Premolar extractions for jaw surgery

[IDontBlameAnybody]

I'm a Class 3, trying to get Lefort 1 / DJS. 8mm recession of the maxilla.
Got back from a consultation with my jaw surgeon today after having done 2 ortho visits and all my scans. She told me that she doesn't personally recommend premolar extractions since she had them done and she regrets it. I forgot to ask if she did them for camouflage or for jaw surgery preparation.

Anyways I'm scared shitless about extractions, I've read so much shit about how it can make your smile more narrow and even give you less bonemass.
My surgeon also told me that I should discuss it more with my ortho and look for alternatives, but my ortho messaged me today and told me that this is the only option pretty much. I sent her another message larping about other options and asking about the potential side effects. I'm most likely consulting another ortho just in case. Though my surgeon told me that my current ortho is actually a really good ortho. But we'll see.

Also, what do yall think about surgery-first approach? My occlusion is fine dentally and my teeth are straight, 0 crowding. So maybe I could be a potential candidate? I also asked that from my ortho. Though I highly doubt they'll do it lol.

 

[hye732]

Got back from a consultation with my jaw surgeon today after having done 2 ortho visits and all my scans. She told me that she doesn't personally recommend them since she had them done and she regrets it. I forget to ask if she did them for camouflage or for jaw surgery preparation.

Anyways I'm scared shitless about extractions, I've read so much shit about how it can make your smile more narrow and even give you less bonemass.
My surgeon also told me that I should discuss it more with my ortho and look for alternatives, but my ortho messaged me today and told me that this is the only option pretty much. I sent her another message larping about other options and asking about the potential side effects. I'm most likely consulting another ortho just in case. Actually my surgeon told me that my current ortho is actually a really good ortho. But we'll see.

Also, what do yall think about surgery-first approach? My occlusion is fine dentally and my teeth are straight, 0 crowding. So maybe I could be a potential candidate? I also asked that from my ortho. Though I highly doubt they'll do it lol.

Personally I did not have my molars extracted. I dislike the idea of extracting any bone from the face unless you actually have a dental issue (crowding). You already get bone resorption with age that people try to reverse with filler but it never works.

 

[tweaqo]

I’m confused why ur jaw surgeon is saying that lol

 

[IDontBlameAnybody]

Personally I did not have my molars extracted. I dislike the idea of extracting any bone from the face unless you actually have a dental issue (crowding). You already get bone resorption with age that people try to reverse with filler but it never works.

I mean yeah I also hate the idea of it, but I've read some people did it for jaw surgery and came out just fine. Though there are bunch of horror stories aswell. It would suck dick if I couldn't get a lefort 1 just because I were against extractions.

Oh and also, my ortho talked to me about bimax, but my surgeon told me that she is comfortable with 8mm forward advancement of the maxilla and a bimax wouldnt be neccessary, but I'm wondering if that would be kind of overadvancing? Maybe I should then be worried about the chimp lip effect or philtrum getting bigger (even though there is no downgrafting planned).

 

[IDontBlameAnybody]

I’m confused why ur jaw surgeon is saying that lol

Saying what specifically? That premolar extractions are bad? Because she had negative experience with it I guess.. And obviously she has been in the field for years and is one of the best in our country. But again, she had hers done like 30 years ago lol.

 

[SkeetNeet]

Not a big deal to extract premolars in the lower arch it’s going to help achieve bigger mandibular movements, but I’m wary of whether it’s a good idea to extra teeth in the upper arch.

If your surgeon doesn’t recommend it, does she have an alternative solution to what the ortho is suggesting?

 

[ltn_looksminner]

I'm a Class 3, trying to get Lefort 1 / DJS. 8mm recession of the maxilla.
Got back from a consultation with my jaw surgeon today after having done 2 ortho visits and all my scans. She told me that she doesn't personally recommend premolar extractions since she had them done and she regrets it. I forgot to ask if she did them for camouflage or for jaw surgery preparation.

