yussimania
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This thread is specifically going to go over some disadvantages of the lefort 1 osteotomy and its effect on the nasiolabial angle in double jaw surgery - please note that you should do your own research and weigh up the pros and cons yourself.
Usually we see people advocate for CCW or DJS for something as simple as a normodivergent (not sfs or lfs) class 2. This isn't the correct approach as it could cause issues such as chimp lip and sometimes a class 3 lip profile. It would instead in this case be preferred to do BSSO single lower jaw surgery. Please don't get DJS thinking you're getting a free rhinoplasty from the tip upturning.
I hypothesise the philtrum curve is due to the relationship between the ANS and the A point of the maxilla (the infradentale can also be part of the problem in people with bimaxillary protrusion but that's for another time).
Here above it is labeled for you plebs.
When the A point moves forward but the ANS doesn't move forward (as much) the result will be a "chimp lip".
Before we jump into it I wanna show the importance of having a nice nasolabial or simply put "philtrum" curve.
It's what makes a side profile balanced - not hyper masculine but "pretty" to look at - angularity and curves in the right places make the side profile beautiful.
Case study #1)
Yes this isn't a true side profile but we can still compare as the orientatation is similar.
A dead giveaway is the Nasolabial angle becoming more acute - this means the nasal spine and the A point haven't moved as one and thus the relationship has changed.
But yussimania how can you prove this?
See the difference in relation between the ANS and the A point. It's also evident on the soft tissue part of the scan.
Case study #2)
A good way to check this is to see caucasoids who are class 3 - this eliminates and controls for the Asian trait of having an entirely recessed midface.
In the before the ANS is clearly further projected than the A point as can be seen by the curve. My logic follows that the nose is relatively projected which follows the norm of caucasoids but due to class 3 it is evident that the A point will be further back relative to the ANS. Now when he advanced the A point during the lefort 1 he fixed his profile - it looks nice and way better than the before but now the nasolabial curve has gone (not that it was good before but this is just theory talk).
Case study #3)
He had a class 2 originally but due to CCW he now has class 3 lips. When the lefort 1 area is overrotated this way it causes the A point to tip back which causes the upper lip to fall behind the lower lip. This is offset by advancing further but then you could run into other issues like anteface and soft tissue problems.
Credits to @lurking truecel
Wider reading:
Usually we see people advocate for CCW or DJS for something as simple as a normodivergent (not sfs or lfs) class 2. This isn't the correct approach as it could cause issues such as chimp lip and sometimes a class 3 lip profile. It would instead in this case be preferred to do BSSO single lower jaw surgery. Please don't get DJS thinking you're getting a free rhinoplasty from the tip upturning.
I hypothesise the philtrum curve is due to the relationship between the ANS and the A point of the maxilla (the infradentale can also be part of the problem in people with bimaxillary protrusion but that's for another time).
Here above it is labeled for you plebs.
When the A point moves forward but the ANS doesn't move forward (as much) the result will be a "chimp lip".
Before we jump into it I wanna show the importance of having a nice nasolabial or simply put "philtrum" curve.
It's what makes a side profile balanced - not hyper masculine but "pretty" to look at - angularity and curves in the right places make the side profile beautiful.
Case study #1)
Yes this isn't a true side profile but we can still compare as the orientatation is similar.
A dead giveaway is the Nasolabial angle becoming more acute - this means the nasal spine and the A point haven't moved as one and thus the relationship has changed.
But yussimania how can you prove this?
See the difference in relation between the ANS and the A point. It's also evident on the soft tissue part of the scan.
Case study #2)
A good way to check this is to see caucasoids who are class 3 - this eliminates and controls for the Asian trait of having an entirely recessed midface.
In the before the ANS is clearly further projected than the A point as can be seen by the curve. My logic follows that the nose is relatively projected which follows the norm of caucasoids but due to class 3 it is evident that the A point will be further back relative to the ANS. Now when he advanced the A point during the lefort 1 he fixed his profile - it looks nice and way better than the before but now the nasolabial curve has gone (not that it was good before but this is just theory talk).
Case study #3)
He had a class 2 originally but due to CCW he now has class 3 lips. When the lefort 1 area is overrotated this way it causes the A point to tip back which causes the upper lip to fall behind the lower lip. This is offset by advancing further but then you could run into other issues like anteface and soft tissue problems.
Credits to @lurking truecel
Wider reading:
Last edited:
