I have 2 face photos and 2 photos of my CBCT scans. Should I get Bimax surgery or not?

[F_Wilks]

I went to the orthodontist today and was able to get a CBCT scan done. They let me take pictures of it.

Here's a link to a photo gallery with my CBCT scans and facial photos.

Image Chest

1024 views on Image Chest

imgchest.com

The first 2 photos are side view / front view from the CBCT scan. The last 2 photos are side view / front view of myself, taken with my phone camera.

The orthodontist noted that I have:

1. "vertical maxillary deficiency"
2. "midline deviation"
3. "moderate" overcrowding of the upper teeth
4. "severe" overcrowding of the lower teeth
5. "overjet"

My wisdom teeth have been removed.

I tried to get advice earlier via PM but basically nobody responds to PM's. I'm posting this publicly so that I can get an answer to my question.

My only concern here is aesthetics.

Should I get bimax? I need to make this decision before getting braces.

 

[Ziaoni]

100%
You're recessed as shit

 

[SubhumanForever]

@BlackpillRemedy

 

[F_Wilks]

@normie_joe
@perpetuallytired

 

[chrishell]

yes, you need downgraft

 

[k99]

100%
You're recessed as shit

he is not reccessed as shit stop lying

 

[cc_7373]

Slightly reccesed

 

[Sodoku]

I think you should. You clearly suffer from SFS. At the very least, consider a genio. But bimax would correct all of the problems that your orthodontist pointed out

 

[perpetuallytired]

I went to the orthodontist today and was able to get a CBCT scan done. They let me take pictures of it.

Here's a link to a photo gallery with my CBCT scans and facial photos.

Image Chest

1024 views on Image Chest

imgchest.com

The first 2 photos are side view / front view from the CBCT scan. The last 2 photos are side view / front view of myself, taken with my phone camera.

The orthodontist noted that I have:

1. "vertical maxillary deficiency"
2. "midline deviation"
3. "moderate" overcrowding of the upper teeth
4. "severe" overcrowding of the lower teeth
5. "overjet"

My wisdom teeth have been removed.

I tried to get advice earlier via PM but basically nobody responds to PM's. I'm posting this publicly so that I can get an answer to my question.

My only concern here is aesthetics.

Should I get bimax? I need to make this decision before getting braces.

Shit tooth area.

 

[F_Wilks]

I think you should. You clearly suffer from SFS. At the very least, consider a genio. But bimax would correct all of the problems that your orthodontist pointed out

What is SFS exactly? Is that when the shortness is coming from your midface, or coming from your mandible?

Thank you.

 

[F_Wilks]

@NZb6Air

yes, you need downgraft

What exactly is a downgraft, also, what problem is it fixing?

 

[FutureSlayer]

@NZb6Air

What exactly is a downgraft, also, what problem is it fixing?

it heightens your maxilla

 

[chrishell]

@NZb6Air

What exactly is a downgraft, also, what problem is it fixing?

your maxilla is opened up and bone is inserted to increase its height and solve vertical maxillary deficiency

 

[F_Wilks]

your maxilla is opened up and bone is inserted to increase its height and solve vertical maxillary deficiency

So basically a bone graft? Are they removing a piece of bone from another part of my body?

 

[chrishell]

So basically a bone graft? Are they removing a piece of bone from another part of my body?

Yes that's right

It will help your lip shape too

 

[F_Wilks]

Yes that's right

It will help your lip shape too

How does it change the lips exactly? My lips are slightly turned down at the corners.

Would they become straight after bimax?

Separately, is there any chance that bimax would rotate the lips outwards, basically a "permanent puckering"? My lips are basically nonexistent right now. I'm wondering if perhaps that's caused by recessed jaws not properly supporting the lips?

 

[Zenis]

How does it change the lips exactly? My lips are slightly turned down at the corners.

Would they become straight after bimax?

Separately, is there any chance that bimax would rotate the lips outwards, basically a "permanent puckering"? My lips are basically nonexistent right now. I'm wondering if perhaps that's caused by recessed jaws not properly supporting the lips?

puckering lips are way better then non existent

 

[sportsmogger]

sfs

 

[Sodoku]

What is SFS exactly? Is that when the shortness is coming from your midface, or coming from your mandible?

Thank you.

Short face syndrome

 

[F_Wilks]

Short face syndrome
View attachment 3107676

I've seen that video on youtube. Crazy improvement. Do you know what surgeons I should consider?

