What do you think? (with pics)

[Carla]

Hi everyone,
I should start by saying that english is my second language, so this will probably have some errors. (sorry about that)

I'm a 24 year old female and I've been wearing braces for 10 months now.
I used to have overbite but braces corrected that, and besides that I never had any functional problem with my teeth/maxilla/mandible. In the beginning of my process my orthodontics said that probably I would need surgery, but right now, since the overbite no longer exists, he says he wouldn't recommend it. I have the option, but he doesn't recommend it.

The only problem is I have a huge distance between my lips, they don't close naturally. (I should add this is not caused by the braces since I always had a big distance, and even my upper lip doesn't touch the braces in the front, so I don't think there's much of a influence there..).
My inter-labial distance is 12mm.

Since my teeth won't be moving anymore, the pics are close to my final result




I'll be honest, of course I don't like the way I look... , but on the other hand we're talking about a surgery that can cause nerve damage, bad results and is not possible to reverse (I think..). And, the most important part, my orthodontics says I shouldn't.

I'd really like to hear some opinions. What would you do?
Thanks

[OhioM]

I just had surgery to correct a very similar problem. I also had a gummy smile and recessed chin. I had no real medical issues yet, but had the surgery because I just couldn't accept my facial appearance any longer. After searching the forum and getting to know some posters here, I also learned that problems may not start until you're older, and then you could have to get the surgery down the road anyway.

It is a decision that you have to make, not your orthodontist. At 24, your recovery should be great - I am 37 and so far, I haven't had any major problems.

I would suggest meeting with an oral surgeon to go over your options, and to discuss exactly what a treatment plan would look like. You would probably have to go back into orthodontic treatment (more braces and adjustments) to prepare you for surgery. Talking to an oral surgeon would give you the full picture of risks, benefits, and a realistic view of what going through surgery would really be like.

I would search through the forum for posts on Lefort procedures and that should also give you some background information.

[bb]

I agree. Talk to an oral surgeon rather than an orthodontist.
Also, yes there is a risk of permanent numbness and you will have to decide if the risk is worth it.

[Hope]

Ohio

Were you experiencing any breathing problems?
I have that

thanks

[Carla]

Thanks for the replys, I will definitely talk with a oral surgeon

I've seen some blogs about the surgery and some cases seemed so much worse than mine.. I almost feel guilty for considering this for aesthetic reasons

I forgot to say, and the pictures don't show, but I also have a gummy smile

OhioM, I'm glad to hear you did well! And thanks for your advises, you said that in this case problems may not start until the person gets older, what kind of problems did you mean? Could you explain that?

[ReoSity]

You shouldn't feel guilty at all, your case is both cosmetic and functional. The distance between your lips is fairly severe, I believe the ideal for a woman is 1-2mm. Your upper jaw appears to be too long and your lower jaw/chin is underdeveloped and probably too long vertically as well.

Yes surgery is a big decision but more of than not, complications don't happen if your surgeon is skilled. You are a good candidate for jaw surgery and would probably be covered at least partially depending on your insurance.

[HokieTay]

Your case looks similar to what mine was pre-surgery as far as your upper jaw goes. I had that open mouth look and gummy smile. However, my lower jaw was more receded.

I think you should def. consult with an oral surgeon. It's amazing the difference this surgery makes way beyond looks. i.e. eating, breathing, comfort, bite, etc

[annepanne]

I have the same problem. I have an open bite. but it's not that big. and I don´t have a gummy smile. But my lips does not close naturally. This is my main problem. It gives me a low selfesteem. And it's a problem when I sleep -gives me a dry mouth. I saw an oral surgeon yesterday. And he said he thinks I should live with it. that it's not that severe. He recommended having braces and pull out some teeths in the upper jaw. But I don't really like the idea of wearing braces for years and still not be able to close my mouth naturally. He said to me that because he thinks I have a very hamonic face after all -to do the surgery could be a problem later on. He said that many people shortening their upper jaw will later on get premature aging. I got a bit afraid of this. He said that people that have gone through this surgery often 10 years after looked very old because of the excess tissue in the face. (I'm not either that good in english, as it's my second language!!) have anyone heard of this??
I should take some pictures and post.

[Hope]

coulnt a person just get a face lift down the road if the get saggy skin from jaw surgery?

[annepanne]

well. I really am not that eager to do an operation and then need to do a facelift before I'm 40.. I wonder if it's anyone in here that has experienced this. But I guess there's not many people on this forum that is so many years post op (5-10 years)

[bb]

He said that many people shortening their upper jaw will later on get premature aging.

Sounds ridiculous! A competent surgeon would ensure that the patient wouldn't end up get a scrunched up face.
Who was your consultation with? An oral surgeon or an orthodontist?

[Hope]

yes, after researching I dont believe this surgery would cause the face to sag

[wearetheborg]

Carla, I would not do it. I just dont see lips naturally not closing as enough to risk the complications. You could always smile/conciously close the lips in pics etc.

Why do people feel lips being closed without any conscious effort is worth the risk of jaw surgery ?

[annepanne]

hope & bb; this was of course from a surgeon. I have searched the internet, and there seems to be alot of articles about this (but you have to pay to read the whole. http://www.docstoc.com/docs/25099019/di ... ic-surgery) just search for "premature aging after orthognathic surgery) This is something that has not been written so much about because it isn't a problem for the pasient right after the surgery, but so many years later.

I really hope this isn't the case, but I got a bit scared. I don't have that much lip incompetence, but it's giving me enough trouble, and I have an open bite. But this surgeon said that I should live with it, and instead go for orthodontics. I do not think that is a solution, so I think I will go for a second opinion. My bite makes me grind teeth at night and I have seriously pain in my jaws every morning, and also I get a very dry mouth cause I don't sleep with my mouth closed.

[annepanne]

http://www.sciencedirect.com/science?_o ... 69bc36[url]

here's also one site -but it's just the intro..[/url]