Plan on Getting Bimax + Cheek-Infraorbital Implants

[dingopump]

Hi,

I have a recessed maxilla that extends up to the zygomatic & infraorbital area. I also had orthodontic compensation in the past (underbite).
This year, I had SARPE (palatal expansion surgery) and will start orthodontic decompensation (12-18 months).

The plan is to do bimax + cheek-infraorbital implants.

I'd like to get some feedback on my plan, things to look out for, and what movements would benefit me most.

The SARPE was with Dr. Defrancq (Belgium). I wanted to do the next surgery with him as well unless I find someone better.


1) Before orthodontic compensation.


2) After orthodontic compensation.


3) Front, left, right.


4) SARPE - before, after.

 

[Mongrelcel]

Not sure how much of a movement you can get away with without having the chimp look

 

[dingopump]

Not sure how much of a movement you can get away with without having the chimp look

Is the chimp look a result of an over-advanced maxilla?

I'm sure most surgeons work with guidelines to prevent that.
My case is probably a 4-6mm maxillary advancement with a CW rotation.

 

[dub779]

I have a class 2 overbite, deep recessed maxilla and narrow upper jaw. I consulted Dr Defrancq last year and he designed a SARPE plan for me, but becuase my lower jaw isn't narrower than the upper he also proposed widening of the lower jaw (called Mandibular distraction osteogenisis or MDSO) using a symphsyeal exapnder - 4-5mm expansion max, upper and lower. The plan is to first, followed by a bimax (I suggested a CCW as i have a slight negative occlusion plane but Defracnq recommended forward advancement with some anterior impaction to reduce the maxillary height or teeth show). Once thing thats left me skeptical is his bimax advancement, I beleive it stems from his concerns about creating the chimp look (as he did mention that he is vigilant of this) but he said that lower jaw advancment (or BSSO) may only be limited to 6mm of movement. He mentioned the upper (in my cse) should be limited to no more than 2mm of advancement to avoid the chimp look, looking at your case I would suggest that above 4mm over of upper advancement would be extreme and risk the anteface/chimp look, but get Defrancq to advise you on this has he will have your scans and models.
My sarpe/mdso is likely planned for this year but i'm still undecided but .

I have questions about your sarpe procedure since you've already had it done with him:
- How were you after the sarpe operation - how long did it take to recover after the operation? I plan on taking 2 weeks off before getting back to work
- how long did you wait until he had to start turning the expander - how much did you expand by?
- did you end up with a big gap between the front two incisors? did it start closing itself after you stopped expanding or did you ahve to wait for braces.
- how long did you have to wait for the bone to heal before the orthodontist started the braces (or as planned for me Invsalign) treatment.