Reversing jaw surgery: has anyone ever heard of this?

[jawregret1]

There seems to be some pretty noticeable soft tissue changes. Your smile doesn't pull up the same on the top. I wonder if that'll get better as time goes on. If it does, it seems like it could help your tooth show on the top a fair bit.

I hope so, but I'm doubtful. An almost 3.5 mm impaction without a gummy smile is significant. I'll basically forever show 3 mm less of upper teeth now. I don't think I have particularly large teeth either, so it's bothering me a lot. That's the length of half of my lateral incisors. Its significant.

[snapdresser]

People pay big money for lips like that! Can you smile any bigger than in that previous pic that you sent? It looks like you're not smiling as big as in the pre-op pic, or maybe it's that the muscles are now pulling in a slightly different direction. Maybe you have some muscle mobility issues still resolving in the top? Doing some impaction on the top to offset pulling forward the maxilla is par for the course and maybe they didn't predict the muscle changes. 6mm advancement and 3.5mm impaction doesn't sound crazy tho, so it's a bit puzzling

[jawregret1]

It was 3mm advancement in the upper jaw and 3.5mm impaction. So they impacted more than they advanced, but I had no gummy smile...

[snapdresser]

Ah, it was your mandible that came forward 6mm. I show about 50% upper tooth and 50% lower tooth if I try to let my lips open a bit at rest (tho they're naturally closed now, as yours should be) but I'm not sure what the ideal is. I've only seen ideal tooth-show when smiling. So what's your plan of action? You trying to get a graft to pull your maxilla down? I think that has a lot higher chance of not healing up as well, tho I could be wrong. I suspect your surgeon will make you wait 9 months or a year before they're willing to go back in. How does your profile compare? That's where I really saw the improvement for my case.

[SingleJawMelb]

No. But it's interesting that your ortho suggested you only needed one and your surgeon did both. My surgey decisions was left up to my surgeon and I wasn't given any suggestions about what would be needed.

It's a 2D image so I really can't say that you look worse and it's bad your surgeon did more work than necessary. Mine was one of those conservative Australian doctors that do as little as possible - prob so I don't end up in this position?

What has your surgeon said post op? Can you go for another consult elsewhere?

I have an appointment with my surgeon this week. I'm going with my mother just because she completely agrees with what I'm saying, so I'd like someone to back me up so he doesn't brush me off. My mom's 50 and has better tooth show than me lol.

I have spoken to some other doctors and showed them the x-rays and lateral cephs from pre-op and before and after photos and they seem to think that toying with my upper jaw was completely unnecessary.

Ok maybe you need to go down the legal route? If he's doing unnecessary procedures and other surgeons agree - time to get some procedures put in place?

[SingleJawMelb]

In my opinion and aesthetically speaking, a larger BSSO with vertical and slightly forward genio without any maxilla change would have looked the best. Generally, people that get their maxilla impacted have long faces with steep jaw angles, but you don't have those it seems. Your maxilla also doesn't look recessed but these things are impossible to tell from just an ordinary picture and I'm not a professional. I would say your lower jaw is still retrusive, relative to your face. This is something you should be striving for aesthetically: https://gyazo.com/3db3b329abfc1d0ff62e752ee31e6252 I moved the upper lip back and extended the chin downwards a bit and brought your mandible forward. Even if you leave your maxilla as is and bring the mandible forward the difference is hugely positive.

You definitely do look better post op. But you are right about the results being aesthetically underwhelming.

Just wondering where you get your information from?

Read a lot and talk to a lot of jaw surgery nerds.

Where do you find these fellow insecure people, sorry jaw nerds.

Just kidding, I don't know how anyone can be so dedicated/interested about something that I think isn't a big deal

Can you answer my post about jaw surgey without braces. I think you will enjoy answering. Ta.

[jawregret1]

Ah, it was your mandible that came forward 6mm. I show about 50% upper tooth and 50% lower tooth if I try to let my lips open a bit at rest (tho they're naturally closed now, as yours should be) but I'm not sure what the ideal is. I've only seen ideal tooth-show when smiling. So what's your plan of action? You trying to get a graft to pull your maxilla down? I think that has a lot higher chance of not healing up as well, tho I could be wrong. I suspect your surgeon will make you wait 9 months or a year before they're willing to go back in. How does your profile compare? That's where I really saw the improvement for my case.

