I feel like soft tissue augmentation will do more for midface than osteotomy

[franziz]

I've spent a lot of time looking into ways to make the midface longer or shorter. I want a longer midface, but from what I’ve seen, surgeries like maxillary osteotomies (LeFort or bimax) don’t really change midface length for people with normal facial development. A lot of people here suggest those surgeries with one-word answers like "bimax" or "LeFort," like every dude has an underlying skeletal issue when its just genetics.

A simpler and less expensive option might be rhinoplasty and a lip lift for people with a long midface. A short midface is harder to fix, and it’s not talked about as much. However, rhinoplasty might help by making the nose longer, which can create the illusion of a longer midface. What do you guys think?

 

[lurking truecel]

It is case dependant. If you need a bimax or not depends on the teeth show

 

[Snicket]

A lot of people here suggest those surgeries with one-word answers like "bimax" or "LeFort," like every dude has an underlying skeletal issue when its just genetics.

You're right, people here completely over-prescribe surgery.

A short midface is harder to fix, and it’s not talked about as much.

Not true. If want a longer midface, bimax is actually very effective. That's why the best bimax transformations are patients with a short maxilla (short face syndrome) and mandible. In these cases, both the maxilla and mandible are downgrafted.

In fact, it's shortening the midface which is near impossible with LeFort osteotemies. Lengthening is much easier and the results are usually better too.

However, rhinoplasty might help by making the nose longer, which can create the illusion of a longer midface. What do you guys think?

Yes, you can create the illusion but if your midface is actually short but downgrafting the maxilla actually solves the underlying problem. There is no either or with soft tissue vs skeletal. Obviously, it depends on your case but many people need a combination of the two.

 

[franziz]

You're right, people here completely over-prescribe surgery.

Not true. If want a longer midface, bimax is actually very effective. That's why the best bimax transformations are patients with a short maxilla (short face syndrome) and mandible. In these cases, both the maxilla and mandible are downgrafted.

Yeah but aren't those cases of dudes with receded maxilla? Mine is normal and genetic

In fact, it's shortening the midface which is near impossible with LeFort osteotemies. Lengthening is much easier and the results are usually better too.

Yes, you can create the illusion but if your midface is actually short but downgrafting the maxilla actually solves the underlying problem. There is no either or with soft tissue vs skeletal. Obviously, it depends on your case but many people need a combination of the two.

This is my side profile and my maxilla is actually kinda forward grown. How would a surgeon tackle this? Seems more risky since you are cutting a face that's already "normal"

 

[Snicket]

Yeah but aren't those cases of dudes with receded maxilla? Mine is normal and genetic

Not necessarily. You can have decentish maxillary development but a short midface.

View attachment 3495858

This is my side profile and my maxilla is actually kinda forward grown. How would a surgeon tackle this?

The angle isn’t great but your midface looks a bit under developed to me - mildly though. Your jaw development looks normal, you seem to have bimaxillary protrusion (protruding jaws).

Better pics, ideally scans would be appreciated. Especially ones of you smiling to see if you have decent tooth show.

Seems more risky since you are cutting a face that's already "normal"

This is true. You’re within normal range. It certainly might not be worth it. Soft tissue operations are cheaper and less invasive. This is a personal calculation that only you can make.

 

[DavidWho]

You're right, people here completely over-prescribe surgery.

Not true. If want a longer midface, bimax is actually very effective. That's why the best bimax transformations are patients with a short maxilla (short face syndrome) and mandible. In these cases, both the maxilla and mandible are downgrafted.

In fact, it's shortening the midface which is near impossible with LeFort osteotemies. Lengthening is much easier and the results are usually better too.

Yes, you can create the illusion but if your midface is actually short but downgrafting the maxilla actually solves the underlying problem. There is no either or with soft tissue vs skeletal. Obviously, it depends on your case but many people need a combination of the two.

Why is bimax better for the patients with short face syndrome if it doesn't affect the maxilla. I mean I think i have long downward maxilla but short mandible. Isn't bimax solving only lower jaw problems. I thought only leforts for maxilla

 

[franziz]

Why is bimax better for the patients with short face syndrome if it doesn't affect the maxilla. I mean I think i have long downward maxilla but short mandible. Isn't bimax solving only lower jaw problems. I thought only leforts for maxilla

i think he just used bimax as a catch all term

 

[franziz]

The angle isn’t great but your midface looks a bit under developed to me - mildly though. Your jaw development looks normal, you seem to have bimaxillary protrusion (protruding jaws).

i dont think i have any protrusion tbh.

This is true. You’re within normal range. It certainly might not be worth it. Soft tissue operations are cheaper and less invasive. This is a personal calculation that only you can make.

Yeah i need to consult docs to see if they can do it. You think a rhino to lengthen nose is possible tho? I can send my full frontal in dms

 

[Snicket]

View attachment 3495933
i dont think i have any protrusion tbh.
Yeah i need to consult docs to see if they can do it. You think a rhino to lengthen nose is possible tho? I can send my full frontal in dms

Okay you don't have SFS.
My first impression from your photo which was at a weird angle so i accept that I could be wrong.
My instinct is retruded maxilla and short mandible - very mild though.
DM me if you want.

Why is bimax better for the patients with short face syndrome if it doesn't affect the maxilla. I mean I think i have long downward maxilla but short mandible. Isn't bimax solving only lower jaw problems. I thought only leforts for maxilla

You're right that you mandible looks a bit short. I actually thought that myself but it's really mild.
SFS means that the maxilla is vertically short. This usually manifests with poor tooth show.
Bimax = Upper + lower jaw surgery.

 

[moze]

You're right, people here completely over-prescribe surgery.

Not true. If want a longer midface, bimax is actually very effective. That's why the best bimax transformations are patients with a short maxilla (short face syndrome) and mandible. In these cases, both the maxilla and mandible are downgrafted.

In fact, it's shortening the midface which is near impossible with LeFort osteotemies. Lengthening is much easier and the results are usually better too.

Yes, you can create the illusion but if your midface is actually short but downgrafting the maxilla actually solves the underlying problem. There is no either or with soft tissue vs skeletal. Obviously, it depends on your case but many people need a combination of the two.

I am pretty sure you have a short midface

 

[franziz]

I am pretty sure you have a short midface

Wait who?

 

[moze]

Wait who?

Snicket