What type of Bimax should I go for and is it even worth it at almost 26?

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NoaA99

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Talked to different (bluepilled of course) surgeons.
I have a moderate medical class 3 skeletal underbite with severe TMJ on the left side primarily. This was due to early tooth loss and stunted jaw growth in consequence.
My mandible bone is also very narrow despite my dad having a huge jaw and chin.
It was suggested I needed 6-7mm advancement for my occlusion to be corrected. At the moment I have a compromised bite, that induces a mid-line discrepancy. So the chin is off Center basically.
Did MSE beforehand and still in the middle of Invisalign.
Wished I never did it, as my face was already wide and compact and now it looks comical, as I am slightly less lean atm.
It also induced asymmetry (larger side expanded more)- my palate isn’t straight but canted, as is my maxilla now obviously.
This can only be corrected again by surgery, which was planned afterwards in the first place.
At least it did cure my nose breathing difficulties, which is actually pretty cool.

1) One surgeon suggested, that I have mild sfs and wanted to slightly set back the mandible, why doing cw maxillary rotation to lengthen the mid-Face and make the nose appear a bit longer and less bulbous at the tip.

2) Some other surgeon wants to actually do the opposite, although I believe it would look comical. So CCW rotation with only the maxilla advanced.

3) The third surgeon in question opted for a high cut lefort, as she mentioned, that my mid-face is relatively flat and that this will provide volume and make me look less tired.
Other than that, she opted to advance the mandible slightly ( as apparently it wants to move even more forward but is held back by the maxilla) and also advance the maxilla adequately in response.
She also said the cant would be eliminated, making the face more symmetrical.
Unfortunately she also mentioned, that the cartilage around my left TMJ is already damaged, so some pain will persist.
 

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LF3 + LF1 + BSSO + TMJ reconstruction with the bros in Turkey
 
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Did MSE beforehand and still in the middle of Invisalign.
Wished I never did it, as my face was already wide and compact and now it looks comical, as I am slightly less lean atm.
What age were you when you did MSE?
 
Started at 24 but had a few complications, so I had to turn slower
do you think it worked? My bite is fine now I just want a wider face.
 
do you think it worked? My bite is fine now I just want a wider face.
Yeah it did work. It’s also really good if you have a narrow head/face shape. But my byzgomatic width was above 15cm before, so MSE was just overkill.
Funnily enough my palate was narrow, despite wide facial structure.

Also you need a plan for your mandible if there is no size discrepancy between the two
 
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How high a LeFort cut did she propose?

What's your current occlusal plane?
 
How high a LeFort cut did she propose?

What's your current occlusal plane?
She didn’t go into much detail. She just mentioned it would be beneficial to make the cut slightly higher for slightly more midfacial volume. Nothing major I suppose.
She mentioned my face is relatively flat with 181 degrees, if I remember correctly, which is indicative of the class 3 occlusion.

Would have to measure, she didn’t tell me.
Doesn’t appear particularly high though.
When smiling half of my teeth are not really visible, since the maxilla is deficient in every dimension apparently.
She actually said my mandible is really good but it does seem poor in real life.
 
How high a LeFort cut did she propose?

What's your current occlusal plane?
In real life it’s actually not that visible but it could be because of my poor posture.
I visited several different docs before realising, that the neck, jaw and head pain came from an skeletal underbite
 

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26 isn't over, don't let the teenagers on the forum make you think that.
 
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Not over yet
 
26 isn't over, don't let the teenagers on the forum make you think that.
Yes I know that. I plan to proceed with surgery primarily for medical reasons, but I want to ensure an aesthetically pleasing outcome as well. Surgeons have differing opinions on my case. A high-cut LeFort would be ideal if the risk of complications isn't significantly higher, but I'm unsure if clockwise rotation is necessary or if simple advancement is more reasonable. Everyone agrees on bimax surgery, but one surgeon suggested setting back the mandible, while another preferred slight advancement. After wearing a temporary splint I received from him for a few weeks, my mandible moved slightly forward once it was removed, indicating pressure to move forward.

I'm also unclear on the best approach to correct my canted maxilla. Any suggestions on how to proceed?
 
I'm also unclear on the best approach to correct my canted maxilla. Any suggestions on how to proceed?
It depends if youre willing to go private (spend 25-30K out of pocket) for the best aesthetic result or if youre staying with insurance where you get what you get.
 
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It depends if youre willing to go private (spend 25-30K out of pocket) for the best aesthetic result or if youre staying with insurance where you get what you get.
Have to go private and I am willing to pay that. My ortho declared, that insurance will never cover anything here in Germany unless your lower teeth are severely protruding relative to the upper ones. Or if you have severe sleep apnea, which I do not.
My body apparently compromised well for the skeletal discrepancy.
 
