Overdeveloped maxilla can cause long midface

[FartingSponge]

There are many types of jaw deformities. A not so common one is an overdeveloped maxilla which is often paired with an underdeveloped mandible (lower jaw), or it can create an illusion that the mandible is underdeveloped.

This is an example for an overdeveloped maxilla.

There are two major approaches that mostly surgeons do:

1. Total maxillary setback with mostly counter clockwise rotation + genioplasty

2. Only CCW rotation without maxillary setback (basically they move the mandible to match the maxilla)

The second option is not good, if you have an overdeveloped maxilla because it might make your philtrum even more prominent and you get a so called 'chimp limp' effect.

Example:

Total maxillary setback surgery with mandibular advancement before after photos:

Her middle face looks shorter. Cheekpads got pushed up and now it looks more harmonious.

Side profile:

Mandible and chin are more prominent.

Another example:

Conclusion:
If you have long midface first make sure that your maxilla is not overdeveloped. (You need to get x-ray or CT to make sure.)
A total maxillary setback is not a common surgery and it requires a different approach, like on the picture below.

 

[spark]

very few people have overdeveloped maxillas, wouldn't be surprised if the majority of diagnosed ones didn't even have it

a proper maxilla should be quite forward, Coceancig shows how much:

all three of these points should be touching the line in a completely non recessed (male) person:
(females due to a smaller chin should have the third point at about 5 mm off the line)

 

[FartingSponge]

very few people have overdeveloped maxillas, wouldn't be surprised if the majority of diagnosed ones didn't even have it

a proper maxilla should be quite forward, Coceancig shows how much:

View attachment 934586
all three of these points should be touching the line in a completely non recessed (male) person:
(females due to a smaller chin should have the third point at about 5 mm off the line)

Yes, it's not too common, I personally do have an overdeveloped maxilla however. I just wanted to share this because most of the surgeons I was talking with wouldn't consider a setback and I believe it would do more harm for my face than good.

 

[Deleted member 5746]

reverse lefort

 

[sandcelmuttcel]

what a shit thread.

i tested the first lady in the frankfort plane. she doesn't have overdeveloped maxilla, her mandible is underdeveloped and needs lower jaw advancement and i think that's what she got.

the other examples weren't reverse lefort either. it seems like the top teeth got pushed back orthodontically, they probably stuck out due to overjet causing this chimp mouth effect you are talking about. oh also they got lower jaw advancement too.

 

[Deleted member 8904]

JFLL AT YOUR IDIOCY

THAT WOMAN HAS A RECESSED ASS MAXILLA

JUST LOOK AT HER UNDEREYES

 

[Deleted member 3020]

Joined Monday at 4:54 AM

 

[FartingSponge]

what a shit thread.

i tested the first lady in the frankfort plane. she doesn't have overdeveloped maxilla, her mandible is underdeveloped and needs lower jaw advancement and i think that's what she got.

the other examples weren't reverse lefort either. it seems like the top teeth got pushed back orthodontically, they probably stuck out due to overjet causing this chimp mouth effect you are talking about. oh also they got lower jaw advancement too.

The pictures are from studies about maxillary setback, I doubt that happened.

It pretty much seems reverse lefort to me. They also had orthodontic treatment prior the surgery I assume.

 

[sandcelmuttcel]

The pictures are from studies about maxillary setback, I doubt that happened.

View attachment 934657
View attachment 934659
It pretty much seems reverse lefort to me. They also had orthodontic treatment prior the surgery I assume.

maybe. it's probably small and barely visible from the photos you first posted. also this xray obviously shows mandibular advancement.

 

[Deleted member 6305]

This thread makes no sense

 

[FartingSponge]

maybe. it's probably small and barely visible from the photos you first posted. also this xray obviously shows mandibular advancement.

And I also stated that maxillary setback goes with CCW rotation with genioplasty which means mandibular advancement. Maybe I wasn't clear but they got both, maxillary setback AND mandibular advancement, except one.

