I'm getting a bimax with a blackpilled surgeon but i don't know how to ask them to design it for my harmony

[pudhpreet]

Just logged back on after a few years to this site. I finally got the money and an agreeing ortho to take my case and they want me to get MARPE + Lefort I + BSSO + Genio.


The surgeon is a well known guy, and they're open to planning the movements with me. I have a weird case with a deep bite which makes my face look normal when I jut but keeps it vertically short. I don't have a gummy smile at all, which is uncommon for Class II jaw surgery cases.

I sitll have my pre moals and all my teeth in. Does anyone know how I can study anatomy + soft tissue so I can direct the surgical planning towards my goals. Please highIQ suggestions only no AI slop.

 

[yussimania]

If you're asking how to learn enough to have an informed discussion with your surgeon, that's a sensible goal. It's worth keeping in mind that planning procedures like MARPE, a Le Fort I osteotomy, bilateral sagittal split osteotomy (BSSO), and genioplasty involves balancing aesthetics, function, airway, bite, joint health, and long-term stability. Surgeons also have to account for factors that aren't obvious from photographs.

A good progression would be:

Skull and facial anatomy: Learn the maxilla, mandible, zygoma, nasal complex, orbits, cranial base, muscles of facial expression, and muscles of mastication.

Cephalometrics: Understand landmarks like SNA, SNB, ANB, Wits appraisal, occlusal plane, mandibular plane, facial height ratios, and incisor inclination.

Orthodontics: Study deep bites, curve of Spee, dental compensations, transverse discrepancies, arch coordination, and decompensation before surgery.

Orthognathic surgery planning: Learn what maxillary impaction vs. downgrafting does, clockwise vs. counterclockwise rotation, advancement, setback, yaw, roll, and pitch.

Soft-tissue response: Understand that soft tissue doesn't move 1:1 with bone. Different structures (upper lip, lower lip, nose, chin, cheeks) each respond differently depending on the movement and individual anatomy.

You can also read published orthognathic surgery papers, especially those on:

Soft-tissue prediction after maxillary advancement or impaction.

Effects of clockwise vs. counterclockwise rotation.

Nasal changes after a Le Fort I.

Chin position and lower facial proportions.

Since your surgeon is open to collaborative planning, it can help to go in with goal-oriented questions rather than exact movement requests. For example:

"I'd like to preserve natural facial proportions while correcting the bite."

"How would more versus less maxillary downgrafting affect my lower facial height?"

"How would changing the occlusal plane affect my profile and lip support?"

"What trade-offs would different plans have for aesthetics, stability, and function?"

That approach lets you communicate your priorities while relying on the surgeon's expertise to translate them into a safe and feasible surgical plan.

 

[pudhpreet]

If you're asking how to learn enough to have an informed discussion with your surgeon, that's a sensible goal. It's worth keeping in mind that planning procedures like MARPE, a Le Fort I osteotomy, bilateral sagittal split osteotomy (BSSO), and genioplasty involves balancing aesthetics, function, airway, bite, joint health, and long-term stability. Surgeons also have to account for factors that aren't obvious from photographs.

A good progression would be:

Skull and facial anatomy: Learn the maxilla, mandible, zygoma, nasal complex, orbits, cranial base, muscles of facial expression, and muscles of mastication.

Cephalometrics: Understand landmarks like SNA, SNB, ANB, Wits appraisal, occlusal plane, mandibular plane, facial height ratios, and incisor inclination.

Orthodontics: Study deep bites, curve of Spee, dental compensations, transverse discrepancies, arch coordination, and decompensation before surgery.

Orthognathic surgery planning: Learn what maxillary impaction vs. downgrafting does, clockwise vs. counterclockwise rotation, advancement, setback, yaw, roll, and pitch.

Soft-tissue response: Understand that soft tissue doesn't move 1:1 with bone. Different structures (upper lip, lower lip, nose, chin, cheeks) each respond differently depending on the movement and individual anatomy.

You can also read published orthognathic surgery papers, especially those on:

Soft-tissue prediction after maxillary advancement or impaction.

Effects of clockwise vs. counterclockwise rotation.

Nasal changes after a Le Fort I.

Chin position and lower facial proportions.

Since your surgeon is open to collaborative planning, it can help to go in with goal-oriented questions rather than exact movement requests. For example:

"I'd like to preserve natural facial proportions while correcting the bite."

"How would more versus less maxillary downgrafting affect my lower facial height?"

"How would changing the occlusal plane affect my profile and lip support?"

"What trade-offs would different plans have for aesthetics, stability, and function?"

That approach lets you communicate your priorities while relying on the surgeon's expertise to translate them into a safe and feasible surgical plan.

Yes, I meant enough to have a informed decision. The MARPE is mainly for functional reasons and reducing the number of cuts needed in the Lefort, but I'm hopeful for any aesthetic benefits. But this is a pretty good list for me to understand what's going on with my surgery.

 

[yussimania]

Yes, I meant enough to have a informed decision. The MARPE is mainly for functional reasons and reducing the number of cuts needed in the Lefort, but I'm hopeful for any aesthetic benefits. But this is a pretty good list for me to understand what's going on with my surgery.

Dude I copied that from GPT because you said no AI slop just High IQ suggestions, this gave you a better answer than 95% the mfs on this forum would

 

[pudhpreet]

Dude I copied that from GPT because you said no AI slop just High IQ suggestions, this gave you a better answer than 95% the mfs on this forum would

lmao u got my ass