I was actually about to contact Alfaro before creating an account here and realizing he has a reputation for overadvancing people.

 

[F_Wilks]

puckering lips are way better then non existent

I agree. Is that generally the result of bimax though? Lips going from thin to thick, or just going from thin to normal?

 

[Zenis]

I agree. Is that generally the result of bimax though? Lips going from thin to thick, or just going from thin to normal?

Probably won’t change much I don’t think, normal at best you might still some fat grapting for your non existent lips

 

[mvp2v1]

I went to the orthodontist today and was able to get a CBCT scan done. They let me take pictures of it.

Here's a link to a photo gallery with my CBCT scans and facial photos.

Image Chest

1024 views on Image Chest

imgchest.com

The first 2 photos are side view / front view from the CBCT scan. The last 2 photos are side view / front view of myself, taken with my phone camera.

The orthodontist noted that I have:

1. "vertical maxillary deficiency"
2. "midline deviation"
3. "moderate" overcrowding of the upper teeth
4. "severe" overcrowding of the lower teeth
5. "overjet"

My wisdom teeth have been removed.

I tried to get advice earlier via PM but basically nobody responds to PM's. I'm posting this publicly so that I can get an answer to my question.

My only concern here is aesthetics.

Should I get bimax? I need to make this decision before getting braces.

I hat makes them think u need lf1 downgraft? U may need it but the biggest issue I see is with your mandible being way too small.

 

[F_Wilks]

I hat makes them think u need lf1 downgraft? U may need it but the biggest issue I see is with your mandible being way too small.

The orthodontist didn't say I needed downgraft, the people in this thread and in my DM's are saying I need it, because of my SFS. I'm inclined to believe them, because I have the opposite of a gummy smile.

When I smile, only the bottom half of my front teeth are visible, and my mouth takes on the shape of a trapezoid, instead of a crescent.

Downgrafting would presumably push my maxilla downwards, which would expose my upper teeth.

 

[rrm_ss2]

I went to the orthodontist today and was able to get a CBCT scan done. They let me take pictures of it.

Here's a link to a photo gallery with my CBCT scans and facial photos.

Image Chest

1024 views on Image Chest

imgchest.com

The first 2 photos are side view / front view from the CBCT scan. The last 2 photos are side view / front view of myself, taken with my phone camera.

The orthodontist noted that I have:

1. "vertical maxillary deficiency"
2. "midline deviation"
3. "moderate" overcrowding of the upper teeth
4. "severe" overcrowding of the lower teeth
5. "overjet"

My wisdom teeth have been removed.

I tried to get advice earlier via PM but basically nobody responds to PM's. I'm posting this publicly so that I can get an answer to my question.

My only concern here is aesthetics.

Should I get bimax? I need to make this decision before getting braces.

Get bimax or Lefort

 

[F_Wilks]

Probably won’t change much I don’t think, normal at best you might still some fat grapting for your non existent lips

Would it at least raise up the drooping corners of my mouth?

 

[Zenis]

Would it at least raise up the drooping corners of my mouth?

I don’t think so. I think that’s a muscle issue

 

[Codeinlover]

Get bimax or Lefort

Why would he just get a lefort are u retarded

 

[Codeinlover]

I don’t think so. I think that’s a muscle issue

It’s aging to

 

[Codeinlover]

I went to the orthodontist today and was able to get a CBCT scan done. They let me take pictures of it.

Here's a link to a photo gallery with my CBCT scans and facial photos.

Image Chest

1024 views on Image Chest

imgchest.com

The first 2 photos are side view / front view from the CBCT scan. The last 2 photos are side view / front view of myself, taken with my phone camera.

The orthodontist noted that I have:

1. "vertical maxillary deficiency"
2. "midline deviation"
3. "moderate" overcrowding of the upper teeth
4. "severe" overcrowding of the lower teeth
5. "overjet"

My wisdom teeth have been removed.

I tried to get advice earlier via PM but basically nobody responds to PM's. I'm posting this publicly so that I can get an answer to my question.

My only concern here is aesthetics.

Should I get bimax? I need to make this decision before getting braces.

U seem pretty old how old are u and u need down graft

 

[Sodoku]

The orthodontist didn't say I needed downgraft, the people in this thread and in my DM's are saying I need it, because of my SFS. I'm inclined to believe them, because I have the opposite of a gummy smile.

When I smile, only the bottom half of my front teeth are visible, and my mouth takes on the shape of a trapezoid, instead of a crescent.