 

[Deleted member 6128]

It’s the over way round greycell an over developed maxilla causes Short midface

 

[spark]

She seems to have an overjet. She needs MSE to create more space and then you can orthodontically push back the front teeth a little bit so they don't stick out so much. I would never push my entire maxilla back.

 

[Deleted member 5061]

She seems to have an overjet. She needs MSE to create more space and then you can orthodontically push back the front teeth a little bit so they don't stick out so much. I would never push my entire maxilla back.

Exactly this, both cases are not overdeveloped maxilla, but what looks like overjet with improper alignment of her teeth, so that she cant close the mouth properly. Also the first picture is with her having and open mouth, which further proves that she cant close her mouth properly due to misalignment of jaw and teeth.

The proof that the maxilla is not overdeloped in both examples is the side profile picture. You can see that they dont have proper cheekbone under eye support and their cheekbone is projecting at a downwards angle too much.

Overdeveloped maxilla would ALWAYS be too much forwards growth, as you can see on her beofore picture she has average forwards growth at best.

If Maxilla is rotated upwards too much, her nose angle would be closer to 90° when compared to the forehead, basically look very comical, it would be instantly visible that the maxilla is rotated too much counter clock wise. But that is not the case also with her.

Again the reason why her midface looks longer in the before pictire is:

a- because the mouth is not closed properly

b- due to mouth protrusion, you can see how her upper and lower lip (and philtrum skin area) is stretched if she even attempts to close her mouth properly. When you push back the mouth protrusion (overjet) and align the jaws properly, so that when she closes her mouth, the lips can be in relaxed state- her midface becomes visibly smaller.

I see how it is easy to confuse overdeveloped maxilla with mouth protrusion, but that is not the case here. Overdeveloped maxilla would result in too much forward growth when you look at the side profile and the face would appear very monkey-ish from the side view and the face from the front would usually look like a fish face- very narrow.

 

[FartingSponge]

Exactly this, both cases are not overdeveloped maxilla, but what looks like overjet with improper alignment of her teeth, so that she cant close the mouth properly. Also the first picture is with her having and open mouth, which further proves that she cant close her mouth properly due to misalignment of jaw and teeth.

The proof that the maxilla is not overdeloped in both examples is the side profile picture. You can see that they dont have proper cheekbone under eye support and their cheekbone is projecting at a downwards angle too much.

Overdeveloped maxilla would ALWAYS be too much forwards growth, as you can see on her beofore picture she has average forwards growth at best.

If Maxilla is rotated upwards too much, her nose angle would be closer to 90° when compared to the forehead, basically look very comical, it would be instantly visible that the maxilla is rotated too much counter clock wise. But that is not the case also with her.

Again the reason why her midface looks longer in the before pictire is:

a- because the mouth is not closed properly

b- due to mouth protrusion, you can see how her upper and lower lip (and philtrum skin area) is stretched if she even attempts to close her mouth properly. When you push back the mouth protrusion (overjet) and align the jaws properly, so that when she closes her mouth, the lips can be in relaxed state- her midface becomes visibly smaller.

I see how it is easy to confuse overdeveloped maxilla with mouth protrusion, but that is not the case here. Overdeveloped maxilla would result in too much forward growth when you look at the side profile and the face would appear very monkey-ish from the side view and the face from the front would usually look like a fish face- very narrow.

It's from a study where they show cases for overdeveloped maxillas. Probably you know better than the doctors. Everybody is so smart here but nobody actually take the time to look for what exactly overdeveloped maxilla means in maxillofacial surgery. You can clearly see on the x-rays I posted that the SNA angle is way higher than average which clearly indicates an overdeveloped maxilla. And having underdeveloped mandible doesn't mean that you can't have overdeveloped maxilla. Anyways they look far better after maxillary setback surgery imo.

