Mouth protrusion, forward growth, and le fort 1

[neithernorwood]

I'm a bit confused by mouth protrusion -- for which surgeons offer fix by bringing back the mouth towards the back of the skill -- vs discussions of forward growth -- which suggest the opposite is desirable.

Mouth protrusion

Bimaxillary Protrusion Surgery

Bimaxillary Protrusion Surgery

www.engbanobagi.com

You can see here these surgeons intentionally recess the mouth:

Forward growth

Whereas here we have:

So my current understanding is that the forward growth is more about the UPPER part of the maxilla (and keeping the lower jaw in line). So you can have bad forward growth if your upper maxilla is recessed and your lower maxilla is projected outward. Is that right? And the proper fix in this case not to bring the mouth backwards as is offered on that website but rather bring the upper part of the maxilla forwards (maybe with CCW).

So if you have mouth protrusion but also not a lot of forward growth, probably you need le fort 2? Because le fort 1 advancement would just make the protrusion worse? I'm having trouble understanding how le fort 1 with forward growth helps you if you have mouth protrusion already.

 

[Deleted member 399]

Downward maxillary forward growth which results in prognathism is one of the most difficult things to correct. You probably need counterclockwise distraction of the maxilla and mandible.

 

[Deleted member 4430]

Downward maxillary forward growth which results in prognathism is one of the most difficult things to correct. You probably need counterclockwise distraction of the maxilla and mandible.

its over

 

[Deleted member 399]

its over

Yeah its really difficult if you have something like that.

 

[Selinity]

Downward maxillary forward growth which results in prognathism

Prognathism is caused by downward growth of the maxilla?
I thought it was just protrusion.

 

[Selinity]

Yeah its really difficult if you have something like that.

The girl in the photo had it fixed through bimax without losing mandibular length or forwards growth though, didn't she?

 

[Deleted member 399]

The girl in the photo had it fixed through bimax without losing mandibular length or forwards growth though, didn't she?

Yeah she did, but now her face is very flat overall.

 

[Deleted member 5634]

I have this my surgeon told me they had to extract my premolars and then do the lefort 1 so i dont look like a chimp, actually both my maxilla and mandible are reccessed but my mouth protrudes a lot

 

[Deleted member 5634]

Do you have this OP? Im also confused tbh

 

[MD_Hopeful69]

I have this my surgeon told me they had to extract my premolars and then do the lefort 1 so i dont look like a chimp, actually both my maxilla and mandible are reccessed but my mouth protrudes a lot

Are you class 3?

 

[Deleted member 5634]

Are you class 3?

No, im class 2 bro, but i do have protruded teeth according to the ceph, also add me back to the surgery discord, you guys banned me lol

 

[Deleted member 4430]

I have this my surgeon told me they had to extract my premolars and then do the lefort 1 so i dont look like a chimp, actually both my maxilla and mandible are reccessed but my mouth protrudes a lot

same, its the worse thing you can have

 

[Babushkacatlady]

I have this my surgeon told me they had to extract my premolars and then do the lefort 1 so i dont look like a chimp, actually both my maxilla and mandible are reccessed but my mouth protrudes a lot

opt for CCW rotation with any surgery you get. Or keep your teeth together and tongue tip on the roof of your mouth with the rest of your tongue and maintain a good lip seal and these teeth will slowly upright.

 

[Deleted member 5634]

opt for CCW rotation with any surgery you get. Or keep your teeth together and tongue tip on the roof of your mouth with the rest of your tongue and maintain a good lip seal and these teeth will slowly upright.

Na bro, i have bimaxillary protrusion because my grandma was black, no amount of mewing will fix it. My dad has more transversally big maxilla and he also has bimax protrusion.

 

[Deleted member 5634]

same, its the worse thing you can have

It makes you look like a chimp

 

[Babushkacatlady]

Na bro, i have bimaxillary protrusion because my grandma was black, no amount of mewing will fix it. My dad has more transversally big maxilla and he also has bimax protrusion.

Oral posture tendencies can be genetically inherited because they are part of unconscious innervation, especially as a response to airway obstruction.

 

[AlwaysHaveQuestions]

opt for CCW rotation with any surgery you get. Or keep your teeth together and tongue tip on the roof of your mouth with the rest of your tongue and maintain a good lip seal and these teeth will slowly upright.

wouldnt it be a cw rotation against the protrusion?
also mewing wouldn't fix it. another option from extraction is sarpe/mse

 

[neithernorwood]

Do you have this OP? Im also confused tbh

idk. tell me what you think here https://looksmax.org/threads/rate-this-ct-scan-profile-forward-45deg.323033/

 

[Deleted member 5634]

idk. tell me what you think here https://looksmax.org/threads/rate-this-ct-scan-profile-forward-45deg.323033/

Mine Is much worse than yours and I'm more recessed. I don't think you have it, but they should send you also the values on a sheet where you can see your teeth inclination

 

[Deleted member 5634]

wouldnt it be a cw rotation against the protrusion?
also mewing wouldn't fix it. another option from extraction is sarpe/mse

My es ratio Is already good so that is a not possible, I have a really weird maxilla it's good transversally but really long and with my teeth protruding

 

[Mr.cope]

prognathism and bimaxillary protrusion is from protruding teeth or a very short and weak nose

 

[MD_Hopeful69]

No, im class 2 bro, but i do have protruded teeth according to the ceph, also add me back to the surgery discord, you guys banned me lol

Ok I didn’t ban you but I will look into the matter. Probably was another admin

 

[AlwaysHaveQuestions]

