Do people who favor the "Anteface" look aim for an abnormally high SNA/SNB?

[secondtimearound]

I was not tilter like that. My occlusal plane was good preop. He massively downgraded my maxilla anteriorly and posteriorly.

So the problem is the heavy ccw rotation he provided with a massive tilt to your jaws. Your jaws are not too far forward. They're pretty much perfect. But you've been rotated to oblivion.

That could definitely justify a revision.

I'm curious - can you PM or post the surgeon? I actually need a bit of ccw. They obviously love providing it... Though unreasonably so in this case.

[PloskoPlus]

90.4, 86.9

[ditterbo]

I don't know what your ceph outline looked like pre-op, but interesting that my Gunson-proposed bimax outline diagram doesn't advance nor use CCW quite as much as your current state, and yet he said this outline would have helped "even severe OSA". BTW you should've posted either this ceph outline or your x-ray weeks ago for better information.  Also, don't trust all measurements taken from cephx. There's another thread with Kavan explaining why.  What are those numbers, Plosko?

[ditterbo]

I'm referring to your ceph xray.  I thought you took a picture of it but didn't get an official copy from the doc. If it worked for cephx though, it would've been helpful here as well. Don't take the cephx occlusal plane number literally.  They were off 3 degrees on mine.

[PloskoPlus]

I don't know what your ceph outline looked like pre-op, but interesting that my Gunson-proposed bimax outline diagram doesn't advance nor use CCW quite as much as your current state, and yet he said this outline would have helped "even severe OSA". BTW you should've posted either this ceph outline or your x-ray weeks ago for better information.  Also, don't trust all measurements taken from cephx. There's another thread with Kavan explaining why.  What are those numbers, Plosko?

My SNA, SNB numbers.

[qwe]

I know what you mean,

I was from the begging sold on antefaces, but honestly I've realised that I really dont like the swollen look it gives, as you are hiding something under your lip.
If you look at this guy, after his bimax surgery he just looks swollen, https://i.imgur.com/E4hw11t.jpg because his face dont suit the big maxilla.
Compare it to Errol Flynn, that also have a ''forward profile'' but without a prominant maxilla, https://i.pinimg.com/236x/76/b3/45/76b3451b2124b8e1d0ed0f5f364696b5--errol-flynn-classic-movies.jpg,
his nose is long,and his philrum is pushed out little with it, I think  this looks alot better than having a to strong maxilla, especially on caucasian males

Lisa fonssagrives is also an example of what I mean,
http://i9.lisimg.com/7469179/280full.jpg she does have a forward face, but without her maxilla looking to bloated.

Also,Often people like Angelina Jolie are told to have an anteface, but really I dont know if that's the case here, I think her maxilla is normal, with an very agressive mandibular+m-angle, https://i.pinimg.com/736x/b5/ff/e6/b5ffe6245aaefed9d062b06c50732fed--angelina-jolie-young-female-faces.jpg,
(again as Errol Flynn, And LF,philrum + big lips mimic a more forward face), you can see that her face looks slick in a way compare to someone as Elizabeth Banks that has this ''bloated maxilla look'' http://www.wallpapers-web.com/data/out/72/4360462-elizabeth-banks-wallpapers.jpg.

Conclusion, if you want an anteface from surgery, be prepared to look like Willem Dafoe after.
/Qwe

[secondtimearound]

Mazilla you will need a revision bsso and lf1 to undo the excessive ccw. You should ask them to keep your front top iincisor exactly where it is and rotate everything from that point. The back top will be impacted. You might want to aim for 8-10 degrees occlusional plane.

People complaining about measurements being off a few degrees should understand this isn't a perfect science. There is always a small margin of error based on how you define the landmarks eg. The center point of S.

The point is it all gives you a general understanding of the trends of your face and what to do about them.