 

[tyronelite]

Exactly this, both cases are not overdeveloped maxilla, but what looks like overjet with improper alignment of her teeth, so that she cant close the mouth properly. Also the first picture is with her having and open mouth, which further proves that she cant close her mouth properly due to misalignment of jaw and teeth.

The proof that the maxilla is not overdeloped in both examples is the side profile picture. You can see that they dont have proper cheekbone under eye support and their cheekbone is projecting at a downwards angle too much.

Overdeveloped maxilla would ALWAYS be too much forwards growth, as you can see on her beofore picture she has average forwards growth at best.

If Maxilla is rotated upwards too much, her nose angle would be closer to 90° when compared to the forehead, basically look very comical, it would be instantly visible that the maxilla is rotated too much counter clock wise. But that is not the case also with her.

Again the reason why her midface looks longer in the before pictire is:

a- because the mouth is not closed properly

b- due to mouth protrusion, you can see how her upper and lower lip (and philtrum skin area) is stretched if she even attempts to close her mouth properly. When you push back the mouth protrusion (overjet) and align the jaws properly, so that when she closes her mouth, the lips can be in relaxed state- her midface becomes visibly smaller.

I see how it is easy to confuse overdeveloped maxilla with mouth protrusion, but that is not the case here. Overdeveloped maxilla would result in too much forward growth when you look at the side profile and the face would appear very monkey-ish from the side view and the face from the front would usually look like a fish face- very narrow.

That’s what I need My protruding teeth ruins my side profile

 

[Deleted member 5061]

It's from a study where they show cases for overdeveloped maxillas. Probably you know better than the doctors. Everybody is so smart here but nobody actually take the time to look for what exactly overdeveloped maxilla means in maxillofacial surgery. You can clearly see on the x-rays I posted that the SNA angle is way higher than average which clearly indicates an overdeveloped maxilla. And having underdeveloped mandible doesn't mean that you can't have overdeveloped maxilla. Anyways they look far better after maxillary setback surgery imo.

Well the thing is mate, doctors arent all-knowing gods, we know that at the very least since realizing that orthodontics esp. retractive orthodontics aesthetically and from health aspect are bad. Teeth extractions are in 99% of cases the wrong thing to do, yet most orthodontists still do it.

Let me bring your attention to the front before picture of this woman on the bottom left:

see how she literally has no undereye support and even with covered eyes, one can tell from the cheekbones alone that she has droopy eyes or sclera show under the pupil and most likely she has NCT.

Her maxilla isnt overdeveloped, but I agree it is overprojected. She has the typical case of mouth protrusion like many black ppl have. Its when the mouth area looks like a chimp mouth. What most likely happened was, she was swallowing improperly for years, pushing with the tongue against her teeth. That resulted in pushing the maxilla horizontally forwards, instead of upwards against the roof of the mouth. And pushing against her teeth with the tongue also most likely resulted in a narrow palate.

I hope they expanded these womens palate during the treatment and figured out whether these women have incorrect swallowing pattern.

 

[FartingSponge]

Well the thing is mate, doctors arent all-knowing gods, we know that at the very least since realizing that orthodontics esp. retractive orthodontics aesthetically and from health aspect are bad. Teeth extractions are in 99% of cases the wrong thing to do, yet most orthodontists still do it.

Let me bring your attention to the front before picture of this woman on the bottom left:

see how she literally has no undereye support and even with covered eyes, one can tell from the cheekbones alone that she has droopy eyes or sclera show under the pupil and most likely she has NCT.

Her maxilla isnt overdeveloped, but I agree it is overprojected. She has the typical case of mouth protrusion like many black ppl have. Its when the mouth area looks like a chimp mouth. What most likely happened was, she was swallowing improperly for years, pushing with the tongue against her teeth. That resulted in pushing the maxilla horizontally forwards, instead of upwards against the roof of the mouth. And pushing against her teeth with the tongue also most likely resulted in a narrow palate.

I hope they expanded these womens palate during the treatment and figured out whether these women have incorrect swallowing pattern.