My es ratio Is already good so that is a not possible, I have a really weird maxilla it's good transversally but really long and with my teeth protruding

what does that have to do with es ratio?
and yea negroid and mongoloid skull are longer sagitally. caucasians evolved to have more sunken in face which makes them look forward grown

 

[Deleted member 5634]

what does that have to do with es ratio?
and yea negroid and mongoloid skull are longer sagitally. caucasians evolved to have more sunken in face which makes them look forward grown

Mse can change es ratio as far as I know

 

[AlwaysHaveQuestions]

Mse can change es ratio as far as I know

you can use sarpe it only expands the palate

 

[Deleted member 5634]

you can use sarpe it only expands the palate

I think my issue is the teeth tilting in a retarded way forwards spanding the palate may not fix it tbh

 

[Deleted member 13294]

I'm a bit confused by mouth protrusion -- for which surgeons offer fix by bringing back the mouth towards the back of the skill -- vs discussions of forward growth -- which suggest the opposite is desirable.

Mouth protrusion

Bimaxillary Protrusion Surgery

Bimaxillary Protrusion Surgery

www.engbanobagi.com

You can see here these surgeons intentionally recess the mouth:

View attachment 1063251

View attachment 1063252

Forward growth

Whereas here we have:
View attachment 1063263

So my current understanding is that the forward growth is more about the UPPER part of the maxilla (and keeping the lower jaw in line). So you can have bad forward growth if your upper maxilla is recessed and your lower maxilla is projected outward. Is that right? And the proper fix in this case not to bring the mouth backwards as is offered on that website but rather bring the upper part of the maxilla forwards (maybe with CCW).

View attachment 1063259

So if you have mouth protrusion but also not a lot of forward growth, probably you need le fort 2? Because le fort 1 advancement would just make the protrusion worse? I'm having trouble understanding how le fort 1 with forward growth helps you if you have mouth protrusion already.

View attachment 1063262

If you have protruded maxilla already then you need a surgery that won't advance the maxilla itself. So in this case there are more possible solutions, like rotation, or total maxillary setback + rotation.

 

[Deleted member 10172]

I'm a bit confused by mouth protrusion -- for which surgeons offer fix by bringing back the mouth towards the back of the skill -- vs discussions of forward growth -- which suggest the opposite is desirable.

Mouth protrusion

Bimaxillary Protrusion Surgery

Bimaxillary Protrusion Surgery

www.engbanobagi.com

You can see here these surgeons intentionally recess the mouth:

View attachment 1063251

View attachment 1063252

Forward growth

Whereas here we have:
View attachment 1063263

So my current understanding is that the forward growth is more about the UPPER part of the maxilla (and keeping the lower jaw in line). So you can have bad forward growth if your upper maxilla is recessed and your lower maxilla is projected outward. Is that right? And the proper fix in this case not to bring the mouth backwards as is offered on that website but rather bring the upper part of the maxilla forwards (maybe with CCW).

View attachment 1063259

So if you have mouth protrusion but also not a lot of forward growth, probably you need le fort 2? Because le fort 1 advancement would just make the protrusion worse? I'm having trouble understanding how le fort 1 with forward growth helps you if you have mouth protrusion already.

View attachment 1063262

CCW Rotation

 

[Deleted member 10172]

Mse can change es ratio as far as I know

Tf is Es ratio

 

[sandcelmuttcel]

The girl in the photo had it fixed through bimax without losing mandibular length or forwards growth though, didn't she?

she likely did extractions

 

[thecel]

So my current understanding is that the forward growth is more about the UPPER part of the maxilla (and keeping the lower jaw in line). So you can have bad forward growth if your upper maxilla is recessed and your lower maxilla is projected outward. Is that right?

UPPER maxillary projection is the key to aesthetics

What's the upper maxilla? The upper maxilla is essentially the Le Fort 2 area minus the Le Fort 1 area. Figure 1: The 3 Le Fort fractures. The upper maxilla is Le Fort 2 minus Le Fort 1. The upper maxilla includes the inner infraorbital rims, the nasal ridge, the canine fossa area...

looksmax.org

 

[Deleted member 756]

UPPER maxillary projection is the key to aesthetics

What's the upper maxilla? The upper maxilla is essentially the Le Fort 2 area minus the Le Fort 1 area. Figure 1: The 3 Le Fort fractures. The upper maxilla is Le Fort 2 minus Le Fort 1. The upper maxilla includes the inner infraorbital rims, the nasal ridge, the canine fossa area...

looksmax.org

Is it a rare procedure?

 

[OOGABOOGA]

Fuck man I wish lefort 2 was more available and safe. Idk if I’d benefit more from 1 ccw or 2

 

[anti caking agents]

I have this my surgeon told me they had to extract my premolars and then do the lefort 1 so i dont look like a chimp, actually both my maxilla and mandible are reccessed but my mouth protrudes a lot

Same. Remove upper and lower premolars, 4 teeth in total and pull back all the teeth backwards into the mouth. Removes the protusion and from there operate normally. He said it was nothing complicated at all but then again he is world class. A side effect is it takes like 12-18 months from teeth extractions to operation...

 

[Donc0ck]

No, im class 2 bro, but i do have protruded teeth according to the ceph, also add me back to the surgery discord, you guys banned me lol

can you send me you ceph bro? i think i have the same but my surgeon didnt tell me that, so i fear the chimp

 

[Growth Plate]

Same. Remove upper and lower premolars, 4 teeth in total and pull back all the teeth backwards into the mouth. Removes the protusion and from there operate normally. He said it was nothing complicated at all but then again he is world class. A side effect is it takes like 12-18 months from teeth extractions to operation...

What are the effects of removing the premolars

Bone loss, narrow airway, etc? What happened