Maxillary Impaction (HELP!) =(

Message

#1 Post by **facet** » Thu Sep 17, 2009 3:47 am

Hi everyone here,

I'm new so please be nice =)

Ok, I'm scheduled for Orthognathic Surgery on Oct 9 and I desperately need some advice.

Firstly, I do NOT have a gummy smile. This might be due to the fact that I don't smile very very widely. But, when I smile a normal smile, I dont show any gum at all.

However, having said that, I do have lip incompetence when my mouth is relaxed and as a result I show quite a bit of front teeth with my lips hanging.

My surgeon suggested that I have Leforts1 (Maxillary Impaction), BSSO and genioplasty.

He will be lifting my maxilla up by 3mm. Is that alot? Considering that I do not have a gummy smile in the first place, only lip incompetence.

Also, what changes to my face can I expect?

Sorry for so many questions! Thanks a lot by the way.

#2 Post by **facet** » Thu Sep 17, 2009 3:54 am

sorry one more thing:

Will my lips move upward closer to my nose also?

Thankssss

#3 Post by **Esoteric** » Thu Sep 17, 2009 8:00 am

The top jaw (maxilla) direct affects the position of the bottom. Impacting the maxilla will not move your top lip in relation to your nose, but everything behind the lips will be moved upwards. Obviously your bottom lip will move up because of the 3mm impact of the upper correcting lip incompetence. Your nose may slightly widen, though that can be minimized with sutures. Depending on your case you could see dramatic changes that for most are positive both cosmetically and functionally.

I to am having lefort impacting and lower jaw surgery on this Mon. Like you I don't show a ton of gum when smiling, but that's because I never let my self truly smile big. I also have pretty significant lip incompetence while the jaw is at rest. I think I have come to terms with the changes that will be coming, but I know it's going to be pretty crazy.

Hope this answered your question lol, I was kind of rambling.

#4 Post by **facet** » Thu Sep 17, 2009 8:35 am

No not at all! I appreciate all replies =) And thanks so very much for your response, looks like we'll be going through the same thing! haha

Just another question though:

For the lower third of my face, will the total hard and soft tissue movement upward be 3mm or more than 3mm?

#5 Post by **facet** » Thu Sep 17, 2009 8:38 am

Esoteric wrote: I to am having lefort impacting and lower jaw surgery on this Mon.

oooh i almost forgot. all the very best for your surgery and God bless! =)

#6 Post by **perfectsmile** » Thu Sep 17, 2009 5:43 pm

I had exactly what you just described. I didn't have gummy smile I only had (Tooth Show) and at rest my tooth show was 4 mm, I also had class II malocclusion (mild). My surgery was 4 months ago (4 mm lefort impaction + Genioplasty), the surgeon decided against BSSO at the last pre-op appointment. What I really regret at this point is not being conservative with the changes; now at rest I have 0 tooth show which is not feminine or youthfull look. Genioplasty was a big mistake, I had it revised 10 days ago.

#7 Post by **HokieTay** » Thu Sep 17, 2009 6:19 pm

perfectsmile wrote:I had exactly what you just described. I didn't have gummy smile I only had (Tooth Show) and at rest my tooth show was 4 mm, I also had class II malocclusion (mild). My surgery was 4 months ago (4 mm lefort impaction + Genioplasty), the surgeon decided against BSSO at the last pre-op appointment. What I really regret at this point is not being conservative with the changes; now at rest I have 0 tooth show which is not feminine or youthfull look. Genioplasty was a big mistake, I had it revised 10 days ago.

You mean your upper lip covers all of your top teeth when your lips are resting? Man it seems like a good deal of people end up unhappy with genio. Did you just have it changed or totally reversed?