[secondtimearound]

I know what you mean,

I was from the begging sold on antefaces, but honestly I've realised that I really dont like the swollen look it gives, as you are hiding something under your lip.
If you look at this guy, after his bimax surgery he just looks swollen, https://i.imgur.com/E4hw11t.jpg because his face dont suit the big maxilla.
Compare it to Errol Flynn, that also have a ''forward profile'' but without a prominant maxilla, https://i.pinimg.com/236x/76/b3/45/76b3451b2124b8e1d0ed0f5f364696b5--errol-flynn-classic-movies.jpg,
his nose is long,and his philrum is pushed out little with it, I think  this looks alot better than having a to strong maxilla, especially on caucasian males

Lisa fonssagrives is also an example of what I mean,
http://i9.lisimg.com/7469179/280full.jpg she does have a forward face, but without her maxilla looking to bloated.

Also,Often people like Angelina Jolie are told to have an anteface, but really I dont know if that's the case here, I think her maxilla is normal, with an very agressive mandibular+m-angle, https://i.pinimg.com/736x/b5/ff/e6/b5ffe6245aaefed9d062b06c50732fed--angelina-jolie-young-female-faces.jpg,
(again as Errol Flynn, And LF,philrum + big lips mimic a more forward face), you can see that her face looks slick in a way compare to someone as Elizabeth Banks that has this ''bloated maxilla look'' http://www.wallpapers-web.com/data/out/72/4360462-elizabeth-banks-wallpapers.jpg.

Conclusion, if you want an anteface from surgery, be prepared to look like Willem Dafoe after.
/Qwe

All fair to state. I think the other thing that has to be taken into account is what someone said earlier in the thread about black people having more bulbous foreheads.

I have a bulbous forehead as well. It does not slope back above my eyebrows. It goes straight up.

If I retruded my jaws to the ideal sna/snb it actually makes my face look less balanced by bringing more prominence to my forehead.

So I guess we can't all aim for the exact same targets and possibly having perfect cephalometric data is not always going to be the aesthetic ideal.

As a counterpoint, here's Jordan Barrett who definitely looks a bit odd but also beautiful and has the most forewards jaw of any white guy I've seen.

[kavan]

Wow, this study confirms everything that I don't like about my results.

Occlusal Plane

Mean: 14
Standard Dev: 3
Myself: 5.67
Comment: closed occlusal plane

Nasolabial angle: 78

It sais my lips, my teeth, my mandible protrudes too much, my occlusal plane goes upwards!

What is the NAME of the analysis that is telling you the 'mean' of the OP is 14 degrees? Is it the Steiner analysis?  In some analysis (say Downs) 14 degree OP is associated with the MAX, not the mean. 1.5 is associated with minimum and the mean is 9.3. It is the angle the OP line makes with the Frankfort horizontal line.

the angle your OP makes with a horizont is about 6 degrees when i do an estimate using a line closer to that of a horizont (say Downs).

[secondtimearound]

Thanks second time around. I would want the anterior maxilla impacted as well, but more the posterior to allow for the CW rotation. Why do I need double jaw surgery if im only getting a rotation? I dont get it

Because the jaws need to meet and the teeth need to bite. If you only rotated the top, the lower teeth would no longer meet. You need both rotated together to maintain the bite. If you want the front impacted you could do that as well.

For a man you generally want 1-2 mm of teeth visible at the front upper incisor when the lips are apart but at rest.

[kavan]

Mazilla you will need a revision bsso and lf1 to undo the excessive ccw. You should ask them to keep your front top iincisor exactly where it is and rotate everything from that point. The back top will be impacted. You might want to aim for 8-10 degrees occlusional plane.

People complaining about measurements being off a few degrees should understand this isn't a perfect science. There is always a small margin of error based on how you define the landmarks eg. The center point of S.

The point is it all gives you a general understanding of the trends of your face and what to do about them.

