Do you know the name of the following lower jaw surgery ?

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Noam
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Joined: Tue Oct 13, 2009 1:51 pm

Do you know the name of the following lower jaw surgery ?

#1 Post by Noam »

Up until today, in order to solve my underbite I was supposed to go through BSSO (to take my lower jaw 6mm backwards) + Lefort1 (to take my upper jaw 4mm forward) + Genio (to compensate for the chin going backwards because of BSSO).

Here is a cephalo of my current situation (you can see that the upper jaw in underdeveloped, the lower lip protrudes forward, yet the chin is in correct place):

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Today, the hospital's Mouth and Jaw committee (about 25 people) together with my orothodontist, evaluated my situation so I could get a surgery date (this committee always gather together before every jaw surgery, and try to come to a consensus regarding what exactly to do in the operation).

Anyhow, several people in the committee noted that in my simulated "after" pictures (which showed how I suppose to look after BSSO + Lefort1 + Genio (the original plan) my chin look too receded. It seems that my chin currently is in an ideal position, and taking the lower jaw backward creates a problem that genio can't fully solve.

In order to solve the problem, the following suggestion was made: they will still do Lefort1, but instead of doing BSSO, they will make the following cut:

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After this cut is made (symmetrically in the other side too), it will separate the upper front part of the lower jaw, from the rest of the lower jaw, then they will get rid of one tooth on each side (the tooth surrounded by red lines), and slide the separated part backwards (connecting it with plate and screws to the rest of the lower jaw). This will solve the protruding lower lip, without taking my chin backwards.

Does anyone know the name of this lower jaw operation ?, is it common ?

Teeth of Cthulhu
Posts: 73
Joined: Thu Jul 09, 2009 6:37 pm

#2 Post by Teeth of Cthulhu »

It's called a mandibular segmental osteotomy. Basically, after a lefort/BSSO you would have what is called bimaxillary protrustion... where the whole mouth area protrudes. Think Arnold Schwarzenegger. This will solve that.

Noam
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Joined: Tue Oct 13, 2009 1:51 pm

#3 Post by Noam »

Thanks.

I wonder why BSSO is so popular here and not mandibular segmental osteotomy...

Audra
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#4 Post by Audra »

Noam wrote:Thanks.

I wonder why BSSO is so popular here and not mandibular segmental osteotomy...
I would guess because with BSSO they don't remove teeth.
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Teeth of Cthulhu
Posts: 73
Joined: Thu Jul 09, 2009 6:37 pm

#5 Post by Teeth of Cthulhu »

Noam wrote:Thanks.

I wonder why BSSO is so popular here and not mandibular segmental osteotomy...
Well, because the segmental osteotomy is only called for when bimaxillary protrusion is present, which is very rare in people of European descent. This kind of procedure is common in east Asia for example though.

Noam
Posts: 98
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#6 Post by Noam »

Audra wrote:
Noam wrote:Thanks.

I wonder why BSSO is so popular here and not mandibular segmental osteotomy...
I would guess because with BSSO they don't remove teeth.
This is not true, my surgeon said that if I'll do BSSO, they'll probably remove my wisdom teeth (which will not be removed if I do the mandibular segmental osteotomy).

Noam
Posts: 98
Joined: Tue Oct 13, 2009 1:51 pm

#7 Post by Noam »

Teeth of Cthulhu wrote:
Noam wrote:Thanks.

I wonder why BSSO is so popular here and not mandibular segmental osteotomy...
Well, because the segmental osteotomy is only called for when bimaxillary protrusion is present, which is very rare in people of European descent. This kind of procedure is common in east Asia for example though.
But I don't have bimaxillary protrusion. Look again:

Image

My upper jaw is underdeveloped (and needs to be pushed forward), while my lower jaw is overdeveloped.

The thing is that my chin is in correct position (it's not too forward), so if they'll use BSSO to take my lower jaw backwards (to solve the lower lip protrusion), my chin will get too far behind, and so they'll have to advance my chin too much forward and this will compromise aesthetics...

Mandibular segmental osteotomy of the lower jaw will take the lower lip backwards, without taking the chin backwards, so it seems superior to BSSO in this case.

Audra
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Joined: Tue May 20, 2008 2:33 pm
Location: Calgary, Alberta (Canada)
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#8 Post by Audra »

Noam wrote:
Audra wrote:
Noam wrote:Thanks.

I wonder why BSSO is so popular here and not mandibular segmental osteotomy...
I would guess because with BSSO they don't remove teeth.
This is not true, my surgeon said that if I'll do BSSO, they'll probably remove my wisdom teeth (which will not be removed if I do the mandibular segmental osteotomy).
The picture above shows a pre-molar being segmentally removed. When I was referring to teeth not being removed during BSSO, I was not referring to wisdom teeth, but to healthy molars or pre-molars.
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Teeth of Cthulhu
Posts: 73
Joined: Thu Jul 09, 2009 6:37 pm

#9 Post by Teeth of Cthulhu »

Noam wrote:
Teeth of Cthulhu wrote:
Noam wrote:Thanks.

I wonder why BSSO is so popular here and not mandibular segmental osteotomy...
Well, because the segmental osteotomy is only called for when bimaxillary protrusion is present, which is very rare in people of European descent. This kind of procedure is common in east Asia for example though.
But I don't have bimaxillary protrusion. Look again:

Image

My upper jaw is underdeveloped (and needs to be pushed forward), while my lower jaw is overdeveloped.

The thing is that my chin is in correct position (it's not too forward), so if they'll use BSSO to take my lower jaw backwards (to solve the lower lip protrusion), my chin will get too far behind, and so they'll have to advance my chin too much forward and this will compromise aesthetics...

Mandibular segmental osteotomy of the lower jaw will take the lower lip backwards, without taking the chin backwards, so it seems superior to BSSO in this case.
What I said is that you would have bimax protrusion if you underwent a simple lefort/BSSO correction without the segmental osteotomy. This is because your entire lower jaw is angled outwards.

yliu123
Posts: 16
Joined: Wed Mar 17, 2010 9:56 pm

#10 Post by yliu123 »

which cost most, surgery on the upper or lower?

what if it's combined. both, how much??

Audra
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Joined: Tue May 20, 2008 2:33 pm
Location: Calgary, Alberta (Canada)
Contact:

#11 Post by Audra »

I can only speak for my cost, but my surgeon charges $2000 for one jaw (either one) and $1500 each ($3000 total) if he does both.
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