Orthognathic surgery/SARPE/Genioplasty/Gingivectomy/Veneers

[barbiewithbraces]

Hi, I was wondering if anyone could give me as much as info as they can on the certain subjects I'm about to speak about.

I have long face syndrome; its not so drastic or bad, I'm a very pretty girl, but there are a couple things I'd like to change regarding this issue for both aesthetics as well as my future health. I haven't spoken to an orthodontist or a specialist yet. My brother is a dentist but he's of no help. I will go for a consultation as soon as I get my hands on some cash. I haven't had braces, but my teeth are straight. Let me list what's wrong with my teeth. I have an overbite, it's not drastic but you cant see my main bottom teeth when I close my mouth. I am a mouth breather, have been my entire life due to my deviated septum. My palate and mouth are very narrow and my smile is narrow small and not the typical A-line. My smile is gummy and my bottom lip has a bit of trouble meeting my top lip, it creates a strain on my chin making it look deformed. My chin is too far back and my face is quite narrow and has gotten more narrow within time. At one point I had a retained which opened up my palette back in Grade 6, which in turn made my face look chubbier and much more aesthetically pleasing. I myself have researched a bunch of options, drawn my own conclusions and seen the risks vs benefits. Here's what I'd like to carry out:

SARPE- to open my narrow palette, widen my face and create a larger smile. From what I understand it takes an "average" of 3-4 months for the gap to close, braces would be worn during this time. How painful is this process?

Lefort 1- To surgically get rid of long face syndrome, get rid of the gummy smile and shorten my face. How long till I am presentable to the public? I understand there are risks, do majority of people encounter nerve damage? Is this process as bad as it sounds? Does this alter your nose in any way? Would I carry out a nose job to fix my deviation as well as the non-straightness of my nose prior to or post-op? How long do I need braces for before and after? From what I understand people usually get 1 year prior and 6-12 months post-op. I'm trying to avoid wearing braces for too long. Would LINGUAL braces do for the first year prior to surgery?

Braces- How would they get rid of my overbite? Do I NEED braces to change my overbite?

Osseous/Sliding Genioplasty- I understand there are risks for this procedure due to possible nerve damage. My chin is uneven and longer on one side due to an injury I had a few months back. I'd like to carry this procedure out in order to shorten my face vertically and move the chin forward to create a better/more appealing profile.

Gingivectomy- In order to make my teeth larger when paired with veneers and reduce the gummy smile alongside Lefort 1.

Veneers- To make teeth larger (I have small teeth). The molar veneers would be much larger to create the illusion of an even larger smile.


Would these procedures be carried out in the order I put them in? How long will this all take?
Thank You and I hope someone responds with some answers and insight.

[barbiewithbraces]

Forgot to add *Would I need MSDO? My bottom mandible is also very narrow.
If I did Lefort 1 could I pair it with SARPE as a two piece Lefort 1
How much are the average costs for all the listed procedures (minus the veneers)

[maxhammer]

Surgically widening the pallet is the most unstable procedure you can do so find a great surgeon.
When you bring the mandible forward it should widen a little.
I wouldn't rely on braces to fix your overbite. Not if you want good aesthetics. It will have to be done by moving the mandible forward and possibly changing the angle of the maxilla.

Veneers are expensive and they damage your teeth permanently. Gingivectomy might be unnecessary if you get a le fort 1 with impaction, but maybe not. We'd have to see photos. Consult a surgeon--they will tell you exactly what you need.

It would probably take close to 2.5-3 years to carry it all out

[barbiewithbraces]

okay b/c I don't really mind my overbite at all. It's the gummy smile, and the narrowness of my smile/mouth that bugs me. I hate how I can't keep my mouth closed, and I absolutely hate how I'm a mouth breather. I just want a shorter/chubbier/wider face and a large wide smile I can be proud of, it's been my dream for years.

I will begin consulting some doctors as soon as I can, but here's a photo for now.
How do I post a photo? Help!

[maxhammer]

I don't think we can upload photos here. You have to upload to tinypic or imageshack, then copy/paste the link.

Your face likely won't widen too much from surgery unless they bone graft the zygomatic arch area. The lower will widen a little as it moves forward, but the upper might not widen at all unless you surgically expand it (which as I said, is relatively unstable so you face possible relapse).

[barbiewithbraces]

please go to photobucket com then search for "barbiewithbraces", click the user and check the recent album with 5 photos


the photo's make my smile look better than it really is.
I mean all in all it's not that bad, but it ain't a beautiful/perfect celebrity smile.

I just want a beautiful smile, and to get rid of long face syndrome, not just for aesthetics, but also b/c I don't want it to progress and lead to even worse symptoms later on in life.

[barbiewithbraces]

I just thought of something,
Since SARPE will cause a gap and I want to do veneers to make my teeth larger, would I do them when the gap is there that ways it's easier? or way post-SARPE. Maybe that's something Id ask a cosmetic dentist.

[beccak]

it sounds like you have a lot of things going on. i wouldnt try to decide what you should have done..you need to consult with a very good oral surgeon.
also..dont let anyone extract any of your teeth.

i have had major problems..for years and had no clue what was wrong..similar face...as you describe..but they extracted teeth..which was not the correct treatment. (this was when i was very young)

as an adult..i have had several surgeries..and still have some issues. i had to have orthognathic and then total joint replacement..(and revisions of first orthognathic)..bc they did the first surgery when the tmj joints were severely arthritic. or else the surgery worsened it..

it sounds like you also might be having some tmj issues..and if that is the case..you dont want to do the orthognathic surgery..until this is correctly diagnosed..and adressed.

it has to be adressed before your surgeries..or if done simulaneously the tmj joint has to be fixed before they approach the orthognathic part.

where do you live..can you afford to travel.
if i were you i would see dr wolford in dallas texas..(he is the only one i would recommend) to check out the tmj status properly. if your tmjs are okay...then a very good oral surgeon would be fine. however..dr wolford is very good..but you really need health insurance..to see most of these people

or orthodontist...dr hang in california. i see both.

or at least consult with dr hang via email and send him your photos.

i had to go to him after my first orthognathic surgery..bc of problems..
i had to go from nc to california..every 2 months..and am still going.

i have had to have financial help..from parents..(unfortunately).
not every one can do this.
i suggest get some consults..and get more than one opinion.
do not have anything done..until you are fully comfortable it is the right thing.
you probably need a sleep study also..bc you might have obstructive sleep apnea..

you are better off doing nothing..than having someone do the wrong treatment.

i know what i am talking about..learn from me.

also..you are right about your brother...2 of my brothers are dentists..they are often no help..they dont always understand the problem...(and family can be the worst). my brothers are great..but
i understand totally.

i hope this helps.