Bimax with flat occlusional plane. How can I achieve a taller lower third without lengthening the midface?

[one job away]

So i have a mild deep bite and a pretty flat occlusional plane

I want around a 4-5mm taller lower third. And around 9mm projection

I got offered downgrafts and CW which would get me the desired result BUT downgrafts lengthen the midface and I already am on the longer side.

is there a way to achieve the desired result without ANY lengthening of the midface?

I have Scans and morphs which I would share in dm if someone can help me out here

 

[Deleted member 7725]

Both CCW and linear advancement will create a taller lower third afaik unless your mandible is literally at a 90 degree angle.

 

[one job away]

Both CCW and linear advancement will create a taller lower third afaik unless your mandible is literally at a 90 degree angle.

The mandible isn’t but my occlusional plane is pretty much flat. I just can’t risk a longer midface. My front is so beatiful

 

[Deleted member 10615]

what is occusal plane? how to tell what one you have?

 

[one job away]

what is occusal plane? how to tell what one you have?

Occasional plane is the plane of your teeth biting together

 

[Deleted member 10615]

Occasional plane is the plane of your teeth biting together

how do you know if you have flat or something else? do deep bite people always have flat?

 

[one job away]

how do you know if you have flat or something else? do deep bite people always have flat?

Get a scan

 

[ScramFranklin]

Bimax won't lengthen your midface. I have made several in depth comments about this in other posts.

Your lower third is not your midface. Bimax will impact your lower third.

 

[one job away]

Bimax won't lengthen your midface. I have made several in depth comments about this in other posts.

Your lower third is not your midface. Bimax will impact your lower third.

Wrong. Downgrafts and cw will lengthen the midface

 

[ScramFranklin]

NO, it won't. I'm fucking tired of retards on here always "matter of factly" about things when they are dead wrong.

Imagine the lefort 1 cut, and downgrafting happening in relation to the entire skull. It is impacting the lower third. This is not that difficult. Your midface is above this cut. You could downgraft the maxilla fucking 2 feet and it wouldn't impact the midface.

 

[one job away]

NO, it won't.

 

[ScramFranklin]

View attachment 1394727
View attachment 1394729
View attachment 1394728

exactly. You are literally proving my point. Midface is the same. The difference in in the lower third. See my edited post.

Movements affecting the lower third can give the ILLUSION of a longer/shorter midface

 

[one job away]

exactly. You are literally proving my point. Midface is the same. The difference in in the lower third. See my edited post.

Movements affecting the lower third can give the ILLUSION of a longer/shorter midface

No. His midface literally moved down lol. A taller third makes the midface appear shorter. But his midface increased in length.

I absolutely have to avoid any movement in that area

 

[AlwaysHaveQuestions]

exactly. You are literally proving my point. Midface is the same. The difference in in the lower third. See my edited post.

Movements affecting the lower third can give the ILLUSION of a longer/shorter midface

i think i know what you are saying: the soft tissue is the same
but you dont want gummy smile

 

[one job away]

NO, it won't. I'm fucking tired of retards on here always "matter of factly" about things when they are dead wrong.

Imagine the lefort 1 cut, and downgrafting happening in relation to the entire skull. It is impacting the lower third. This is not that difficult. Your midface is above this cut. You could downgraft the maxilla fucking 2 feet and it wouldn't impact the midface.

View attachment 1394726

The midface is measured to top of the lips or to the middle of the lips.

I think the middle of the lips is what we subconsciously recognize as midface and as you can see that line is noticeably lower

 

[one job away]

exactly. You are literally proving my point. Midface is the same. The difference in in the lower third. See my edited post.

Movements affecting the lower third can give the ILLUSION of a longer/shorter midface

As you can see by the lines. No matter how you measure it’s noticeable longer

 

[Deleted member 7725]

The mandible isn’t but my occlusional plane is pretty much flat. I just can’t risk a longer midface. My front is so beatiful

Just get BSSO then. It will make it slightly taller assuming your occlusal plane isn't 90 degrees. Your lower third height looked fine from your pics but iirc you were jutting/frauding it. BSSO would get it closer to that but not exactly.

 

[one job away]

Just get BSSO then. It will make it slightly taller assuming your occlusal plane isn't 90 degrees. Your lower third height looked fine from your pics but iirc you were jutting/frauding it. BSSO would get it closer to that but not exactly.

Not enough projection. I will defenitly get a bimax. Only the question is how to achieve the taller lower third.

 

[one job away]

Just get BSSO then. It will make it slightly taller assuming your occlusal plane isn't 90 degrees. Your lower third height looked fine from your pics but iirc you were jutting/frauding it. BSSO would get it closer to that but not exactly.

Let me dm you fam

 

[Deleted member 7725]

Not enough projection. I will defenitly get a bimax. Only the question is how to achieve the taller lower third.

Any sort of advancement will make your lower third slightly taller. Obviously CW is the best option for significant lower third height but you don't need it and any kind of lengthening it will necessarily mean an increase in height.

 

[ScramFranklin]

View attachment 1394747
As you can see by the lines. No matter how you measure it’s noticeable longer

this shows an overall longer skull height and LOWER THIRD. holy shit

you are stubborn as shit.

 

[AlwaysHaveQuestions]

do you have short molars? advancement and some extrusion might give you what you want

 

[one job away]

this shows an overall longer skull height and LOWER THIRD. holy shit

Yeah whatever … done talking to you tbh

 

[ScramFranklin]

a longer mid face would mean lengthening the area in between these two blue lines I've drawn.

