Author Topic: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????  (Read 4382 times)

Lazlo

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Okay from across this thread and I didn't want to single out anyone but I am included in this poll before and after surgery of class II's still seem to show that an aggressive genioplasty in all cases (whether we compare men and women or even Arnett and Gunson (who do very large lower jaw movements) or the run of the mill surgeon we still see the lower LIP behind the UPPER LIP)

What is with that???? My Lower lip is behind my upper (and hence it looks like my lower jaw is still defiecient) even though my lower jaw is behind upper). And I mean I specifically showed my dr. pictures of what I wanted.

Now of course it may be swelling but six weeks will DEFINITELY be enough to tell to what degree my surgery was successful. Let me show you examples of profile view where the lower jaw is more ideally in line with upper jaw. And if this isn't the "norm" then it's at least the hollywood ideal which I was hoping for. And if I require another surgery for it, will it really be a chin wing that just affects the chin, or another BSSO entirely?????? I'm afraid it may be the latter.











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Lazlo

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #1 on: August 06, 2016, 11:25:18 AM »
see how in the upper people's results the lower lip is in line if not in front of the upper lip!!!! For me and I've seen everyone else who had jaw surgery that I can see on this site the upper lip is significantly farther back even though it looks like there has been a significant advancement.

PloskoPlus

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #2 on: August 06, 2016, 02:37:33 PM »
Not enough ccw. I had a curled up lip when I had an underbite. Decompensating the teeth made my lip vertical. Advancing the upper jaw linearly put the upper lip ahead of the lower. My occlusal plane angle is 15 degrees. Wolford says it should be 8-12 for everybody. My surgeon says that's crap. Wolford has great results, mine does not.

Lazlo

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #3 on: August 06, 2016, 05:59:41 PM »
Not enough ccw. I had a curled up lip when I had an underbite. Decompensating the teeth made my lip vertical. Advancing the upper jaw linearly put the upper lip ahead of the lower. My occlusal plane angle is 15 degrees. Wolford says it should be 8-12 for everybody. My surgeon says that's crap. Wolford has great results, mine does not.

oh is there someway you can find out the measurement for mine? I had lip eversion through really great V-Y plasty. Sinn is part of Dallas surgery club so maybe he did a good job, but then again, I got a linear advancement but with CCW. I'm looking at hardcore CCW results like Marisama's on the private board plosko and all these guys have the same problem worse than mine. Upper lip hangs over the lower lip. So just be careful your prejudices or what should i call it your frustration is not making you blind to empirical results. Like CCW class IIs who had massive rotation and lower jaw advancement have the same issue even though they should not right?

Maybe in my case it's swelling ?I'm 11 days out of surgery, should I even be looking at results? Things could go any which way.

I mean I'm absolutely not afraid of getting a redo or revision since this surgery is WAY easier than I ever imagined and I could totally do this again for a better result.

I'm really happy with my result overall and I anticipate I'll get more procedures for sure, so you won't disturb my mental health either way, just help me with your analytic and scientific knowledge.

So I should look for occlusial plane of 8-12???? Sounds good, will check this with max fac here in Toronto this week.

Lazlo

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #4 on: August 06, 2016, 08:16:30 PM »
Guys, you know Im a veteran here and have probably thought about facial and specifically jaw aesthetics enough for more than one lifetime. But I'm having like one of those revelation moments like at the end of THE USUAL SUSPECTS or SIXTH SENSE where the hero has like this rapid flashback containing innumerable shots of almost every aspect of his life --that's what's happening me now with Jaw surgery and my result as I realize that for a result to be truly excellent the lower lip/jaw must be perfectly aligned with or in front of the upper jaw.

NOW there are exceptions. Like the pic here of Mads Mikkelsen. His massive jaw and mandible and chin and his gorgeous cheekbones balance each other but if one just saw the lips it would appear as an unfortunate class II loser. But no, he's gorgeous. But in most cases the upper examples are the norm and it's massively important, once the swelling resolves (i.e. no more than 8 weeks) for the result to be apparent. For myself, I'm gonna keep doing chin wing or even a revision of some sort till i get the result the eastwood's have. Clint is 86 years old and is still directing films. See how having such a large lower jaw/chin keeps him from having a turkey gobbler neck. It's a great scaffolding for the facial tissue.

