Advice please! Longface syndrome. Bsso+lefort1+genio

[tretreor]

Hello everyone! First time for me posting here.
Im going to have consultation with a surgeon soon because of my overbite/lip incompetence/long face syndrome.

I had email contact with him and he said this would be the best plan for me after looking at my pics:
Lefort 1 intrusion (what does this intrusion mean?) moving jaw up and forward.
Bsso autorotation (?) and advancement.
Genioplasty advancement and vertical reduction.
Cheekbone augumentation

What do you guys think?

I really HATE HATE HATE my face in "rest" and my side profile. So many years this got me feeling so depressed and not satiesfied with myself.

Thank you for any advice and input!

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[kavan]

It does not look like 'long face'. It looks like you are a good candidate for a sliding genio in which they make a diagonal cut and advance the chin forward along that cut. It would do 2 things,  project it out more and shorten it, especially from frontal perspective. Even if you had other things to do (like more max fax surgery), the chin aspect would most likely be one component of it.

[Lazlo]

i'd go for the full out double jaw surgery plus an aggressive genioplasty. Don't get too much impaction if any you probably have a gummy smile but that's fine. Instead get ccw to shorten face a bit and bring out that lower jaw and release lip icompetence. You probably also have a narrow palate so you may need some widening. You're very pretty so you could be really good looking if you get the right movements. Great features.

[tretreor]

i'd go for the full out double jaw surgery plus an aggressive genioplasty. Don't get too much impaction if any you probably have a gummy smile but that's fine. Instead get ccw to shorten face a bit and bring out that lower jaw and release lip icompetence. You probably also have a narrow palate so you may need some widening. You're very pretty so you could be really good looking if you get the right movements. Great features.

Thanks for your input!
I feel very dumb but I tried to search for CCW rotation but can't understand what that means?
Can you explain? :-)

[PloskoPlus]

Find a surgeon who does CCW rotation not only through anterior impaction ("intrusion" - vertically shortening the upper jaw at the front) , but also posterior downgrafting (vertically lengthening the rear part of the upper jaw). Most surgeons can only do anterior impaction. This may not give you sufficient rotation and they will just do a massive genio to compensate. These results never look natural. You will look different, but no better. They tend to overimpact as well. Mind you, some surgeons claim to do posterior downgrafting, but in fact don't.

[tretreor]

Hello everyone! First time for me posting here.
Im going to have consultation with a surgeon soon because of my overbite/lip incompetence/long face syndrome.

I had email contact with him and he said this would be the best plan for me after looking at my pics:
Lefort 1 intrusion (what does this intrusion mean?) moving jaw up and forward.
Bsso autorotation (?) and advancement.
Genioplasty advancement and vertical reduction.
Cheekbone augumentation

What do you guys think?

I really HATE HATE HATE my face in "rest" and my side profile. So many years this got me feeling so depressed and not satiesfied with myself.

Thank you for any advice and input!

[attachment deleted by admin]

[tretreor]

Find a surgeon who does CCW rotation not only through anterior impaction ("intrusion" - vertically shortening the upper jaw at the front) , but also posterior downgrafting (vertically lengthening the rear part of the upper jaw). Most surgeons can only do anterior impaction. This may not give you sufficient rotation and they will just do a massive genio to compensate. These results never look natural. You will look different, but no better. They tend to overimpact as well. Mind you, some surgeons claim to do posterior downgrafting, but in fact don't.

Thank you so much for your answer! Im going to ask about that :-)

[kavan]

From your frontal photo, it looks like you have some excess tooth show. That in itself is not a problem. However IF the smile also reflects a LOT of gum show, (gummy smile), the surgery becomes more straight forward which is one that just resolves to ANTERIOR impaction to reduce the gummy smile. That is CCW (counterclockwise rotation) in which the lower jaw rotates CCW, up and out, where they MAY not have to displace the lower jaw at all and all they have to do is the genioplasty.

[tretreor]

From your frontal photo, it looks like you have some excess tooth show. That in itself is not a problem. However IF the smile also reflects a LOT of gum show, (gummy smile), the surgery becomes more straight forward which is one that just resolves to ANTERIOR impaction to reduce the gummy smile. That is CCW (counterclockwise rotation) in which the lower jaw rotates CCW, up and out, where they MAY not have to displace the lower jaw at all and all they have to do is the genioplasty.

