Author Topic: What surgery does my face need? PHOTOS included from different angels (PLZ VOTE)  (Read 8183 times)

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advancing the maxilla and rotating the anterior part of it down via segmented lefort I. 

I think this could bring your maxilla in better alignment with your mandible, flatten your upper curve of spee, close the anterior open bite, and help your midface with the support you desire.

Your mandible looks almost perfect to me.  Good length, good incisor inclinations, chin lines up perfectly, and mandibular occlusal plane is spot on.  Braces would flatten the lower curve of spee in minimal time.


Thank you so Much KJohnt for sharing your views with me.

In real life, I have 0 support from family or friends regarding any surgery related topic. I get snuffed off by everyone, my parents and best friends included, and no1 even listens to what i have to say because everyone has the pre-assumption that i dont need anything or maybe they are just used to my face or they have different aesthetic views from mine.

So, I reached out to this forum because:
- I am hoping that other people with jaw issues can identify with me and feel what Im going through
- Have someone to talk to about this because in real life i dont have anyone who listens to me about this
- Get ideas/advice/warnings from people who have/or going through similar situation
- I came online because i want honest, mean, harsh critique of my face. I really want to know what are my face problems!!!


1) Telling me I am pretty is not helpful - yes i am not ugly or deformed. But I thought this is the Aesthetics part of the forum?
Also I clearly have a skelital problems with my face - this is backed by eastman cephalometric analysis done on my face that I attached earlier.
SKELETAL
1- My WITS Appraisal is way off from where it should be at -6.3mm ! when it should be -1.0 only
2- LAFH 77 instead of 66
3- PFH (S-Go) 98 instead of 79

and Soft tissue is concerned :
My L1-MP (LADH) is 50 when it is supposed to be 40 only

So this is issue is not in my head its backed by scientific numbers.





2) My topic here does not question "should i get a surgery or not" rather I want to find out WHAT KIND of surgery do i need? my mistake for putting - no surgery needed option. Because clearly its not an option unless I go to Dr.Mew and he can naturally expand my maxilla but when i spoke to my orthodontist he said my upper arch width is good so when i spoke to him about expanding my upper jaw he looked at me like i am the most retarded person at all.


3) Also, for those who ask me to go to see orthos and MFC. I did but the trend I see today in all Drs even in other specialities, they are just genuinely NOT INTERESTED IN ANSWERING patients questions. And here I must say I mean our type of patients that google and research and read science journals. This is very sad, but we are a very very small minority of patients and Drs. couldnt give 2 flyingg f***s about us since not only we tend to ask lot of questions that in many situations expose areas Dr. wants to overlook or might not give 100% results, but we can easy find faults post OP/treatment that normal patients would go happily home with.


4) I am not sold on any sort of Implant or filler. I think a strong maxilla can naturally bring out my mid face without resorting to implants etc which sooner or later have to be removed and dont in my opinion look natural on the long term.

5) I want to have a revision rhinoplasty and veneers done. But i am on hold because I want to fix the foundation of the face first AKA JAWS and then any further cosmetic modification will have better results.


- PloskoPlus mentioned Jaw advancement can wreck faces. I tried to google but I am not sure what you mean? what are the complications of too much jaw advancement.

- I feel that Kylie Jenner had similar problem to what I am facing now. Any idea what she got done?











I feel i have the same problem as Kylie as far as Maxilla Mid face is concerned - except her lower jaw was more square and my more pointy and also skin texture. From rhinoplasty i realized that skin texture has an important role to play when talking about cosmetic results and my skin texture is thick so thats a disadvantage in my view since its difficult to achieve sculpted looks with it.


- I am attaching pre-rhinoplasty pre-second-round of braces 10 years ago pics that are of little relevance now. But just to show you what i started with.