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Peter6789

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #5 on: August 06, 2016, 11:21:56 PM »
Okay from across this thread and I didn't want to single out anyone but I am included in this poll before and after surgery of class II's still seem to show that an aggressive genioplasty in all cases (whether we compare men and women or even Arnett and Gunson (who do very large lower jaw movements) or the run of the mill surgeon we still see the lower LIP behind the UPPER LIP)

What is with that???? My Lower lip is behind my upper (and hence it looks like my lower jaw is still defiecient) even though my lower jaw is behind upper). And I mean I specifically showed my dr. pictures of what I wanted.

Now of course it may be swelling but six weeks will DEFINITELY be enough to tell to what degree my surgery was successful. Let me show you examples of profile view where the lower jaw is more ideally in line with upper jaw. And if this isn't the "norm" then it's at least the hollywood ideal which I was hoping for. And if I require another surgery for it, will it really be a chin wing that just affects the chin, or another BSSO entirely?????? I'm afraid it may be the latter.

To my limited knowledge, Class II is usually caused by a small mandible.

So the mandible is volumetric small in all three dimensions. Repreat this: we have a volume problem with Class II, not a position or length problem.

People like Clooney or Eastwood have massive mandibles, and Clooney has a massive chin, too, and this keeps them handsome even at old age.

BSSO can fix the bite but only add limited volume to the mandible.



So far I found two solutions to the small mandible:



1. Distraction osteogenesis to grow the mandible in all three dimensions. See

https://www.youtube.com/watch?v=tGbWQZ2W1vw

and all other videos from this doctor about IMDO at

https://www.youtube.com/user/paulcoceancig/videos

Problem: distraction osteogenesis is routinely done for children but in adults only very few cases have been done. And only very few doctors do this.



2. Chin wing, if your bite is good (e.g. after BSSO or camouflage orthodontics). For the visual impression of a large mandible, it is sufficient to move the border of the mandible in all three dimensions. The really great thing about the chin wing: you can stack them on top of each other. So you can have a second chin wing on top of the first one.




Lazlo

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #6 on: August 07, 2016, 08:47:37 AM »
To my limited knowledge, Class II is usually caused by a small mandible.

So the mandible is volumetric small in all three dimensions. Repreat this: we have a volume problem with Class II, not a position or length problem.

People like Clooney or Eastwood have massive mandibles, and Clooney has a massive chin, too, and this keeps them handsome even at old age.

BSSO can fix the bite but only add limited volume to the mandible.



So far I found two solutions to the small mandible:



1. Distraction osteogenesis to grow the mandible in all three dimensions. See

https://www.youtube.com/watch?v=tGbWQZ2W1vw

and all other videos from this doctor about IMDO at

https://www.youtube.com/user/paulcoceancig/videos

Problem: distraction osteogenesis is routinely done for children but in adults only very few cases have been done. And only very few doctors do this.



2. Chin wing, if your bite is good (e.g. after BSSO or camouflage orthodontics). For the visual impression of a large mandible, it is sufficient to move the border of the mandible in all three dimensions. The really great thing about the chin wing: you can stack them on top of each other. So you can have a second chin wing on top of the first one.



Huh so that's interesting. What you're saying is that the small mandible is the problem. And we can grow the mandible with chin wing (for me it would be a second procedure since I already have had a bsso and genioplasty).

If I have a chin wing it will be like a second chin wing to my now bigger mandible and chin, right?

But how to increasing the volume of the chin wing change the position of your MOUTH?????

And how does it increase more volume to the inside of your mouth??????

Does chin wing affect the interior of your mouth as well? I thought it was wholly an external cosmetic procedure?????

Peter6789

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #7 on: August 07, 2016, 10:34:31 AM »


Huh so that's interesting. What you're saying is that the small mandible is the problem. And we can grow the mandible with chin wing (for me it would be a second procedure since I already have had a bsso and genioplasty).

