Is it over for low fructose indexmaxxing

[cxpidlover]

Title: Brutal realization post-CBCT scan: My fWHR is $1.86$ but my soft tissue drape is completely failing my pyriform aperture. Are custom PEEK implants the final ascension or just high-tier cope?

I’ve been lurking and posting on this board since 2018, back when half of you were still asking if chewing gum would give you a Hunter aesthetic. I’ve moved way past the beginner tier, but after dropping $800 on a fresh cone beam CT scan to properly align my Frankfurt horizontal plane, I’ve hit a wall of profound anatomical despair.

I spent five hours yesterday mapping my cephalometric landmarks in Photoshop, and the data is absolutely brutal. I always thought my midface was compact, but when you actually measure from the nasion to the prosthion, the soft tissue thickness completely obfuscates the underlying bone structure. My skeletal midface ratio is an ideal $1:1$, but structurally, I’m being dragged down to a $4$ PSL by sheer genetic sabotage in my facial fat pads.

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The Cephalometric Breakdown​

Let’s talk raw numbers, because I know the moment I post a morph, half the new accounts here are going to give me baseline normie advice about lowering my sodium intake.

• Bizygomatic to Bigonial Ratio: Currently sitting at $1.3$. The zygomatic arches have decent lateral projection, but they completely lack forward growth.
• Interpupillary Distance (IPD): $64\text{mm}$. It's exactly average, but paired with my medial canthal distance, it creates an optical illusion of being slightly close-set.
• Gonial Angle: $116^\circ$. On paper, this is prime O'Pry territory. In reality? My ramus is so absurdly short that the angle means nothing. The jawline just terminates directly into my hyoid bone.
• Nasofrontal Angle: $132^\circ$. My brow ridge has the thickness, but it completely lacks the necessary supraorbital hooding to compress the upper eyelid exposure.

The Surgical Dilemma (Where I'm at now)​

I’ve already consulted with three different maxillofacial surgeons. The first two offered standard LeFort I osteotomies with a $4\text{mm}$ impaction, which is absolute butchery for my specific phenotype. If I impact the maxilla without addressing the paranasal hollowing, I’m going to end up with a chimp-lip effect and totally obliterate my upper incisor show.

The third surgeon suggested a Counter-Clockwise (CCW) rotation of the occlusal plane combined with a sliding genioplasty. The projected morph he sent back looked decent, but I noticed he completely ignored the lack of infraorbital rim support. If I advance the lower third by $8\text{mm}$ without placing custom PEEK implants on the orbital floor, my eyes are going to look permanently bugged out. It’s a cascading failure of facial harmony.

$$\text{Total Projection} = \Delta \text{Maxilla} + \Delta \text{Mandible} - \text{Soft Tissue Resistance}$$
The equation above is what keeps me awake at night. My soft tissue is too thick. I’m sitting at 11% body fat, but my buccal fat pads hold onto volume like it's a matter of survival.

The Question for the Veterans​

I'm looking at flying to Europe for a custom wrap-around jaw implant combined with paranasal grafting, but I need to know if I'm just throwing money at a structurally doomed skull.

1. Does a CCW rotation actually fix a steep mandibular plane angle if your occlusal cant is already level, or will it just create a gummy smile in dynamic motion?
2. Has anyone here actually survived the recovery of bilateral custom PEEK orbital implants without getting permanent nerve damage in the infraorbital nerve?
3. Am I hyper-fixating on a $2\text{mm}$ asymmetry in my lateral canthi, or is this the exact kind of millimeter-level flaw that drops you from an $8$ to a $6$ in the real world?

 

[tict]

Title: Brutal realization post-CBCT scan: My fWHR is $1.86$ but my soft tissue drape is completely failing my pyriform aperture. Are custom PEEK implants the final ascension or just high-tier cope?

I’ve been lurking and posting on this board since 2018, back when half of you were still asking if chewing gum would give you a Hunter aesthetic. I’ve moved way past the beginner tier, but after dropping $800 on a fresh cone beam CT scan to properly align my Frankfurt horizontal plane, I’ve hit a wall of profound anatomical despair.

I spent five hours yesterday mapping my cephalometric landmarks in Photoshop, and the data is absolutely brutal. I always thought my midface was compact, but when you actually measure from the nasion to the prosthion, the soft tissue thickness completely obfuscates the underlying bone structure. My skeletal midface ratio is an ideal $1:1$, but structurally, I’m being dragged down to a $4$ PSL by sheer genetic sabotage in my facial fat pads.

---

The Cephalometric Breakdown​

Let’s talk raw numbers, because I know the moment I post a morph, half the new accounts here are going to give me baseline normie advice about lowering my sodium intake.

• Bizygomatic to Bigonial Ratio: Currently sitting at $1.3$. The zygomatic arches have decent lateral projection, but they completely lack forward growth.
• Interpupillary Distance (IPD): $64\text{mm}$. It's exactly average, but paired with my medial canthal distance, it creates an optical illusion of being slightly close-set.
• Gonial Angle: $116^\circ$. On paper, this is prime O'Pry territory. In reality? My ramus is so absurdly short that the angle means nothing. The jawline just terminates directly into my hyoid bone.
• Nasofrontal Angle: $132^\circ$. My brow ridge has the thickness, but it completely lacks the necessary supraorbital hooding to compress the upper eyelid exposure.

The Surgical Dilemma (Where I'm at now)​

I’ve already consulted with three different maxillofacial surgeons. The first two offered standard LeFort I osteotomies with a $4\text{mm}$ impaction, which is absolute butchery for my specific phenotype. If I impact the maxilla without addressing the paranasal hollowing, I’m going to end up with a chimp-lip effect and totally obliterate my upper incisor show.

The third surgeon suggested a Counter-Clockwise (CCW) rotation of the occlusal plane combined with a sliding genioplasty. The projected morph he sent back looked decent, but I noticed he completely ignored the lack of infraorbital rim support. If I advance the lower third by $8\text{mm}$ without placing custom PEEK implants on the orbital floor, my eyes are going to look permanently bugged out. It’s a cascading failure of facial harmony.

$$\text{Total Projection} = \Delta \text{Maxilla} + \Delta \text{Mandible} - \text{Soft Tissue Resistance}$$
The equation above is what keeps me awake at night. My soft tissue is too thick. I’m sitting at 11% body fat, but my buccal fat pads hold onto volume like it's a matter of survival.

The Question for the Veterans​

I'm looking at flying to Europe for a custom wrap-around jaw implant combined with paranasal grafting, but I need to know if I'm just throwing money at a structurally doomed skull.

1. Does a CCW rotation actually fix a steep mandibular plane angle if your occlusal cant is already level, or will it just create a gummy smile in dynamic motion?
2. Has anyone here actually survived the recovery of bilateral custom PEEK orbital implants without getting permanent nerve damage in the infraorbital nerve?
3. Am I hyper-fixating on a $2\text{mm}$ asymmetry in my lateral canthi, or is this the exact kind of millimeter-level flaw that drops you from an $8$ to a $6$ in the real world?

 

[cxpidlover]

View attachment 4960161

At this current juncture, I am profoundly distraught and enveloped in unyielding despondency.

 

[tict]

At this current juncture, I am profoundly distraught and enveloped in unyielding despondency.

dnr fag

 

[81xa]

Ai slop
Kys
Dnr

 

[cxpidlover]

Ai slop
Kys
Dnr

lies, your just vacuous