Analyze my Ceph

[Jilkster]

No comments/context, just give your opinions, I suppose. Interested in aesthetic improvement, don't know if I have functional issues.

[Maxillofacial Scalpel]

Your airway's size and lips' position confirm that you don't seem to have any functional issues related to breathing or bite.

The mandibular & occlusal plane might be a bit steep but obviously that is not enough for you to consider major orthognathic surgery.

A slightly recessed chin is really the only imbalance one can note by looking at your profile view which can be simply resolved through a sliding genioplasty approach.


 

[Jilkster]

Your airway's size and lips' position confirm that you don't seem to have any functional issues related to breathing or bite.

The mandibular & occlusal plane might be a bit steep but obviously that is not enough for you to consider major orthognathic surgery.

A slightly recessed chin is really the only imbalance one can note by looking at your profile view which can be simply resolved through a sliding genioplasty approach.

Wouldn't that increase my mentolabial fold?

[Lefortitude]

wont increase your mentolabial fold unless the surgeon sucks and gives u too much forward movement without the vertical to compensate.  chin implants are notorious for increasing the ML fold

[kjohnt]

Chin is perfect to lower lip (no chin implant or SG), occlusal and mandibular planes are good.  Tooth show is probably okay just judging from other cephs I've seen.  Looks like slightly compensated upper incisors.  Bimax projection could be increased and may help posture of area from upper lip to nose (philtrum).  I think treatment would include dental decompensation to increase overjet very slightly then minor bimax... maybe a few mm upper and then whatever lower to match.  This would bring your lower lip and chin right in line with your upper.

I DO NOT think this treatment is necessary.  We're talking very minor movements.

[PloskoPlus]

Chin is perfect to lower lip (no chin implant or SG), occlusal and mandibular planes are good.  Tooth show is probably okay just judging from other cephs I've seen.  Looks like slightly compensated upper incisors.  Bimax projection could be increased and may help posture of area from upper lip to nose (philtrum).  I think treatment would include dental decompensation to increase overjet very slightly then minor bimax... maybe a few mm upper and then whatever lower to match.  This would bring your lower lip and chin right in line with your upper.

I DO NOT think this treatment is necessary.  We're talking very minor movements.

All I saw was the wisdom teeth.

[UKMaxfac]

Dont get bone-related surgery.

Are you nuts?

The fact anyone could suggest it is ludicrous

[Jilkster]

Dont get bone-related surgery.

Are you nuts?

The fact anyone could suggest it is ludicrous

Elaborate why, please.

The lateral ceph doesn't show it, but my chin is quite off center also.

[ditterbo]

Your airway's size and lips' position confirm that you don't seem to have any functional issues related to breathing or bite.

The mandibular & occlusal plane might be a bit steep but obviously that is not enough for you to consider major orthognathic surgery.

A slightly recessed chin is really the only imbalance one can note by looking at your profile view which can be simply resolved through a sliding genioplasty approach.

I was with you until the 2nd and 3rd sentence.   This is like one of the best built pre-surgery side skull shots I've seen on this board. I don't know what his/her complaints are aesthetically but this is like not even aesthetic maxillofacial surgery. There's basically no movement here, but what do I know.  I think uneven chins are fixed with bone burring.  But I think the loss of bone creates much worse support problems compared to the problem you started with.

[PloskoPlus]

The occlusal plane is normal.

[Jilkster]

Any more comments? Could genio to center chin and add a bit of vertical height combined with rhino to make the nose less upturned be worthwhile?

[kjohnt]

Any more comments? Could genio to center chin and add a bit of vertical height combined with rhino to make the nose less upturned be worthwhile?

I am not familiar with rhinoplasty but if that can be achieved then i think it's a good plan.  You don't need jaw surgery.

You have pano xray to see chin from front?

[Jilkster]

I am not familiar with rhinoplasty but if that can be achieved then i think it's a good plan.  You don't need jaw surgery.

You have pano xray to see chin from front?

I do not.

I do have this


This is my main issue I think, substantial mandibular asymmetry. Any input on the ideal way to fix this? If both sides were like my right side I'd be fairly satisfied.

[stupidjaws]

i agree with the analysis you sent me, especailly for this asymmetry:

Step one: Chin and jaw augmentation
We recommend an osteotomy and/or graft on the chin and the border of the mandible. In these procedure, parts of the mandible can be increased in projection by segmentation and also shaven off to decrease projection. This combination often yields good results in improving asymmetries and shape of the lower jaw. The bony process which holds the teeth is not moved within this procedure.
Another option of chin and jaw augmentation is the use of jaw and chin implants, which can be custom-fit to the patient.
The goal of this step is to turn the convex profile into a straight profile, eliminate or improve facial asymmetry and masculinize the face.



however i disagree with what they call "step II" with the filler augmentation of the upper midface. i see no need for that and imho your upper midface is close to perfect.

[CCW]

Chin is perfect to lower lip (no chin implant or SG), occlusal and mandibular planes are good.  Tooth show is probably okay just judging from other cephs I've seen.  Looks like slightly compensated upper incisors.  Bimax projection could be increased and may help posture of area from upper lip to nose (philtrum).  I think treatment would include dental decompensation to increase overjet very slightly then minor bimax... maybe a few mm upper and then whatever lower to match.  This would bring your lower lip and chin right in line with your upper.

I DO NOT think this treatment is necessary.  We're talking very minor movements.

This is spot on. Your airway is one of the best I have seen and many people people don't have an airway as big as yours even after surgery. I  don't think you have any functional issues, but you lack a bit of bimax projection and considering your asymmetry bimax might make sense aesthetically (if one side of the mandible is longer than the other, it's usually fixed by advancing the other side more). The only thing that really caught my eye was the increased nasolabial angle which bimax would improve. No genio.