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Have to go private and I am willing to pay that. My ortho declared, that insurance will never cover anything here in Germany unless your lower teeth are severely protruding relative to the upper ones. Or if you have severe sleep apnea, which I do not.
My body apparently compromised well for the skeletal discrepancy.
Well that's good news. First step is getting some CT scans.
 
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Well that's good news. First step is getting some CT scans.
A few CBCT´s have already been made in association with the MSE treatment. Unfortunately as a mac user I can not open the data, they sent me.
In a few months I have to do some more for the upcoming surgical route.
 
You don’t need surgery imo.
 
26 isn't over, don't let the teenagers on the forum make you think that.
true I'm 32 turning 33 next month and people often think I'm 24-25.

whith good habits and forward growth you can look 35 until like 44.

Teenagers are so retarded and think men can't age well because they see oldcel and baldcel looking 50 at 36 like Wayne Rooney.
 
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The fatalistic comments in this forum about LF3 should be ignored. If you want to go down the surgical route, you should be aware that a 6-7mm advancement could screw up your nose: it will cause alar base widening and further elevate your nasal tip. Your pics are a bit blurry but your nostrils already look somewhat upturned from the front so this could be an unwanted change. Your midline discrepancy doesn't look noticeable to the naked eye. To decide, the best thing to do is figure out what your objectives are, what the benefits and drawbacks of different surgical options are how close each option gets to achieving your goals. Is your SFS noticeable when you smile? I.e. How bad is your upper tooth show?
 
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The fatalistic comments in this forum about LF3 should be ignored. If you want to go down the surgical route, you should be aware that a 6-7mm advancement could screw up your nose: it will cause alar base widening and further elevate your nasal tip. Your pics are a bit blurry but your nostrils already look somewhat upturned from the front so this could be an unwanted change. Your midline discrepancy doesn't look noticeable to the naked eye. To decide, the best thing to do is figure out what your objectives are, what the benefits and drawbacks of different surgical options are how close each option gets to achieving your goals. Is your SFS noticeable when you smile? I.e. How bad is your upper tooth show?
chat gpt over here
 
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true I'm 32 turning 33 next month and people often think I'm 24-25.

whith good habits and forward growth you can look 35 until like 44.

Teenagers are so retarded and think men can't age well because they see oldcel and baldcel looking 50 at 36 like Wayne Rooney.
could you recommend habits to make sure you age well, im 20 years old and get panic attacks daily cuz im scared of aging like shit
 
Talked to different (bluepilled of course) surgeons.
I have a moderate medical class 3 skeletal underbite with severe TMJ on the left side primarily. This was due to early tooth loss and stunted jaw growth in consequence.
My mandible bone is also very narrow despite my dad having a huge jaw and chin.
It was suggested I needed 6-7mm advancement for my occlusion to be corrected. At the moment I have a compromised bite, that induces a mid-line discrepancy. So the chin is off Center basically.
Did MSE beforehand and still in the middle of Invisalign.
Wished I never did it, as my face was already wide and compact and now it looks comical, as I am slightly less lean atm.
It also induced asymmetry (larger side expanded more)- my palate isn’t straight but canted, as is my maxilla now obviously.
This can only be corrected again by surgery, which was planned afterwards in the first place.
At least it did cure my nose breathing difficulties, which is actually pretty cool.

1) One surgeon suggested, that I have mild sfs and wanted to slightly set back the mandible, why doing cw maxillary rotation to lengthen the mid-Face and make the nose appear a bit longer and less bulbous at the tip.

2) Some other surgeon wants to actually do the opposite, although I believe it would look comical. So CCW rotation with only the maxilla advanced.

3) The third surgeon in question opted for a high cut lefort, as she mentioned, that my mid-face is relatively flat and that this will provide volume and make me look less tired.
Other than that, she opted to advance the mandible slightly ( as apparently it wants to move even more forward but is held back by the maxilla) and also advance the maxilla adequately in response.
She also said the cant would be eliminated, making the face more symmetrical.
Unfortunately she also mentioned, that the cartilage around my left TMJ is already damaged, so some pain will persist.
Look at that giga wide face. Look at those zygos look at the jaw. Look at that person who things its over while looking like what we wish we will end up looking after surgeries. But of course there is no surgery for my narrow ear to ear distance
 
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Talked to different (bluepilled of course) surgeons.
I have a moderate medical class 3 skeletal underbite with severe TMJ on the left side primarily. This was due to early tooth loss and stunted jaw growth in consequence.
My mandible bone is also very narrow despite my dad having a huge jaw and chin.
It was suggested I needed 6-7mm advancement for my occlusion to be corrected. At the moment I have a compromised bite, that induces a mid-line discrepancy. So the chin is off Center basically.
Did MSE beforehand and still in the middle of Invisalign.
Wished I never did it, as my face was already wide and compact and now it looks comical, as I am slightly less lean atm.
It also induced asymmetry (larger side expanded more)- my palate isn’t straight but canted, as is my maxilla now obviously.
This can only be corrected again by surgery, which was planned afterwards in the first place.
At least it did cure my nose breathing difficulties, which is actually pretty cool.

