Advise Please

[aestheticseeker]

Have had a edge to edge malocclusion for 5 years now

1) NYU ortho dept wanting to do camouflage treatment (IPR lower which im not wanting) now that corticotomy "failed" (never was the right treatment method lol)

2) Already wanting genioplasty (Surgeon advised me of 7mm)

3) Steinbacher (yale) wants do to bimax

Intra oral, lateral ceph and panorex: https://imgur.com/a/zEf9rJf

Thank you

Facial profile pics: https://www.instagram.com/p/B0tz3_jJVYG/ (Have had filler to compensate for skeletal deficiencies)

[kavan]

An edge to edge malocclusion can be corrected by creating approx. a 3 mm clearance where front teeth are that much ahead of the lowers via displacing the maxilla by that amount as was the suggestion of your #3.

Maxfax or bimax surgery although aimed at addressing skeletal deficiencies so there is a jaw to jaw balance are not aimed at highly customized contours such as those (temporarily) 'sculpted' in with fillers. That is to say, you would not want to rely on maxfax  to kick up the same contours in the instagram shots.

[aestheticseeker]

An edge to edge malocclusion can be corrected by creating approx. a 3 mm clearance where front teeth are that much ahead of the lowers via displacing the maxilla by that amount as was the suggestion of your #3.

Maxfax or bimax surgery although aimed at addressing skeletal deficiencies so there is a jaw to jaw balance are not aimed at highly customized contours such as those (temporarily) 'sculpted' in with fillers. That is to say, you would not want to rely on maxfax  to kick up the same contours in the instagram shots.

Understood. Do you think i will get any more aesthetic benefit from moving the upper jaw forward opposed to camouflage treatment?

[Post bimax]

Understood. Do you think i will get any more aesthetic benefit from moving the upper jaw forward opposed to camouflage treatment?

I wouldn't mess with your upper jaw if your primary goal is aesthetics.  If your edge-to-edge bite is a real functional problem for you, then option 3 is reasonable.  Just be aware the isolated LF1 advancement will tend to make you look recessed whereas the genioplasty will tend to offset this effect.  So I would not advise a genioplasty of anything less than your LF1 displacement if a BSSO is not a factor.  Luckily your occlusal plane looks pretty normal and you don't have much of a mentolabial fold, so maybe you can get away with this.

[kavan]

Understood. Do you think i will get any more aesthetic benefit from moving the upper jaw forward opposed to camouflage treatment?

Assuming that's YOU in the instagram photos, you can see that the doctor pointed to the tip of the nose and you see in the after that the downwardly rotated tip rotates upward a bit and there is more nostril show in the after. Basically, he used some filler to project out the base of your nose. Since that can also happen when the maxilla is brought forward, assuming you like the changes to the nasal base area, maxillary advancement to correct the edge to edge bite would also stand to bring some aesthetic improvement with it.

[aestheticseeker]

Assuming that's YOU in the instagram photos, you can see that the doctor pointed to the tip of the nose and you see in the after that the downwardly rotated tip rotates upward a bit and there is more nostril show in the after. Basically, he used some filler to project out the base of your nose. Since that can also happen when the maxilla is brought forward, assuming you like the changes to the nasal base area, maxillary advancement to correct the edge to edge bite would also stand to bring some aesthetic improvement with it.

exactly what im also wanting! I am in need of a septoplasty but want to do the whole nose... How long should I wait after LF1

[kavan]

exactly what im also wanting! I am in need of a septoplasty but want to do the whole nose... How long should I wait after LF1

About a year.

DISCLOSURE: When I answer the questions on the initial post and perhaps a follow up question to that, it's not meant to be an invitation to keep answering spin off questions.

[Post bimax]

exactly what im also wanting! I am in need of a septoplasty but want to do the whole nose... How long should I wait after LF1

Most maxfacs will do a septoplasty concurrently with a LF1 if it is called for.  This could help you get the functional benefits sooner and also avoid multiple surgeries if you decide you are happy with your nose after the LF1.

[aestheticseeker]

Most maxfacs will do a septoplasty concurrently with a LF1 if it is called for.  This could help you get the functional benefits sooner and also avoid multiple surgeries if you decide you are happy with your nose after the LF1.

If my bulbous tip really bothers me could it become better after LF1 if its lifted?