Downgrafting would presumably push my maxilla downwards, which would expose my upper teeth.

A lot of retards will tell you to get xyz. Your smile looks like this right?

Anyways just a second opinion from another ortho and see what they say

 

[geenk worg]

How does it change the lips exactly? My lips are slightly turned down at the corners.

Would they become straight after bimax?

Look at the mirror and move your jaw down a bit without opening your mouth. that's how it would look like

 

[F_Wilks]

A lot of retards will tell you to get xyz. Your smile looks like this right?
View attachment 3107977View attachment 3107979

Anyways just a second opinion from another ortho and see what they say

My smile looks like this:

Smiling as hard as possible

1 views on Image Chest

imgchest.com

 

[F_Wilks]

U seem pretty old how old are u and u need down graft

I'm 25. I destroyed my health with alcohol for years. I'm trying to atone for it nowadays by being a health nut lol.

 

[k99]

i have the same thing but the only thing it would improve is ur smile u wont get a major improvement like that Alfaro case

 

[F_Wilks]

i have the same thing but the only thing it would improve is ur smile u wont get a major improvement like that Alfaro case

Are you getting it yourself? Do you know if it's okay to consult with a surgeon first, then find yourself an orthodontist afterwards?

 

[k99]

Are you getting it yourself? Do you know if it's okay to consult with a surgeon first, then find yourself an orthodontist afterwards?

surgeon will probably work with that orthodontist so surgeon probably be ready to pay 20k+ minimum

 

[F_Wilks]

surgeon will probably work with that orthodontist so surgeon probably be ready to pay 20k+ minimum

Who do I speak to first though? Right now I don't have an orthodontist, and I haven't picked a surgeon. Should I go to an orthodontist first, tell them what I want, then contact a surgeon?

 

[k99]

Who do I speak to first though? Right now I don't have an orthodontist, and I haven't picked a surgeon. Should I go to an orthodontist first, tell them what I want, then contact a surgeon?

surgeon first imo most orthos dont even know what sfs is since its not a health issue

 

[F_Wilks]

surgeon first imo most orthos dont even know what sfs is since its not a health issue

The surgeons themselves are usually former orthodontists, aren't they? After the initial consultation with the surgeon, if you decide to go with them, they'll create an orthodontic plan, and then you take that plan to your local orthodontist and be like "I'm getting jaw surgery, here's a copy of the plans"...or does the surgeon communicate directly with the orthodontist?

Thank you for answering my questions btw.

 

[Mealworm]

@optimisticzoomer This is what you should be doinv you fucking retqrd, send me your CT scans

 

[Mealworm]

These images have been immortalized inside my phone. Ngl thank you

 

[k99]

The surgeons themselves are usually former orthodontists, aren't they? After the initial consultation with the surgeon, if you decide to go with them, they'll create an orthodontic plan, and then you take that plan to your local orthodontist and be like "I'm getting jaw surgery, here's a copy of the plans"...or does the surgeon communicate directly with the orthodontist?

Thank you for answering my questions btw.

they could be but i dont think they are they need more years of med school to be surgeons but every surgeon has an ortho working for them anyways

 

[Mealworm]

@F_Wilks Can I ask you something really important

 

[F_Wilks]

they could be but i dont think they are they need more years of med school to be surgeons but every surgeon has an ortho working for them anyways

Do surgeons put limitations on what orthos you can work with, or would I be able to pick pretty much any of the orthodontists in my area?

 

[k99]

Do surgeons put limitations on what orthos you can work with, or would I be able to pick pretty much any of the orthodontists in my area?

i am not sure where are u from go with italian surgeons they are probably the best

 

[F_Wilks]

i am not sure where are u from go with italian surgeons they are probably the best

I'm from USA.

 

[lookmaxxer998]

I went to the orthodontist today and was able to get a CBCT scan done. They let me take pictures of it.

Here's a link to a photo gallery with my CBCT scans and facial photos.

Image Chest

1024 views on Image Chest

imgchest.com

The first 2 photos are side view / front view from the CBCT scan. The last 2 photos are side view / front view of myself, taken with my phone camera.

The orthodontist noted that I have:

1. "vertical maxillary deficiency"
2. "midline deviation"
3. "moderate" overcrowding of the upper teeth
4. "severe" overcrowding of the lower teeth
5. "overjet"

My wisdom teeth have been removed.

I tried to get advice earlier via PM but basically nobody responds to PM's. I'm posting this publicly so that I can get an answer to my question.

