how does the average normie maxfac plan their bimax?

[dakchuh]

what criteria do they use and how do you not get fucked by them? because its pretty clear that many before and afters seem pretty unimpressive and that many patients look like they could've had bigger movements.

from what i understand from my research there are two main components to a bimax and its the occlusal plane angle (CCW in my case) and advancement. optimal occlusal plane angle is around 3-7 degrees? and the lower the angle the better to maximize mandible length for aesthetics. in that case, why don't surgeons reduce the angle as much as possible? stability concerns especially with posterior downgraft? secondly the advancement. what landmarks do you use to determine the mm of advancement for an aesthetical outcome?

@RealSurgerymax @SixCRY

 

[mewcoper]

bump

 

[Exsubhuman]

There is also SNA and SNB angles which are important, and also you dont wanna advance the lefort 1 area to much so it will not casue chimp look (the high maxilla is far behind the lower maxilla), i would say preferable OP angle is 1-7 depend on the case, and as higher SNB and SNA angles that wont casue chimp look.

 

[dakchuh]

There is also SNA and SNB angles which are important, and also you dont wanna advance the lefort 1 area to much so it will not casue chimp look (the high maxilla is far behind the lower maxilla), i would say preferable OP angle is 1-7 depend on the case, and as higher SNB and SNA angles that wont casue chimp look.

SNA and SNB are based on the nasion. what if you have a low nasion like this guy?

on the left is his actual result and he looks chimpmaxxed, but morph him a higher nasion and he looks totally fine. is the upper maxilla in whether you look like a chimp or not just the nasion and nasal bridge height?

 

[Deleted member 7725]

SNA and SNB are based on the nasion. what if you have a low nasion like this guy?

View attachment 1446016
on the left is his actual result and he looks chimpmaxxed, but morph him a higher nasion and he looks totally fine. is the upper maxilla in whether you look like a chimp or not just the nasion and nasal bridge height?

I have the same recession as him and need the same movements as him too. My nasion is slightly higher than his so hopefully it won't look chimpmaxxed. I even brought his pics to my surgeon and he said it's because he has a low radix which I don't.

 

[dakchuh]

I have the same recession as him and need the same movements as him too. My nasion is slightly higher than his so hopefully it won't look chimpmaxxed. I even brought his pics to my surgeon and he said it's because he has a low radix which I don't.

low radix can be easily fixed with a nose job so is chimpmaxxing really such a concern unless you get some insane 15mm+ maxilla movement that puts your forward growth outside of what is naturally possible? people keep talking about chimpmax but i rarely see cases after surgery where thats actually an issue.

 

[Deleted member 7725]

low radix can be easily fixed with a nose job so is chimpmaxxing really such a concern unless you get some insane 15mm+ maxilla movement that puts your forward growth outside of what is naturally possible? people keep talking about chimpmax but i rarely see cases after surgery where thats actually an issue.

Sure. But a dorsal grafting rhino is $$$ when it could be avoided in most cases. Is this guy's case, his nose was small despite his retruded maxilla so he had no option.

 

[dakchuh]

Sure. But a dorsal grafting rhino is $$$ when it could be avoided in most cases. Is this guy's case, his nose was small despite his retruded maxilla so he had no option.

yes, his nose was small and he got maxilla movement that im guessing fell outside of the SNA guidelines only because he has a properly grown mandible that his surgeon wanted to match his maxilla up with. if he had needed bimax he wouldnt have gotten as much advancement due to his low nasion because the average maxfac will just follow the numbers from a guideline without giving any consideration to the actual aesthetics. therefore extra care should be taken if you have a low nasion that can be augmented.

 

[Deleted member 2816]

yes, his nose was small and he got maxilla movement that im guessing fell outside of the SNA guidelines only because he has a properly grown mandible that his surgeon wanted to match his maxilla up with. if he had needed bimax he wouldnt have gotten as much advancement due to his low nasion because the average maxfac will just follow the numbers from a guideline without giving any consideration to the actual aesthetics. therefore extra care should be taken if you have a low nasion that can be augmented.

