How would Maxillary advancement surgery benefit me?

[NoaA99]

Hello,

I recently got diagnosed with a TMJ and a recessed Maxilla, that also leads to several health problems.
Since ever my lips do not align properly, my chin isn’t in the center of the face, I do have scleral show & my jaw width is terrible (despite both parents having wide lower jaws as well as great forward growth).
I don’t know why but it seems I have basically zero ramus length too. Unsure if it has something to do with the angle of my mandible. The Gonion also does look to go inwards, which makes my lower jaw even less wide looking.

Anyone knows how maxilla advancement surgery would benefit me aesthetically?
Would it fix the sclera show or is it just, that I have low cheekbones?
Would my lower jaw width pale even more in comparison and would my face generally become more harmonious?

 

[Lorsss]

have you ever gotten a consultation with a maxfac doctor?

 

[Creatine]

Consult with a blackpilled maxfac. If it’s causing you functional problems I really don’t see why this is even a question. U need bimax (and maybe TMJ replacement?)

I read something before about maxillary advancement through bimax reducing scleral show but as lefort 1 advances the lower maxilla (and cheekbones/infraorbitals relate to the upper maxilla) it would be limited (and I’m assuming by maxillary advancement you don’t mean through a modified lefort 3).

You shouldn’t worry about your jaw looking small after (that isn’t really a concern) and you can always get implants after for width/angularity

 

[NoaA99]

Consult with a blackpilled maxfac. If it’s causing you functional problems I really don’t see why this is even a question. U need bimax (and maybe TMJ replacement?)

I read something before about maxillary advancement through bimax reducing scleral show but as lefort 1 advances the lower maxilla (and cheekbones/infraorbitals relate to the upper maxilla) it would be limited (and I’m assuming by maxillary advancement you don’t mean through a modified lefort 3).

You shouldn’t worry about your jaw looking small after (that isn’t really a concern) and you can always get implants after for width/angularity

Thanks for your answer. Sorry, that I have to ask but I am from Germany.
Does Bimax simply refer to both jaws being moved simultaneously?
And what is the difference between the upper maxilla region and the lower one (I thought there was only one)?

The scleral show simply doesn’t make sense to me, since as a child or during early puberty I’ve never had it.
I’ve read, that it usually has to do with
having low/ flat cheekbones but I can’t really tell, if they sit that low. Besides I somehow seem to have developed very unsymmetrical cheekbones (the ones on the left sit a good amount higher).

I’ve already visited a maxfac surgeon, who told me, that my nose will get bigger/upturned, my face more symmetrical/ wider around the cheek region as well as more prominent looking cheekbones (don’t know why that is exactly, but I guess he meant perception wise due to a fuller cheek area).

Nothing on scleral show and jaw width though.
I also find it strange, that the mandible does look very long in the side profile, despite it being really narrow from a frontal view. Shouldn’t there be less volume due to less bigonial width and how is this caused in the first place? Since both parents have very wide jaws, I just can’t seem to understand it.

 

[NoaA99]

have you ever gotten a consultation with a maxfac doctor?

Yes, I had one so far.

 

[Deleted member 2729]

You don’t look recessed

 

[NoaA99]

You don’t look recessed

I am recessed per multiple orthodontists. My lower Jaw wants to move even further forward to make more space for breathing. This makes my maxilla even more recessed in comparison. It just can not, since the upper front teeth (that already broke due to that) hold it in place, forcing the lower teeth to bend. Therefore it is not a visible underbite but health wise it is. There is constant pressure on the joints & the whole face/neck/back. This will become more severe with age. I am currently 23.
That is the reason every orthodontists urged me to go for surgery.

 

[randomvanish]

you maxilla clearly recessed and the other features are quite ok. so go get it.

 

[NoaA99]

you maxilla clearly recessed and the other features are quite ok. so go get it.

Yes, I will do so, if Insurance covers it. They are really strict here in Germany.

Any suggestions, as to why I do have scleral show, if it is not the maxilla?

Also should I additionally go for lower jaw implants to achieve a wider lower jaw?
Since they told my face would be getting even wider when advancing the maxilla, I fear it would look even more narrow.

 

[snuzzly]

Why do you have it? That's a good question because I also have the same issue. I've looked for answers all across the internet but apparently nobody has any good answers. But I'm going to give you my best guess because we have the same face.

No joke, your facial shape/aesthetics are so similar to my own face that I feel like I'm looking at myself (especially your sideways profile). Maybe we can figure out together why our faces turned out this way.

I also have scleral show, a flat/recessed maxilla, a prominent lower jaw. As a kid I never had this issue. I look at my childhood pictures and my eyes looked alive. My eyes/face have looked dead for the last 10+ years. I can dm you a picture of my face and you can compare it to yours if you want but I'm telling you that it's basically the same.

I don't think that this is genetic because none of my parents, siblings, relatives, etc look like this. I also didn't look like this as a child.

Here's what I think happened to me. I had severe childhood allergies. My sinuses got clogged up so bad that I had to breathe through my mouth. Since my mouth was constantly open, my lower jaw wasn't there to support my maxilla from dropping downwards. Instead of growing forwards, my maxilla dropped downwards. This pulls the entire mid-face downwards and causes scleral show due to a lack of undereye support. It looks like this happened to you in your first picture because your mid-face is flat (like my own). There is zero undereye support which shows up as scleral show.

So I think your maxilla not only failed to grow forwards but it also dropped downwards which pulled your entire mid-face downwards as well. Why did this happen? Probably something to do with mouth breathing during childhood or a lack of support from the lower jaw against the upper jaw which caused the maxilla to drop downwards and everything else to droop downwards with it.

Before I can recommend any solutions, please answer these questions for me so I can further help you

1) Do your parents, siblings, or relatives look like this? Do they also have scleral show? It sounds like they don't which means that this isn't a genetic issue.

2) Did you have severe childhood allergies that forced you to breathe out of your mouth? (or any reason besides allergies to breathe out of your mouth during childhood which could have caused your maxilla to drop downwards instead of growing forwards)

3) Do you have any childhood pictures when you didn't look like this? Do you have any before/after pictures showing your face gradually becoming this way so I can see what part of your face actually changed?

 

[NoaA99]

Thanks for your answer. I appreciate your help and would be glad if the both of us could find possible solutions.
Yeah sure you can send them to

1)
No one from my family has any scleral show. It’s also pretty strange, since my eyes are rather upturned- making genetic scleral show rather unlikely.
No one of them has a recessed maxilla.
My mum has round, compact eyes along with very high cheekbones.
My dad has very narrow eyes, deep set eyes and mid-high cheekbones.

2)
I have never had any apparent breathing issues during childhood.
Still I remember, that I was indeed a mouth breather while going through childhood & puberty.
My Maxilla is so narrow, that I am completely unable to fit my tongue on the roof of the mouth, making normal tongue positioning impossible.
As a child my face was rather full and no part of the sclera was showing.
I did ask my orthodontist, if the eyes would change after advancing the maxilla. He said they would not. Instead he told me, that the face would widen and the cheekbones would stand out more
(Which honestly doesn’t even make sense to me, as to me they do look less visible in the after pictures after surgery).
Also no significant improving in scleral show.
So if advancing the maxilla doesn’t improve the under eye support, what else could have caused it?
Are the cheekbones likely to be recessed too in that case?

3) I could sent you some privately here yes. However I don’t really have much Photos from that time anymore. So hopefully there are a few useful ones amongst them.
Around 15 years old is when I noticed, that the lower lip is far more pronounced than the upper one.