If I have a chin wing it will be like a second chin wing to my now bigger mandible and chin, right?

But how to increasing the volume of the chin wing change the position of your MOUTH?????

And how does it increase more volume to the inside of your mouth??????

Does chin wing affect the interior of your mouth as well? I thought it was wholly an external cosmetic procedure?????

The IMDO can grow a smallish mandible in all three dimensions. But as far as I know only in children.



Chin wing does not grow the mandible. It can move the border of the mandible in all three dimensions. This can make the mandible to appear to be larger, as the border of the mandible kind of strains the soft skins. Think of the mandible border as sticks which strain up a tent of soft skin.

As far as I know you can have a chin wing after BSSO and after genioplasty. But your nerve has to be within certain limits (otherwise cutting the mandible border might injure your nerve).

Chin wing will not change the position of your mouth. And it will not increase the space inside your mouth.

You are right, chin wing is a wholly external procedure.

But it has a medical effect, too: it can help to increase lip competence.

Background: there are many people out there who had a big overjet and got treated by camouflage orthodontics. They have now a good occlusion at the price of lower front teeth flared out forward.

These people often have lip incompetence which leads to mouth breathing and permanently dry lips.

They can't get a BSSO because after camouflage orthodontics this would give them a negative overjet and basically mess up the whole bite.

Genioplasty or chin wing can help with the lip competence then, and give a Class I mandible border for the aesthetic result.

Hope this helps!


Lazlo

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #8 on: August 07, 2016, 01:03:31 PM »
Thanks man yeah it does help.

I mean just emphasizes for me the chin wing is to make the mandible look bigger. '

But there are side effects of this that that are important to consider i.e. the relative size of the maxilla etc.

I think it's the last finishing procedure I'll need.

jawprobs16

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #9 on: August 08, 2016, 09:58:58 AM »
I've noticed that I'm the opposite. I had an underbite but after the surgery my lower lip still hangs ever so slightly in front of my upper which still makes me look like I have a slight underbite, at least I my opinion. I think it's because I didn't have the upper done in conjunction...but I know someone who had upper jaw surgery and they found they have the same lip issue. Is this just the structure of my lips or is it something underlying with skeletal discrepancy?

GJ

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #10 on: August 08, 2016, 01:40:03 PM »
I've noticed that I'm the opposite. I had an underbite but after the surgery my lower lip still hangs ever so slightly in front of my upper which still makes me look like I have a slight underbite, at least I my opinion. I think it's because I didn't have the upper done in conjunction...but I know someone who had upper jaw surgery and they found they have the same lip issue. Is this just the structure of my lips or is it something underlying with skeletal discrepancy?

How come you didn't have the upper done?
Millimeters are miles on the face.

Lazlo

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #11 on: August 08, 2016, 05:02:44 PM »
How come you didn't have the upper done?

god i have no idea. this surgery pisses me off lol

jawprobs16

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #12 on: August 08, 2016, 07:59:47 PM »
How come you didn't have the upper done?
Because my surgeon said advancing my upper would look bad on me. He said it would push out my nose and lips too forward making me look chimpish. He said if he were to do it he wouldn't have done more than 1 maybe 2 mm.

Lazlo

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #13 on: August 08, 2016, 08:36:48 PM »
why the f**k did pushing my front so forward not affect f**king anything?

I mean okay nasolabial folds are gone and my nose looks smaller and honestly yeah my face which had no width looks a bit wider, but nothing fulled out. and i had 5cm advancement. my smile is looking really good, i'll say that. and of course just tons of pain.

Bobbit

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Re: WHY IS THERE NO EFFECTIVE SOLUTION TO CLASS II THROUGH SURGERY?????????
« Reply #14 on: August 08, 2016, 08:48:53 PM »
why the f**k did pushing my front so forward not affect f**king anything?

I mean okay nasolabial folds are gone and my nose looks smaller and honestly yeah my face which had no width looks a bit wider, but nothing fulled out. and i had 5cm advancement. my smile is looking really good, i'll say that. and of course just tons of pain.

5 cm =  ~ 2 inches ?