Biggest Concern about Maxilliary Advancement

[Bobby]

Hey guys, apparently my surgeon told that they wanted to do my upper as well. I'm a class 3 case. The procedure would be Lefort 1 Osteotomy, Bilateral Sagital Split Osteotomy with genioplasty.
When the maxilla will be forwarded there's a possibility that your nose will change in a way e.g. position or shape.
So I'm trying to ask opinions of other OMS to find out if I really need maxillary advancement.
Do someone on here whom undergone maxillary advancement? What was the result then?

[mikeg]

I have to have the same thing.. upper jaw is too narrow for lower...

EVERYONE i have talked to that had it done, said it was well worth it. If you can live with it and it doesn't bother you than by all means dont worry about it.

but in my case, I have TMJ and am grinding my teeth down....

The surgery is scary, but it is pretty common and in most cases worth the committment.

[SweetTooth]

Hi - I had both upper and lower brought forward and I can say that it was a pretty big change. It's a little
odd to see yourself in the mirror and see what looks to be another person, but you get used to it. My nose didn't
change shape necessarily, but it was brought forward a little by the shift in the bones behind it. My incision seemed
to be directly underneath my nose so I suppose that could technically change things too. Overall, I like my new look
better and got really good reactions from everyone.
It's good that you're asking questions especially when it comes to the upper jaw. I had my surgery in 03 so it's been a
while, and I'm sure they've made improvements, but it's a lot of added surgery and a lot of added recovery time. The 6
week splint means no solids for a full 6 weeks. For me, that involved a lot of weight loss, hair loss, muscle loss, and
general weakness. I would just give it a lot of thought before doing the upper jaw. I feel like some doctors want perfection
and sometimes it's not that neccessary. I STILL after 10 years of braces and the jaw surgery have a pretty nice overbite.

PS Zip-N-Squeeze.com is a life saver, I ended up having to overnight extras

[Bobby]

Hi - I had both upper and lower brought forward and I can say that it was a pretty big change. It's a little
odd to see yourself in the mirror and see what looks to be another person, but you get used to it. My nose didn't
change shape necessarily, but it was brought forward a little by the shift in the bones behind it. My incision seemed
to be directly underneath my nose so I suppose that could technically change things too. Overall, I like my new look
better and got really good reactions from everyone.
It's good that you're asking questions especially when it comes to the upper jaw. I had my surgery in 03 so it's been a
while, and I'm sure they've made improvements, but it's a lot of added surgery and a lot of added recovery time. The 6
week splint means no solids for a full 6 weeks. For me, that involved a lot of weight loss, hair loss, muscle loss, and
general weakness. I would just give it a lot of thought before doing the upper jaw. I feel like some doctors want perfection
and sometimes it's not that neccessary. I STILL after 10 years of braces and the jaw surgery have a pretty nice overbite.

PS Zip-N-Squeeze.com is a life saver, I ended up having to overnight extras

Hi, thank you for sharing some infos, so your case was overbite, both jaws were forwarded. Yeah i can imagine what would be the most common movement for your nose if they are going to do your upper jaw as well, most of the time your nose will get bigger or wider and will be flipping outwards like your nostrils will be more noticeable
It's because yeah mostly the incision will be done directly underneath the nose that's why maybe.
How millimeters did they forwarded your upper jaw?
I was thinking maybe the effects with the nose will depend on how millimeters they will move your upper jaw forward?
I've seen a lot of videos of people who documented their journey of the treatment and they also went on upper jaw advancement and it's amazing. I mean the results! Uggghh.. And I've seen some who were complaining about their noses so that makes me confused if whether I will let them do my upper as well.
The doctor has told when it comes to stability and results, involvements of the two jaw is better than only one, have you heard about this?
And if only one jaw will be involved there's more risk of relapses.

[mzkimx3]

I just had my palate cut to open up and widen my upper jaw to the perfect with since it was too narrow. there was some change in my face and my nose but nothing to major more so my face looks fuller and across my cheek bones. I know it isnt the same thing but your changes my only be slight. I do know i enjoy being able to breathe better thru my nose post the expander. I'm having my lower jaw moved forward to match my upper. figured id throw my input in for the nose changes. i had it expanded 6mm

[Bobby]

I just had my palate cut to open up and widen my upper jaw to the perfect with since it was too narrow. there was some change in my face and my nose but nothing to major more so my face looks fuller and across my cheek bones. I know it isnt the same thing but your changes my only be slight. I do know i enjoy being able to breathe better thru my nose post the expander. I'm having my lower jaw moved forward to match my upper. figured id throw my input in for the nose changes. i had it expanded 6mm

hi! this is purely for cosmetic reasons? why you didnt do both operations in one then, i think it is better. did you experienced nose bleeding with your upper being widen during post op? this happens i think if they will do your upper. upper is more complicated since the nasal and cavity involved, thats why im seeking other opinion of other surgeons if i really need the upper too. but if i really need it then ill go with it. maybe the degree of some changes with the nose will depend on how drastic they would move forward your upper jaw. I saw a lot of videos of people whom undergone orthognathic surgery both upper and lower and yeah there are some changes with their noses actually for the better haha. there are some whom complained.

