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Class I bite with convex philtrum, retruded mandible OR too forward maxilla?

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(@theworldisyours)
Posts: 1
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I'm pretty new to this forum and I'm wondering if you could give me some insights about improving my lower third.

 

So I have visited an orthodontist and she told me that my bite is normal. I have a little crowding in my lower teeth, but it's not too bad.

My problems that I'd like to improve or solve (if it's possible) are: My philtrum area from side profile is convex, my upper lip is not really ideal. My mandible is retruded despite having normal, Class 1 bite or actually my maxilla under my nose area is too forward growth, giving me a bit of convexity on my philtrum and disharmony from side profile (I'm Caucasian, so it's not really normal to have a profile like that for me.) 

Something that might important that my upper midface is actually recessed (cheeks are flat, under eye area also not strong).

 

Few pictures here: https://imgur.com/a/YBNq0yn

You can also see that my upper lip blends in with the philtrum. So if my lip could be rotated a with a treatment a bit upwards, probably it would cause my philtrum to be a bit concave or at least straight. 

So I have talked with some maxillofacial surgeons and they suggested me to get double jaw surgery. In Korea they do the surgery first approach (where I would get mine done probably). I'm a bit afraid if a CCW rotation surgery that has been suggested to me would give me some dramatic results that would worth the money and my maxilla region probably would not improve, however maybe if my mandible gets more forward, my maxilla will be balanced, so it will look better in the end.

 

As you can see on me side profile picture where I show my teeth, the upper teeth seem to be very straight, I would say they bend a little towards me ("inside"). I was thinking if braces could actually help on my philtrum/maxilla region without messing up my face? 

Someone also told me maybe setting back my maxilla only could solve my problem instead of having CCW rotation and getting my mandible forward (with genioplasty). Since the lower part of my maxilla is more forward than my cheeks, maybe actually this is not really a bad idea. They do this in Asia mostly, but I'm clueless if this could be a solution for me. I'm also confused how could be this done on a patient who has class 1 bite like me.

Something that is also important note that my nasolabial angle is already on the bigger end of normal, so I would not want to make it bigger. It should be smaller, but not sure if any surgery that impacts jaws can alter that.

 

So ideally what I supposed to achieve to look better are the followings: My mandible should line up with my maxilla. My upper lip should "roll up more" to create a concave philtrum which would create a bit of smaller nasolabial angle (this is just a plus) without making my midface longer.

Here is a picture of an example that seems to address similar problem like mine (or at least an outcome that seems appealing to me), but my mandible is way less recessed than hers: https://imgur.com/a/xdJ6GkA

 

Note that maybe what I'm stating here is totally stupid, I'm just guessing.

Any ideas or helpful comments are appreciated.

 

 

 

 


 
Posted : 30/09/2020 1:59 am
(@progress)
Posts: 878
 

Moved to case discussions.


 
Posted : 30/09/2020 7:06 am
 TGW
(@admin)
Posts: 398
Admin
 

@theworldisyours


 
Posted : 30/09/2020 6:40 pm

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