[attachment deleted by admin]

[attachment deleted by admin]
« Last Edit: February 15, 2017, 04:21:42 AM by 爱 »

diculo

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She probably got bimax (upper and lower jaw advancement) and genioplasty (moved forward) as well as fillers for nasolabial folds and cheeks (more pronounced cheeks could be an implant or a result of her Lefort I). She also has lip augmentation with fillers. I would recommend you to get the bimax and genioplasty with not so aggressive advancements.

molestrip

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Jaw surgery is highly invasive surgery that is way beyond what you're probably expecting. It comes with real risks and tradeoffs. Swelling lasts for up to a year after surgery and you'd be on a liquid to soft diet for 2-3mo afterwards. Many people thin or bald in recovery and it cane take up to 2 years for it to return. It's very common for people to lose some sensation in their face afterwards, lips, gums, palate, etc. That means kissing is less fun (I'd recommend chapstick btw). It's not uncommon for people to develop joint problems afterwards or to hate the way they look, even if they look objectively better. Sometimes tooth alignment can be off too. Plates can cause problems decades later and there isn't always options for fixing these problems. The osteotomies don't always heal perfectly, particularly if graft materials are used, and may be more prone to refracture later in life. Teeth can die in the process, requiring root canals and eventually tooth loss. People do this surgery because they have problems that outweigh the risks. Any improvement to aesthetic is a bonus except in severe cases. I mention all of this because I want you to know what you're getting into here.

You didn't capture the angles we look for in your pictures, in particular I'd like to see a clear profile picture. The less smiling you do the better so we can see your bones. You are attractive from your pictures so from a practical standpoint, you're not going to gain much in the dating market I think. Assuming your functional problems can be addressed without surgery, therapy may provide more value to you than surgery (I recommend it often, not just to you).

You clearly have facial deformity from your lateral xrays. It's very common, nothing to be surprised or impressed by. Looks like you still have your wisdom teeth, fully erupted. That's awesome. You had an anterior open bite which your orthodontist camouflaged and it has partially relapsed. Your case is similar to mine actually but your airway looks better and being female sleep apnea is probably not something you need to worry about for a very long time. You have a slightly underbite growth pattern with a slightly long face. Your maxilla is slightly underdeveloped, vertically posterior and horizontally anteriorly. From your pics it looks like you have a slight cant. These are all very routine problems seen in orthodontic and surgical practice, not to mention in the general population.

I think your bite is close enough that an orthodontist can close your bite again. You might want to consider extracting those wisdom teeth in the process. They'd need to come out if you wanted surgery anyway. I'd guess that surgically you'd need a 3-piece LeFort to widen the arch and flatten the curve of Spee, advancement and CCW rotation to level the occlusal plane. I'd only consider it if your orthodontist says surgery is needed to fix your bite. I do think you'd look better, assuming the surgeon got all the movements right. They would be small movements by our standards. It won't help your cheekbone projection because the fracture is near the bottom of the nose. Otherwise, I'd ask your orthodontist to retract the lower incisors to reduce some fullness and mask the maxillary deficiency. You might consider a genioplasty to reduce the volume even further, though it'd be a shame since you have such a nice chin. Given your growth pattern, I'd guess your cheekbones are in the right spot but not prominent enough. I don't like cheekbone augmentations but if you go that route, the Xilloc product looks interesting and it should be available to you in Europe.

You have a sharp eye btw with those pictures. Regarding lack of support, we feel you. My friends and family question whether I even have sleep apnea. What the big deal is having only one tooth occlude. What the big deal is not being able to breathe through my nose. They think I'm making stuff up or exaggerating. In our world, if you look fine you must feel fine. There are nice groups on FB btw, if you haven't looked there yet.
« Last Edit: February 15, 2017, 09:00:45 AM by molestrip »

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Molestrip, I really enjoyed reading your msg.

though when you suggested I go for therapy I am not sure if you meant dental therapy or mental therapy???

Quote
Your maxilla is slightly underdeveloped, vertically posterior and horizontally anteriorly. From your pics it looks like you have a slight cant

Can you just elaborate please? also whats a slight cant?

So if I dont need jaw surgery how do I fix my face? Whats all this fat on my face its like a hippopotamus or elephant skin folds when I smile and it will only sag and look uglier with age!

If i go back to braces, this will be my 3rd round of braces and also my cephalo shows skeletal problems not much dental issue there. I went to the ortho last week and he was least interested in treating me , he just suggested i put my retainer or get invislign which i think are crap.



