Orbital decompression for recessed upper maxilla

[Foreverbrad]

Orbital decompression will make my eyes slightly more deep set.

This would improve the maxillary triangle and the cheek line, but it wouldn’t actually make my face any more forward grown except relative to the eyes.

Would this be of any aesthetic value?
I’ve not included anything other that OD in this morph (based on the movement seen in b&a side profiles I found online) but I’m aware that infraorbital implants and (jaw surgery / ortho) fixing bite are required.

 

[Foreverbrad]

Personally I think it’s a minor improvement but this is not a cheap surgery and I’m not 100% sure but I think it would have to be done before placing infraorbital implants.

 

[Deleted member 24444]

Personally I think it’s a minor improvement but this is not a cheap surgery and I’m not 100% sure but I think it would have to be done before placing infraorbital implants.

Is the ROI worth it tho?

 

[Foreverbrad]

Is the ROI worth it tho?

As usual with the harder surgeries there’s no way of knowing.

It’s a much cheaper and more accessible alternative / supplement to Lefort 2 + brow ridge implant that improves the maxillary triangle from 13 degrees to 20 degrees (while it needs to be 45 degrees JFL).

So ideally it would be lefort 2 combined with orbital decompression, but I don’t see myself being able to get lefort 2.

 

[Deleted member 24444]

As usual with the harder surgeries there’s no way of knowing.

It’s a much cheaper and more accessible alternative / supplement to Lefort 2 + brow ridge implant that improves the maxillary triangle from 13 degrees to 20 degrees (while it needs to be 45 degrees JFL).

So ideally it would be lefort 2 combined with orbital decompression, but I don’t see myself being able to get lefort 2.

tbh fixing triangle wont do smth since you will still have naso folds and dark circles/under eye lines even after that. Implants it is I guess

 

[Foreverbrad]

tbh fixing triangle wont do smth since you will still have naso folds and dark circles/under eye lines even after that. Implants it is I guess

Implants and lefort 1 will fix the naso folds and dark circles but the triangle will remain extremely poor.

High cut lefort 1 will just fuck up my nose and make my upper face look pushed in so it’s not a valid solution to the triangle either.

 

[SubHumanHere]

Orbital decompression will make my eyes slightly more deep set.

This would improve the maxillary triangle and the cheek line, but it wouldn’t actually make my face any more forward grown except relative to the eyes.

Would this be of any aesthetic value?
I’ve not included anything other that OD in this morph (based on the movement seen in b&a side profiles I found online) but I’m aware that infraorbital implants and (jaw surgery / ortho) fixing bite are required.

Orbital implants are better if you actually have reccesed bones and not grave disease.

 

[SubHumanHere]

Personally I think it’s a minor improvement but this is not a cheap surgery and I’m not 100% sure but I think it would have to be done before placing infraorbital implants.

Yeah that was my thoughts at first, if you get od should you do it before implants or after?

 

[DownUnderCopeAttack]

Yeah. I got MSE and it helped a bit, but I am in the same boat.
i don’t have high hopes for DJS but I really it cures my sleep apnea.

 

[Foreverbrad]

Orbital implants are better if you actually have reccesed bones and not grave disease.

I just don’t see how that can look harmonious when the nasal base is recessed. Look how close my eyes are to my nasion. This dimension can’t really be changed.

 

[Deleted member 3105]

You have no bones. The solution would be creating more bone, not pushing your eyeballs deeper into those boneless sockets

 

[zap]

You have no bones. The solution is would be creating more bone, not pushing your eyeballs deeper into those boneless sockets

In orbital decompression surgery they remove bones from your eye socket to let it go deeper tho

 

[Deleted member 18582]

You don't need OBO. You need LeFort I or Clockwise Rotation Bimax + Infras and Supras

 

[Deleted member 3105]

In orbital decompression surgery they remove bones from your eye socket to let it go deeper tho

what parts? even worse

 

[Foreverbrad]

You have no bones. The solution is would be creating more bone, not pushing your eyeballs deeper into those boneless sockets

I already did say that infraorbital implants are clearly needed (closest thing to creating more bone).

However they don’t solve the recessed upper maxilla issue as those implants are placed on the malar arches, not near the nasal base.

Paranasal implants will most likely just give me a flat face as my face is already pretty flat.

Lefort 2 would be an excellent solution but JFL.

You don't need OBO. You need LeFort I or Clockwise Rotation Bimax + Infras and Supras

Lefort 2, unobtainable. Lefort 1 will not solve the recessed upper maxilla… I can do a morph to show how badly this all harmonises. But I will just describe the look: Ogre

 

[Deleted member 18582]

I already did say that infraorbital implants are clearly needed (closest thing to creating more bone).

However they don’t solve the recessed upper maxilla issue as those implants are placed on the malar arches, not near the nasal base.

Paranasal implants will most likely just give me a flat face as my face is already pretty flat.

Lefort 2 would be an excellent solution but JFL.



Lefort 2, unobtainable. Lefort 1 will not solve the recessed upper maxilla… I can do a morph to show how badly this all harmonises.

What part of the upper maxilla?

You get clockwise bimax and you fill out the upper midface with implants as necessary. Custom implants covering whatever portion of the infraorbital, malar, and paranasal regions you need.

I saw your morphs, you did NOT do a clockwise rotation.

 

[Deleted member 29167]

I already did say that infraorbital implants are clearly needed (closest thing to creating more bone).

However they don’t solve the recessed upper maxilla issue as those implants are placed on the malar arches, not near the nasal base.

Paranasal implants will most likely just give me a flat face as my face is already pretty flat.

Lefort 2 would be an excellent solution but JFL.



