Looking for advice on surgery plan

[bimaxxer3000]

Hey. I'm new here and am interested in hearing what you guys think about the surgery plan I received. I have been in invisalign for ~18months, and actually need to do another 4 months to decompensate the upper incisors a little more. If I do more decompensation, surgeon said he can advance mandible by an extra 1-2mm.

But here is the preliminary plan the surgeon provided (based on current orthodontics):

Custom plates and fixation

-Lefort 1
9mm total advancement with 6 degrees CCW rotation
1.8mm anterior impaction
Posterior downgraft


- BSSO
10.4/12mm one side
12mm other side

Optional genio
- The surgeon offered slight reduction, but is open to different options.

Total advancement at pogonion ~13mm

I am personally unsure whether to go for more vertical genio or not. Secondly, I have a prominent ANS, which screws up my nasolabial angle and makes it way too obtuse. Nose is already quite upturned aswell, so I am not sure what to do about that. I am probably going to ask if he can perform a subspinal Lefort (a V/W cut which maintains position of the ANS), which might help to fix the NLA.

Like I said, final plan might have 1-2mm extra advancement at the mandible.

So, what do you think?

P.S - I had slightly tilted head on CBCT, so I rotated a few of the images slightly.

Thanks

 

[bimaxxer3000]

bump