What is SNA”

 

[SixCRY]

SNA SNB is outdated like many surgeon said (Alfaro, Arnett, Antipov etc)

The projection depend on the surgeon:
-Alfaro have a special line where he project the jaws , it's called soft tissue plane
-Arnett and Gunson also have a special line, its slightly behind the Alfaro line
-Some surgeon will go by face when they 3D plane like antipov

For CCW, CW etc, ideally u want a flat occlusale plane and that's why Alfaro will give a 0degree occlusale plane on ALL his cases almost, it maximize mandibule projection and act as a reverse facelift by pushing mandibule outside the neck

Top surgeon will all give you max CCW if they can for ur specific case.
Not every case can have 0 CCW, for exemple if someone already has his teeth inclined 20 degree more than the norm then CCW will increase inclinasion and make it 30 if he get CCW etc

 

[Deleted member 7725]

SNA SNB is outdated like many surgeon said (Alfaro, Arnett, Antipov etc)

The projection depend on the surgeon:
-Alfaro have a special line where he project the jaws , it's called soft tissue plane
-Arnett and Gunson also have a special line, its slightly behind the Alfaro line
-Some surgeon will go by face when they 3D plane like antipov

For CCW, CW etc, ideally u want a flat occlusale plane and that's why Alfaro will give a 0degree occlusale plane on ALL his cases almost, it maximize mandibule projection and act as a reverse facelift by pushing mandibule outside the neck

Top surgeon will all give you max CCW if they can for ur specific case.
Not every case can have 0 CCW, for exemple if someone already has his teeth inclined 20 degree more than the norm then CCW will increase inclinasion and make it 30 if he get CCW etc

Antipov's cases aren't the best results tbh. Too many chimpmaxxed noseminned results, especially in the class 3 patients.

Wym by pushing the mandible outside the neck?

 

[Mouthbreath]

SNA and SNB are based on the nasion. what if you have a low nasion like this guy?

View attachment 1446016
on the left is his actual result and he looks chimpmaxxed, but morph him a higher nasion and he looks totally fine. is the upper maxilla in whether you look like a chimp or not just the nasion and nasal bridge height?

I wouldnt say he looks fine on the right side. In a 3/4 profile, nasal bridge wont really matter that much and the difference will be very small

 

[Mouthbreath]

SNA SNB is outdated like many surgeon said (Alfaro, Arnett, Antipov etc)

The projection depend on the surgeon:
-Alfaro have a special line where he project the jaws , it's called soft tissue plane
-Arnett and Gunson also have a special line, its slightly behind the Alfaro line
-Some surgeon will go by face when they 3D plane like antipov

For CCW, CW etc, ideally u want a flat occlusale plane and that's why Alfaro will give a 0degree occlusale plane on ALL his cases almost, it maximize mandibule projection and act as a reverse facelift by pushing mandibule outside the neck

Top surgeon will all give you max CCW if they can for ur specific case.
Not every case can have 0 CCW, for exemple if someone already has his teeth inclined 20 degree more than the norm then CCW will increase inclinasion and make it 30 if he get CCW etc

If my occlusion plane is already angled ideally and I don't have an overbite, what can be done to enlarge my mandible (I have mandibular deficiency)? So far I think I could: 1)Lefort 1 -> Bsso, 2) Genioplasty, 3) Implants: Ramus, chinwing, etc

Most of Alfaros patients got the biggest size increase of their mandible from CCW rotation (which makes space for a pretty extreme Bsso) from what I've seen. Sadly that seems to be no option in my case.

 

[dakchuh]

SNA SNB is outdated like many surgeon said (Alfaro, Arnett, Antipov etc)

The projection depend on the surgeon:
-Alfaro have a special line where he project the jaws , it's called soft tissue plane
-Arnett and Gunson also have a special line, its slightly behind the Alfaro line
-Some surgeon will go by face when they 3D plane like antipov

For CCW, CW etc, ideally u want a flat occlusale plane and that's why Alfaro will give a 0degree occlusale plane on ALL his cases almost, it maximize mandibule projection and act as a reverse facelift by pushing mandibule outside the neck

Top surgeon will all give you max CCW if they can for ur specific case.
Not every case can have 0 CCW, for exemple if someone already has his teeth inclined 20 degree more than the norm then CCW will increase inclinasion and make it 30 if he get CCW etc

can you give a specific landmark for arnett and gunson's line? i was actually looking up alfaro's line and found your posts that explained its at the soft tissue nasion

 

[dakchuh]

also how autistic would i look if i insist my normie maxfac to disregard SNA SNB and do alfaro's line? jfl

 

[ifyouwannabemylover]

also how autistic would i look if i insist my normie maxfac to disregard SNA SNB and do alfaro's line? jfl

they usually get pissed when you bring up this kinda stuff

 

[dakchuh]

they usually get pissed when you bring up this kinda stuff

lol is that from your experience

 

[Deleted member 7725]

I wouldnt say he looks fine on the right side. In a 3/4 profile, nasal bridge wont really matter that much and the difference will be very small

Wtf are you even on about?

