[Crash Course] Who will ascend with Orthognatic surgery and who likely won't

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Preface:
I had this thought for a longer while, because it is logical if you imagine what the LeForts and BSSOs do

But one thread on Lookism put my thoughts into words and even expanded further on it

And I have translated this into the "facade" surgeries like, pretty much, all made on the splanchocranium (LeFort 3, facial fillers and implants, MSE, typical Bimax etc.)

You might still get an anteface somewhat from Bimax, even if you fall into the category I will expand on now, but it will not really be a big aesthetic boost or it may look unnatural

Short Introduction - The Common Bimax:

The Common Bimax is the standard LeFort 1 (there are many different kinds)
and the BSSO (Bisagittal Split Osteotomy) per Dal Pont

the BSSO looks like this:
source.gif


the normal LeFort 1 like this:
c6626418650377.562cd6bc8959a.gif

(straigth advancement)


Most important is the Base ... literally

So what is the "Base" I talk about?

The Cranial Base angle

One of many things you can not change (with normal surgeries) but still determines your face

1579728754019


The angle I marked in red is the cranial base Angle (there are 7 types, this is the most common one)

"Why is this so important ?"

This is what I associate with downward growth

This not only affects your mandible, but also the whole maxilla, orbitals the whole neurocranium (everything of your skull which is not your face) and your head posture (and airways and upper spine)

cranial-base-angle-in-relation-to-malocclusion-18-638.jpg


" But Shekel, this doesnt look so bad! those with higher Angle just need a BSSO"

As I said, you can achieve a proper orthognatic side-profile with a higher and a lower base (it depends on severity)

!BUT!

Schematic-showing-effect-of-cranial-base-angle-of-facial-rotation-when-S-N-are-on-the.png

Left one has normal angle, the right one a higher angle

This, Ladies and gentlemen, is the true facial growth

one bad orthognatic feature? You probably have more

They go hand in hand


Ever wondered whyy I can tell faces so good, especially from Cephs or Cts ? because I integrate this in my thought pattern

Many of you know this already subconsciously, for example, many can tell if a Jew got a Rhinoplasty


Those with short angles can easily get a LeFort and BSSO and benefit from it easily (aesthetically)

Those with higher Angles? They can quench the rope between jaw and neck, so it does not slip jfl






A Good Angle?

If we measure from

Basion - Sella - Nasion
1579731049372



the ideal angle should be around 125°/130°


the one in the picture above is approx. 135° / 140° and thus (most likely) a Class 2

Human with a B-S-Na Angle of lower than 125° are (most likely) Class 3










This thread was written with one thumb, is unstructured and has many grammatical errors or is not followable


I thought about studying into Cephs and making custom Cephs per-vista for members here but I do not think this would benefit me nor you
 
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Another high iq thread
 
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Short ramus= Bad Angle
Long ramus= Good Angle

?
 
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I'm too low IQ for this but does that mean if you have a deformity (deepbite, under bite etc) its over? or is it still possible to have a "good base"?
 
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Short ramus= Bad Angle
Long ramus= Good Angle

?
the Angles do not determine the length of the ramus

but I can see that someone with high Cranial base angle commonly has a shorter ramus too


Rather look at the form of the Ramus

4AVnR6S

(bit simplified)

This GIF is interesting again after we have learnt where the Nasion, Sella and Basion is and the Angle ofc
I'm too low IQ for this but does that mean if you have a deformity (deepbite, under bite etc) its over? or is it still possible to have a "good base"?
it is fairly possible to be recessed but with good angle

I myself have BSNa of 125° and my estimated surgery outcome looks pretty good

With high Angle you can still obtain better airways and better bite, but you wont be a "well-developed Chad"
 
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Is the only way to determine your angle is via xray?
 
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In this case, I'm already ascended then jfl.

My cranial base and angle is perfect.
Just trying to elongate my ramus.

If It weren't for being curry, I would have been 6 PSL.
 
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In this case, I'm already ascended then jfl.

My cranial base and angle is perfect.
Just trying to elongate my ramus.

If It weren't for being curry, I would have been 6 PSL.
how can u tell if ur base is good or nah
 
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how can u tell if ur base is good or nah
Cephs from Surgeon or make it your own from X-Rays or CT


otherwise you would have to look at common traits of people with high angle and compare yourself


Many people have a high base


and those with low base usually look like they have a stunted and retarded face

I will search an example of low Angle
 
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If I pm you my xray scans, can you tell if I fall in to that 'good' category?
 
