Can a bimax ruin my harmony or my occlusion?

[Jeiko]

So yesterday my surgeon told me that i don't need bimax for theses reasons (by order):
- No severe breathing/health problems
- Perfect oclusion for all my teeths (which is true)
- Good harmony (hyoid and chin/lips/nose allignement, but my facial depth, midface projection and frankfort recession are more important and bad on me)

He told me that if we go for a bimax only for aesthetic, i'm gonna be worse in term of harmony and oclusion.
And that if i go to others surgeons, sure i will find someone to make it but because all they want is money without caring about their patients results and fonctional/breathing health so i need to be careful etc.

I don't know how my harmony can be worse if i don't go for a huge bimax.

My idea now is to get another opinion from another surgeon (im from France) and also from Dr Ramieri (in Italy).

Here are my scans (i didn't got cbct), 20yo :

Note that for the side, my head is more tilted backwards here because their machine is build for shortcells, my natural position make the chin more backwards and my forehead more flat for exemple.

What do you think and what should i do ?

 

[Jeiko]

bump

 

[Jeiko]

bump

 

[Jeiko]

bump

 

[Rylie]

I don't know how my harmony can be ruined

It depends on your current fwhr.

He told me that if we go for a bimax only for aesthetic,

You have a narrow airway, even if you get an aesthetic bimax your life will change.

You need to figure out your current ratios down to the MM and what each movement will effect.

I’m getting a bimax for my airway, which technically is classified as cosmetic.

 

[Jeiko]

It depends on your current fwhr.

1.75x to 1.83x for my midface and 1.45x for total faceshape, so it's long.

And yeah for all the ratios of the bimax, it will ascend me from the side and slightly for the front. But difficult to tell for the chin/lips area.

You have a narrow airway, even if you get an aesthetic bimax your life will change.

quit narrow, my ortho agree on this point and i got slithly sleep apnea like for 3min on a 8 hours night, nothing for this surgeon but i'll keep looking for bimax for sure.

 

[Rylie]

quit narrow, my ortho agree on this point and i got slithly sleep apnea like for 3min on a 8 hours night, nothing for this surgeon but i'll keep looking for bimax for sure.

That’s a good orthodontist, it took me 3 different orthodontists and airway TMJ specialist to finally get a recommendation to see an airway surgeon.

I have mild sleep apnea, very narrow airway, and an underbite. They wanted to tilt my teeth and camaflauge it while also wearing a mandibular advancement device while sleeping and working out so I could actually breath. they looked at me as crazy for considering this surgery.

The current fucking state of orthodontics and conservative TMJ specialist make me sick.

Even if you had conservative movements they would be enough for aesthetics and airway.

 

[Jeiko]

That’s a good orthodontist, it took me 3 different orthodontists and airway TMJ specialist to finally get a recommendation to see an airway surgeon.

I have mild sleep apnea, very narrow airway, and an underbite. They wanted to tilt my teeth and camaflauge it while also wearing a mandibular advancement device while sleeping and working out so I could actually breath. they looked at me as crazy for considering this surgery.

The current fucking state of orthodontics and conservative TMJ specialist make me sick.

Even if you had conservative movements they would be enough for aesthetics and airway.

That's brutaly sucks. They are so bluepilled and not considered airway problems if it's not severe. Get that bimax and don't hide the root cause.
Yeah an airway specialist told me that i can get this mandibular device if i want