Why must you fix bite before augmenting lower third

[Anchor_Ship]

I've seen results of overbite patients (Class II) get chin implants and results can look uncanny. Why is this?

 

[Creatine]

Issue is that throwing on a chin implant (or getting a genio) messes up your mentolabial angle if you have a recessed mandible and try to cover it by j making ur chin bigger. Your dental arches need to be in the right place and chin augmentation doesn’t do that.

 

[Anchor_Ship]

Issue is that throwing on a chin implant (or getting a genio) messes up your mentolabial angle if you have a recessed mandible and try to cover it by j making ur chin bigger. Your dental arches need to be in the right place and chin augmentation doesn’t do that.

Okay makes sense why these mentolabial folds look weird after chin augmentation

 

[Creatine]

Okay makes sense why these mentolabial folds look weird after chin augmentation

Yeah in a vast vast majority of genio before/afters they have recessed jaws and need bimax. Genioplasty has its place (mostly in combination with bimax), but without the proper positioning of the actual dental arches they always look off.

You can see with their philtrums that their maxillae are recessed and without fixing that with a lefort, their upper lip stays deficient (notice how it doesn’t project out enough). I think that’s the bigger issue with these before/afters.

It’s stupid because these people actually need bimax (recession has legitimate health issues) but they’re too bluepilled to either realize that’s the issue or to realize that fixing the recession is worth the painful recovery.

 

[Anchor_Ship]

Yeah in a vast vast majority of genio before/afters they have recessed jaws and need bimax. Genioplasty has its place (mostly in combination with bimax), but without the proper positioning of the actual dental arches they always look off.

You can see with their philtrums that their maxillae are recessed and without fixing that with a lefort, their upper lip stays deficient (notice how it doesn’t project out enough). I think that’s the bigger issue with these before/afters.

It’s stupid because these people actually need bimax (recession has legitimate health issues) but they’re too bluepilled to either realize that’s the issue or to realize that fixing the recession is worth the painful recovery.

I don't understand why I see so many of these and the surgeon doesn't just tell them they need Lefort, BSSO or both... like wouldn't they make more money by promising better results? Maybe it's because they don't practice jaw surgery? I'd assume you need a license to do genio and then as well as lower and upper jaw surgery, maybe not so much a chin implant?

 

[Creatine]

Maybe it's because they don't practice jaw surgery?

I think it’s a combination of a few things.

Firstly, the doctors themselves might not even do jaw surgery. Only maxillofacial surgeons do that and for most maxfacs, jaw surgery isn’t seen as a cosmetic procedure (it’s more for fixing peoples bites and sleep apnea issues) and is more rare for them to actually perform (as opposed to surgeons like Alfaro who do tons of bimax’s every week)

Secondly, jaw surgery is not a simple cosmetic procedure like a rhino or genio. For most patients, they have to wear braces for around a full year before getting surgery and the recovery for bimax is rough (weeks of not being able to have solid food, tons of pain, etc). For the average patient, they’re j not blackpilled enough to go through with it even if they were aware of their issues. Having a surgeon try to sell you on a very invasive, often expensive (if insurance doesn’t cover) surgery isn’t a great look

Even worse, you can’t even rely on the surgeons judgement for what you need as a lot of these surgeons don’t actually know what you need. A lot of maxfacs don’t even do techniques like ccw rotation with their bimax’s and so they often just fix the patients bite without actually fixing their recession.

 

[Anchor_Ship]

I think it’s a combination of a few things.

