Jaw surgery - doubts about surgical plan (pic attached)

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VincentGT

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Hi everyone,

My surgery is supposed to be on Monday. But I’m totally panicking once I saw the simulation. I postponed it for now.

I always presumed (and was told) I would get bimax, however my surgeon told me today that he would only do BSSO (and potentially a genio). First pic is before, second with BSSO and third with genio as well: simulation.

Some more pictures of my face and CBCT, although these were taken before the premolar extractions and orthodontics.

However, I don’t like this current simulation at all. This looks like a flat face and I feel like I need upper jaw advancement as well? My surgeon told me it’s not necessary or needed in my case and that the lower jaw advancement would be too big if we move the upper jaw too (with the gonials flaring out too much in that case?). I don’t even think I have gonial angles that flare out that much now? A smaller advancement, e.g. 3 mm, wouldn’t be worth it in his opinion. But I immediately see, in the simulation and daily in the mirror, the lack of upper jaw support for my nose. Multiple surgeons pointed it out.. I think even a few mm could make an aesthetic difference.

I’d highly prefer something like this with additional upper jaw advancement: modified simulation.

Now what?
 
I agree some maxillary movement is needed
In the modified simulation you are doing a large linear advancement of both jaws (which is unlikely to be what you need) as well as moving forward the alar base which the LeFort 1 does not recruit anyway.
But I would consult a few more surgeons.
 

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