1) One surgeon suggested, that I have mild sfs and wanted to slightly set back the mandible, why doing cw maxillary rotation to lengthen the mid-Face and make the nose appear a bit longer and less bulbous at the tip.

2) Some other surgeon wants to actually do the opposite, although I believe it would look comical. So CCW rotation with only the maxilla advanced.

3) The third surgeon in question opted for a high cut lefort, as she mentioned, that my mid-face is relatively flat and that this will provide volume and make me look less tired.
Other than that, she opted to advance the mandible slightly ( as apparently it wants to move even more forward but is held back by the maxilla) and also advance the maxilla adequately in response.
She also said the cant would be eliminated, making the face more symmetrical.
Unfortunately she also mentioned, that the cartilage around my left TMJ is already damaged, so some pain will persist.
I have a group of 7 friends, most of them are good looking and slay, i bone mog them all and i can tell you, you bone mog me to oblivion. Just,,; wow
 
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Wouldn’t get surgery. At best you get no change. Worst case you get botched. The primary benefit would be fixing your bite.
 
Wouldn’t get surgery. At best you get no change. Worst case you get botched. The primary benefit would be fixing your bite.
Main goal is to fix the TMJ or at least ease the pain in that region, which is likely to happen with surgery according to my ortho and the jaw surgeons I talked to, as the pressure will be more balanced again, when the jaws move into their supposed position.
It will fix the bite issue as well and correct the midline discrepancy but yeah I feel the actual visual changes will be minor if any and I have a good risk of looking worse, if the surgery is not carefully planned beforehand.
 
Look at that giga wide face. Look at those zygos look at the jaw. Look at that person who things its over while looking like what we wish we will end up looking after surgeries. But of course there is no surgery for my narrow ear to ear distance
Yeah it is relatively wide. Got that from my dad. But my jaw is actually pretty narrow bone wise. I just have a lot of muscle and soft tissue their and also I am currently at a higher body fat percentage.
But as I mentioned I have severe TMJ on the left side, my midline is off and not enough tooth show. All surgeons and orthos I visited concluded, that my my Maxilla has not grown properly and that I am a skeletal class 3.
So I will get the surgery for health reasons but of course want to ensure a good aesthetic result as well.
 
could you recommend habits to make sure you age well, im 20 years old and get panic attacks daily cuz im scared of aging like shit
have good aging genetics

don't smoke , i stopped at 25

drinking is ok as long you're not alcoholic

if you're white and no ginger try to tan your full body first while wearing a hat , so then after 2-3 years your face will tan easy and you'll get free sunprotection like a small sunscreen on your face/body for free ( tan is like 5 spf )

wear a cap or hat under heavy sun in summer months, i don't even need sunscreen anymore.

don't get fat / bald

dye your grey hair ( I only have a dozen at 33 right now, but will dye my hair definitely at 40 like Tom Cruise )

don't be boneless or recessed ( bimax + implants scheduled in the next years )

use tret

if you looksmax and no balding, you should be set until at least 45 as a man.

don't trust teenagers that tell you it's over at 28 because you're oldcel and can't get 15 girlfriend
Gen Z women under 20 are retarded and annoying , living on Instagram and Tinder + are Chad only anyway
 
have good aging genetics

don't smoke , i stopped at 25

drinking is ok as long you're not alcoholic

if you're white and no ginger try to tan your full body first while wearing a hat , so then after 2-3 years your face will tan easy and you'll get free sunprotection like a small sunscreen on your face/body for free ( tan is like 5 spf )

wear a cap or hat under heavy sun in summer months, i don't even need sunscreen anymore.

don't get fat / bald

dye your grey hair ( I only have a dozen at 33 right now, but will dye my hair definitely at 40 like Tom Cruise )

don't be boneless or recessed ( bimax + implants scheduled in the next years )

use tret

if you looksmax and no balding, you should be set until at least 45 as a man.

don't trust teenagers that tell you it's over at 28 because you're oldcel and can't get 15 girlfriend
Gen Z women under 20 are retarded and annoying , living on Instagram and Tinder + are Chad only anyway
I stopped at 25 too, good job saar
 
The fatalistic comments in this forum about LF3 should be ignored. If you want to go down the surgical route, you should be aware that a 6-7mm advancement could screw up your nose: it will cause alar base widening and further elevate your nasal tip. Your pics are a bit blurry but your nostrils already look somewhat upturned from the front so this could be an unwanted change. Your midline discrepancy doesn't look noticeable to the naked eye. To decide, the best thing to do is figure out what your objectives are, what the benefits and drawbacks of different surgical options are how close each option gets to achieving your goals. Is your SFS noticeable when you smile? I.e. How bad is your upper tooth show?
Sorry for the late response, somehow I didn’t receive or missed the notification.

