General Category > Aesthetics
Bimax advancement (CCW rotation) plus genio (pics attached)
jellyflower:
Hi guys,
My surgeon is proposing to do a CCW bimax (upper jaw advancement of 3-5 mm, and lower jaw advancement of 8-10 mm) and a modest genioplasty.
I've been in braces for 2 years and am ready for the surgery - I'm just having second thoughts about the plan. Specifically, I'm worried about moving the maxilla forwards as I’m worried it will make my nose too upturned, because it is already somewhat upturned. I'm also worried about the dreaded 'chimp look' of the upper lip.
I've uploaded pics below and also uploaded a video as I always think a video is clearer.
Please give me any advice you have. (Please do not repost or embed the pics).
https://youtu.be/se1FqFmBsMw (I show my profile towards the end)
https://imgur.com/a/3VJyD5h
PloskoPlus:
Where will the CCW come from? You don't have a gummy smile. Your tooth show looks perfect. Will you have a posterior downgraft? AFAIK, no surgeon in UK does this. IMO, advancing the maxilla is a bad idea in your case. No surgery has the potential to make you look uglier than a maxillary overadvancement.
jellyflower:
--- Quote ---Where will the CCW come from? You don't have a gummy smile. Your tooth show looks perfect. Will you have a posterior downgraft? AFAIK, no surgeon in UK does this. IMO, advancing the maxilla is a bad idea in your case. No surgery has the potential to make you look uglier than a maxillary overadvancement.
--- End quote ---
I don't know the answer to this unfortunately - my surgeon hasn't mentioned a posterior downgraft or impaction.
He's UK based and definitely intends to do CCW rotation.
GJ:
To me that plan seems appropriate.
There is a difference between a 3mm movement and a 5mm movement, though, in terms of the upper jaw and how much projection you'll get from the lower, so I'd try to get that clarified.
You shouldn't get the chimp look from CCW rotation that small, so I'd say that concern is completely unwarranted.
The nose could be an issue. To me your nose doesn't look upturned right now. Looks normal/level from what I see. But let's say it is a little upturned...you can expect that to worsen to a degree. Whether it's worth it depends on you as an individual and all the pros/cons, but mentally prepare for it now. You can ask the surgeon if he knows how to perform and is willing to do an alar cinch and maybe remove some of the ANS (anterior nasal spin), if they are needed, to help compensate for any adverse affects.
Your upper lip should sit a little better after surgery and won't be as extreme as you make it when you just your jaw. You have to remember that "advancement" of the upper jaw during CCW is minimal. It's more like a rotation than an advancement if he's pivoting the jaw on a fixed point. If he actually intends to advance it and pivot it that's different and would probably not be appropriate. But a pure CCW on a fixed point does make sense to me based off what I see.
You have good general features and seem like a nice guy. You should turn out okay if the surgeon executes properly. That would be my biggest concern, not the plan. Just my opinion.
There's a private forum if you want your case there. It does require a small donation for entrance. Also, you'll get fewer eyes/opinions on it than here in the public section. Email me if interested in that.
ghiggson90:
--- Quote from: jellyflower on July 14, 2019, 10:54:09 AM ---Hi guys,
My surgeon is proposing to do a CCW bimax (upper jaw advancement of 3-5 mm, and lower jaw advancement of 8-10 mm) and a modest genioplasty.
I've been in braces for 2 years and am ready for the surgery - I'm just having second thoughts about the plan. Specifically, I'm worried about moving the maxilla forwards as I’m worried it will make my nose too upturned, because it is already somewhat upturned. I'm also worried about the dreaded 'chimp look' of the upper lip.
I've uploaded pics below and also uploaded a video as I always think a video is clearer.
Please give me any advice you have. (Please do not repost or embed the pics).
https://youtu.be/se1FqFmBsMw (I show my profile towards the end)
https://imgur.com/a/3VJyD5h
--- End quote ---
You're quite handsome already, I think the risks do not outweigh the benefits here.
I would recommend running the specifics of your surgeon's plan by this forum before pulling the trigger.
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