Recessed maxilla confirmed – free bimax in Sweden, but can I really trust them to care about aesthetics?

[baygad]

Just got my clinical report back from my surgeon in Sweden. Full analysis confirms what I already suspected: recessed upper maxilla, concave profile, and poor incisor display.

Some key points from the report:

• Nasolabial angle > 90° with reduced upper lip support
• Upper lip is 7 mm behind E-line, lower lip is on E-line (0 mm)
• Concave profile, mild mandibular clockwise rotation
• 0 mm incisor show at rest, only 4 mm incisor show when smiling actively
• Thin infraorbital and paranasal region
• No asymmetry, good oral health, 7–7 dentition
• Diastema 2.5 mm, mild crowding
• Functional bite, slight anterior crossbite, 4 mm HÖB, 2 mm VÖB
• Jaw joints and muscles normal

Diagnosis: K07.2 – Anomalies in the relationship of dental arches

Treatment plan (public healthcare):

1. Extract 18s
2. 2 years of pre-op ortho
3. Bimax (might be downgraded to only maxilla depending on result)
4. Post-op ortho

So yeah – the surgery (Lefort I + maybe BSSO) will be fully covered by the Swedish public health system. Zero cost.

And while that sounds like a win, here’s where my doubt kicks in:

Yes, they let me talk about aesthetics, and yes, I was clear about my recessed features. But still… I can’t shake the feeling that public surgeons here mainly see a bite problem – not a face. They care about occlusion, function, dental alignment – not midface projection, orbital harmony or actual aesthetics.

They even noted: “shows 0 mm upper incisors at rest” – which we all know is a red flag for poor upper maxillary projection. But nowhere do they mention that as an aesthetic concern. Just a functional one.

I’m worried they’ll just do Lefort I, not BSSO, and create the classic “mouthguard boxer” face – projecting the mouth while leaving the orbital rims and paranasal region recessed. And once it’s done, there’s no going back.

I know this sounds overly cautious (it’s free surgery after all), but I don’t want to end up with worse aesthetics just because the system only cares about chewing. And if I ask too many questions? There’s always the risk they say I’m being “too cosmetic” and pull the plug on the case.

Has anyone here had bimax or Lefort I done through public healthcare (especially in Europe)?

Did they care about aesthetics at all? Did you get a say in the final projection, incisor display, harmony etc?

right now, it’s either trust the state with my face… or save up and go private.

 

[lurking truecel]

They will advance you as little as possible, sweden are bluepilled to the moon and back

 

[baygad]

They will advance you as little as possible, sweden are bluepilled to the moon and back

Yeah that’s exactly my fear. Sweden is function-maxxed to oblivion. Their version of “aesthetic improvement” is just getting your lips to close without strain.

They literally measured:

• 0mm incisor show at rest
• 7mm behind E-line
• 90° nasolabial angle
• paper-thin infraorbital zone

And somehow still talk like the priority is “bite stability and muscle balance” JFL


I’ll be lucky if I get more than 3mm advancement unless I fight for it.

 

[lurking truecel]

Yeah that’s exactly my fear. Sweden is function-maxxed to oblivion. Their version of “aesthetic improvement” is just getting your lips to close without strain.

They literally measured:

• 0mm incisor show at rest
• 7mm behind E-line
• 90° nasolabial angle
• paper-thin infraorbital zone

And somehow still talk like the priority is “bite stability and muscle balance” JFL


I’ll be lucky if I get more than 3mm advancement unless I fight for it.

I mean thats obv important too, but i had friend and he got 4 mm forward and a setback on the lower jaw. And no ccw or anything

 

[browncurrycel]

Wish I was born in Europe man fuck this country

 

[baygad]

Wish I was born in Europe man fuck this country

Honestly, yeah, Europe (or at least Sweden) has its downsides, but getting full bimax + ortho covered for free is a massive W.

 

[chrishell]

As with all public health systems, the quality of your result is determined by the surgeon you get assigned and you typically can't make that choice. It is a shot in the dark.

Showing only 4mm upper incisors when smiling indicates you need a downgraft but since this movement is unstable many public health system surgeons aren't willing to take the risk with it so that factor may predispose you to a poor result.

I would at least consult with some private surgeons and see what they say.

 

[baygad]

As with all public health systems, the quality of your result is determined by the surgeon you get assigned and you typically can't make that choice. It is a shot in the dark.

Showing only 4mm upper incisors when smiling indicates you need a downgraft but since this movement is unstable many public health system surgeons aren't willing to take the risk with it so that factor may predispose you to a poor result.

I would at least consult with some private surgeons and see what they say.

Yeah I feel that. I’ve heard the same outcome depends heavily on the surgeon you randomly get, and most public systems won’t entertain high-risk movements like downgrafts or large advancements. Especially not if aesthetics is the main goal.

The 4 mm incisor show on smile is definitely a red flag, and I agree it likely means I need vertical movement as well, not just sagittal. But yeah, public surgeons usually just want to “fix the bite” and play it safe.

I’m sticking with public ortho for now, but I’ll 100% consult privately once I’m surgery-ready even just to compare plans.

 

[Snicket]

They will advance you as little as possible, sweden are bluepilled to the moon and back

If it’s public healthcare, then their prerogative will be to be as conservative as possible.

 

[lurking truecel]

If it’s public healthcare, then their prerogative will be to be as conservative as possible.

Yea they see anything as risky