Lefort 2, unobtainable. Lefort 1 will not solve the recessed upper maxilla… I can do a morph to show how badly this all harmonises. But I will just describe the look: Ogre

wont giant preform lefort 2 at his cambodia hardmax clinic? @RealSurgerymax

 

[Deleted member 20064]

Just get bimax + periorbital augmentation with implants. I wouldn’t even bother with OD.

 

[Foreverbrad]

What part of the upper maxilla?

You get clockwise bimax and you fill out the upper midface with implants as necessary. Custom implants covering whatever portion of the infraorbital, malar, and paranasal regions you need.

I saw your morphs, you did NOT do a clockwise rotation.

Specifically the nasion is recessed. My eyes are so close to the nasion and I don’t know any way to help that except lefort 2 or OD.

Just to be clear, with CW bimax you are suggesting front of maxilla comes down like this and lower jaw is rotated at the BSSO cut to accommodate the movement:

Looks decent from the side but might be a bit of a long face from the front.

 

[Deleted member 18582]

Specifically the nasion is recessed. My eyes are so close to the nasion and I don’t know any way to help that except lefort 2 or OD.

Just to be clear, with CW bimax you are suggesting front of maxilla comes down like this and lower jaw is rotated at the BSSO cut to accommodate the movement:

Looks decent from the side but might be a bit of a long face from the front.

Both jaws are rotated clockwise in clockwise bimax. The maxilla is grafted as needed to execute the rotation. You might just need a LeFort I. I really have no idea and the only way to know is to get a consult with a maxfac surgeon and look at your CT scans.

When I say stop fucking around with morphs: what I mean is that you are not doing a good job producing morphs that accurately reflect the procedures you're bringing up and allowing these badly produced morphs to dramatically influence your course of action. Orbital decompression should not even be on the table.

 

[Foreverbrad]

Both jaws are rotated clockwise in clockwise bimax. The maxilla is grafted as needed to execute the rotation. You might just need a LeFort I. I really have no idea and the only way to know is to get a consult with a maxfac surgeon and look at your CT scans.

When I say stop fucking around with morphs: what I mean is that you are not doing a good job producing morphs that accurately reflect the procedures you're bringing up and allowing these badly produced morphs to dramatically influence your course of action. Orbital decompression should not even be on the table.

It’s impossible to produce good morphs of complex movements with the tools I have available, it’s true. But it kind of gives a very rough idea of what would happen and I’d like to be a bit informed when taking to a surgeon.

Thoughts if a 125 degree gonial angle and a lower third 25% longer than middle third are good traits? Seems hyper masculine.

 

[Deleted member 18582]

It’s impossible to produce good morphs of complex movements with the tools I have available, it’s true. But it kind of gives a very rough idea of what would happen and I’d like to be a bit informed when taking to a surgeon.

Thoughts if a 125 degree gonial angle and a lower third 25% longer than middle third are good traits? Seems hyper masculine.

Generally you want your facial thirds to have equal proportions.

125 is a good gonial angle.

 

[Deleted member 32760]

Generally you want your facial thirds to have equal proportions.

125 is a good gonial angle.

something between 100 - 120 is an ideal gonial angle.

 

[SubHumanHere]

I just don’t see how that can look harmonious when the nasal base is recessed. Look how close my eyes are to my nasion. This dimension can’t really be changed.

Depends from patient to patient, there is a post on ig where giant implant aka realsurgerymax performed it, he called it nose genioplasty.

 

[Foreverbrad]

Generally you want your facial thirds to have equal proportions.

125 is a good gonial angle.

How does clockwise bimax work with the philtrum and upper lip? My smile right now is “correct” in terms of upper teeth exposed and no gum show.

Will CW bimax give me a gummy smile due to the lip/philtrum attachment point being above the lefort 1 cut?

 

[Deleted member 18582]

How does clockwise bimax work with the philtrum and upper lip? My smile right now is “correct” in terms of upper teeth exposed and no gum show.

Will CW bimax give me a gummy smile due to the lip/philtrum attachment point being above the lefort 1 cut?

I don't know the exact terminology or how it works but in cw/ccw bimax they can graft the maxilla in such a way to avoid creating a gummy smile on those who don't have one.

 

[PrimoMaxxer]

Would radix augmentation with a rhinoplasty be a potential solution?

 

[rubberduck]

Does orbital decompression make your IPD lower?

 

[Foreverbrad]

Does orbital decompression make your IPD lower?

Yes if you get the wrong one (medial wall).
Lateral wall only maintains IPD.

 

[rubberduck]

Yes if you get the wrong one (medial wall).
Lateral wall only maintains IPD.

I have shit eyes but I’m more bothered by my ESR than my negative orbital vector. I have 67mm IPD but 0.43 ESR due to wide face/zygos, idk what to do jfl

 

[Foreverbrad]

I have shit eyes but I’m more bothered by my ESR than my negative orbital vector. I have 67mm IPD but 0.43 ESR due to wide face/zygos, idk what to do jfl

What’s your ICD though?

 

[rubberduck]

What’s your ICD though?

haven’t measured it but it’s over a full eye apart. So it’s a little weird my eyes aren’t actually close set but my face is super wide which makes them look closer set than they are lol. I think probably should leanmax as my face is pretty bloated and fat, and fraud with hair that covers the sides so you don’t see how wide my temples & zygos are as much?

 

[Foreverbrad]

haven’t measured it but it’s over a full eye apart. So it’s a little weird my eyes aren’t actually close set but my face is super wide which makes them look closer set than they are lol. I think probably should leanmax as my face is pretty bloated and fat, and fraud with hair that covers the sides so you don’t see how wide my temples & zygos are as much?

Yes. There are also zygo osteomies you can do if it would help, check South Korean plastic surgery websites.