My only concern here is aesthetics.

Should I get bimax? I need to make this decision before getting braces.

OP, none of the people commenting here have a medical degree nor a dentistry degree, so don't take their advice too seriously. I'd say you should go to at least three maxillofacial surgeons to be properly assessed. They usually use a lateral cephalometric and do tracings to mark up the important angles and talk to you regarding movements. At the moment, you have a severe crowding which means you're likely going to need extractions regardless of whether you do jaw surgery, but if you want to do jaw surgery, you'll need pre molar extractions to give room to dental decompensate. Essentially they're going to need to create an under/over bite to allow jaw movements. Your occlusal plane doesn't look too bad and your teeth inclination is roughly 90 degrees. I don't personally feel like you're "severely recessed" like some people claim on this forum, but for a medical opinion, always consult the professionals. As for the midline discrepancy, that's not abnormal if it is only 2mm. Severe discrepancy is 4-5mm or over. You don't present with inferior scleral show, so I would say your infraorbital rims are normal.

 

[F_Wilks]

They usually use a lateral cephalometric and do tracings to mark up the important angles and talk to you regarding movements.

Is that different from the CBCT scans performed at the orthodontist? The screenshots of the CBCT scans that I uploaded were from my local orthodontist. They told me they can provide me with the .dicom file if I pay them $400. I'm not sure yet if I should do that, I'd hate to spend the money and then be told by the surgeon that it wasn't necessary.

At the moment, you have a severe crowding which means you're likely going to need extractions regardless of whether you do jaw surgery

The orthodontist I consulted with last week told me that he could straighten my teeth without the need for extractions. To be fair though, I never mentioned jaw surgery.

but if you want to do jaw surgery, you'll need pre molar extractions to give room to dental decompensate

Wouldn't that permanently ruin the appearance of my smile?

Thank you for you help.

 

[lookmaxxer998]

Is that different from the CBCT scans performed at the orthodontist? The screenshots of the CBCT scans that I uploaded were from my local orthodontist. They told me they can provide me with the .dicom file if I pay them $400. I'm not sure yet if I should do that, I'd hate to spend the money and then be told by the surgeon that it wasn't necessary.

The orthodontist I consulted with last week told me that he could straighten my teeth without the need for extractions. To be fair though, I never mentioned jaw surgery.

Wouldn't that permanently ruin the appearance of my smile?

Thank you for you help.

Ok but did the ortho say you don't even need to file down the teeth from the sides? How is he going to create the space? I guess if it's only the front tooth mainly he could do it without extractions.

As for the lat ceph- I would not get it unless you're asked as it shows the same thing as the screenshot of the CBCT from the side. Also, that's kinda insane to me that he's charging you 400 for the files. Like, you already paid for the CBCT so how does it cost him to simply share the files with you? The files can usually be opened with free and publicly available software. You don't even need the medical software they use.

As for the extraction for the jaw surgery, it really depends on what you want. Do you simply want to do a lefort 1 and BSSO and translate your jaw forward to create more volume? ( this might give you a slightly dogmaxxed appearance if overdone. I would be careful with excessive movements).

Do you want to address your nasolabial angle? moving the upper jaw with lefort 1 can make your nasolabial angle less obtuse. I think there is some room for this. If the nasal framework and the infraorbital region are unchanged as with a non-modified lefort 1, it could shorten your philtrum.

Do you want to make your labiomental angle less deep? That can be done in various ways and is usually to do with the mentalis muscle and its attachment.

Do you want to vertically lengthen your face? Your middle and lower thirds are similar but shorter than your upper third. What is your incisor show at normal smile (this also matters for stuff like downgrafting)

On the whole, in the absence of medical indications, you should have strong reasons to do jaw surgery for aesthetic reasons- that is, a clear goal of what you dislike and want changed.The osteotomy in BSSO is performed in close proximity to the inferior alveolar nerve (IAN), and thus IAN damage often results. The incidence of IAN deficits after mandibular osteotomies varies from 0% to 100%. Deficits include numbness or unusual sensations in the lower lip, chin, teeth, and gingiva. There is also a 5-10% chance of a permanently runny nose/ chronic sinusitus. Honestly, there is like several pages worth of post operative complications and not all of them can be reversed. This isn't to say you shouldn't pursue surgery, but I wouldn't move everything unecessarily. Sometimes, singular jaw movements etc. can achieve the desired result.