Metal Mouth Message Board

How important is the aesthetic sensibility to you when choosing a surgeon? After all, it is your face that is being performed on that you're paying for.

What's aesthetically pleasing is definitely subjective, however, it's vital to maintain realistic in terms of aesthetic goals. I've had braces, plus the headgear, when I was a child (I was the boy with the overbite), which was quite traumatizing as I once had to wear the headgear in public at my after-school program. I literally cried my eyes out as I was exposed wearing the contraption in front of my peers. At the time, it was known to me for the reasoning of getting braces was to achieve a more aesthetically "pleasing smile". But at that age, I could care less about the way I looked. But in reality, anything related to a malocclusion is accompanied by functional issues as well as aesthetic imbalances which can cause emotional and psychological distress once the young-adult years rolls in. Now being 21, I am completely displeased with my childhood orthodontist's poor judgment and lack of aesthetic sensibility. I've lived my entire adolescent years being self-conscious about the way I looked, something that "braces" was "supposed" to help avoid. My ortho achieved "straight" teeth for me, however, failed to realize the underlying problem, which was my jaw. I was disliked by many and made fun of a lot during my childhood simply because of the way I looked. It's sad and wrong, but that's life. People judge books by it's covers. Anyhow, that's not the point. There are tons of people whom had the orthodontic treatment during their childhood whom are seeking the orthognathic treatment now. And because I am currently in the process of starting my orthognathic journey as I search for a surgeon, I am just fearful to experience all that emotional distress when I was growing up all over again, it was utterly uncomfortable and awkward. I apologize for the unnecessary ranting, but back to the primary question.....how important is aesthetic sensibility to you?

There are various diagrams with proportions etc, that most surgeons use as a "standard"; though some surgeons will probably put more importance on aesthetics than others. For example, even though my issues were probably 50% cosmetic and 50% functional, he was insistant on getting a good compromise between the two, rather than getting the absolutely best possible functional result and negatively effecting my appearance (or visa versa).

I am completely displeased with my childhood orthodontist's poor judgment and lack of aesthetic sensibility. I've lived my entire adolescent years being self-conscious about the way I looked, something that "braces" was "supposed" to help avoid. My ortho achieved "straight" teeth for me, however, failed to realize the underlying problem, which was my jaw. I was disliked by many and made fun of a lot during my childhood simply because of the way I looked.

As for your orthodontist: mine too failed to mention the jaw issues during my first course of braces; but as soon as I mentioned it a few months after getting my braces removed (at 16) he suggested surgery and got things in place for me. Perhaps he simply didn't notice, or perhaps he didn't want to put me through all the stress and risks of surgery if I was allready happy with my bite and appearance (he might have thought bringing it to my attention would have made it bother me more); either way I can't say I feel too much resentment over it. I will admit to having a strong "like/dislike" relationship with my ortho; it's hard not too when they put you through so much torture; but I think he's a decent man really and he has gone the extra mile for me at times over this.

It's also worth bearing in mind, that as it sounds like you were pretty young when you got your braces off, your jaw issues might have worsened as you got older. Plus, if your problem is mainly cosmetic, he might have thought you wouldn't be able to get it on national healthcare or insurance (I don't know where you're posting from); which due to cost makes the surgery unfeasible to a lot of people. Obviously I don't know your specific circumstances... just wondering if it might explain anything?

There are tons of people whom had the orthodontic treatment during their childhood whom are seeking the orthognathic treatment now

As you're only 21, I doubt it's the case with you, but for some of the older patients on this board; it's worth mentioning that the risks, recovery time and success rate of this operation has dramatically increased over the last few decades. If I was 30 years older, and had been offered this surgery three decades ago, I seriously doubt whether I'd have been up for it!

Even nowadays; my dentist thought I was mad to agree to this kind of surgery (despite tutting about my bite pretty much every time I've been to see him ). I suppose some dental professionals (including orthodontists) don't really think it's appropriate except in extreme cases... not sure if that's right or wrong, but someone who feels that way is hardly likely to suggest it as a treatement. Mind you, I know a girl about my age who has an obviously quite severe overbite due to a recessed chin and she only got her braces off recently; I can't help feeling she's someone who's just slipped through the net.

dayeangphurr wrote:How important is the aesthetic sensibility to you when choosing a surgeon? After all, it is your face that is being performed on that you're paying for.

how do you judge the surgeon`s aesthetic sensibility?
you cant really by before and after photos, because a lot of people just look good "by accident" when their functional problem is fixed.

I guess the only thing you can do is find out if your surgeon would go the extra mile to achieve a better result, e.g. both jaws when only one is medically necessary.

I don't know if this will apply to you, but I definitely had a lot of thought about aesthetics before I had my surgery. I'm Korean, so I had a lot of questions regarding the beauty standards that fall with an [white] American doctor and a Korean doctor. The biggest difference I saw with the procedure was that Korean doctors recommended mentoplasty (redesigning/restructuring of the chin) in addition to the double jaw procedure.

There were a lot of other factors that made me go with the Korean doctor, but the fact that he was used to operating on faces that looked like mine definitely pushed me towards deciding with him.