My profile is not retrusive but still weird. They shouldn't have touched the upper jaw at all, and the chin looks strange.

Pre-op: https://i.imgur.com/Mz9B1FV.png
Post-op: https://i.imgur.com/9jNUZoU.png

In my opinion and aesthetically speaking, a larger BSSO with vertical and slightly forward genio without any maxilla change would have looked the best. Generally, people that get their maxilla impacted have long faces with steep jaw angles, but you don't have those it seems. Your maxilla also doesn't look recessed but these things are impossible to tell from just an ordinary picture and I'm not a professional. I would say your lower jaw is still retrusive, relative to your face. This is something you should be striving for aesthetically: https://gyazo.com/3db3b329abfc1d0ff62e752ee31e6252 I moved the upper lip back and extended the chin downwards a bit and brought your mandible forward. Even if you leave your maxilla as is and bring the mandible forward the difference is hugely positive.

You definitely do look better post op. But you are right about the results being aesthetically underwhelming.

Thanks for this, but I honestly want something close to my old face back, even with a smaller jaw. I can't take any more surprises with my face.

[Lostfaith]

I'm having mine reversed , I had a impaction that has left me with maxillary hypoplasia (short upper jaw) so
You no longer see my upper teeth. It's going to be complicated and comes with risks but it's not right so what option do I have .

[Lostfaith]

Think I may have spoken to you before , I have the same thing that you don't see my upper teeth and only the lower . The impaction was over done , really if it's the same for you then the upper needs to come down, I wouldn't start asking for them to the do the lower as well , as your upper jaw comes down then your chin will rotate backwards slightly . It's considered a unstable procedure and has a higher chance of relapse but they can stabilize it as much as possible using a graft or Hydroxyapitate and bone plates . I know exactly what you are going through and it's awful , find a very very experienced surgeon as if he's got it wrong once then would you trust him to do a revision .

[jawregret1]

Think I may have spoken to you before , I have the same thing that you don't see my upper teeth and only the lower . The impaction was over done , really if it's the same for you then the upper needs to come down, I wouldn't start asking for them to the do the lower as well , as your upper jaw comes down then your chin will rotate backwards slightly . It's considered a unstable procedure and has a higher chance of relapse but they can stabilize it as much as possible using a graft or Hydroxyapitate and bone plates . I know exactly what you are going through and it's awful , find a very very experienced surgeon as if he's got it wrong once then would you trust him to do a revision .

The thing is that my upper jaw is way too forward now, and my lip sticks out as far as my nose when I'm at rest. I wish for it to be brought back as it was in addition to downgrafting, so that requires the lower jaw to be redone as well. It looks very bad with the upper protruding so much.

[snapdresser]

The thing is that my upper jaw is way too forward now, and my lip sticks out as far as my nose when I'm at rest. I wish for it to be brought back as it was in addition to downgrafting, so that requires the lower jaw to be redone as well. It looks very bad with the upper protruding so much.

Wait... I thought you said they only advanced your maxilla 3mm? Why would it suddenly be way too forward now? 3mm is a pretty small movement. When's the last time you met with your surgeon?

[Snophik]

If it wasn't necessary from the start, then 3 mm is a lot.

[jawregret1]

If it wasn't necessary from the start, then 3 mm is a lot.

Exactly.

[snapdresser]

If it wasn't necessary from the start, then 3 mm is a lot.

3mm is 3mm and what I'm getting at is that perhaps the bone movement itself isn't to blame for the appearance; maybe she has an infection. That's why I asked when the last time she saw her surgeon was.

[jawregret1]

If it wasn't necessary from the start, then 3 mm is a lot.

3mm is 3mm and what I'm getting at is that perhaps the bone movement itself isn't to blame for the appearance; maybe she has an infection. That's why I asked when the last time she saw her surgeon was.

Last time I saw the surgeon was four days ago, and there was no infection.