How to fix SHORT philtrum?

[FutureSlayer]

My midface ratio is perfect but i look like shit due to a SHORT pilhtrum, the tip of my nose is essentially touching my upper lip.
Which surgically procedure can i pair with rhino? is there a procedure that moves the entire mouth in a lower position? (ofc paired with a maxillary downgrafth)
@Lorsss @curlyheadjames

 

[potentialzaddy]

raul rosas jr has a short philtrum and hes a mogger

 

[Sens]

this or death

 

[potentialzaddy]

this or death

View attachment 1993038

all that matters is eyes and jaw

 

[Sens]

all that matters is eyes and jaw

personality mogs

 

[potentialzaddy]

personality mogs

personality mogs having autism

 

[FutureSlayer]

The absolute state of this forum. Nobody knows shit

 

[FutureSlayer]

HOW are there 100000 threads for a long philtrums and nothing for a short one

 

[Deleted member 21340]

kinda hard to tell without pics tbh
do you have an underbite? whats your bite class

but my guess would be recessed maxilla
a downturned nose and a short philtrum are usually symptoms for being recessed in the lefort area

a surgery that moves the entire mouth to a lower position would be CW (clockwise) bimax
downgraft of the maxilla combined with the cw rotation of the mandible normally accompanied with a sliding genio

 

[FutureSlayer]

kinda hard to tell without pics tbh
do you have an underbite? whats your bite class

but my guess would be recessed maxilla
a downturned nose and a short philtrum are usually symptoms for being recessed in the lefort area

a surgery that moves the entire mouth to a lower position would be CW (clockwise) bimax
downgraft of the maxilla combined with the cw rotation of the mandible normally accompanied with a sliding genio

Exactly what I was planning to do. Would this guarantee a LONGER philtrum and only just the improvement of the recessed midface?
I know the CW would move the teeth in a lower position, but would the soft tissue follow?

 

[Deleted member 21340]

Exactly what I was planning to do. Would this guarantee a LONGER philtrum and only just the improvement of the recessed midface?
I know the CW would move the teeth in a lower position, but would the soft tissue follow?

not really
the philtrum length stays the same
although you say you have a perfect midface ratio which indicates to me that its not the length of the philtrum that youre trying to fix but the forward projection of your entire maxilla

usually cw bimax candidates have a relatively short midface ratio and a low gonial angle

ignore the eye area but does your philtrum and nose sort of look like this

if so you may have midface hypoplasia

 

[FutureSlayer]

not really
the philtrum length stays the same
although you say you have a perfect midface ratio which indicates to me that its not the length of the philtrum that youre trying to fix but the forward projection of your entire maxilla

usually cw bimax candidates have a relatively short midface ratio and a low gonial angle

ignore the eye area but does your philtrum and nose sort of look like this
View attachment 1993288
if so you may have midface hypoplasia

My surgeon suggested cw rotation and maxillary downgraft bimax.
I have a slitghtly OVERBITE.
I came in office asking to reduce the chin length in order to have a better rate but he suggested as i stated.
My main concern is the elongation of the face, it already is narrow and longish, and the soft tissue that is not going to follow the bone work

 

[Deleted member 21340]

My surgeon suggested cw rotation and maxillary downgraft bimax.
I have a slitghtly OVERBITE.
I came in office asking to reduce the chin length in order to have a better rate but he suggested as i stated.
My main concern is the elongation of the face, it already is narrow and longish, and the soft tissue that is not going to follow the bone work

kinda difficult to tell with the naked eye but your maxilla/possibly rest of midface does look a little recessed
your surgeon was smart in denying your request to reduce your chin length and instead opt for cw bimax

considering you already have a fairly projected chin it seems you won't have to get a sliding genio so ignore it in this diagram

but in a manner what cw bimax does is correct an overbite (which you have) by moving the maxilla and mandible forward while also rotating in a slight cw angle
this should also fix your maxilla/midface hypoplasia as it will increase the projection of your lower maxilla without increasing philtrum length because your midface ratio is already ideal

as you can see here his philtrum length stays entirely the same despite maxilla downgrafting

 

[FutureSlayer]

kinda difficult to tell with the naked eye but your maxilla/possibly rest of midface does look a little recessed
your surgeon was smart in denying your request to reduce your chin length and instead opt for cw bimax

considering you already have a fairly projected chin it seems you won't have to get a sliding genio so ignore it in this diagram
View attachment 1993324View attachment 1993325View attachment 1993327
but in a manner what cw bimax does is correct an overbite (which you have) by moving the maxilla and mandible forward while also rotating in a slight cw angle
this should also fix your maxilla/midface hypoplasia as it will increase the projection of your lower maxilla without increasing philtrum length because your midface ratio is already ideal
View attachment 1993338 as you can see here his philtrum length stays entirely the same despite maxilla downgrafting

