Midface Compaction Surgery

[thecel]

 

[HardmaxxUser]

View attachment 3636846

just ccw bimax. Sometimes they take bone off of your maxilla/lefort area.

 

[lurking truecel]

just ccw bimax. Sometimes they take bone off of your maxilla/lefort area.

Ccw bimax with impaction

 

[Manfrommars]

View attachment 3636846

With implants she would look so good, just looking at her jaw alone in pic 2 it looks properly grown now

 

[Lefor3Laser]

View attachment 3636846

And many users want to get it with out any signs, it is only meant for people who have severe gummy smile (also other functional problems)

 

[thecel]

And many users want to get it with out any signs, it is only meant for people who have severe gummy smile (also other functional problems)

What if you get a lip lift to create a gummy smile to qualify for this?

 

[greycel]

@lurking truecel @thecel @Snicket @chrishell

A high cut LF1 has limited ability to rotate the jaws CCW.
Whereas a normal cut LF1 does.

If you are downgrown, and have midface hypoplasia, with paranasal hollowing, then why hasn't anybody done a normal cut LF1 CCW, then waited for the bone to ossify, and then do a high cut lefort 1 for purely advancement after?
So both the jaws move forwards in the right direction with the alar rim

 

[Snicket]

If you are downgrown, and have midface hypoplasia, with paranasal hollowing, then why hasn't anybody done a normal cut LF1 CCW, then waited for the bone to ossify, and then do a high cut lefort 1 for purely advancement after?
So both the jaws move forwards in the right direction with the alar rim

Good question.

In fact, for cases of severe midfacial retrusion, orthognathic surgery is done in tandem with LF2/3.

I don't know why you couldn't do high LF1 minus the upper jaw. Never heard of this before.
I assume it's not a stable procedure in the way that a higher level osteotomy is.

 

[greycel]

View attachment 3636846

Not sure if it's angles, but her undereye region moved up a few mm less PFH

 

[Lefor3Laser]

What if you get a lip lift to create a gummy smile to qualify for this?

View attachment 3638557

Nice try, but it will look much worse at the end of the day.

 

[greycel]

Good question.

In fact, for cases of severe midfacial retrusion, orthognathic surgery is done in tandem with LF2/3.

I don't know why you couldn't do high LF1 minus the upper jaw. Never heard of this before.
I assume it's not a stable procedure in the way that a higher level osteotomy is.

Yeah doing them together might be an issue
It's just that I've heard people go for revisions for their Bimax, which means they would change rotation angle/ amount of projection, which means the bone has to be stable at that point, surely?

So splitting it up in two section surgeries, with the high cut around 1-2yrs earlier should be fine

What do you think @Lefor3Laser

 

[thecel]

Nice try, but it will look much worse at the end of the day.
View attachment 3638587

but I’m a long-philtrum-cel and want to shorten both the bone and the skin of the philtrum area:

 

[Lefor3Laser]

@lurking truecel @thecel @Snicket @chrishell

A high cut LF1 has limited ability to rotate the jaws CCW.
Whereas a normal cut LF1 does.

If you are downgrown, and have midface hypoplasia, with paranasal hollowing, then why hasn't anybody done a normal cut LF1 CCW, then waited for the bone to ossify, and then do a high cut lefort 1 for purely advancement after?
So both the jaws move forwards in the right direction with the alar rim

I mean, this is actually a good question, but i would think that:
a) patient is happy and doesn't want to do another one (wich makes it rarer to see)
b) unstable and costly and also mentally and psychically wasting (also your pockets haha)

But b stands out the most for me.

 

[Lefor3Laser]

but I’m a long-philtrum-cel and want to shorten both the bone and the skin of the philtrum area:

View attachment 3638605

If you do have a gummy smile then you can get it but doing 2 surgeries that are meant to fix the philtrum isn't a good idea, you get what i mean.

Your proportions will be much smaller than you think.

 

[thecel]

If you do have a gummy smile then you can get it but doing 2 surgeries that are meant to fix the philtrum isn't a good idea, you get what i mean.

Your proportions will be much smaller than you think.

my philtrum is 20 mm long tho

 

[Lefor3Laser]

my philtrum is 20 mm long tho

Work with what you can tbh, better look natural than uncanny right?

 

[thecel]

Work with what you can tbh, better look natural than uncanny right?

I look uncanny already

I’d do anything to increase my 0.82 midface ratio

 

[latetothegame]

The only thing would be lip lift to create gummy smile then a LF1 impaction to reduce it. It would have to be done with incredible planning or by the same surgeon. It would be tough convincing a surgeon to over-impact you (at that point in the case), though.

 

[moze]

Her midface hasnt moved a bit changes are there only in the lower third

 

[cendawan]

Thecel can you DM me I would like to help you

 

[cendawan]

Can you start convo with me or however it works on here, I'm not sure how to do it as I just made this account It says I can't access your profile

 

[chrishell]

@lurking truecel @thecel @Snicket @chrishell

A high cut LF1 has limited ability to rotate the jaws CCW.
Whereas a normal cut LF1 does.

If you are downgrown, and have midface hypoplasia, with paranasal hollowing, then why hasn't anybody done a normal cut LF1 CCW, then waited for the bone to ossify, and then do a high cut lefort 1 for purely advancement after?
So both the jaws move forwards in the right direction with the alar rim

Highcut LeFort 1 is an awkward shape for many reasons. You are better off doing a regular LF1 and implants for any upper midface augmentation. If OP wants to reduce both bone and skin of the philtrum he needs both impaction and lip lift. There are many variations of lip lift depending on his needs. And if you are going to do that you need to account for philtrum to chin ratio, upper lip to lower lip ratio, ratio of facial thirds, absolute vermilion show of the upper lip, existing gingival show, teeth size, crown length, and absolute chin height. Of course the nose height cannot be changed so if that is where the excess midface length is coming from then he is out of luck.