So, the CCW is that a produce for itself or is it the same as "intrusion" that my surgeon was mention?
Im sorry but english is not my languange so its hard for me to understand everything. Sorry for that :-)

[kavan]

So, the CCW is that a produce for itself or is it the same as "intrusion" that my surgeon was mention?
Im sorry but english is not my languange so its hard for me to understand everything. Sorry for that :-)

CCW when used to describe anterior 'impaction' refers to taking a wedge like section from the front of the maxilla. Intrusion is when they take an EVEN slice of the whole thing and shift the maxilla up evenly. So, if he said; 'intrusion', it means he wants to take an even section from the upper jaw and push it UP. It would help if you could tell us ALL the movements your doc wants to do. You don't need the numbers but just the movements.

[tretreor]

CCW when used to describe anterior 'impaction' refers to taking a wedge like section from the front of the maxilla. Intrusion is when they take an EVEN slice of the whole thing and shift the maxilla up evenly. So, if he said; 'intrusion', it means he wants to take an even section from the upper jaw and push it UP. It would help if you could tell us ALL the movements your doc wants to do. You don't need the numbers but just the movements.

Thank you so much for your answer! Now i really understand what the different is! THANK You!

[miwe13]

Stunning features though. I would only consider genio as mentioned above about but even then I feel like you have defined cheeks, jaw and chin not in that manly way but like lean face + strong features you see on attractive women. They all seem to complement each other nothing stands out over the other as being too prominent. Also I thought half the reason women got lip lifts were because they wanted more tooth show. But if there are functional issues or smile aesthetics then I guess thats a different story.

[tretreor]

Stunning features though. I would only consider genio as mentioned above about but even then I feel like you have defined cheeks, jaw and chin not in that manly way but like lean face + strong features you see on attractive women. They all seem to complement each other nothing stands out over the other as being too prominent. Also I thought half the reason women got lip lifts were because they wanted more tooth show. But if there are functional issues or smile aesthetics then I guess thats a different story.

Thank you so much for your reply! My main issue is the lip incompetence that makes my chin strain, i've been a mouthbreather as long as i can remember. Always been very unsecure with my profile and when people take photos :-(
I like my cheeks, eyes and nose. But not the face that is down the nose. I want i it to be in balance, with a nice chin that have a good size to the rest of my face.

Do you think i only need genio instead of bsso?

[miwe13]

Thank you so much for your reply! My main issue is the lip incompetence that makes my chin strain, i've been a mouthbreather as long as i can remember. Always been very unsecure with my profile and when people take photos :-(
I like my cheeks, eyes and nose. But not the face that is down the nose. I want i it to be in balance, with a nice chin that have a good size to the rest of my face.

Do you think i only need genio instead of bsso?

I know what you mean. Its like with my nose I hate the side profile but its ok from the front. But I have a deviated septum with functional issues so I have to address it either way. In anycase, I think when I see your profile from the side and IF you told me exactly what you were sensitive about I could pick up on the detail of the long face and only from the lips down. If you got just a little vertical height reduction and forward projection through a genio I think both those movements could take away from the long face appearance. BSSO versus genio I can't comment as to which would give you the best result you are after. I think this question is probably addressed through a consult with an OMFS with a good eye for aesthetics?

Also fwiw these are the details that are easily overlooked from a male's perspective...believe me I am not trying to blow your tires up for nothing. But eyes, lips and just feminine features is what guys notice as far as just the face is concerned. But I know that doesn't matter because this is something that bothers you. But those would be my suggestions.

[tretreor]

I know what you mean. Its like with my nose I hate the side profile but its ok from the front. But I have a deviated septum with functional issues so I have to address it either way. In anycase, I think when I see your profile from the side and IF you told me exactly what you were sensitive about I could pick up on the detail of the long face and only from the lips down. If you got just a little vertical height reduction and forward projection through a genio I think both those movements could take away from the long face appearance. BSSO versus genio I can't comment as to which would give you the best result you are after. I think this question is probably addressed through a consult with an OMFS with a good eye for aesthetics?

Also fwiw these are the details that are easily overlooked from a male's perspective...believe me I am not trying to blow your tires up for nothing. But eyes, lips and just feminine features is what guys notice as far as just the face is concerned. But I know that doesn't matter because this is something that bothers you. But those would be my suggestions.

Thank you! I have been considering surgery so many years but im also very scared...
My surgeon who i Am going to meet in a month says: lefort 1, bsso, genio and probably cheek augmentation.

Going to be interesting to see those photos, scans and x-rays though 😃