In this case what I can really expect is to upturn the nose and have profile improvements, while my chin to philtrum rate is still going to look fucked

 

[Deleted member 21340]

In this case what I can really expect is to upturn the nose and have profile improvements, while my chin to philtrum rate is still going to look fucked

forward projection of the maxilla via lefort 1 maxillary downgraft and a rhinoplasty should improve your chin to philtrum ratio

 

[FutureSlayer]

forward projection of the maxilla via lefort 1 maxillary downgraft and a rhinoplasty should improve your chin to philtrum ratio

Really scared to get fucked up like this guy tbh.

Case 2: retromaxillism, narrow maxilla,
mandibular retroalveolism
Clinical characteristics
Frontal view showing narrow facies with poor
gonial angle contour (Fig. 2A)
Concave profile
Flat midface: maxilla and malar
??Edentulous?? facial expression
The chin prominent but in normal position
Lack of dental support to the upper and lower lip
Prominence of nasolabial folds and crease
Narrow alar base
Class I molar and canine relation
Crowding in the maxillary and mandibular
dental arches
Incongruent curves of Spee
Protrusive maxillary incisors

Treatment plan
The treatment plan is a combined surgical and
orthodontic approach. The two-stage surgical
approach (Figs. 2B?D) is
1. Anterior mandibular alveolar segment distrac-
tion osteogenesis [4,5] and surgically assisted
rapid palatal expansion (see Fig. 2B).
2. Orthodontic alignment of two dental arches,
including full decompensation of the existing
skeletal anomalies. Now it becomes clear that
this case is a class III case (retro-/micromaxil-
lism). The occlusion before the second surgical
procedure shows class III molar relation and
a negative overjet. The opened space behind
the canines will be managed by dental implants
at the end of the treatment.
3. Bimaxillary surgery: 13 mm of maxillary
advancement at the LeFort I level, mild mandib-
ular set back through BSSO [6], and clockwise
rotation of both jaws. In addition, vertical chin
augmentation and, again, mandibular segmen-
tal osteotomy for widening of the mandible
(see Fig. 2D).
Outcome
The outcome shows improved facial aesthetics with
good lip support, balanced skeletal relation, and
widened maxilla and mandible (Fig. 2E). From
the frontal view, the face has harmonized, with
normal mandibular width and gonial angles. The
occlusion shows a normal overbite and overjet.
The creation of a gap behind the canines allows
class II molar relation. The bone and gingiva gener-
ated there through distraction is excellent and ready
for dental implants.

 

[Deleted member 21340]

View attachment 1993383View attachment 1993384
Really scared to get fucked up like this guy tbh.

Case 2: retromaxillism, narrow maxilla,
mandibular retroalveolism
Clinical characteristics
Frontal view showing narrow facies with poor
gonial angle contour (Fig. 2A)
Concave profile
Flat midface: maxilla and malar
??Edentulous?? facial expression
The chin prominent but in normal position
Lack of dental support to the upper and lower lip
Prominence of nasolabial folds and crease
Narrow alar base
Class I molar and canine relation
Crowding in the maxillary and mandibular
dental arches
Incongruent curves of Spee
Protrusive maxillary incisors

Treatment plan
The treatment plan is a combined surgical and
orthodontic approach. The two-stage surgical
approach (Figs. 2B?D) is
1. Anterior mandibular alveolar segment distrac-
tion osteogenesis [4,5] and surgically assisted
rapid palatal expansion (see Fig. 2B).
2. Orthodontic alignment of two dental arches,
including full decompensation of the existing
skeletal anomalies. Now it becomes clear that
this case is a class III case (retro-/micromaxil-
lism). The occlusion before the second surgical
procedure shows class III molar relation and
a negative overjet. The opened space behind
the canines will be managed by dental implants
at the end of the treatment.
3. Bimaxillary surgery: 13 mm of maxillary
advancement at the LeFort I level, mild mandib-
ular set back through BSSO [6], and clockwise
rotation of both jaws. In addition, vertical chin
augmentation and, again, mandibular segmen-
tal osteotomy for widening of the mandible
(see Fig. 2D).
Outcome
The outcome shows improved facial aesthetics with
good lip support, balanced skeletal relation, and
widened maxilla and mandible (Fig. 2E). From
the frontal view, the face has harmonized, with
normal mandibular width and gonial angles. The
occlusion shows a normal overbite and overjet.
The creation of a gap behind the canines allows
class II molar relation. The bone and gingiva gener-
ated there through distraction is excellent and ready
for dental implants.