No idea how to tell if mines good or not
 
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He looks like he has a bit lower cranial base angle

S12u4fa.jpg


many surgeons approach this by setting mandible back

but imagine if his midface gets advanced instead
If I pm you my xray scans, can you tell if I fall in to that 'good' category?
I need to see Sella (turcica) and Basio and ofc Nasion

then I will tell you
 
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I have a high cranial base angle :feelsrope:
 
Cephs from Surgeon or make it your own from X-Rays or CT


otherwise you would have to look at common traits of people with high angle and compare yourself


Many people have a high base


and those with low base usually look like they have a stunted and retarded face

I will search an example of low Angle
would u be willing to make a thread with people who have good and bad cranial bases?
 
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Isn't ccw jaw rotation trying to solve the problem of bad cranial base angle?
 
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Isn't ccw trying to solve the problem of bad cranial base angle?
Maxillary Protraction with CCW would have been the solution (with strong bone remodelling)

you can cover the Splanchnocranium with LeFort and BSSOs

but LeFort 3 / 2 with CCW is difficult + no one would get it anyways

LeFort1 with CCW is either anterior impaction or posterior downgraft

It will only change the LeFort 1 fracture, maybe gonial angle later

You have to get a BSSO to keep a proper bite

if you would only get the CCW LeFort 1 with advancement and do nothing to your mandible, then, yes indeed, the ramus would move forward and force you into a perma jut, but you can most likely not bite properly (logically; because of the movement)

so you can only really take a BSSO with your LeFort1, and this would not change the ramus at all because the bone gets lengthened


not a single surgery affects the cranial base, only maxillary protraction (facemask / facepulling)
but this is a too unresearched field
 
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I read the full lookism thread but what the fuck do you do if you have an angle that indicates downward growth? Just kill yourself??
 
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I read the full lookism thread but what the fuck do you do if you have an angle that indicates downward growth? Just kill yourself??
Those with higher Angles? They can quench the rope between jaw and neck, so it does not slip jfl





jk

as I mentioned in earlier comments, maxillary protraction would be the most legit thing to really change the angle (and the whole skull)

LeForts are just a facade
You can get a proper profile with them and whatever, but you will not have that generally attractive and well-developed skull
 
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nigga high iq thread, mirin four digit iq, do you know any medical books i can learn tjings like this?
 
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jk

as I mentioned in earlier comments, maxillary protraction would be the most legit thing to really change the angle (and the whole skull)

LeForts are just a facade
You can get a proper profile with them and whatever, but you will not have that generally attractive and well-developed skull

Can I pm you about my own situation?
 


Fucking brutal, all my hopes were shattered subhumanity is an inescapable hell on earth
 
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Another banger from the doc

Lifefuels me tbh, I’ve got the right angle, just recessed
 
Another banger from the doc

Lifefuels me tbh, I’ve got the right angle, just recessed
How tf do you know you have the right angle? Do you have an xray of your skull just lying in your room?
 
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Even if you don't have the right angle, it's still an improvement, right?
 
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How tf do you know you have the right angle? Do you have an xray of your skull just lying in your room?
Based on the pics he said and my skull shape+gonial angle
 
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Considering how steep the jawline is, does this look like the skull of someone who could ascend from orthognathic surgery?

 
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Very very high iq, I have been reading about neurocranial restructuring, the cranial bones and their relations. All of this makes perfect sense, I had never explicitly thought of it this way but subconsciousy it was what I always analysed, especially the occiput and how much it's protruded outward vs flat.

Flat occiput is usually associated with people whose frontal craniofacial complex is well supported and angled forward. Key word here is "angled"
1579759169465


Look at Cain Velasquez's occiput, neck posture, the way his nose is supported and under eye support, they all seem to lock together like a 3-D jigsaw.

Compare this to the incel skull
1579758260571

What sticks out is his rounded occiput, a key distinction needs to be made here, the incel and Cain Velasquez have the same shaped occiput.
1579758438484

The only reason you see a difference in shape is because of the inclination at which Cain hold his occiput vs the inel. i.e. neck posture.
1579758553059

Think about it for a second in these 2 pics. The centre of gravity of the two skulls are different, the chad skull has a more inward CG allowing him to keep straight neck posture and occiput, while the inel skull has a CG that is further outwards, forcing his neck forward to balance his head without straining his neck disproportionately.