Anyways I'm scared shitless about extractions, I've read so much shit about how it can make your smile more narrow and even give you less bonemass.
My surgeon also told me that I should discuss it more with my ortho and look for alternatives, but my ortho messaged me today and told me that this is the only option pretty much. I sent her another message larping about other options and asking about the potential side effects. I'm most likely consulting another ortho just in case. Though my surgeon told me that my current ortho is actually a really good ortho. But we'll see.

Also, what do yall think about surgery-first approach? My occlusion is fine dentally and my teeth are straight, 0 crowding. So maybe I could be a potential candidate? I also asked that from my ortho. Though I highly doubt they'll do it lol.

How would lower premolar extraction make the smile narrower

 

[tweaqo]

Saying what specifically? That premolar extractions are bad? Because she had negative experience with it I guess.. And obviously she has been in the field for years and is one of the best in our country. But again, she had hers done like 30 years ago lol.

Yeah but for some people they’re very much necessary… she is also an orthodontist because all maxfacs surgeonhave studied orthodontics in order to become a surgeon.

So idk why she is demonising extractions when they can make decomp easier…

 

[IDontBlameAnybody]

Yeah but for some people they’re very much necessary… she is also an orthodontist because all maxfacs surgeonhave studied orthodontics in order to become a surgeon.

So idk why she is demonising extractions when they can make decomp easier…

Mainly due to the aesthetic reasons. This fucking premolar shit has me doubting all the jaw surgery shit and maybe just cope with a rhino and other shit instead, but deep down ik that lefort 1 could give me the most superior results. I’m just honestly so fucking scared that I’ll look like a disgusting piece of shit for the next 1.5 years in the decomp phase.

 

[IDontBlameAnybody]

Not a big deal to extract premolars in the lower arch it’s going to help achieve bigger mandibular movements, but I’m wary of whether it’s a good idea to extra teeth in the upper arch.

If your surgeon doesn’t recommend it, does she have an alternative solution to what the ortho is suggesting?

No she didnt have any alternative solutions, she just said that I can refuse it and discuss with my ortho, but other than that no. She also said that the ortho is really good and the ortho told me that extractions are neccessary in order to achieve good maxillary movements. She sounded rly confident, but fuck man idk…

 

[IDontBlameAnybody]

Yeah but for some people they’re very much necessary… she is also an orthodontist because all maxfacs surgeonhave studied orthodontics in order to become a surgeon.

So idk why she is demonising extractions when they can make decomp easier…

Some people claim they lost cheekbone / jaw width and whatever the fuck… sunken face pretty much. I dont fucking know honestly man I’m trying to looksmax not looksmin here and im super fucking stressed about it..

 

[IDontBlameAnybody]

How would lower premolar extraction make the smile narrower

Im extracting upper premolars

 

[ltn_looksminner]

Im extracting upper premolars

Bro you're class 3 why extract upper premolars

 

[IDontBlameAnybody]

Bro you're class 3 why extract upper premolars

upper incisors flared forward

 

[tyler1234]

Show pics of ur teeth

 

[IDontBlameAnybody]

Show pics of ur teeth

 

[tyler1234]

did u have braces to camouflage ur underbite ? Why can’t they decomposite the lower ?

 

[IDontBlameAnybody]

did u have braces to camouflage ur underbite ?

no

 

[tyler1234]

So u don’t have an underbite

 

[IDontBlameAnybody]

So u don’t have an underbite

Structurally my upper jaw is 8mm recessed, its just that my teeth compensated by themselves. My maxilla is still recessed.

 

[tyler1234]

What does ur side profile look like and why don’t they just advance both jaws

 

[IDontBlameAnybody]

What does ur side profile look like and why don’t they just advance both jaws

cuz my lower jaw is well developed, it might even be setback a tad bit but my maxfac is against it.