he looks uncanny af because he almost has a byzgo:bigonial width of 1
also chimp limp from too much advancement of the maxilla in relation to the upper maxilla and zygos
13mm of maxilla advancement is alot, probably shouldnt have done that much

 

[FutureSlayer]

he looks uncanny af because he almost has a byzgo:bigonial width of 1
also chimp limp from too much advancement of the maxilla in relation to the upper maxilla and zygos
13mm of maxilla advancement is alot, probably shouldnt have done that much

looks like a chipmunk. If I came out like this whit all that effort and pain I'd go ER

 

[Deleted member 14392]

View attachment 1993023
raul rosas jr has a short philtrum and hes a mogger

His nose is so fucked up lmao

One of the worst i've ever seen, if not the worst

 

[kriz44]

Think short philtrum can't really be a falio unless the chin overpowers it a ton. Either way bimax would longen it so if you need that you're in a perfect situation.

 

[FutureSlayer]

Think short philtrum can't really be a falio unless the chin overpowers it a ton. Either way bimax would longen it so if you need that you're in a perfect situation.

You can see mine up there in this thread dude

 

[tahahd11]

Im way too late but I do have a noticeable short philtrum, the only way to really fix this is a maxillary downgraft

 

[FutureSlayer]

Im way too late but I do have a noticeable short philtrum, the only way to really fix this is a maxillary downgraft

Good old times lmao I ended up getting a downgraft, yes

 

[averagenormie]

My midface ratio is perfect but i look like shit due to a SHORT pilhtrum, the tip of my nose is essentially touching my upper lip.
Which surgically procedure can i pair with rhino? is there a procedure that moves the entire mouth in a lower position? (ofc paired with a maxillary downgrafth)
@Lorsss @curlyheadjames

Grow 70s mustache nigga

 

[FutureSlayer]

Grow 70s mustache nigga

It's been 2 years, I had a bimax done in the process lmao

 

[tahahd11]

Good old times lmao I ended up getting a downgraft, yes

It's been 2 years, I had a bimax done in the process lmao

Damn bro, you have any before after pics?

 

[FutureSlayer]

Damn bro, you have any before after pics?

Yes, but I'm getting veneers in september and still need some soft tissue work done because it didn't follow the skeletal changes 1:1, I have a bit of a gummy smile now

 

[tahahd11]

Yes, but I'm getting veneers in september and still need some soft tissue work done because it didn't follow the skeletal changes 1:1, I have a bit of a gummy smile now

Nice, wish I would have that much money for surgery tbh

 

[averagenormie]

It's been 2 years, I had a bimax done in the process lmao

Show before and after, did it fix the problem?

 

[FutureSlayer]

Show before and after, did it fix the problem?

Not showing rn, I still need to fix some things and yeah it does fix the problem but the soft tissue doesn't always follow the bone 1:1 hence I will require a lip repositioning surgery + a lip reduction to elongate the philtrum even more.
It's really a long process

 

[averagenormie]

Not showing rn, I still need to fix some things and yeah it does fix the problem but the soft tissue doesn't always follow the bone 1:1 hence I will require a lip repositioning surgery + a lip reduction to elongate the philtrum even more.
It's really a long process

I hate genetics

 

[tahahd11]

I hate genetics

Chad was born perfect, the genetic lottery really is brutal

 

[Adee]

My surgeon suggested cw rotation and maxillary downgraft bimax.
I have a slitghtly OVERBITE.
I came in office asking to reduce the chin length in order to have a better rate but he suggested as i stated.
My main concern is the elongation of the face, it already is narrow and longish, and the soft tissue that is not going to follow the bone work

Hey there, got the same issue - elongated midface and lower third, even after a rhinoplasty a droopy looking nose. I finally decided to start my decomp + MARPE. I have a very downward growth pattern (I need to augument the rest of the face later). For my movements I'm having at least 5* counter clockwise rotation - that was the value before the decompensation I was offered, so it will probably be less limited now, likely around 8–11* and also a maxillary impaction. My gum show is almost ideal but could use the given movements.
I’m a little concerned that the combination of impaction and ccw rotation might improve other ratios but further reduce my already very short philtrum, not something I worry about a lot but I think it’s worth mentioning to the surgeon.
As a last resort solution which I think may be necessary anyway after the trimax, I'm considering augmentation of the premaxillary area with some kind of pyriform implants which could push the soft tissue forward and slightly rotate the nose upward creating a visually larger gap.
Have you had any procedures done so far? How did they affect that area? I believe my nasal base is positioned lower than yours but I’m curious whether you managed to address this issue.

 

[maxillious]

View attachment 1993023
raul rosas jr has a short philtrum and hes a mogger

Take the scissors and make ypur nose shorter problem solved