 

[Joaquin]

And many users want to get it with out any signs, it is only meant for people who have severe gummy smile (also other functional problems)

That girl did not have a severe gummy smile

 

[mightbecooked123]

Highcut LeFort 1 is an awkward shape for many reasons. You are better off doing a regular LF1 and implants for any upper midface augmentation. If OP wants to reduce both bone and skin of the philtrum he needs both impaction and lip lift. There are many variations of lip lift depending on his needs. And if you are going to do that you need to account for philtrum to chin ratio, upper lip to lower lip ratio, ratio of facial thirds, absolute vermilion show of the upper lip, existing gingival show, teeth size, crown length, and absolute chin height. Of course the nose height cannot be changed so if that is where the excess midface length is coming from then he is out of luck.

Why is this the case ? Ive seen results where a specific type of lefort 1 cut impaction has managed to shrink nose length in midface in several different patients. I dont get why you said "of course" when there are loads of results of nose lengths being shrunken in patients with a high cut lefort 1.

 

[chrishell]

Why is this the case ? Ive seen results where a specific type of lefort 1 cut impaction has managed to shrink nose length in midface in several different patients. I dont get why you said "of course" when there are loads of results of nose lengths being shrunken in patients with a high cut lefort 1.

Because LeFort 1, high cut or not, with or without impaction, does not reduce the length of your nose. It just doesn't. You did not see what you think you saw.

 

[geenk worg]

Ok but where is the midface compaction?

 

[zemult]

I look uncanny already

I’d do anything to increase my 0.82 midface ratio

Tbh it's probably just over bro. I have a 1.1 midface as well

 

[Debetro]

Plastic surgery is so lame

 

[Lefor3Laser]

That girl did not have a severe gummy smile

Talking about people who tend to have it like this

 

[thecel]

Because LeFort 1, high cut or not, with or without impaction, does not reduce the length of your nose. It just doesn't. You did not see what you think you saw.

Why doesn’t it shorten the length of your nose if the bottom of the nasal aperture is pushed upwards?

 

[Joaquin]

Talking about people who tend to have it like thisView attachment 3649681

Yeah I show a similar amount of gum when smilling, even more, is that considered gummy smile, or at least a slight one?

 

[geenk worg]

Why doesn’t it shorten the length of your nose if the bottom of the nasal aperture is pushed upwards?

Because the cartilage stays the same

 

[chrishell]

Why doesn’t it shorten the length of your nose if the bottom of the nasal aperture is pushed upwards?

Because it's not pushed upwards

If LF1 shortened your nose, it would, but it doesn't.

 

[thecel]

Because the cartilage stays the same

Because it's not pushed upwards

If LF1 shortened your nose, it would, but it doesn't.

how is the cartilage the same if the base of the nose bone is higher up? do you mean that the cartilage droops down under the bone?

the height of the nasal aperture is shorter, so where does the extra cartilage go? the surgeon doesn’t shorten the cartilage off the bottom?

 

[moze]

Because it's not pushed upwards

If LF1 shortened your nose, it would, but it doesn't.

how is the cartilage the same if the base of the nose bone is higher up? do you mean that the cartilage droops down under the bone?

View attachment 3650552

the height of the nasal aperture is shorter, so where does the extra cartilage go? the surgeon doesn’t shorten the cartilage off the bottom?

Looks like its movef upward.corrct me if i am wrong

 

[chrishell]

how is the cartilage the same if the base of the nose bone is higher up? do you mean that the cartilage droops down under the bone?

View attachment 3650552

the height of the nasal aperture is shorter, so where does the extra cartilage go? the surgeon doesn’t shorten the cartilage off the bottom?

The type of impaction represented in that image requires very particular circumstance (equal amounts of bone removed anteriorly and posteriorly). It would indeed very slightly reduce your nose height, as in absolute distance from radix to ans, although the cartilage would reform and likely in ways that counteract that effect and potentially require a rhinoplasty thereafter if your sole goal is to reduce nose height. The biggest "nose gains" you get from jaw surgery result not from the reduction of that absolute distance but the illusion of its reduction afforded by a more projected ANS, reduction in gingival show, and flatter occlusal plane. Most of the time that illusion matters more than reality. It is much more productive to worry about whether you are giving off a good illusion of a shorter nose instead of actually having a shorter nose. You can marginally lower the radix in rhinoplasty though.

 

[mightbecooked123]

Tbh it's probably just over bro. I have a 1.1 midface as well

Fellow horsecles we meet again

Its over

 

[moze]

The type of impaction represented in that image requires very particular circumstance (equal amounts of bone removed anteriorly and posteriorly). It would indeed very slightly reduce your nose height, as in absolute distance from radix to ans, although the cartilage would reform and likely in ways that counteract that effect and potentially require a rhinoplasty thereafter if your sole goal is to reduce nose height. The biggest "nose gains" you get from jaw surgery result not from the reduction of that absolute distance but the illusion of its reduction afforded by a more projected ANS, reduction in gingival show, and flatter occlusal plane. Most of the time that illusion matters more than reality. It is much more productive to worry about whether you are giving off a good illusion of a shorter nose instead of actually having a shorter nose. You can marginally lower the radix in rhinoplasty though.