[Post bimax]

If my bulbous tip really bothers me could it become better after LF1 if its lifted?

i am not seeing a particularly 'bulbous' nasal tip in your pics.  Then again i only have 1 angle of reference and the arrows are obsuring the tip in your 'before' photo.

LF1 advancement can make a downward-pointing tip more in line with the nasal bridge.  Although this is pretty unpredictable IMO.

Here is my before and after from a 10mm linear bimax advancement.  My case is different than yours because my nasolabial angle was already obtuse whereas yours may be acute.  Consequently, you may see some aesthetic benefit.  You'll notice my tip raised, but not by a substantial amount.  The main side effect was increased nostril flare.  It's hard to say what the impact of a 4mm advancement on your nose would be: https://imgur.com/a/vEWPY9b

My main point is you should manage your expectations, and that soft tissue response cannot be predicted with a high degree of accuracy.

[aestheticseeker]

i am not seeing a particularly 'bulbous' nasal tip in your pics.  Then again i only have 1 angle of reference and the arrows are obsuring the tip in your 'before' photo.

LF1 advancement can make a downward-pointing tip more in line with the nasal bridge.  Although this is pretty unpredictable IMO.

Here is my before and after from a 10mm linear bimax advancement.  My case is different than yours because my nasolabial angle was already obtuse whereas yours may be acute.  Consequently, you may see some aesthetic benefit.  You'll notice my tip raised, but not by a substantial amount.  The main side effect was increased nostril flare.  It's hard to say what the impact of a 4mm advancement on your nose would be: https://imgur.com/a/vEWPY9b

My main point is you should manage your expectations, and that soft tissue response cannot be predicted with a high degree of accuracy.

Okay your nose came out sooooooo nice wow

[ben from UK]

I wouldn't touch your nose. Masculinity is key. A slightly convex nose is ideal imo when it comes to masculinity. It's a trade off. A straighter more femine nose versus a more masculine nose. Women love masculinity.

[aestheticseeker]

I wouldn't touch your nose. Masculinity is key. A slightly convex nose is ideal imo when it comes to masculinity. It's a trade off. A straighter more femine nose versus a more masculine nose. Women love masculinity.

see one issue im having is the corticotomy procedure seemed to have f**ked up my nose somehow. Either its swollen from the bone grafting or the tube they shoved up my nose to intubate messed it up...

corticotomy was done jan 10 and this is what my nose looks like now

https://imgur.com/a/RXeYjgn


I personally think rhinoplasty will complement the sliding genio well

[ben from UK]

see one issue im having is the corticotomy procedure seemed to have f**ked up my nose somehow. Either its swollen from the bone grafting or the tube they shoved up my nose to intubate messed it up...

corticotomy was done jan 10 and this is what my nose looks like now

https://imgur.com/a/RXeYjgn


I personally think rhinoplasty will complement the sliding genio well

Could be if you find someone who does it well. But it's a very tricky procedure. Slightly convex nose = masculine/dismorphic. I see that you might thin it off from the sides. Making it straight makes it a bit more aestethic but less masculine. Doing too much could make it look fake. You don't want to end up with a fake nose as a man. Ramos did a nosejob, Zlatan did a nosejob. Look how subtle it was. You need a surgeon that is subtle and makes it look real. Some surgeons are butchers with zero aesthetic knowledge.

Casemiro from Real did a nosejob as well by the way. Does it look better? I don't know, it looks a bit less masculine, a bit fake.

[aestheticseeker]

Could be if you find someone who does it well. But it's a very tricky procedure. Slightly convex nose = masculine/dismorphic. I see that you might thin it off from the sides. Making it straight makes it a bit more aestethic but less masculine. Doing too much could make it look fake. You don't want to end up with a fake nose as a man. Ramos did a nosejob, Zlatan did a nosejob. Look how subtle it was. You need a surgeon that is subtle and makes it look real. Some surgeons are butchers with zero aesthetic knowledge.

Casemiro from Real did a nosejob as well by the way. Does it look better? I don't know, it looks a bit less masculine, a bit fake.

What do you think about this guys work?

https://www.instagram.com/dr.muratustundag/?hl=en

I personally think theres a balance of femininity and masculinity in a mans face that can be balance harmoniously.


I think this guys result is impressive: https://www.instagram.com/p/B-7KWPbFD9y/