Is there a way to get more mandibular advancement?

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CdK

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I'm currently doing pre-surgery ortho treatment. My ortho said I need about 8-9mm of advancement, which is the upper limit for LJS. The issue is my maxilla is also recessed so I’m looking for ways to get more mandibular advancement.

One option is distraction osteogenesis but can’t find anyone in Turkey doing it. Not even sure if they do it outside of special cases.

A more likely option in my opinion would be getting an LJS now and then having a second surgery a few years later. Sounds reasonable since muscles would have adjusted and bones healed but I couldn’t find anyone who's done it that way.

I was offered either an LJS or DJS and I don’t want to miss the chance to go for the DJS. I’d rather not overpay some blackpilled surgeon later for maxillary impaction if it turns out it’s not even possible.

Here’s my pre-surgery (but post-extraction) ortho X-ray if anyone’s curious. Thanks in advance.


Sideview
 
Go to Alfaro or Safi. You risk nerves damage or botch with longer mandibular advancement though
 
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Who the hell said 8-9 is limit ? People have done 20 mm +
 
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Go to Alfaro or Safi. You risk nerves damage or botch with longer mandibular advancement though
Do you think it would be safer or even possible to do it in two steps? Honestly, the idea of going abroad for DJS is kinda scary. I wonder if blackpilled surgeons in Turkey agree to do this kind of advancement?
 
Who the hell said 8-9 is limit ? People have done 20 mm +
I’ve seen advancements around 15mm, but those seem to involve some kind of rotation while my occlusal plane is almost flat. You sure it's without that?
 
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I’ve seen advancements around 15mm, but those seem to involve some kind of rotation while my occlusal plane is almost flat. You sure it's without that?
Nah without CCW it might not be possible, how much upper ?
 
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Stupid to pay 2 times for the same thing that cost up to 25k.

Do online consultation with your surgeons, send them your X Rays , CT scan.

Then tell them you want your face + simulation of advancement on their software.

You 're also going to need sending them photos to blend with the software so maybe you will need meet them in their office so they can pick 360 degree photos of your face.

Then choose which movement suits your face better. Longer isn't always better

You can go too far if you're eyes are too setback, cannot be change surgically.

Same for nose you will need LF2 for that.
 
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Nah without CCW it might not be possible, how much upper ?
The surgeon said she might do a 1mm forward movement but that’ll be decided after the ortho is done. I’m guessing she’ll stick to safe limits and stop around 10mm
 
Stupid to pay 2 times for the same thing that cost up to 25k.

Do online consultation with your surgeons, send them your X Rays , CT scan.

Then tell them you want your face + simulation of advancement on their software.

You 're also going to need sending them photos to blend with the software so maybe you will need meet them in their office so they can pick 360 degree photos of your face.

Then choose which movement suits your face better. Longer isn't always better

You can go too far if you're eyes are too setback, cannot be change surgically.

Same for nose you will need LF2 for that.
I see, I’m currently treated under a University Hospital, so they don’t have those advanced capabilities. If you mean private hospitals in Turkey would also go beyond 10mm, I can get a consultation. I didn’t try it before since both my surgeon and ortho implied the limit is 10mm.

Also my nose is fine irl, it just looks weird on xray lol.

Xxx

(pushing my lower jaw here)
 
You don't need more than 8-9 mm movement. You're just going to get chimp lips.

You're not even a good bimax candidate in my opinion. Unless your jaw jutting give you that level of forward growth. Your occlusion is perfect.
 
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You don't need more than 8-9 mm movement. You're just going to get chimp lips.

You're not even a good bimax candidate in my opinion. Unless your jaw jutting give you that level of forward growth. Your occlusion is perfect.
I’m a bimax candidate mostly because of my asymmetry, but yeah, you have a point. My lower maxilla is already pretty forward compared to the upper part, so a Le Fort 1 could end up creating that kind of look. I’ll try to find a surgeon who also focuses on cosmetics, not just functionality instead of making some numbers up myself. Thanks for your help.
 
I'm currently doing pre-surgery ortho treatment. My ortho said I need about 8-9mm of advancement, which is the upper limit for LJS. The issue is my maxilla is also recessed so I’m looking for ways to get more mandibular advancement.

One option is distraction osteogenesis but can’t find anyone in Turkey doing it. Not even sure if they do it outside of special cases.