I think the problem is that in maxillofacial surgeons mostly refer to the lower part of the maxilla and in your definition you mean the entire maxilla. You're totally right about under eye support, but the post is not related to that. 'Chimp mouth' mostly caused by overdeveloped maxilla (lower part) which can be addressed with maxillary setback surgery (lefort 1) or other methods like removing teeth and cut the bones to set back that area.

I get your point but these women had overdeveloped LOWER maxilla and the issue was addressed with the right type of surgery.

Anyways it doesn't matter, I just wanted to show that bringing forward the maxilla is not the answer for some people.

 

[Deleted member 5061]

I think the problem is that in maxillofacial surgeons mostly refer to the lower part of the maxilla and in your definition you mean the entire maxilla. You're totally right about under eye support, but the post is not related to that. 'Chimp mouth' mostly caused by overdeveloped maxilla (lower part) which can be addressed with maxillary setback surgery (lefort 1) or other methods like removing teeth and cut the bones to set back that area.

I get your point but these women had overdeveloped LOWER maxilla and the issue was addressed with the right type of surgery.

Anyways it doesn't matter, I just wanted to show that bringing forward the maxilla is not the answer for some people.

Thats right, bringing lower maxilla forward is not allways the answer, in fact its almost never the answer. But bringing the whole maxilla forwards + upwards at the same time usually is.

These women had the right treatment one could say, because they look much better after surgery, thats true. And in their adult age, it was probably the most realistic solution to the problem.

See Im just not a fan or teeth extraction and any retractive orthodontics. Mouth protrusion is the only exception I guess, but even there, I think better solutions will be found in the future (I hope) than extracting teeth and pushing lower maxilla back.

But I guess at adult age, it is harder to remodel the bone through non surgical ways, so it was the quickest and most effective solution for these women I guess.

Although I still have the oppinion, that if their lower jaw was fixed through genioplasty or something, then crooked teeth/bite was fixed with braces (without rubbers that push maxilla back) and these women worked on their swallowing pattern + body posture, they couldve fixed it in maybe like 6-10 years naturally, perhaps. But that is all speculation from my side, Im just not a fan of having someones teeth extracted, maxilla cut off and repositioned and then fixed by screws, and then the walk around with all sorts of metal retainers and screws in their head. But I guess sometimes its the only effective solution.

One more thing though- this solution worked fine with these women on the pictures, because women dont always need good cheekbones to look decent. Women in general can get away with waaay more flaws then men and still look decent with some big flaws like big UEE, flat cheekbones, even recessed mandible or maxilla. Failos that are completely huge looksmins on men, dont seem to looksmin women that much.

 

[arbaz_khan]

the other examples weren't reverse lefort either. it seems like the top teeth got pushed back orthodontically, they probably stuck out due to overjet causing this chimp mouth effect you are talking about. oh also they got lower jaw advancement too.

Agree

 

[FartingSponge]

6-10 years naturally

Nobody has time for that. Personally I would always choose the most effective, fastest method for myself because who knows when my life ends and I want to enjoy the better me.

Btw it's possible to get all the metal removed, some places do that if you pay more, it's nothing special. Just most people don't care because they cut you open again and it's unnecessary.

 

[ropemax]

a paper has recently been published (co-authored by Arnett (pbuh)) which presents a novel modification of Low LF1 called "UnderSpinal Osteotomy" (USO) that's superior to a total maxillary setback because it prevents the loss of nasal bone support and preserves the nasal chamber volume. This seems like a godsend for people with dentoalveolar protrusion.

The UnderSpinal Osteotomy: A modified low Lefort I osteotomy to correct maxillary dentoalveolar protrusion

Maxillary dentoalveolar protrusion is a common dentofacial deformity in some communities. The gold standard movement to treat this deformity is maxill…

www.sciencedirect.com

@RealSurgerymax have you heard about this? Is this a good option?