Surgery plan Ramieri

[PlagiocephalyTypeIV]

I have consulted with Dr.Ramieri to talk about surgery. My main goal is to fix my overbite(according to Ramieri it is a deep bite, I don’t understand the difference I would appreciate someone explaining it) and to create a longer lower third with genioplasty.
I thought jaw surgery would not be required to fix my misaligned lips. But Ramieri said I will need braces that will push the upper teeth forward(5-6mm more) so that he can perform BSSO. This will take some time and I will look worse before surgery.

Obviously for the longer lower third he suggested genioplasty. I knew that before.

Does this sound like a logical plan? I will attach my CT-scan

I would greatly appreciate any help, still trying to gain info before I do anything.

 

[Foreverbrad]

Overbite is when top teeth are too far forward relative to lower teeth.
Deep bite is when top teeth cover the lower teeth too much.

Not sure how pushing the upper teeth forward with braces 5-6mm is meant to work. I would have thought it would just be a case of forward movement with Lefort 1 - aka Bimax.

Your chin looks very projected already, are you sure you need genio on top of BSSO? You don’t want to end up looking weird.

 

[PlagiocephalyTypeIV]

So I could have bimax without braces to fix my lip seal ?
I am actually kind of irritated right now, before I get these braces I need to know if they make sense.
The doctor said my chin camouflages my slight recession of the lower jaw. So after BSSO I would need a little chin reduction.
I definitely want to have a longer lower third.

 

[FutureSlayer]

So I could have bimax without braces to fix my lip seal ?
I am actually kind of irritated right now, before I get these braces I need to know if they make sense.
The doctor said my chin camouflages my slight recession of the lower jaw. So after BSSO I would need a little chin reduction.
I definitely want to have a longer lower third.

Your scans look like mine and I’m having the same procedure

 

[twilight]

So I could have bimax without braces to fix my lip seal ?
I am actually kind of irritated right now, before I get these braces I need to know if they make sense.
The doctor said my chin camouflages my slight recession of the lower jaw. So after BSSO I would need a little chin reduction.
I definitely want to have a longer lower third.

@Foreverbrad

 

[PlagiocephalyTypeIV]

Your scans look like mine and I’m having the same procedure

So braces to create an overjet and then BSSO? will your maxilla be moved?

 

[FutureSlayer]

So braces to create an overjet and then BSSO? will your maxilla be moved?

I’m getting a CW rotation with advancement of both maxilla and mandible but unlike you I’m developing a negative ovjerjet (underbite) before having the surgery done.
The chin is going to be slightly reduced as well

 

[PlagiocephalyTypeIV]

I’m getting a CW rotation with advancement of both maxilla and mandible but unlike you I’m developing a negative ovjerjet (underbite) before having the surgery done.
The chin is going to be slightly reduced as well

Okay, GL.
Do you know how to determine if you need maxilla advancement ?
Will insurance cover parts of your surgery?

 

[Deleted member 21403]

Hes right, you need to wear braces youre not gettjng lefort. How is he suppsed to move lower jaw forward without moving your upper teeth forward first? Youd ebd up with an underbite

Your mandible is recessed but yiu have a protruding chin to make up for it, id agree with chin shaving plus mandible advancement.

Genio obv if you decide for it hss thinking only vertical movement not horizontal

 

[FutureSlayer]

Okay, GL.
Do you know how to determine if you need maxilla advancement ?
Will insurance cover parts of your surgery?

No clue, surgeon said it.
Yes, a little bit of it

 

[FutureSlayer]

Hes right, you need to wear braces youre not gettjng lefort. How is he suppsed to move lower jaw forward without moving your upper teeth forward first? Youd ebd up with an underbite

Your mandible is recessed but yiu have a protruding chin to make up for it, id agree with chin shaving plus mandible advancement.

Genio obv if you decide for it hss thinking only vertical movement not horizontal

I think he doesn’t really need an increase in height, look at that philtrum, he’s going to further mess up his ratios badly

 

[Deleted member 21403]

I think he doesn’t really need an increase in height, look at that philtrum, he’s going to further mess up his ratios badly

I was about to write that aswell, agreed.

 

[PlagiocephalyTypeIV]

I think he doesn’t really need an increase in height, look at that philtrum, he’s going to further mess up his ratios badly

I see that. But a slight increase would be more aesthetic imo. No extreme movements at all.

 

[PlagiocephalyTypeIV]

Hes right, you need to wear braces youre not gettjng lefort. How is he suppsed to move lower jaw forward without moving your upper teeth forward first? Youd ebd up with an underbite

Your mandible is recessed but yiu have a protruding chin to make up for it, id agree with chin shaving plus mandible advancement.

Genio obv if you decide for it hss thinking only vertical movement not horizontal

Makes sense.
Thanks

 

[FutureSlayer]

I see that. But a slight increase would be more aesthetic imo. No extreme movements at all.

Can you post a pic of your midface and lower third?

 

[PlagiocephalyTypeIV]

lower third is slightly longer but only slightly. I want to have a more masculine appearance (lower third noticeably longer than midface). My chin to philtrum ratio is less important than the ratio of the 2 thirds.