Firstly, the doctors themselves might not even do jaw surgery. Only maxillofacial surgeons do that and for most maxfacs, jaw surgery isn’t seen as a cosmetic procedure (it’s more for fixing peoples bites and sleep apnea issues) and is more rare for them to actually perform (as opposed to surgeons like Alfaro who do tons of bimax’s every week)

Secondly, jaw surgery is not a simple cosmetic procedure like a rhino or genio. For most patients, they have to wear braces for around a full year before getting surgery and the recovery for bimax is rough (weeks of not being able to have solid food, tons of pain, etc). For the average patient, they’re j not blackpilled enough to go through with it even if they were aware of their issues. Having a surgeon try to sell you on a very invasive, often expensive (if insurance doesn’t cover) surgery isn’t a great look

Even worse, you can’t even rely on the surgeons judgement for what you need as a lot of these surgeons don’t actually know what you need. A lot of maxfacs don’t even do techniques like ccw rotation with their bimax’s and so they often just fix the patients bite without actually fixing their recession.

So I'm thinking most class II or class III patients are recommended braces to avoid the actual problem which is jaw recession... When is CCW rotation needed btw? High gonial angle? (Read CCW rotation is for rotation and adding upwards projection to the maxilla)

 

[Creatine]

When is CCW rotation needed btw?

Ccw rotation helps correct downward growth. By rotating counterclockwise, they’re able to get more mandible forward movement than maxilla forward movement. This is important because for someone whose bite is fine, advancing both jaws linearly can give chimp lip (over advanced maxilla) or just not advance the mandible enough. They can fix the issues by rotating the jaws (which lowers the gonial angle).

Ccw rotation can also fix someone’s gummy smile and in the process of doing so, shorten their midface slightly.

There’s def a lot of technical stuff I’m missing about all this stuff (like occlusional plane stuff) but I’m not well-read enough on the subject. It’s def worth it to watch raffaini’s lecture on youtube (it’s aimed towards beginners) and Alfaro’s YouTube vids on jaw surgery to actually better understand this stuff

 

[Anchor_Ship]

Ccw rotation helps correct downward growth. By rotating counterclockwise, they’re able to get more mandible forward movement than maxilla forward movement. This is important because for someone whose bite is fine, advancing both jaws linearly can give chimp lip (over advanced maxilla) or just not advance the mandible enough. They can fix the issues by rotating the jaws (which lowers the gonial angle).

Ccw rotation can also fix someone’s gummy smile and in the process of doing so, shorten their midface slightly.

There’s def a lot of technical stuff I’m missing about all this stuff (like occlusional plane stuff) but I’m not well-read enough on the subject. It’s def worth it to watch raffaini’s lecture on youtube (it’s aimed towards beginners) and Alfaro’s YouTube vids on jaw surgery to actually better understand this stuff

Can you send me the Raffaini lecture and I watch a lot of alfaro vids, but I don't fully understand when CCW is needed usually if I see someone that looks like this

 

[khvirgin]

Is bsso plus implants enough

 

[Jerryterry129]

Can you send me the Raffaini lecture and I watch a lot of alfaro vids, but I don't fully understand when CCW is needed usually if I see someone that looks like this View attachment 1586019

I have this exact thing. Does this dude need cc or he already has foward growth? Does he just need chin implant?

 

[Creatine]

Is bsso plus implants enough

It depends on your case. The issue with just doing a bsso is that if you also have maxillary recession you can’t address that (and you can still have a recessed maxilla even if you have an overbite). Also this makes you unable to do stuff like jaw rotations which may have different other benefits in someone’s case.

I think if you’re able to gain additional benefit from doing a bimax over just a bsso, it’s probably worth it (because you’re already going through all the motions). Doesn’t make sense to make an unneeded compromise on your face

 

[Deleted member 17308]

Orthodontist

 

[khvirgin]

It depends on your case. The issue with just doing a bsso is that if you also have maxillary recession you can’t address that (and you can still have a recessed maxilla even if you have an overbite). Also this makes you unable to do stuff like jaw rotations which may have different other benefits in someone’s case.

I think if you’re able to gain additional benefit from doing a bimax over just a bsso, it’s probably worth it (because you’re already going through all the motions). Doesn’t make sense to make an unneeded compromise on your face

Im worried about my philtrum and my lips