I think you have to be very honest with your surgeon about your goals/expectations. I had the option of doing only lower jaw/chin surgery to fix my bite and the option of doing also upper jaw to advance everything further which would be only esthetic. In a ortho/surgeon misunderstanding my surgeon was under the impression that I had no esthetic motivation, which isn't the case. After long talk with him and some soul searching I elected to go ahead with just the lower jaw/chin but that was after I really grilled him about EXACTLY how much better aesthetics we were talking about (which he tought would be pretty minimal, like 5% improvement if doing the upper as well).

I think any decent surgeon won't let you do something he would feel will make you look WORSE without making sure you are absolutely happy with this - for instance, my chin reduction is purely esthetic. It was already sticking out before surgery so if I didn't do anything with it and advanced my lower jaw I would probably look worse post op. I don't think any of us here are willing to go throught all this and look worse. On the same note I think most of us also wouldn't go through all this if there wasn't a functional reason to do it. And any surgeon who does enough of these procedures should understand these concerns.

I would say it is extremely important. This surgery is as much an art, if not more so, as it is a science. As to the OD not recognizing/addressing your jaw issues, unfortunately this seems to be a fairly common occurence. Orthodontists, for the most part, are trained to move teeth, not necessarily deal with jaw issues. This varies greatly of course, but I've heard and read this quite a few times before and have had same personal experience.

my surgeon is more concern about how i want to look. so for esthetic reasonf my jaw surgery plans have changed...............


whoever says they arent doing it to look good is a liar........

shanalouis wrote:my surgeon is more concern about how i want to look. so for esthetic reasonf my jaw surgery plans have changed...............


whoever says they arent doing it to look good is a liar........

I must say that I take exception to that comment. I would be doing the exact same surgery if there were no aesthetic benefits at all (and there may be none, once it's all said and done). For some of us, this was purely a functional choice, and if there are some aesthetic benefits, so be it. Personally, 4 days post-op, the way I feel right now would not have been worth it solely for vanity.

Broadway Bill wrote:

shanalouis wrote:my surgeon is more concern about how i want to look. so for esthetic reasonf my jaw surgery plans have changed...............


whoever says they arent doing it to look good is a liar........

I must say that I take exception to that comment. I would be doing the exact same surgery if there were no aesthetic benefits at all (and there may be none, once it's all said and done). For some of us, this was purely a functional choice, and if there are some aesthetic benefits, so be it. Personally, 4 days post-op, the way I feel right now would not have been worth it solely for vanity.

Agreed... I have not had my surgery yet but I would prefer there NOT be an change in my appearance. I want to be able to chew and save my teeth from further destruction due to grinding. I DO NOT want to look different. It is the one thing making me very anxious over the whole surgery. I have always been happy with my appearance. It is me...

I apologize for never getting around to thanking everyone for their responses, so thank you! Everyone made some valid points.

shanalouis wrote:my surgeon is more concern about how i want to look. so for esthetic reasonf my jaw surgery plans have changed...............


whoever says they arent doing it to look good is a liar........

... I didn't have the surgery to look good. I had a pretty massive overbite but never had any comments about it during my life. I only really found out that I had this overbite when I went to see the orthodontist for the first time when I was 16. I actually left it up to my surgeon on whether or not I should have genioplasty as well as the double jaw surgery. He told me he would ask the nurses and other staff during the surgery if they think I should have the genioplasty performed as well, so it wasn't just his decision/opinion in the end Thankfully, they decided against it. I guess this is a better result because if I do want to have my chin done in the future, there is always that opportunity. And plus, I'm not sure how hard it would be to reverse the genioplasty... or even if that's possible at all.

shanalouis wrote:my surgeon is more concern about how i want to look. so for esthetic reasonf my jaw surgery plans have changed...............


whoever says they arent doing it to look good is a liar........

I am absolutely shocked and upset at that comment. I am having the surgery (BSSO) extremely reluctantly, just for functional reasons. I look fine without it. I just want the jaw pain to go away.

I think this surgery is harder for people who are happy with their appearance already - the outcome is so hard to predict.

For my son, his jaw was so messed up that any change that brought his face back into more normal proportions would improve his appearance. There really wasn't any part of face, other then his eyes, that he wanted to keep the same.

Even with all that, he absolutely would not have had the surgery if he hadn't felt that he had to have it in order to preserve his back teeth. We were all ready to back out over the summer, until his orthodontist pretty much told him he had to go through with it.

Its evident that we all have different motives and intentions for undergoing orthognathic surgery - whether its solely for functional reasons, aesthetic/cosmetic reasons, or both. It definitely depends on what we want and what we're looking for.

I for one, indeed put a high emphasis on the aesthetic value. I've seen pre-surgical patients who possess an aesthetically pleasing face, despite their malocclusion. Unfortunately, I'm not one of them. Therefore, I'm not content with the way I look.

Linnie wrote:

shanalouis wrote:my surgeon is more concern about how i want to look. so for esthetic reasonf my jaw surgery plans have changed...............


whoever says they arent doing it to look good is a liar........

I am absolutely shocked and upset at that comment. I am having the surgery (BSSO) extremely reluctantly, just for functional reasons. I look fine without it. I just want the jaw pain to go away.

I think it's quite evident, based on that particular person's other posts on this board, that she has a lot of issues that need to be worked on. Other members have gently (and not so gently) have suggested numerous times that she may require counselling.