Metal Mouth Message Board

I came across this case:
http://0.tqn.com/w/experts/Oral-Surgery ... arison.jpg

Guy had narrow upper palate and got it expanded, he also had LefortI with advancement and impaction. What questions me is that he fixed flaws by the rules of every maxillo facial surgery manual, yet he ended way worse looking.

[quote]
Hi, I am going through orthodontic treatment. I was told my upper jaw was too narrow causing a cross bite. I was told that I would need to get surgery to correct this and have my upper jaw widened. I did not realize the implications this would have on my face. I absolutely hate how my face looks now. Something is wrong with it and I want it fixed, but I don't know exactly what is wrong with it so I was hoping that you could tell me with the pictures I am providing.

In the photos, hopefully I resized them properly. My presurgery photos I weigh 145 to 155 lbs. All the other photos I weigh about 150 to 165 lbs. I workout a lot so my weight fluctuation is mostly muscle mass. Obviously in the presurgery photos I am younger.

I feel like I my face now looks fat. I also have this bizarre feature with my mouth popping out from my facial outline in the 3/4 view in the pictures.

The first jaw surgery (SARPE) was the expansion as I said and the second jaw surgery was to move my upper jaw slightly upwards and forwards, and make my lower jaw a bit longer. I only went through with the second surgery because I was hoping it would make my face look better after what happened from the first surgery.

Is there plastic surgery that can correct this? What would need to be done? Should I try to get my upper jaw reduced? Even though I would have a cross bite I would be happy with my face...
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Could somebody explain to me why this happened?I'm considering jaw surgery, but cases like this leave me doubtful whether it's worth undergoing this.

It's all subjective... the after pictures certainly look different, but I wouldn't say they look worse.

Speaking for myself, the rear of my palate was widened (but not the front, so no SARPE) and it did make my mid-face a little broader, but I'm not displeased with the result.

You'd have to ask your ortho and/or OMFS what movements are expected in the surgery and ask if they can guess (or model) what that will do to your face.

I agree it's subjective. For one the pre-surgery photos are when the guy was 10-15lbs lighter before he started working out (he mentions this in his posts). I don't think his end result is that bad. I think he has just gained considerable weight and is masking his jaw structure. His SARPE didn't go as planned and was very asymmetrical.

Asymmetrical expansion isn't common but it isn't rare either, about in one in 8 experience it. Why does it happen? There are multiple reasons why it can occur but the most likely culprits are the surgeon didn't completely free the bones on one side during surgery or the person has more resistance on one side of their face to expansion because of tissue resistance or jaw structure.

I had SARPE and experienced this with my left palate expanding more than my right but not as badly as this guy. Orthodontist says rubber bands will correct it. Do I still notice asymmetry? Yes if I stare stare at my mouth for a minute or two but no one else notices. There is no noticeable difference in my face structure. I'm still in braces so the result isn't completed yet. Maybe the asymmetry will completely disappear either way it's infinitely improved from my starting point.

tbh i think he did look so much better pre-op. Plus like he said 1st the weight change is rather insignificant (your face doesn't show as much change as your body would) 2nd its mostly muscle mass. I think the "fat look" comes from the expansion. Poor guy.

I think upper jaw widen and moved forward gave such a impact to make mid-face looks broader. It could work for some people who has small/narrow upper jaw to balance the face but not for everybody. Speaking from my experience, I had my upper jaw moved forward 3 mm, up 4 mm and tilted to the front gave me such a impact on my mid-face. My mid-face looks fatter and my nose is getting flatter and upturn which is not a good thing for me. My look has change from my eyes down to the chin. I can't even recognized myself in the mirror.

Please be clear with your oral surgeon and tell them what is your expectation. Try to work with them as much as possible to achieve satisfy result. I let my surgeon did things to me and thought it is going to be ok because they are an expert but I am not one of the lucky people so the result is really killing me.

To be honest I think (some) the oral surgeon should look more to the aesthetics side as well as the technical side. Look at the face character and try to achieve what is best for each patient. The jaw surgery is a big thing and we all have to go through so much and I believe nobody wants to have a good bite but bad looking after surgery.

I feel sorry for this guy. I hope he could find the solution to fix it.

I trusted my ortho to guide the processes to correct my overbite. He only look at the technical not the impact on the face. My problem was protrusion for overbite,they move my Lower jaw too much and now I have protrusion in both upper and lower jaw. I am suffering, not sure what to do?

[quote="Sadjaw"]I trusted my ortho to guide the processes to correct my overbite. He only look at the technical not the impact on the face. My problem was protrusion for overbite,they move my Lower jaw too much and now I have protrusion in both upper and lower jaw. I am suffering, not sure what to do?[/quote]

Have your tried correcting your tongue posture and breathing with lips closed? It will advance the maxilla ( very gradual), and might help in getting you your neutral occlusion.