Mazilla's MEASUREMENTS can be seen on his very first post on JSF.
http://jawsurgeryforums.com/index.php?topic=7017.msg60319#msg60319

From the string, his main concern is that he looks 'too different' from 'himself' or what he was used to. He discloses that people who never saw what he looked like prior, find him attractive. He realizes he looks much better in terms of aesthetics or attractiveness. BUT he's NOT happy with that. He's 'attached' to most of his prior look and it doesn't matter to him that most people would prefer his after look than his before. So, do familiarize yourself with his initial string here which also has the numbers of his displacements.

I am not too sure he got "massive" CCW.  A significant CCW would correspond to either a hefty isolated anterior impaction or a hefty isolated posterior downgraft. He did NOT have ANY anterior impaction. It looks to me that he got an overall downgraft with a little more posterior which would have to be the case for any CCW where NO anterior impaction was done.

Also, as to SNA, SNB, and ANB angles which Steiner used, I would not give absolute credence to those in every situation. They arise from the S point being easier to spot in an X ray than the Po (Porion) point used to connect with the Or point (Orbitale) to get the Frankfort horizont.

Hence, the S-N line is used as an alternative reference. Thing is the S-N line is fine when the deviation from a horizont is within 7 degrees. But the more the S-N line deviates enough from 7 degrees away from a horizont, different adjustments have to be made for balance. So, I would not be using SNA,SNB and ANB as 'absolutes' in cases where the S-N line deviates much from 7 degrees from a horizont.

[qwe]

I understand
My advice to you,

I think it would be smarter to do something for the forhead then, instead to force your jaws to be overadvanced
why I commented here was because I've seen surgery´results in office with famous named dr's, where people wanted to have very strong jaws and ended up with the ''chimp look''.
To push the limit dont give this ''mma fighter look'' people want more likely as you are hiding some food under your upperlip.

The thing I want to tell you is that from my experince,  before my surgery  my small lower jaw was the issue for me, and alot of surgerons wanted to overadvance my jaws, making the maxilla also to strong.
Two high name dr's instead recommended me 50-60% smaller movements, + doing a chin wing/implants to adress the real issue, and ofc for the better look.


I understand what you mean, JB definetly doesnt have the most fg jaws for a cacause male.
the beautiful part is subjective, to femine looking male for me but I know that he is famous on  ''look**** sites''.

/qwe

[kavan]

Yes it was Steiner.

Is 6 degrees normal? It seems my OP is divergent. Ive never see a divergent OP, only flat or convergent.

Well your OP is about 6 degrees with reference to a horizont. So, let's say you used an analysis system where the Frankfort horizont was used as relative compare line (assuming your FH is in fact horizontal). IF the standard deviation were about 3 and the mean was 9.3, 9.3-6=3.3 and you would be pretty close to norm for a 6 degree OP.

I believe that is what ditterbo was saying when he told you his was off 3 degrees. What's off is some of those ceph read outs are not useful if you don't know what they are in reference to and you just take as an 'absolute' number. For example, I could GUESS your OP analysis was the Steiner BECAUSE 14 degrees is NOT the 'mean' for a type that uses the Frankfort horizont. But is when the S-N line is used it is.

Thing with Steiner analysis for SNA, B and ANB, it is not that reliable as an absolute when the SN line deviates too much from 7 degrees away from a horizont.

Does your cephX read out show you a diagram where the Po and Orbitale points are?  (Po, Or). those points are useful to see if your Frankfort Horizont is actually horizontal. But they are harder for an automated program to spot on an X ray.

[ditterbo]

Actually I meant the occlusal plane I was given in Clark Analysis and Downs Analysis was 10.8 degrees (not referring to the norm/deviation stuff).  A surgeon measured my OP angle at 13.5 degrees.

[kavan]

Actually I meant the occlusal plane I was given in Clark Analysis and Downs Analysis was 10.8 degrees (not referring to the norm/deviation stuff).  A surgeon measured my OP angle at 13.5 degrees.

That sounds right. I too saw your cephs too and measured your OP at 14 degrees.