This brings us to the sphenoid: the kingpin bone of the craniofacial complex.
1579758884779
1579758911976

This bone basically acts as a hub for the 3-D jigsaw cranial complex.The sphenoid articulates with the frontal, parietal, ethmoid, temporal, zygomatic, palatine, vomer, and occipital bones and helps to connect the neurocranium to the facial skeleton
Could this be the answer to what harmony is?

How do we change this angle? so far there are no surgeries, but there are practitioners like osteopaths who claim to use light forces to help guide bones into their proper neurocranial articulations.
 

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Does the Mackenzie chin tuck have an effect on the cranial base?
 
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Given that the cranial base forms literally from the moment you are born. Does that mean your looks level as a kid (forward growth, maxilla cheekbones, pct all your feautres basically) could be an indicator of your angle?

Even in kids you can observe that some are more beautiful than others usually due to maxilla. And when you are a kid craniofacial dystrophy didnt have the time to manifest itself.
 
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Given that the cranial base forms literally from the moment you are born. Does that mean your looks level as a kid (forward growth, maxilla cheekbones, pct all your feautres basically) could be an indicator of your angle?

Even in kids you can observe that some are more beautiful than others usually due to maxilla. And when you are a kid craniofacial dystrophy didnt have the time to manifest itself.
same reason why Facemasks work so well for kids
 
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Does the Mackenzie chin tuck have an effect on the cranial base?
yes, you are unironically holding your head at a new postition where the center of gravity coincides with that of the low angle position.
Our bodies will adapt over time and gravity to loosen the sutures and reposition the bones into a new equillibrium
 
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24C0A4E9 8AB1 4F17 9CA0 A2C469841AF7
Will I ascend with bimax with CCW rotation and Mandible implants (to add width andvisible jawline?)
Should I get a consultation with the Spanish guy Dr Birbe?
 
@Dr Shekelberg I Have X rays but I’m having trouble measuring the angle correctly, can I PM you?
 
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yes, you are unironically holding your head at a new postition where the center of gravity coincides with that of the low angle position.
Our bodies will adapt over time and gravity to loosen the sutures and reposition the bones into a new equillibrium
Thanks
 
I also have x-ray studies and cephalometric studies, I don't understand anything.

I only see that I have a significant downward growth of my jaw.
 
I also have x-ray studies and cephalometric studies, I don't understand anything.

I only see that I have a significant downward growth of my jaw.
PM me
 
Considering how steep the jawline is, does this look like the skull of someone who could ascend from orthognathic surgery?



@Dr Shekelberg how do the angles on those skull CT scans look? Would that person benefit from bimax surgery?
 
@Dr Shekelberg how do the angles on those skull CT scans look? Would that person benefit from bimax surgery?
Can not see the Sella on such scans

but my estimation (which should not be taken for granted) is 130° maybe a bit more, or a bit less
 
Can not see the Sella on such scans

but my estimation (which should not be taken for granted) is 130° maybe a bit more, or a bit less

Thanks. So basically, they are right on the borderline of just barely being a candidate for bimax? In other words, would they almost be just as well served getting a wraparound jaw implant and maybe fillers/implants in the premaxillary/paranasal areas?
 
being a candidate for bimax?
This is about

"Will you gain natural but still significant aesthetic results from a Bimax"

Anyone can get it, but Bimax will help people the most aesthetically with 125° - 130°
 
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This is about

"Will you gain natural but still significant aesthetic results from a Bimax"

Anyone can get it, but Bimax will help people the most aesthetically with 125° - 130°
1579830468372



what about this one? is he a candidate for bimax?



These are my scans btw
 
View attachment 241042


what about this one? is he a candidate for bimax?



These are my scans btw
I spoke with him over PM, he didn’t mean that if you’re angle is lower or higher than the range, that your not a candidate for bimax, rather that he believes that those within that angle range will benefit the most.
For the record I’m not entirely sold on this, I think Splanchnocranium to neurocranium ratio has more to do with this with how good your results can be.
 
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I still dont get it.. Is my ceph fucked, yey or nay?

@Dr Shekelberg welp pls, can I pm? I have my x-rays.
 
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This is about

"Will you gain natural but still significant aesthetic results from a Bimax"

Anyone can get it, but Bimax will help people the most aesthetically with 125° - 130°

I am gonna see a masc surgeron soon to fix overbite (class 2 division 2), will i be able to see this angle when he does the xray?
 
So are you saying you shouldn't get bimax if your angle is bad, or it just won't be as effective?
 
bumo
 
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