 

[ifyouwannabemylover]

lol is that from your experience

ye most surgeons have a "my way or the highway" attitude and won't deviate from their general methods of choice just because some pleb patient brought it up

it's often just because they've only ever done shit one way and they stick to that

 

[Deleted member 15984]

SNA and SNB are based on the nasion. what if you have a low nasion like this guy?

View attachment 1446016
on the left is his actual result and he looks chimpmaxxed, but morph him a higher nasion and he looks totally fine. is the upper maxilla in whether you look like a chimp or not just the nasion and nasal bridge height?

High IQ. Very well-done

 

[dakchuh]

ye most surgeons have a "my way or the highway" attitude and won't deviate from their general methods of choice just because some pleb patient brought it up

it's often just because they've only ever done shit one way and they stick to that

jfl how is a subhuman supposed to ascend with all these surgeons

the most accomplished surgeons in my area are obviously the 60+ year old boomers but im pretty sure they are set in their ways. think i'd have a better chance convincing a younger surgeon like 40 some year old?

and whats your plan? you havent gotten bimax yet right? plan on saving up for a surgeon?

 

[ifyouwannabemylover]

jfl how is a subhuman supposed to ascend with all these surgeons

the most accomplished surgeons in my area are obviously the 60+ year old boomers but im pretty sure they are set in their ways. think i'd have a better chance convincing a younger surgeon like 40 some year old?

and whats your plan? you havent gotten bimax yet right? plan on saving up for a surgeon?

nah I'm aiming for next year. already got my eyes on a surgeon who seems very based from his publications but not gonna disclose anything until I get around to talking to him.

 

[Deleted member 7725]

nah I'm aiming for next year. already got my eyes on a surgeon who seems very based from his publications but not gonna disclose anything until I get around to talking to him.

US or EU?

 

[ifyouwannabemylover]

US or EU?

EU. unknown guy actually. thankfully those are usually cheap.

 

[PURE ARYAN GENETICS]

jfl how is a subhuman supposed to ascend with all these surgeons

the most accomplished surgeons in my area are obviously the 60+ year old boomers but im pretty sure they are set in their ways. think i'd have a better chance convincing a younger surgeon like 40 some year old?

and whats your plan? you havent gotten bimax yet right? plan on saving up for a surgeon?

yeah. most don't even do ccw. imagine that I just assume 99% of people are fully incompetent at whatever they do nowadays. them getting angry at an educated patient is a giga red flag

 

[Deleted member 5786]

 

[SOS-Sonic]

SNA SNB is outdated like many surgeon said (Alfaro, Arnett, Antipov etc)

The projection depend on the surgeon:
-Alfaro have a special line where he project the jaws , it's called soft tissue plane
-Arnett and Gunson also have a special line, its slightly behind the Alfaro line
-Some surgeon will go by face when they 3D plane like antipov

For CCW, CW etc, ideally u want a flat occlusale plane and that's why Alfaro will give a 0degree occlusale plane on ALL his cases almost, it maximize mandibule projection and act as a reverse facelift by pushing mandibule outside the neck

Top surgeon will all give you max CCW if they can for ur specific case.
Not every case can have 0 CCW, for exemple if someone already has his teeth inclined 20 degree more than the norm then CCW will increase inclinasion and make it 30 if he get CCW etc

You seem to know a lot about jaw surgery. Where did you acquire your knowledge? Can you recommended some sources for me to learn more about this?

 

[ifyouwannabemylover]

You seem to know a lot about jaw surgery. Where did you acquire your knowledge? Can you recommended some sources for me to learn more about this?

here's a good source

I INJECTED FILLER MYSELF

I did it yesterday and i ended up today in the hospital now im at home it was just infected but i wanted to injected upper eyelid and i think i failed. Im not blind or what so ever Plz dont follow youtube tutorial its bullshit. When i injected i didnt felt anything in the moment but when i woke...

looksmax.org

 

[SOS-Sonic]

here's a good source

I INJECTED FILLER MYSELF

I did it yesterday and i ended up today in the hospital now im at home it was just infected but i wanted to injected upper eyelid and i think i failed. Im not blind or what so ever Plz dont follow youtube tutorial its bullshit. When i injected i didnt felt anything in the moment but when i woke...

looksmax.org

lmao

 

[SixCRY]

You seem to know a lot about jaw surgery. Where did you acquire your knowledge? Can you recommended some sources for me to learn more about this?

i literally spent 3y here + i consulted more than 15 OMS + i read 50+ study about jaw surgery

I also watch Alfaro course, Arnett course and shit

There is no secret