Hi there,
My brief story so far:
I've been in braces since March 06 to straighten my teeth and through surgery correct my class III malocclusion.
I've been in with the surgeon and orthodontist in July as my ortho thought I was ready for surgery then, but sadly I still needed some tweaking to sort out my premolars. Apparently I'll be having a relatively small movement of only 3-4 mm and they decided it would be best to do just my lower jaw. Now the thing is I don't show very much of my teeth when I smile and I was wondering will this improve any with setting my lower jaw back?
As at that appointment they showed me a preview image of what I'd look like with my upper jaw moving forwards or my lower moving back, but they said they wanted to move the lower back and I did air my views on my teeth not showing to which they said if they were a perfectionist then I could use a couple more mm being shown, but that lower jaw surgery would probably be the best, also due to the fact that I live more than 2 hours away from the surgeon/ortho and it would require fewer visits back.
So here I am now with another appointment to visit the surgeon and ortho tomorrow and all though at the time I settled for just lower jaw I'm wondering if I should have?
I have the feeling they wish to go down the route with the lowest risks involved. It's just for me anyway I'd rather try for the best result, rather than doing it just for the function as after all what's the point in getting straight teeth if no-ones going to see them?
So should I strive for more or just stop being so vain?
I'll upload the predictive images when I'm home.
Oh yeah I'm a UK based patient but I'll bee doing this privately and also I'm afraid that if I appear not 100% sure they'll postpone the surgery and I really need this done over the christmas break (I'm at Uni)
Surgery choices?
Moderator: bbsadmin
Re: Surgery choices?
My view: you should only have to go through this once, and therefore, you might as well get the best outcome possible. I'd strive for more - it's not vain to want to get the best from this, especially as you're paying for the privilege.Grez wrote: So should I strive for more or just stop being so vain?
I was offered a choice of just BSSO to bring my lower jaw forward, or Lefort and BSSO to bring my lower jaw forward, correct a cant, correct a gummy smile and reduce mentalis strain. I opted for the latter, because ultimately it's going to mean a couple of weeks off work, dribbling, numbness and no-chew whether you have lower or both!
I'd discuss your concerns further with your surgeon. It you don't mind the slightly increased inconvenience and slightly increased risk of complications, why not go the whole hog. I would. I did!
Braced May 2005
Bimaxillary surgery Aug 2007
Debraced Jun 2008
Bimaxillary surgery Aug 2007
Debraced Jun 2008
I agree, you should be as happy as you can with your result and if you want to see more teeth - go for it. That being said..... is there any other way this can be done? Are there cosmetic procedures that can shorten the upper lip a bit and not be as invasive as upper surgery? Maybe someone else out there knows more than I do and can answer that.
Ditto for what every other poster said. It's your mouth, oral alignment, and in the end the aesthetics of the surgery should be pleasing to you. I've been told that many oral surgeons are the PERFECTIONISTS and mine recommended both maxillar reduction (Le Fort osteotomy) and mandibular advancement (I think it was BSSO?), as well as genioplasty to take out a small bone in my chin. The chin bone didn't HAVE to come out, but in looking at the computer generated pictures, I liked the chin bone removal picture better than leaving it alone. My surgeon insisted that I had to be happy with my appearance, and he would do everything in his skill to make that happen. You're paying hard-earned money for the procedure, so if you want your facial appearance to be different than what your OS is recommending and you want additional work to make your smile or gum line show more, then by all means, you have justification for asking for it.Good luck to you and keep us posted on your progress post-op.
Katie A
Grez,
As a person who is currently suffering the consequences of a failed LeFort I (this is VERY rare, but a possibility), if I were in your shoes, I would opt for the BSSO alone. Just my personal opinion. BSSO as a procedure creates quite stable results. Lots of "bone on bone," squeezed together with those screws. If I could have gotten away with BSSO alone, I would have, but my discrepancy was too great (10 mm!). I too would have liked to have a little more tooth showing (originally I wanted my surgeon to consider bringing down my maxilla a couple of millimeters), but these days I will settle for healed bones and a bite that works, neither of which I currently have (see my thread, "Back to Ye Olde CHOP SHOP").
Just my humble opinion. Sometimes simpler is better!
As a person who is currently suffering the consequences of a failed LeFort I (this is VERY rare, but a possibility), if I were in your shoes, I would opt for the BSSO alone. Just my personal opinion. BSSO as a procedure creates quite stable results. Lots of "bone on bone," squeezed together with those screws. If I could have gotten away with BSSO alone, I would have, but my discrepancy was too great (10 mm!). I too would have liked to have a little more tooth showing (originally I wanted my surgeon to consider bringing down my maxilla a couple of millimeters), but these days I will settle for healed bones and a bite that works, neither of which I currently have (see my thread, "Back to Ye Olde CHOP SHOP").
Just my humble opinion. Sometimes simpler is better!
There are no ordinary moments.
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Hello again!
Well I went and saw the surgeon and ortho and aired my views on what I wanted out of the surgery. They said as it was such a small movement and the changes would be so subtle in comparison to a much larger movement, that it didn't really matter either way and that which ever movement was done I'd get an excellent result, it's just that lower jaw surgery has less recovery time from their point of view and I think less risks, but as showing more teeth was a concern of mine and maybe a little bit fuller face then the surgeon agreed that upper jaw was the right decision.
So now I'm just hoping I can get a surgery date in December and finally get this over with.
Phil, thanks for the extra perspective on upper surgery while I realise it may have more risks I still think I'm going to go with it, plus I'm 21 so recovery should be quite quick and lower the risks for me. I'm sorry to hear what has happened, nonunion would frighten the life outta me, but with a positive attitude like yours I'm sure this next surgery will be a complete success!
Well I went and saw the surgeon and ortho and aired my views on what I wanted out of the surgery. They said as it was such a small movement and the changes would be so subtle in comparison to a much larger movement, that it didn't really matter either way and that which ever movement was done I'd get an excellent result, it's just that lower jaw surgery has less recovery time from their point of view and I think less risks, but as showing more teeth was a concern of mine and maybe a little bit fuller face then the surgeon agreed that upper jaw was the right decision.
So now I'm just hoping I can get a surgery date in December and finally get this over with.
Phil, thanks for the extra perspective on upper surgery while I realise it may have more risks I still think I'm going to go with it, plus I'm 21 so recovery should be quite quick and lower the risks for me. I'm sorry to hear what has happened, nonunion would frighten the life outta me, but with a positive attitude like yours I'm sure this next surgery will be a complete success!