Surgery

[Laverne]

Based off my pictures would an lefort 1 suffice or would I need an double jaw surgery?
I heard my mandible is okay or decent however my maxilla is pretty recessed.
What do you guys recommend?

 

[idont]

Based off my pictures would an lefort 1 suffice or would I need an double jaw surgery?
I heard my mandible is okay or decent however my maxilla is pretty recessed.
What do you guys recommend?

do you have CT scans
i dont think you need DJS but idk if l1 would suffice for the deficiency you have

 

[Laverne]

What else is deficient besides my maxilla because that’s obviously recessed

 

[idont]

lefort 2 most likely you have to remember occlusion has to be correct post op

 

[idont]

ngl you have a weird case it seems like you have a hyperdivergent profile with bimaxillary protrusion

you would probably need ASO with lefort 1/2 i have no idea prolly 2 with ccw

@Firstname.Lastname am i wrong or no

 

[idont]

ngl you have a weird case it seems like you have a hyperdivergent profile with bimaxillary protrusion

you would probably need ASO with lefort 1/2 i have no idea prolly 2 with ccw

@Firstname.Lastname am i wrong or no

@lurking truecel ?

 

[idont]

note for OP
aso is a specialised excess bone removal osteotomy for bimaxillary protrusion which i suspect you have

 

[Laverne]

Dam I didn’t think it would be this bad I thought an lefort 1 was All I needed

 

[idont]

sorry im wrong it is dentoalveolar protrusion not bimaxillary

 

[idont]

Dam I didn’t think it would be this bad I thought an lefort 1 was All I needed

it seems it just is ASO with lefort ccw but idk
you need to dm @yussimania and he will give the best advice

 

[idont]

do your upper teeth flare upwards?

 

[Laverne]

My upper teeth do have a slight flare and I have crowding on both arches. And you probably know but also an moderate underbite

 

[Laverne]

From what your describing I’m cooked

 

[Laverne]

it seems it just is ASO with lefort ccw but idk
you need to dm @yussimania and he will give the best advice

It seemed he logged out of his account and only uses discord, I sent him a friend request

 

[Firstname.Lastname]

ngl you have a weird case it seems like you have a hyperdivergent profile with bimaxillary protrusion

you would probably need ASO with lefort 1/2 i have no idea prolly 2 with ccw

@Firstname.Lastname am i wrong or no

Its for sure class 3 skull though.

Lefort 2 isn't an option, probably Lefort 1 and 1-2 ccw.

If he's lucky maybe he could do something like FME + implants though. Depends a lot on things like how long his skull/midface ect are. You can pickup anything like 1-4mm forward advance and theirs down rotation as well with it. But obviously this may not work if say he already has very wide pallet, wide face, ect. As FME is mostly lateral expansion

 

[Laverne]

Its for sure class 3 skull though.

Lefort 2 isn't an option, probably Lefort 1 and 1-2 ccw.

If he's lucky maybe he could do something like FME + implants though. Depends a lot on things like how long his skull/midface ect are. You can pickup anything like 1-4mm forward advance and theirs down rotation as well with it. But obviously this may not work if say he already has very wide pallet, wide face, ect. As FME is mostly lateral expansion

My pallet isn't that wide its somewhat narrow

 

[Firstname.Lastname]

My pallet isn't that wide its somewhat narrow

Then I'd explore FME as an option, its going to be that for lefort 1 with some rotation if you actually want it fixed.

Lefort 1 with rotation is a more standard/sure fire option. FME is like very case dependent and more experimental, so theres risk it doesn't provide full correction or otherwise has issues. It's mostly for widening at the midpalatal suture but like I said it does create some forward advancement and downward rotation. So if the rest of your face has the right setup its a good alternative.

Personally I'd avoid lefort 1 if it all possible. One it's a brutal surgery. Two the standard advancement is only going to be like 5mm, past that complication risk spike.

 

[idont]

Its for sure class 3 skull though.

Lefort 2 isn't an option, probably Lefort 1 and 1-2 ccw.

If he's lucky maybe he could do something like FME + implants though. Depends a lot on things like how long his skull/midface ect are. You can pickup anything like 1-4mm forward advance and theirs down rotation as well with it. But obviously this may not work if say he already has very wide pallet, wide face, ect. As FME is mostly lateral expansion

yes
lefort 1 with ccw and aso

if his palate is narrowish he can get away with implants and fme