A more likely option in my opinion would be getting an LJS now and then having a second surgery a few years later. Sounds reasonable since muscles would have adjusted and bones healed but I couldn’t find anyone who's done it that way.

I was offered either an LJS or DJS and I don’t want to miss the chance to go for the DJS. I’d rather not overpay some blackpilled surgeon later for maxillary impaction if it turns out it’s not even possible.

Here’s my pre-surgery (but post-extraction) ortho X-ray if anyone’s curious. Thanks in advance.


View attachment 3438196
Just have some informations on your surgery and what you want and them find a good surgeon who does what you want, also 8-9 mm's isn't the limit tho.
 
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Just have some informations on your surgery and what you want and them find a good surgeon who does what you want, also 8-9 mm's isn't the limit tho.
That's what I'm planning to do rn. The good thing about the current one is that since it's a University Hospital, it’s dirt cheap ($4-5k) and the surgeon is quite well known. The downside is they don’t offer much flexibility when it comes to aesthetics.
 
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That's what I'm planning to do rn. The good thing about the current one is that since it's a University Hospital, it’s dirt cheap ($4-5k) and the surgeon is quite well known. The downside is they don’t offer much flexibility when it comes to aesthetics.
If ur in Europe there is a surgeon in Romania wich actually has insane results and also has an eye for aesthetics, it's like 10-14k euros.
 
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If ur in Europe there is a surgeon in Romania wich actually has insane results and also has an eye for aesthetics, it's like 10-14k euros.
I mean that's not so cheap, you can get it for like 7k in france
 
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If ur in Europe there is a surgeon in Romania wich actually has insane results and also has an eye for aesthetics, it's like 10-14k euros.
I’m not sure about having it abroad. DJS is probably the surgery with the hardest recovery a healthy person can go through so Istanbul is probably the furthest I can go.

I’m currently searching the forum for surgeons in Turkey and found some who supposedly work with Giant Implants. I assume they’d have an eye for aesthetics.
 
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I’m not sure about having it abroad. DJS is probably the surgery with the hardest recovery a healthy person can go through so Istanbul is probably the furthest I can go.

I’m currently searching the forum for surgeons in Turkey and found some who supposedly work with Giant Implants. I assume they’d have an eye for aesthetics.
Yeah but the problem is that he charges alot, you can get the same results for much cheaper.
 
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Yeah but the problem is that he charges alot, you can get the same results for much cheaper.
Yeah, I mean just the surgeons, it's not like I could even reach Giant even if I had the money lol.

I’m planning on implants when I’m further along in life. But honestly, if I didn’t have to rush because of the extractions my former ortho left me with I’d probably wait on this whole jaw stuff until I’m in a better place. I’m just too invested both mentally (braces are not easy) and financially to stop now.
 
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Yeah, I mean just the surgeons, it's not like I could even reach Giant even if I had the money lol.

I’m planning on implants when I’m further along in life. But honestly, if I didn’t have to rush because of the extractions my former ortho left me with I’d probably wait on this whole jaw stuff until I’m in a better place. I’m just too invested both mentally (braces are not easy) and financially to stop now.
Just don't get any implants based near the eye area, they will always look off, you can also get jaw widening with bsso tho, i know the feeling of braces because i also had them.
 
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Just don't get any implants based near the eye area, they will always look off, you can also get jaw widening with bsso tho, i know the feeling of braces because i also had them.
Idk man I kinda need them, my orbitals are quite large. Maybe they would look better if you followed the natural shape instead of pushing for an overly masculine look.
 
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Idk man I kinda need them, my orbitals are quite large. Maybe they would look better if you followed the natural shape instead of pushing for an overly masculine look.
Probably that, but you can get the same result with lower lid retraction and fat grafts, you can see that the pic below is the brazilian kid who got orbital implants, you can see that they don't look as good as wanted.
Facial fat transfer 237 left side thumbnail
Images 1
 
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Probably that, but you can get the same result with lower lid retraction and fat grafts, you can see that the pic below is the brazilian kid who got orbital implants, you can see that they don't look as good as wanted. View attachment 3442402View attachment 3442404
I want the ones that go inside the orbital, the ones that go on the forehead look unnatural as you said.
 
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I want the ones that go inside the orbital, the ones that go on the forehead look unnatural as you said.
Hopefully you get the results you want ngl, wish you good luck.
 
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