Jaw Surgery and Face Disproportionality and Plastic Surgery

[nbernat]

By my orthodontist's request, I will be having jaw surgery to fix my overbite and give me a perfect smile. However, that will make my face look disproportioned so I am planning on having my lower lip's size reduced, a rhinoplasty and some fat grafting to give my face a more balanced look (as well as some work on my chin since it'll look like it's sticking out!).

Also, when my orthodontist and surgeon tell me to move my jaw to the spot where they want it, the back of my teeth are never touching. Is that how I'll be post-operation?

How long after my jaw surgery could I have these surgeries done? Or should I have the plastic surgery done first and just move my jaw forward so that the surgeon will know how it would look post-jaw-surgery? Would they have an affect on each other?

[Sunny]

Hi nbernat

Jaw and plastic surgery are very precise sciences and I recommend you speak to your surgeons about your concerns.

The few clients I know who've had plastic surgery connected to their jaw surgeries, do so after the jaw surgery. The reason they've chosen this, is that it's not till after the jaw surgery, in fact many months later, after the swelling has gone, that the extent of what you require can be seen. Also check if the work required for your chin can be done at the time of your jaw surgery. Many surgeon's 'fix' the jaw line using prosthesis at the same time as 'fixing' the jaw(s)

With regards to your teeth not matching, that's to be expected, as your jaw is not currently working in that position. Mostly your teeth will be aligned suitable for surgery, then you'll have surgery. Following that a few months of tweaking is usually necessary, before your teeth go naked. This is definitely a question for your orthodontist and surgeon, as it's good to show your interest.

All the best with your surgery plans!

[Zoso]

Orthognathic surgery first, cosmetic work later ... that is, if you still feel you need it.

Your OMS will take into consideration not only your bite, but also the facial aesthetics as he plans your procedure, and it's not at all uncommon for someone to end up feeling much better about their overall facial appearance once all the post-operative swelling has started to subside. Generally, as the lower jaw is advanced (which is what I am guessing is most likely to be done in your situation) this will actually make a subtle but quite noticeable difference also to the nose and midface. In part it is an indirect effect - the new position of the lower jaw makes the mid-face appear to be in better proportion - but in part it is also because there actually will be subtle changes around and to the nose. So you should definitely wait - see how the face ends up after the bite has been fixed, since the rest can be adjusted if necessary to harmonise with that.

You don't say how far in the future your surgery is estimated to be, so it's hard to say too much about those back teeth. But don't worry. The procedure to advance the lower jaw usually allows also for some rotation. Then there's always the possibility of using closing elastics during the post-op orthodontic treatment. As long s your OMS and OD know what they're doing (which they do, because you chose them with care, yes?) everything is going to be fine!

[nbernat]

Thanks for your responses. I'm ready for surgery, now it is just a matter of my family and I deciding we want to go through with the surgery.

The oral surgeon will take into consideration the aesthetics? Really? I had no idea. At the consult, he simply asked me to move my lower jaw forward until his little ruler measured what my orthodontist had recommended. And every time I move my jaw forward I look horrible. I look like I have an under bite which I won't and as if my lower lip is twice as large as my upper lip. Is there any way to move both jaws so that they don't make me look deformed? Kaiser will pay for everything so luckily price is no problem (except for the $15 for the consult ).

[Zoso]

Look at it this way: if your lower jaw is far behind the upper, you can fix this either by moving forward the lower, moving back the upper, or both. At a minimum the OMS will choosing between these three based on aestehtics and overall facial harmony.

Please let me reassure you too that just jutting your jaw forward is an incredibly poor facsimile for the results you will see post-op. As I mentioned, the BSSO procedure generally also includes a rotational component in addition to the forward movement, and you just can't mimic this by jutting your jaw forwards. Almost all people that I have spoken to have been far happier with their actual results than they anticipated based solely on looking at their face with their jaw jutted forward.

Anyway, all of this notwithstanding, the key thing is to get your dental arches into the proper relationship.

[nbernat]

Lol. Thanks, that reassured me quite some bit.