Hi all,
I would really appreciate if you could take a look at my photos and x-rays and give me some feedback on my situation and suggestions as to a course of action might be.
My issues:Class II Malocclusion (1cm originally)
Small palate – difficulty opening mouth wide, eating and sometimes choking on food.
Breathing problems - Deviated septum and sinus problems, had septoplasty surgery in my late teens, it didn’t work and made a mess of my nose, the base of my nose and nostrils became distorted and twisted and my breathing didn’t improve.
Aesthetic issues - discussed in further detail below
Current statusBeing treated by an orthodontist and wearing braces since 2020, initiated under the intention of being treated on the national health for the malocclusion, but have concerns due to a lack of planning and communication. My ortho said I am nearly ready for surgery, but when I got a second opinion from another ortho (who wouldnt take me on), they said I needed at least another year or two treatment. Due to this I am investigating other options.
7 teeth extracted, 1 wisdom tooth extraction outstanding.
Following wearing braces my two upper front teeth have moved over to the left and my teeth have gone from being proclined to currently inclined to the point that one surgeon said he wouldn’t recommend performing surgery with them in the current position.
I should have been treated as a child, but I was not and over time I believe this has affected my face in a number of ways.
My eyes are sunken in and under the orbit of my eye, I have very little cheekbone at all, there is like a ridge where the orbit is, and then directly under that I can push my fingers deep underneath. I believe this may have been something congenital as even as I had a these prominent downward angled bones under my eyes creating a kind of inverted V shape shape coming down from the bridge of my nose and coming down from the orbits. I believe this has resulted in a lack of support for my cheeks, periorbital hollowing and lowering of the malar fat pad from an early age.
I have prominent nasolabial folds and following extractions in the past year I have noticed volume loss all around my jaw and further sagging and increase in the nasolabial folds. I have a short face, which was round but now the lower part of my face is more sucked in and gaunt.
Functionally I want to correct my jaw and breathing and of course get a good aesthetic result. I would like to fix the other aesthetic aspects including my nose and especially my cheeks and midface area issues. I would prefer something like a fat graft but as my issue maybe more structural, I assume some kind of implants would be more appropriate.
I am particularly interested if MSE/MARPE would be beneficial to improve my breathing but to also improve my cheeks by way of lateral expansion.
I would also like to know if following surgery, can extractions be reversed?
I have uploaded some photos
Jaw photos
https://ibb.co/album/q7wkR3Lat Ceph and OPG
https://ibb.co/album/nN4W1TDental Imprints
https://ibb.co/album/nzJCY3Any thoughts and opinions appreciated. Thanks.