Yeah unfortunately my handy camera isn’t the best but I wanted to make sure, that there is minimal lens distortion left, so I took them from a distance & zoomed in a bit.
Of course I ignore these delusional comments of minors, that simply intend to bash each other instead of providing helpful advice.
I know the skeletal discrepancy is relatively mild - moderate but still causes some functional issues like TMJ and it’s probably somewhat related to my rather poor posture and mild scoliosis or vice versa.
In general my main goal is to get some pain relief in the TMJ, which apparently is likely, when the jaws move into a more natural and the TMJ’s into a more “relaxed” position.
But the aesthetic outcome would be close to equally important for me.
I definitely want to avoid looking objectively worse.

To be more specific I want some more mid-face projection. So the high cut seems reasonable, although I am not adequately educated about the added risk potential yet.
Overall the mid-face is just relatively short but it’s subtle. It may be overly compact but just minimally so.
Similarly with the upper tooth show.
It’s just minor and the surgeons also just advised a minimal CW- rotation.
My nose is actually close to ideally upturned to be considered “masculine”, when the measurement is taken from the side.
So surgery could definitely provide some unwanted changes here.
Another problem is, that it’s already relatively wide and bulky, so I was promised a sole advancement would accentuate that even more.
I heard, that there are a few options available for minimising this like an alar stitch.
The proposed CW-rotation would slightly lengthen the nose and make it a bit narrower as well as less prominent through the advancement.
This is what the surgeon told me about it.
It could certainly help balancing my facial thirds but I fear that it could negatively impact my lower third (like a steeper gonial angle).
It’s more of a trade off I suppose.

Ideally I’d want to advance both jaws with the lower one just a bit.
I’d also want the maxilla to be cut at a relatively high position to achieve maximal mid-face projection without additional implants but still at a considerable stable additional risk factor for nerve damage.
At last I’d want the mid-face to be lengthened but just so much, that the facial thirds can become more balanced without inducing a noticeable steep jaw frontal angle + to make the nose add more seamlessly to the mid-face region.
 
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Sorry for the late response, somehow I didn’t receive or missed the notification.

Yeah unfortunately my handy camera isn’t the best but I wanted to make sure, that there is minimal lens distortion left, so I took them from a distance & zoomed in a bit.
Of course I ignore these delusional comments of minors, that simply intend to bash each other instead of providing helpful advice.
I know the skeletal discrepancy is relatively mild - moderate but still causes some functional issues like TMJ and it’s probably somewhat related to my rather poor posture and mild scoliosis or vice versa.
In general my main goal is to get some pain relief in the TMJ, which apparently is likely, when the jaws move into a more natural and the TMJ’s into a more “relaxed” position.
But the aesthetic outcome would be close to equally important for me.
I definitely want to avoid looking objectively worse.

To be more specific I want some more mid-face projection. So the high cut seems reasonable, although I am not adequately educated about the added risk potential yet.
Overall the mid-face is just relatively short but it’s subtle. It may be overly compact but just minimally so.
Similarly with the upper tooth show.
It’s just minor and the surgeons also just advised a minimal CW- rotation.
My nose is actually close to ideally upturned to be considered “masculine”, when the measurement is taken from the side.
So surgery could definitely provide some unwanted changes here.
Another problem is, that it’s already relatively wide and bulky, so I was promised a sole advancement would accentuate that even more.
I heard, that there are a few options available for minimising this like an alar stitch.
The proposed CW-rotation would slightly lengthen the nose and make it a bit narrower as well as less prominent through the advancement.
This is what the surgeon told me about it.
It could certainly help balancing my facial thirds but I fear that it could negatively impact my lower third (like a steeper gonial angle).
It’s more of a trade off I suppose.

Ideally I’d want to advance both jaws with the lower one just a bit.
I’d also want the maxilla to be cut at a relatively high position to achieve maximal mid-face projection without additional implants but still at a considerable stable additional risk factor for nerve damage.
At last I’d want the mid-face to be lengthened but just so much, that the facial thirds can become more balanced without inducing a noticeable steep jaw frontal angle + to make the nose add more seamlessly to the mid-face region.
It's sounds like you're set on some form of surgery. Definitely read up on the material so you can get proper engagement. And don't be afraid to tell prospective surgeons what you want! Obviously tone down some of the language but make it 100% clear what you want out of this. If they're not prepared to even discuss different surgical plans then you can forget them.
 
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