« Last Edit: February 17, 2017, 07:04:23 AM by 爱 »

CCW

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He's saying you need bimax surgery to really fix your issues because you have an open bite. If you didn't have an open bite, you could get away with just upper jaw surgery which some surgeons might still suggest (w/ posterior impaction). Don't agree to that, though, because it won't make you look better. I wouldn't bother with braces anymore if you're not getting surgery because you have already had braces so many times and spent so much money and because your issues are skeletal and orthodontic correction of an open bite tends to be unstable anyway. Aesthetically, I don't think you need anything done because you are already attractive and no one's going to think there's anything wrong with your face, but I guess if you got surgery with a good surgeon, you would look a little better or different.

stupidjaws

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Thank you so Much KJohnt for sharing your views with me.

In real life, I have 0 support from family or friends regarding any surgery related topic. I get snuffed off by everyone, my parents and best friends included, and no1 even listens to what i have to say because everyone has the pre-assumption that i dont need anything or maybe they are just used to my face or they have different aesthetic views from mine.

So, I reached out to this forum because:
- I am hoping that other people with jaw issues can identify with me and feel what Im going through
- Have someone to talk to about this because in real life i dont have anyone who listens to me about this
- Get ideas/advice/warnings from people who have/or going through similar situation
- I came online because i want honest, mean, harsh critique of my face. I really want to know what are my face problems!!!


1) Telling me I am pretty is not helpful - yes i am not ugly or deformed. But I thought this is the Aesthetics part of the forum?
Also I clearly have a skelital problems with my face - this is backed by eastman cephalometric analysis done on my face that I attached earlier.
SKELETAL
1- My WITS Appraisal is way off from where it should be at -6.3mm ! when it should be -1.0 only
2- LAFH 77 instead of 66
3- PFH (S-Go) 98 instead of 79

and Soft tissue is concerned :
My L1-MP (LADH) is 50 when it is supposed to be 40 only

So this is issue is not in my head its backed by scientific numbers.





2) My topic here does not question "should i get a surgery or not" rather I want to find out WHAT KIND of surgery do i need? my mistake for putting - no surgery needed option. Because clearly its not an option unless I go to Dr.Mew and he can naturally expand my maxilla but when i spoke to my orthodontist he said my upper arch width is good so when i spoke to him about expanding my upper jaw he looked at me like i am the most retarded person at all.


3) Also, for those who ask me to go to see orthos and MFC. I did but the trend I see today in all Drs even in other specialities, they are just genuinely NOT INTERESTED IN ANSWERING patients questions. And here I must say I mean our type of patients that google and research and read science journals. This is very sad, but we are a very very small minority of patients and Drs. couldnt give 2 flyingg f***s about us since not only we tend to ask lot of questions that in many situations expose areas Dr. wants to overlook or might not give 100% results, but we can easy find faults post OP/treatment that normal patients would go happily home with.


4) I am not sold on any sort of Implant or filler. I think a strong maxilla can naturally bring out my mid face without resorting to implants etc which sooner or later have to be removed and dont in my opinion look natural on the long term.

5) I want to have a revision rhinoplasty and veneers done. But i am on hold because I want to fix the foundation of the face first AKA JAWS and then any further cosmetic modification will have better results.


- PloskoPlus mentioned Jaw advancement can wreck faces. I tried to google but I am not sure what you mean? what are the complications of too much jaw advancement.

- I feel that Kylie Jenner had similar problem to what I am facing now. Any idea what she got done?











I feel i have the same problem as Kylie as far as Maxilla Mid face is concerned - except her lower jaw was more square and my more pointy and also skin texture. From rhinoplasty i realized that skin texture has an important role to play when talking about cosmetic results and my skin texture is thick so thats a disadvantage in my view since its difficult to achieve sculpted looks with it.


- I am attaching pre-rhinoplasty pre-second-round of braces 10 years ago pics that are of little relevance now. But just to show you what i started with.

I read somewhere the surgeries kylie had. i think i pinned it to my favourites, if i find it i'll link it but i don't think you shoudl do that she had a woerse case than you

stupidjaws

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http://www.analyzemyface.com/2017/01/27/kylie-jenners-become-pretty-discover-incredible-transformation/ i agree i think she had jaw surgery but i really do not think you need it i think her starting point was 10000 times worse and theres  a huge risk u could look uglier after surgery so keep it in mind...

newchin

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I cant believe anyone is suggesting any type of surgery whatsoever on this girl, she is stunning! I think we all have our crazy voices in our head that blow up the smallest cosmetic things and make them into hideous mountains. I do it to myself too so can understand but honestly, people on the internet can be brutally honest and i am myself, its easier to break it to someone that they would look better with surgery from behind a computer anonymously. And i always want people to tell me the truth too and feel like they're lying to protect my feelings, friends, family, anyone that will listen lol.

