just hangs and there is absolutely no incisor show, not even a milimeter, giving me that toothless look  When I smile, my upper lip covers half of my upper teeth.

I spoke to the plastic surgeon dr. about this thinking maybe a lip lift could solve the problem but he was saying it was a maxilla that hadn't grown long enough. Then I started to think about the rest of the things that concern me about my face and realized, what if it really is a jaw problem? Here's what I'm talking about: I have these 3 lines - 1. under both my eyes 2. deep nasolabial folds, and 3. corners of my mouth. This makes my mid-face feel sunken in or something. There's the incisor show thing I mentioned, and my chin is very quite obviously not in proportion to the rest of my face. I don't have an over or underbite, which is the weird part. Could it be that my jaws just didn't grow big enough, even though they occlude well?

I can't post a photo at this time because my cell camera is non-functional from water damage. Without posting one, I am curious if anyone here with much more than my week's worth of knowledge could offer me some thoughts as to what this could be and what procedures the are to remedy this. I just read about the lefort 2 procedure which brings the mid-face forward. I wasn't really able to find any photos illustrating the difference before and after the procedure.

This is driving me crazy. Any help appreciated!

[aristidine]

Thanks for the replies so far, guys.

I was thinking the same about using plastic surgery when it could be a case of a structural problem, but my upper lip is pretty droopy and as I figure out how the hell I'm going to pay $20,000+ out of pocket (insurance won't cover since it isn't an occlusion issue) for jaw surgery, I thought it could be something I can do to remedy it in the meantime, as well as using fillers to get rid of those nasty nasolabial folds. What's hilarious is I am constantly told by others, much to my chagrin (makes it difficult in the professional world), that I "don't look a day over 20", and yet all these lines and sunken look makes me feel like I look like the people in their 50s who are looking to get a facelift for their sagging face. Aagghhh, so f**king frustrating.

Come to think of it, I think people perceive me as being 8 years younger because my facial skeleton is underdeveloped. So I have this, shall I say, shapeless face. No really good angles of projection, and the features are soft, like my chin, which is waaayy underdeveloped.

[jesterofmalice]

hopefully you can get some picture up, but it sounds fairly similar to me.
I have a fairly shapless face, and it feels chubby, even when I am at a very low bodyfat percentage. (that's when I first finally realised that it wasn't a 'fat' issue, but likely a skeletal one!)

I look a million times better when I give myself a 'facelift' but pulling up my skin, but I realy want to treat the cause rather than the symptom!

I think it's because my jaws are too small and too far back. It doesn't provide enough support for the underlying tissue which I think gives me a 'heavy' appearance.
I have an overbite and a crossbite.
I sometimes think about just getting braces to 'fix' the overbite, but I really CANT ' imagine how that will help/affect my face/appearance at all!
(some say it can, some say it definitely won't)

I'm in the UK.
I'd like to speak to both a functional orthodontist, and also a maxfac surgeon to finally get things clear in my head as to what exactly  the problems are

[aristidine]

my bmi for a female my height and weight is perfect. i calculated it the other day. so yea, can't be that.
i do the "mid-facelift" thing too! 
i'm in this weird place right now where i can't seem to be able to schedule a consultation with an orthognathic/maxillofacial surgeon because of the "must be referred" runaround with my insurance. i'm going to see what happens today when i go see the dentist. even though it wouldn't be any kind of solution, i'd be relieved to know what the damn problem is so i can at least start planning to rectify it.

[aristidine]

i have to see one to get referred to any specialists.

[aristidine]

all right, here's a photo. it's blurred, but you can see the deep nasolabial folds, the droopy upper lip and short/recessed chin.
so i have absolutely NO incisor show upon parting my lips.
i really think there's something i can do to improve these things.. but i have no idea what!



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[Tom2]

OK.

Stop.  Wait a second. Hold the presses.

You're pretty.   Hands down.   No debate.

I don't know how you look smiling and I know that is one of your complaints but I'm looking at an attractive woman.

Keep in mind - if you're talking LF2 or moving your maxilla down  - those are at the low end of the stability scale for these types of surgeries so you should consider the risk very carefully.

[aristidine]

having the maxilla advanced was what the plastic surgeon recommended instead of giving me a lip lift and a chin augmentation. he was trained in oral surgery at columbia, so was able to evaluate my concerns about the maxilla/lack of incisor show.

[babyface99]

yeah your attractive but i can see how a maxillary advancement might help make you hotter

[Tom2]

Ok...I get that the OP may have room for improvement but damn near everyone in the world does.


Now - and I can only speak for myself but - if I were as handsome a man as the OP is a woman - there is no way in hell I would put myself through surgery on my skull to be a bit more attractive.

I think you are beautiful just the way you are.   We are often our own worst critics.

I highly suggest you consider what you are proposing to put yourself through, the risks  - vs rewards and make your best decision.

[Tom2]

don't touch your face.

+1

[PloskoPlus]

all right, here's a photo. it's blurred, but you can see the deep nasolabial folds, the droopy upper lip and short/recessed chin.
so i have absolutely NO incisor show upon parting my lips.
i really think there's something i can do to improve these things.. but i have no idea what!

Your upper lip looks long.  But there are no absolutes with faces. (OK, you could get some statistics of philtrum lengths and see where you fit in, but the ratios matter more.)  So you could lengthen the chin to get the ideal 2/3 - 1/3 ratios between your chin and upper lip, but it won't solve your weak smile.

The long upper lip will still look long after advancing the jaws.  It won't lengthen or shorten, but may in fact look longer being closer to the observer (that's my case).

If your jaws are indeed recessed, I would only do linear advancement of both jaws without lowering the maxilla and then get a lip lift.  Lowering the maxilla is really only done on scrunched up short mid faces.  It's not a very stable operation anyway.  A linear advancement alone will give you more tooth show (also my case, but my tooth show is 1-2 mm less than ideal because of my long upper lip.  I will probably get a lip lift to fix this)

tldr;  I would consult with aesthetically minded maxillofacial surgeons.  More than one.

[aristidine]

what is the difference between the procedures of linear advancement and lowering the maxilla? where would the movement be if it was linearly advanced? the reason i'm trying to learn about all this to begin with is that is what the plastic surgeon concluded needed to be done to get the look i'm after. he didn't want to perform cosmetic surgery because he didn't think it would help at all, which i really appreciate. he could have just as well done them and taken my money. he *did* have very good training at columbia dental college (columbia university), so he was able to evaluate me from that perspective.

i don't have better photos right now, the one i posted was something i dug up. i don't take a lot of photos because of the complaints i've presented here.

@ Mark505, i'm new to this, so i'm still learning. after further reading i understood more what a lefort 2 operation was. you probably didn't start out knowing all about it either 

[Lazlo]

all right, here's a photo. it's blurred, but you can see the deep nasolabial folds, the droopy upper lip and short/recessed chin.
so i have absolutely NO incisor show upon parting my lips.
i really think there's something i can do to improve these things.. but i have no idea what!

well internet insanity strikes again. you look FINE. Pretty, yes. I have a feeling the internet combined with the fact every photo is airbrushed is making people have serious BDD. There are many celebrities who are not as attractive as you are. You have no drooping lip. And the lighting is causing us to even notice your nasolabial folds.

Now, if you can see your teeth when you smile you're fine. Maybe you just need a bit of ortho work to move them a bit out. If having nasolabial folds bothers you just get some filler.

Women aren't supposed to have HUGE chins. Yours is perfectly balanced for your face.

[terry947]

Also if you compare yourself to celebrities, remember that they're hotter because they are celebrities, society told us that they are hot/perfect/or whatever.