 

[dakchuh]

View attachment 1394747
As you can see by the lines. No matter how you measure it’s noticeable longer

their eyes arent even on the same level lol. move the right up to the same level and you'll see his midface hasnt changed

 

[one job away]

their eyes arent even on the same level lol. move the right up to the same level and you'll see his midface hasnt changed

I didn’t make the pic. They aren’t on the same level but still ther is a clear difference even if they were leveled

 

[one job away]

their eyes arent even on the same level lol. move the right up to the same level and you'll see his midface hasnt changed

It clearl changed

 

[dakchuh]

I didn’t make the pic. They aren’t on the same level but still ther is a clear difference even if they were leveled

difference is like 1-2mm. also he may have been tilting his head up in the before pic due to recession which would make his face look shorter, so it make very well be that there is almost zero impact on midface soft tissue

 

[one job away]

difference is like 1-2mm. also he may have been tilting his head up in the before pic due to recession which would make his face look shorter, so it make very well be that there is almost zero impact on midface soft tissue

View attachment 1394824

Check my response here. And 2 mm is massive on the face

It clearl changed
View attachment 1394826
View attachment 1394825

 

[dakchuh]

ok, if you have thin lips/long philtrum you can do philtrum lift

 

[one job away]

ok, if you have thin lips/long philtrum you can do philtrum lift

I want to avoid any changes and not run into the next surgery

 

[dakchuh]

the face is a series of interdependent parts its hard to just change one thing without affecting another

this is why chad level harmony is so rare

 

[one job away]

Does anyone have a solution ?

 

[user47283]

So i have a mild deep bite and a pretty flat occlusional plane

I want around a 4-5mm taller lower third. And around 9mm projection

I got offered downgrafts and CW which would get me the desired result BUT downgrafts lengthen the midface and I already am on the longer side.

is there a way to achieve the desired result without ANY lengthening of the midface?

I have Scans and morphs which I would share in dm if someone can help me out here

a maxillary downgraft lengthens red line not blue line. If vertical lefort movements moved your midfsce along with them teeth show would be the same. The jaws move independent of the midfsce when brought down. It is the stomion to menton distance that increases causing the perceived change in facial length , not the midfsce itself getting longer. This is why after downgraft ppl have more incisor show when smiling becaus their lips are at the same height but the teeth have come down with the lefort

 

[user47283]

H

It clearl changed
View attachment 1394826
View attachment 1394825

The stomion to menton distance changed u fucken idiot. Lefort can’t lengthen ur midfsce that makes zero sense. The minute diff you see is from slightly diff head posture between pics.

 

[one job away]

H

The stomion to menton distance changed u fucken idiot. Lefort can’t lengthen ur midfsce that makes zero sense. The minute diff you see is from slightly diff head posture between pics.

Just stfu midface ratio increased

 

[user47283]

Just stfu midface ratio increased

Shut the fuck up and read a craniofacial textbook and learn to interpret pictures u fucken moron

 

[Deleted member 4430]

its over for this forum seriously

 

[one job away]

Shut the fuck up and read a craniofacial textbook and learn to interpret pictures u fucken moron

Look. The midface as you define is not the one I am talking about. I am talking about point G to point St which is a way to measure the midface ratio. It’s really important for the perceived length of the face.

When people are talking about it they mean that point gets lowered

 

[user47283]

Look. The midface as you define is not the one I am talking about. I am talking about point G to point St which is a way to measure the midface ratio. It’s really important for the perceived length of the face.

When people are talking about it they mean that point gets lowered
View attachment 1395138

Yes I know . g point to stomion does not change with a downgraft jfl . Only stomion to menton can change. Only the most outer parts of the face can change this is like thinking a zygomatic osteotomy will change your IPD. That distance you showed is determined by your soft tissue the downgraft is not going to stretch it out because your ANS is not anchored to your nose and philtrum , it moves seperately from them, you can literally see this on X-rays wit the soft tissue profile.

 

[one job away]

Yes I know . g point to stomion does not change with a downgraft jfl . Only stomion to menton can change

That would be great news for me but I can’t really believe it since in this pics it looks like it got clearly longer

Maybe not and my brain just wants me to doubt my chances of ascending. Granted the angle changed. But the simulation one also shows movement in that area

 

[ScramFranklin]

View attachment 1394872
a maxillary downgraft lengthens red line not blue line. If vertical lefort movements moved your midfsce along with them teeth show would be the same. The jaws move independent of the midfsce when brought down. It is the stomion to menton distance that increases causing the perceived change in facial length , not the midfsce itself getting longer. This is why after downgraft ppl have more incisor show when smiling becaus their lips are at the same height but the teeth have come down with the lefort

Thank you. Yes. This is what I have been trying to explain but OP is stubborn as shit.

Even his own post #39 shows exactly what MIDFACE LENGTH is. lmao. And then he essentially says in the same post "im talking about this area below MIDFACE LENGTH when I mean MIDFACE"

 

[one job away]

Thank you. Yes. This is what I have been trying to explain but OP is stubborn as shit.

Even his own post #39 shows exactly what MIDFACE LENGTH is. lmao. And then he essentially says in the same post "im talking about this area below MIDFACE LENGTH when I mean MIDFACE"

I was referring to the midface ratio being affected by the bimax by lowering the ST point. Not the actual midface. I’m still not completely convinced that that’s not the case