Surgery in a couple days, need help on last minute plans

This forum is for discussions relating to oral surgery for orthodontics.

Moderator: bbsadmin

Post Reply
Message
Author
Milly99
Posts: 4
Joined: Mon Feb 29, 2016 7:46 pm

Surgery in a couple days, need help on last minute plans

#1 Post by Milly99 »

Hello everyone. Thanks in advance for your time.

I am getting ready to have jaw surgery in about 5 days and Id like your opinions/advice on aesthetics.
I have a couple options (a lefort 1 or a high lefort 1, with an optional bsso) when it comes the positioning of my jaw(s) and the aesthetic outcome is very important to me as I am self conscience of how I look currently. My goal is to come out with a better bite (of coarse) but better looking as well.

The things that I'd like to improve are my:

⦁ slight gummy smile. Id like a shorter face & philtrum with no gummy smile. I realize a lip lip maybe in order to help achieve my goals.
⦁ flat cheeks. Id like More of a heart shaped face, widest at the UPPER cheek bones (right under the eyes). More projection in the upper cheeks.
⦁ concave paranasal area & retruded collumela/nasal spine. I like a more balanced paranasal area. Not convex, but less concave, and my nasal spine/collumela be less retracted.
⦁ large chin/square lower jaw shape. Id like a shorter, straight, more narrow/feminine chin

What Id like to avoid (and this is very important to me) is the dreaded convex philtruim area that I have seen in many 'after' photos. (lefort 1 patients.) Im thinking that some surgeons might have moved some patients the upper jaw to forward and or low, causing an over projected look that's kind of ape/chimp looking. The philtrum becomes convex or just to full. When most of these patients mile, it look as though their upper jaw was moved to forward causing the upper lip to curl up and be stretched out to much. Also, the buccal fat becomes augmented and the orbital rims look hollow.

However, I have come across a couple before and after pictures, where the people came out so much more attractive. I am hoping to be one of these cases. I prefer to have high cheek bones, a flat paranasal area (not concave or over projected), and a strong but feminine chin/jaw. I prefer a heart shaped face where its widest and most prominent at the upper cheek bone area.
I was thinking about possibly getting a 'v-line' done on my bottom jaw (popular in Korea) but I dont want to end up missing my gonial angles, thus causing my face to look older.

Also, im thinking about a premaxillary implant to bring out my slightly retruted nasal spine and fill out my paransasl area but I have read that some people end up having a distorted smile afterwards. (unable to raise upper lip during smile, only the sides of the mouth. Sort of like the Joker.) However, I believe I read somewhere online that this happens because the edges of the implant are to big and so the muscle cant go over it when smiling. Would shaving down the edges of the implant avoid this dreaded joker smile? And, would the premaxillary implant take out the need for paranasal implants or would those be needed as well to achieve my desired look? (I have heard of HA paste but I dont believe my surgeon uses that.) The reason why Im thinking about a premaiulla implant is because im afraid that if i move my jaw forward during the lefort1, I might end up ape-ish. So maybe just move the jaw up instead of forward during this portion of the surgery??

Id like my cheeks to be a little more prominent but I dont want the obvious cheek implant look that I have seen in some celebrity and some of the "Real Housewives" women on tv. (Madonna, Jada Pinket Smith, etc.) A plastic surgeon told me fillers were the better option and I may go that way, but if I can save $ and do a one time deal implant with my desired look, Id rather go that option, as fillers will cost more over time due to the fact that you have to keep getting them when they desolve over time. Can you get cheek implants and just shave them down to a thin sheet like shape? Would that look artificial?

Finally, My chin is a little elongated and protrudes a little. Id like it to be shorter and more famine. My surgeon mentioned an optional bsso, but I wonder if an osectomy would be better or to add it to the surgery. I think the bsso would make my bottom lip position go back a little bit and make it more balanced with the top lip (my bottom lip protrudes a little more than my upper lip) but I doubt it will make my chin look smaller. Ive heard that if you move the upper jaw forward, then it kinda balances out the rest of your face. However, I feel as though, maybe moving my upper jaw forward might give me that ape look.
Currently, I feel as thought my mouth/philtrum area sticks out already. So Im thinking if I moved my upper jaw forward, it would look even more ape-ish. However, if Im getting a lefort 1 done for an open bite and the doctor takes a wedge out of the back part, wouldn't that cause the front teeth area/philtrum to become less prominent and make it able to move the upper jaw forward a little without the ape look? Also, maybe cutting out the need for the bsso?
I have seen another surgeon before my current one and he recommend a lefort 1 and an optional counter clockwise bsso with a paranasal graft using HA paste (i think). My insurance wouldnt cover it because he wasn't in the network, so I sought out another surgeon.

Your thoughts and opinions are appreciated.
I have included some pictures.

Im trying to include a pic of the projected outcome of the surgery. Id like your guys opinions on what I can tell or ask my surgeon about in order to get the most bag for my buck while Im under the knife. I will try to include what my ideal look/type is so that you guys can help point me in the right direction. Forgive me if I am unsuccessful at up loading any pics.