 

[tyler1234]

Show ur side profile , what ur saying makes no sense if ur teeth meet together class 1 naturally and u never had any orthodontic intervention one jaw can’t be 8mm recessed and the other be well developed

 

[tyler1234]

U should go to another surgeon

 

[Nahorscend]

Some people claim they lost cheekbone / jaw width and whatever the fuck… sunken face pretty much. I dont fucking know honestly man I’m trying to looksmax not looksmin here and im super fucking stressed about it..

But it depends on if you got them extracted in your teens for crowding or as an adult for jaw surgery, no? If it's the latter I don't think it will have any major aesthetic effect, certainly not something that won't be more than offset by the jaw surgery.

 

[IDontBlameAnybody]

Show ur side profile , what ur saying makes no sense if ur teeth meet together class 1 naturally and u never had any orthodontic intervention one jaw can’t be 8mm recessed and the other be well developed

Yes it can. Dental compensation is a thing.

 

[IDontBlameAnybody]

But it depends on if you got them extracted in your teens for crowding or as an adult for jaw surgery, no? If it's the latter I don't think it will have any major aesthetic effect, certainly not something that won't be more than offset by the jaw surgery.

I would like to believe so yes. But many claim that premolar extractions somehow made them look worse even in the adult years.

 

[tyler1234]

But is this ur normal bite cause I used to be able to move my jaw back and forward with an underbite

 

[IDontBlameAnybody]

Update: discussed it further with my ortho and she told me that unfortunately this is the only way, because my upper incisors are flared. The surgeon told me that I could even get away with only an upper jaw surgery in her opinion and the total advancement would be 8mm.

And the shitty thing is, consulting other orthos would mean I'd need to wait up to 1+ year, because waiting lists are long.

Even though the surgeon is against premolar extractions herself, she was the one who recommended me this ortho since they have worked together before, and she told me that the ortho is really good.

 

[tyler1234]

If the surgeon is against the premolar extractions why would u do it

 

[IDontBlameAnybody]

If the surgeon is against the premolar extractions why would u do it

Because I have no other choice most likely, and even though she is against the extractions, she admitted that the ortho is really good, which means that she probably trusts her advice more than her personal experience 30 years ago.

I’m messaging my surgeon tomorrow for more input.

 

[ltn_looksminner]

Because I have no other choice most likely, and even though she is against the extractions, she admitted that the ortho is really good, which means that she probably trusts her advice more than her personal experience 30 years ago.

I’m messaging my surgeon tomorrow for more input.

Damn you could message them , i'd need to pay money for everytime i talk to him

 

[neverthehaircut]

Because I have no other choice most likely, and even though she is against the extractions, she admitted that the ortho is really good, which means that she probably trusts her advice more than her personal experience 30 years ago.

I’m messaging my surgeon tomorrow for more input.

My ortho said its outdated info that premolar extraction fucks your face or health up anyhow. She said it comes from just extracting premolars and no follow up surgery. She said its completely fine to extract premolars if its followed by like a jaw surgery.

 

[IDontBlameAnybody]

My ortho said its outdated info that premolar extraction fucks your face or health up anyhow. She said it comes from just extracting premolars and no follow up surgery. She said its completely fine to extract premolars if its followed by like a jaw surgery.

Yeah thats what most people have told me who got premolar extractions for jaw surgery specifically.

 

[IDontBlameAnybody]

Update: Getting them pulled in a month, just got all my wisdom tooth removed a week ago. Discussed more with my ortho, she said in my case there just are no other realistic alternatives, also talked to some people who were in my situation and they ended up just fine both aesthetically and functionally.

Also messaged my surgeon and she agreed that the premolar extractions will most likely be worth it in my jaw surgery case with no other options. I'm getting 2 premolars removed from the upper arch, 1 from each side.

 

[IDontBlameAnybody]

I think the ortho even showed me a before and after of a female patient of hers who got premolar extractions + a jaw surgery and ended up looking nice.

But overall yes I fucking don't like the idea especially due to the fearmongering, but what the fuck will I do lol, wait a year for another ortho consultation to possibly be told the same thing? FUCK no.