Is getting CCW Bimax to make the occlusal plane have a 0 degree tilt always a Looksmax?

[lilhorizontal32]

If someone has say a 10 degree horizontal tilt of their occlusal plane, would it automatically be a Looksmax to make it flat?

Ie. 10 degrees of CCW, or would it depend on the case and maybe only somewhere between 1-9 degrees of CCW be better? Or maybe even none at all

asking as I have an overbite with a 5-6 degree tilt and only 1 surgeon out of a few I consulted with suggested enough CCW to make my occlusal flat

 

[varbrah]

Theoretically the closer flat and in-line with the other facial planes the greater facial balance and thus harmony, so yes - unless there are significant aesthetic trade-offs the CCW would cause, like unfavorable nasal changes (but you could just get a rhinoplasty).

Not a surgeon though, so no idea if 10 degrees is/isn't enough to warrant CCW in your case. It also depends on your tooth show and other factors.

 

[lilhorizontal32]

Theoretically the closer flat and in-line with the other facial planes the greater facial balance and thus harmony, so yes - unless there are significant aesthetic trade-offs the CCW would cause, like unfavorable nasal changes (but you could just get a rhinoplasty).

Not a surgeon though, so no idea if 10 degrees is/isn't enough to warrant CCW in your case. It also depends on your tooth show and other factors.

this makes sense, thanks for that.

also I dont think I was very clear with my own measurements: occlusal plane is only at around 6 degrees to the horizontal, and my surgeon suggested about 5 degree CCW

 

[Copemaxxing]

nah flat occlusal plane is shit. 4 degree is good

 

[lilhorizontal32]

nah flat occlusal plane is shit. 4 degree is good

any photos to better show this?

 

[SixCRY]

To get a better understanding:

It's not just about occlusale plane but also your mandibular plane, the more your mandibule is parallele to the ground the more sagittal space it will fill so better jawline and better profile

There will be nasal change with 10degree CCW if you don't need maxilla to be downgrafted down, if you need a down movement of maxilla u will see no nasal change

For short faces syndrome almost all of them have very straight mandibule that's why they do CW instead of CCW

Now there is a problem with CCW that's why surgeon will not propose to normal people 10 degree, 15 degree

Its because it's risky cause of muscle memory and also bone healing cuz those kind of movement will make bigger separation

I asked a surgeon for my case to give me CCW he said no he don't want to take risk

But blackpill surgeon will do you good CCW like Alfaro Fernandez

Also idk if 5degree CCW is good

 

[lilhorizontal32]

To get a better understanding:

It's not just about occlusale plane but also your mandibular plane, the more your mandibule is parallele to the ground the more sagittal space it will fill so better jawline and better profile

There will be nasal change with 10degree CCW if you don't need maxilla to be downgrafted down, if you need a down movement of maxilla u will see no nasal change

For short faces syndrome almost all of them have very straight mandibule that's why they do CW instead of CCW

Now there is a problem with CCW that's why surgeon will not propose to normal people 10 degree, 15 degree

Its because it's risky cause of muscle memory and also bone healing cuz those kind of movement will make bigger separation

I asked a surgeon for my case to give me CCW he said no he don't want to take risk

But blackpill surgeon will do you good CCW like Alfaro Fernandez

Also idk if 5degree CCW is good

thanks bro, makes more sense now

 

[SixCRY]

thanks bro, makes more sense now

Look for example case 1 and 2 they got CW, there mandibule were already straight, making it straighter would not result good esthetic outcome

But for the last 2 they did CCW to get more mandibule movement to point forward

 

[lilhorizontal32]

Look for example case 1 and 2 they got CW, there mandibule were already straight, making it straighter would not result good esthetic outcome

But for the last 2 they did CCW to get more mandibule movement to point forward

Got it bro

my biggest concern is that lefort advancements do 3 things which are looksmins: make nose wider and upturned, leave cheekbones behind, and flatten philtrum

to what extent do you think CCW avoids this issue or do you think it Is inevitable to get these changes with CCW rotation as well?