Milly99
Posts: 4
Joined: Mon Feb 29, 2016 7:46 pm

Re: Surgery in a couple days, need help on last minute plans

#2 Post by Milly99 »

@bbsadmin

Hello, I am unsure of how to post an image on here. am I able to?

jaime
Posts: 853
Joined: Mon Jun 02, 2014 8:00 am
Location: Southeastern Michigan
Contact:

Re: Surgery in a couple days, need help on last minute plans

#3 Post by jaime »

You can't post a photo until you have 9 or so posts.

Honestly, everything you're asking is above the level of expertise of a user here. And judging by how you seem to want to look a very specific way, I'm not sure it's smart to even advise you of anything lest you be let down afterwards. I just hope for your sake that you are happy with the way you look after surgery, because it's an art as much as it is a science.
SARPE: December 19, 2013
Expander out/TPA in: May 13th, 2014
Upper and lower braces: May 21, 2014
Lefort I + BSSO + sliding genioplasty: June 11, 2015
TPA out: December 17, 2015 (due to issues)
Braces off: November 28th, 2016!!!
My blog
My ArchWired thread (last updated November 29th, 2016)

SingleJawMelb
Posts: 228
Joined: Sun Sep 25, 2016 8:48 am

Re: Surgery in a couple days, need help on last minute plans

#4 Post by SingleJawMelb »

Why are you asking us... we aren't the ones able to cut up your face nor or we the surgeon cutting up your face in a few days.

Why/how do you have an option about what to do when your surgey is in five days.

Are you getting cosmetic surgey? I think you need an Adsense T before you get this surgey.

snapdresser
Posts: 940
Joined: Wed Feb 18, 2015 7:31 am

Re: Surgery in a couple days, need help on last minute plans

#5 Post by snapdresser »

I hate to break it to you Milly, but you're being unrealistic about this surgery. This surgery won't give you high cheekbones and the effect it has on your soft tissues (which you're apparently very concerned with) is very unpredictable. Your mindset going into this is going to leave you upset with your results. The most you can really ask for is for the results to be straight and symmetrical with a bite that fits together and hopefully minimal permanent numbness (and maybe for them not to advance or impact you too many mm, but even that is not an exact science). The rest is all a crapshoot. Maybe your surgeon gave you the impression that he can give you all the things you're asking for, but he can't, and if you keep chasing it you're going to end up with a whole lot of plastic surgery and still not achieve perfection. I asked my surgeon if I should bring in some pics of what I wanted to look like and she told me "You can but it won't make a difference." All they change is a couple bones to position them more ideally and you can at best expect to look like one of your more attractive family members. Expecting anything more will just leave you disappointed post-op. Even if your case goes amazingly, there will be days that you're not happy with your new face and having sky-high expectations going in is just going to make those days even harder. It will NOT be perfect. Like I said, the most you can ask for is for your results to be symmetrical, with minimal permanent numbness, and hopefully a good bite :D Good luck!
No braces
1-piece LeFort I + BSSO + Sliding Genio on 10 JUNE 2015!
Image

glennstanzalone
Posts: 147
Joined: Sat Feb 14, 2015 1:06 pm

Re: Surgery in a couple days, need help on last minute plans

#6 Post by glennstanzalone »

The surgery you are getting will not impact your cheekbones whatsoever. If you are advancing your lower jaw you will have a wider lower face not a more slim lower face. I'm dealing with these negative outcomes right now 3 months post op.
Wisdom Teeth Removal - 2008
Adult Braces - February 4th 2016
:twisted: Lefort I 3 piece, Septoplasty & BSSO with rigid fixation + Left side IVRO - August 5th 2016
Braces off - February 28th, 2017!!
Image

Godiva
Posts: 3
Joined: Sat Nov 05, 2016 11:11 am

Re: Surgery in a couple days, need help on last minute plans

#7 Post by Godiva »

ANYONE HAVING SURGERY...... Anyone using pain meds after......

1.HAVE A CAN OR TWO OF MANDARIN ORANGES HANDY!!

2. Go to Target: Target has a two pack of hand size cold/hot packs with socks. LOVE THESE!!!! Perfect for face and jaw areas!!!! LOVE THESE!!!

3. Drink Miralax and take 2softeners with your FIRST meal/snacks after surgery!!!!! Keep taking softeners 1-2 each night while on pain meds.

...... I learned the hard way!!!

The pain meds made me so constipated I was so sick. Three days later I called the surgeon, they took me off the pain meds, I took Duclomine(sp?) as a laxative....... OH MY GOSH IT WAS HORRIBLE!!!!! Ya, the doctors don't seem to tell you to "prep your bowels for pain meds" -they just give out a script.

Take Care: ICE, ICE, ICE the first 24 hours.... You will thank yourself by 48 hours!!!!!! Prayers. :wink:

SingleJawMelb
Posts: 228
Joined: Sun Sep 25, 2016 8:48 am

Re: Surgery in a couple days, need help on last minute plans

#8 Post by SingleJawMelb »

glennstanzalone wrote:The surgery you are getting will not impact your cheekbones whatsoever. If you are advancing your lower jaw you will have a wider lower face not a more slim lower face. I'm dealing with these negative outcomes right now 3 months post op.

Intresting. My lips are smaller since surgey... wonder if it's due to a wide face. I had BSSO.

Post Reply