If i could go back and not have any of the jaw work i had done (which was actually in Brussels btw) i would. Its not worth it, ive spent around $35,000 trying to put it right. So many things can go wrong and i honestly can not see a single thing id fault on your face. In fact your side profile when smiling reminds me of Angelina Jolie, and her jawline/chin is unbelievable. Your nose turned out great, dont tempt fate when trying to make changes so minute that no one would ever be able to notice. You are beautiful!

Now use that money to go travelling! see the world and make some memories! Do some non invasive things if you are determined, small amounts of fillers, botox, the reversible inexpensive stuff. I seriously doubt Kylie Jenner had any major surgery, especially bone surgery, Maybe a closed rhino and the lips make a huge difference in her facial harmony

jawregret

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Agree with newchin.

Don't get surgery.

Wraparoundshotgunimplant

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What does my face require ?  :o :-\

Please contribute with your opinions - dental/ orthographic/ cosmetic surgery ideas - any suggestions are welcome even if its about my hair  ;D

PS.
-  I have 2 years to do any surgery.
- I can travel anywhere and have a budget of 20,000Euros for all work that I want to do.
- I live in Brussels. So any Dr Suggestions in countries in Europe is great.



It's not necessarily all bone. The overall distribution and placement of your malar fat pad gives off an 'ethnic' physiognomy. Nothing wrong with that if it's not an issue here but perhaps that's what you're trying to describe.

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It's not necessarily all bone. The overall distribution and placement of your malar fat pad gives off an 'ethnic' physiognomy. Nothing wrong with that if it's not an issue here but perhaps that's what you're trying to describe.

Thanks for the remark. any suggestion on how to get rid of that and have more sculpted face? wouldnt a jaw surgery move the jaw and then the fat tissues will natutally take better positions?

Wraparoundshotgunimplant

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Thanks for the remark. any suggestion on how to get rid of that and have more sculpted face? wouldnt a jaw surgery move the jaw and then the fat tissues will natutally take better positions?

Not at all. There are plenty of cases of 'natural' bone movements causing dysthetic soft tissue distortions as well as unnatural contours and movements. I've seen countless cases first-hand.

Just because all of the geniuses on this forum feel that using your natural bone is more "natural" and therefore universally better than implants, doesn't mean this translates into reality. The result won't always look more natural or give a better result than soft tissue surgery or implants.

If you do get bony movements, you're going to need bimaxillary advancement. Afterwards focus on the soft tissue, as it may not improve much (and as I said it could get worse).

If you really want this fixed you're going to have to raise the malar fat pad. In addition (perhaps, as I haven't look at too many pics of you) a combination of lipo/buccal fat removal.

PloskoPlus

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bimaxillary advancement ? Really? Really?

Peter6789

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What does my face require ?  :o :-\

Please contribute with your opinions - dental/ orthographic/ cosmetic surgery ideas - any suggestions are welcome even if its about my hair  ;D

PS.
-  I have 2 years to do any surgery.
- I can travel anywhere and have a budget of 20,000Euros for all work that I want to do.
- I live in Brussels. So any Dr Suggestions in countries in Europe is great.



If you are really serious about this:

1. Meet several surgeons who are open to aesthetic surgeries and do a high number of jaw surgeries. Collect and compare their advice. Even if it costs time and money.

2. Take your time, don't rush things. Just collect feedback from doctors for several months.

3. Get a basic understanding what the different surgeries can and cannot achieve.

4. You look good, but getting from looking good to looking stunning is more an art than a science. If you were deformed things would be much easier.

5. Get your bite checked and skelettal class checked (minor Class 3?).

6. I know people from the medical sector who got bimax surgery for themselves with very small movements for aesthetic reasons (e.g. jaw movement of 2.5mm). And they are happy about it. And there are people who have basically ruined their lifes with such an operation (chronic pain, unhappy with aesthetic outcome).

7. You will have to pay privately. EUR 20.000,00 may be enough, but maybe you will need a little more cash.

Good luck!


Wraparoundshotgunimplant

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bimaxillary advancement ? Really? Really?

Might as well help her if she's this intent on going through with it. Like is said if she *must* do something about it. I don't think she should.