[mzkimx3]

No my upper jaw was too small so they needed to expand it to match up with lower jaw so i can get the braces put one. Had my wisdoms removed same time but since i had just start my braces journey the month before my lower teeth are not into position yet. They want to align the teeth before moving the lower jaw. Yes I did have nose bleeding pre-op, it was a car ride home from hell i think. If my head was kept level I would have no bleeding but if it was slightly lower than that or above I would bleed, but this only happened for up to 2 hours i believe maybe more but I was sleeping on the couch elevated not sure if it helped or not. The width of my nose is a lil wider than it was before expansion but I can breathe easier since my nasal cavity is more open which I enjoy as I couldn't breathe well through my nose

[Bobby]

No my upper jaw was too small so they needed to expand it to match up with lower jaw so i can get the braces put one. Had my wisdoms removed same time but since i had just start my braces journey the month before my lower teeth are not into position yet. They want to align the teeth before moving the lower jaw. Yes I did have nose bleeding pre-op, it was a car ride home from hell i think. If my head was kept level I would have no bleeding but if it was slightly lower than that or above I would bleed, but this only happened for up to 2 hours i believe maybe more but I was sleeping on the couch elevated not sure if it helped or not. The width of my nose is a lil wider than it was before expansion but I can breathe easier since my nasal cavity is more open which I enjoy as I couldn't breathe well through my nose

ehrmm.. your case is quite complicated, you will have to have undergo twice on surgery. how many hours did your surgery for widening lasted? guess you're overbite?
youre wearing braces the time they performed the widening? wired shut after?

[mzkimx3]

well to surgically open and remove my wisdoms was 3 hours then 2 hours in recovery. To widen the jaw I had a rapid palate expander in that i turned twice a day at home after leaving the hospital. My next surgery is for my overbite correct. Not wired shut after as it was in the palate i need to keep the palate expander in for 6 months for the bone to heal. I was wear lower braces when my upper jaw was widened. I have a blog that includes some pictures of the rapid palatal expander if you'd like to see what I'm talking about

[Bobby]

well to surgically open and remove my wisdoms was 3 hours then 2 hours in recovery. To widen the jaw I had a rapid palate expander in that i turned twice a day at home after leaving the hospital. My next surgery is for my overbite correct. Not wired shut after as it was in the palate i need to keep the palate expander in for 6 months for the bone to heal. I was wear lower braces when my upper jaw was widened. I have a blog that includes some pictures of the rapid palatal expander if you'd like to see what I'm talking about

yes where can i access your pictures for that?

[mzkimx3]

Go to the blogs tabs. at the top of the page and you'll see the one I posted the other day. or if you click on my username and the click view blog entries you'll see it that way

[brite]

I agree that it is well worth it. you should go for it

[Bobby]

Go to the blogs tabs. at the top of the page and you'll see the one I posted the other day. or if you click on my username and the click view blog entries you'll see it that way

aww nice! so what will happen with those gaps in your upper? ermm you have before and after pics of your whole face? i havent explored all your blogs but i will. haha i just remember that arch i used to wear on my upper as well before. i hated it sooo much! it was so hard to eat and swallow!

[Bobby]

I agree that it is well worth it. you should go for it

definitely i will. its just im seeking opinions for the upper jaw surgery if i really need it or lower is just enough. if it will add to more aesthetically balanced face then id go for two jaw surgery. maybe it wouldn't have be that much changes in my nose then, and if there is then it is for the better. but now im contented with the shape and form of my nose i think its really beautiful thats why im quite concerned about it being changed if ever ill undergo upper jaw modification, but im hoping if it will changed then it is for the better than i have now it must be! i saw some people whom undergone upper and lower and there noses got more pleasing and beautiful than before.

[mzkimx3]

I do but they are black and white from my ortho when he did my before pictures I'm gonna search and see if I have any. As for the gaps in the upper the huge one It is closing on its own as the bone heals. Already since the picture was taken it is closed. I barely notice the expander anymore I just have a drink with anything i eat and it's fine. only 5 more months of it lol

[Bobby]

I do but they are black and white from my ortho when he did my before pictures I'm gonna search and see if I have any. As for the gaps in the upper the huge one It is closing on its own as the bone heals. Already since the picture was taken it is closed. I barely notice the expander anymore I just have a drink with anything i eat and it's fine. only 5 more months of it lol

it will close with the teeth also? maybe the braces will move your natural teeth and will be aligned to close the gap. My expander was hanging very low in the middle thats why i was really having a hard time swallowing foods when i was wearing it. doesnt matter if its black and white i just want to see the after effect of your face please lol

[Bobby]

i just noticed now your upper arch is different with mine. the middle of mine is hanging down to my tongue making me so hard to swallow!
i wish i can see the before picture. you have that after picture though.

[mzkimx3]

ill scan them and see what i can get with how they scan

[Bobby]

One more question
For those who went through upper jaw advancement regardless if it was combined with lower jaw or not. Did you guys donated your own blood before the surgery? Because if you're going for upper jaw most likely you're going to be needing blood transfusion.