 

[Acromegaly_Chad]

There's no general rule to this as you have to judge each case individually. But as others have already said, a flatter occlusional plane is usually accompanied by a flatter mandibular plane, contributing to horizontal growth pattern in the sagittal plane and achieving an ideal approximation to the "Frankfurter Horizontale".

That being said, it's not necessary to get CCW t achieve this horizontal growth look, you can also get a regular Bimax + Chin Wing (with the CW doing the CCW by lowering the jaw angles) or getting your chin shortened (but only very carefully because usually shorter chin = looksmin).

Personally I'd go the bimax + chin wing route and not take the CCW rotation risk.

I've already had a Chin Wing with tons of CCW rotation involved and will get a linear bimax next year.

 

[SixCRY]

Got it bro

my biggest concern is that lefort advancements do 3 things which are looksmins: make nose wider and upturned, leave cheekbones behind, and flatten philtrum

to what extent do you think CCW avoids this issue or do you think it Is inevitable to get these changes with CCW rotation as well?

It all depend on your face

If you have recessed midface don't ask for 10mm maxilary movement , 4 to 6mm will be enough

Also for CW or CCW also depends on your face, you can do slight CCW like 2 degree to gain 1mm mandibular advancement , but it will be up to the surgeon to say yes or no

All your concern should be address to the surgeon, sometimes they do bimax + septo, sometimes they just do some movement so nose is not too much affected etc

But always go to blackpill surgeon who have aesthetic eyes

 

[ratiorichard]

go to one of the surgeons who is recommended here for a consultation and u will have the answers u wwant.

 

[lilhorizontal32]

There's no general rule to this as you have to judge each case individually. But as others have already said, a flatter occlusional plane is usually accompanied by a flatter mandibular plane, contributing to horizontal growth pattern in the sagittal plane and achieving an ideal approximation to the "Frankfurter Horizontale".

That being said, it's not necessary to get CCW t achieve this horizontal growth look, you can also get a regular Bimax + Chin Wing (with the CW doing the CCW by lowering the jaw angles) or getting your chin shortened (but only very carefully because usually shorter chin = looksmin).

Personally I'd go the bimax + chin wing route and not take the CCW rotation risk.

I've already had a Chin Wing with tons of CCW rotation involved and will get a linear bimax next year.

Thanks man, appreciate the advice

I guess I’m fortunate that my chin is very long (chin to philtrum ratio of 3.5ish) so will be going with the route of getting a shorter chin

also the surgeons I’m consulting with don’t offer Chin Wing, so got no choice but to take the CCW

 

[lilhorizontal32]

It all depend on your face

If you have recessed midface don't ask for 10mm maxilary movement , 4 to 6mm will be enough

Also for CW or CCW also depends on your face, you can do slight CCW like 2 degree to gain 1mm mandibular advancement , but it will be up to the surgeon to say yes or no

All your concern should be address to the surgeon, sometimes they do bimax + septo, sometimes they just do some movement so nose is not too much affected etc

But always go to blackpill surgeon who have aesthetic eyes

Got it bro, interesting because 1 surgeon I saw suggested 2.5mm of lf1 with 5 degree CCW while the other two are thinking about 5-6mm lf1 with about 1 degree CCW. Similar amounts of BSSO for each

what’s driving me crazy is choosing who to go with, as all 3 surgeons are blackpilled, and 2 are big names on here

 

[SixCRY]

Got it bro, interesting because 1 surgeon I saw suggested 2.5mm of lf1 with 5 degree CCW while the other two are thinking about 5-6mm lf1 with about 1 degree CCW. Similar amounts of BSSO for each

what’s driving me crazy is choosing who to go with, as all 3 surgeons are blackpilled, and 2 are big names on here

Its logic cuz:
When you do CCW you have more room for the mandibule to move forward
-So 2.5mm maxilla, X mandibule 5degree CCW
-So 5mm maxilla, X mandibule 1 CCW

It's same advancement cuz the CCW compensate for the advancement

Also i advise you the 5degree CCW cuz it will make ur mandibular plane more straight so better aesthetic