#8 Post by **facet** » Fri Sep 18, 2009 2:47 am

perfectsmile wrote:I had exactly what you just described. I didn't have gummy smile I only had (Tooth Show) and at rest my tooth show was 4 mm, I also had class II malocclusion (mild). My surgery was 4 months ago (4 mm lefort impaction + Genioplasty), the surgeon decided against BSSO at the last pre-op appointment. What I really regret at this point is not being conservative with the changes; now at rest I have 0 tooth show which is not feminine or youthfull look. Genioplasty was a big mistake, I had it revised 10 days ago.

Oh dear that sounds bad! I suggest you get veneers to increase the length of your teeth and in turn, incisor show. How about that?

And also, what was bad about genioplasty for you

#9 Post by **facet** » Fri Sep 18, 2009 2:51 am

oh and could anyone tell me what BSSO (bisagittal split osteotomy) entails?

Is that splitting your upper jaw from your lower jaw and moving the lower?

Or?

#10 Post by **perfectsmile** » Fri Sep 18, 2009 5:22 pm

I had it completely reversed. I hated every thing about the genioplasty , the muscle strain when I talk , the augmentation thru my face out of balance, when I smile the profile looks like a witch's chin, my lips hangs lower with excessive lower tooth show, lip incompetence and lips shape ( they became significantly thinner and the revision didn't fix this issue). I ended up with permanent numbness in half of my lower lip. I had a great surgeon and the lefort I was a success excluding the zero tooth show result but the genioplasty was a mistake and I regret having it.

#11 Post by **OhioM** » Sat Sep 19, 2009 7:09 pm

Perfectsmile, Hi! I'm sorry to hear that you aren't totally satisfied with your results. I am just starting this journey and I'm so curious about everything. Is zero tooth show at rest not ideal? No tooth show at rest is kind of my dream in life at this point. What is the goal for tooth show if not zero? I can see that we want our teeth to show when smiling....

Can you elaborate on why they wanted you to get the genio if you didn't need a stronger chin?

I can understand if you can't or don't want to post pics, but if you had some before/afters, I would love to see them! I'm new so maybe they are already up somewhere, so I'll check the archives, too.

Thanks!

#12 Post by **perfectsmile** » Sun Sep 20, 2009 4:18 pm

Zero tooth show does not look youthful. The Ideal tooth show for women (between 1-3 mm) and men (1-0 mm). When I smile only half of my teeth shows so my vertical maxillary excess was over corrected. I would always choose my previous gummy smile and tooth show over the over correction I ended with.

Can you elaborate on why they wanted you to get the genio if you didn't need a stronger chin?
To be honest, I don't know myself lol. When I entered the OR my doctor said that he'll probably leave the genio for another operation as I might not need it and I told him that after the impaction if he thought I will benefit from a genio then I trust his judgment and that I prefer to have to it in one operation rather than two (BIG MISTAKE) so at the end I think it's my fault. I thought that the genioplasty was postponed so we didn't discuss the amount of projection and my preferences. When the swelling went down I discovered that we were not on the same page when it comes to aesthetics; however, he was really kind to me and sweet enough to offer a revision.

About the pictures, can you imagine that I was depressed enough to delete all my pictures! Anyway, i think i left one picture early in recovery and another (I think 3 months post op) but with sunglasses covering have of my face. If you are interested you can PM me your e-mail address and I'll be happy to share.

#13 Post by **ReoSity** » Mon Sep 21, 2009 8:33 pm

facet - I'm in a similar predicament, I have very little gum show when I smile but I still have lip incompetence. I'm planning on having upper/lower jaw surgery at some point.

Could you post some pictures?

#14 Post by **facet** » Sun Sep 27, 2009 8:50 pm

hey =) sorry for the late reply. I dont think id be posting my pictures due to privacy reasons

i'll be meeting another surgeon for a second opinion tomorrow. will keep you guys posted!

#15 Post by **SuperJet** » Mon Sep 28, 2009 7:34 am

FACET, are you saying with your Gino. your OS brought your chin out further? as in pointed out? or relaxed it?

Im going in for surgery this Thursday and im having some Gino work.
I know you dont feel comfortable about posting pics.. but I would like to see them also if you ever change your mind.