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Attached are pics of my lower third scans.
Basically, my face is really fucking, and I dont think mewing will fix it. Here's what I have now:
Narrow upper palate: I think my lower palate is a little above 40mm, but my upper is like 33-34.
Underbite: I had underbite before, then I got compensatory ortho to tip my lower teeth behind my upper teeth. Imo, this was a huge mistake. I feel like it made my face longer and narrower.
Cross Bite: Due to asymmetry and narrow palate
Prognatism: African American, so typical. Makes my chin and jaw look even smaller and narrower.
Asymmetry: Left and right jaw are asymmetric and of different lengths, my midline is foff, and my right gonial angle looks more obtuse
Downward growth: Sever allergies as a child, my gonial angle looks very high. Like 150 degrees or more. I look like a horse face
Narrow airway: 40 square mm vs the ideal of 200.
What can I do to fix this. Mewing wont work for me due to my narrow setback palate. I am open to anything short of Lefort 2 or 3. Any osteotomy, treatment, or anything I'll do to fix my face. Just tell me the doctor who is farmiliar with airway and facial growth ortho and gives osteotomies and treatments to fix this stuff. I will do whatever it takes. Here are the treatments I had in mind:
2-3 Piece Lefort 1, BSSO, Clockwise Rotation, and Genio
Pros as I see it (tell me if you're wrong):
Will get advancement
will decrease gonial angle a bit
will make my face looks more masculine
would correct asymmetry more reliably
Cons
one surgeon (Movahed), told me he wouldn't be able to advance me as much as I need (8mm) because of prognatism
he also told me it wouldn't be a huge aesthetic improvement bc I would get relatively small movements
another surgeon told me I shouldn't get this surgery cuz my teeth touch (lol)
recovery and risk
MSE + face mask + genio + undo compensation ortho
Pros as I see it (tell me if you're wrong):
would widen palate just as much without invasiveness
potential for a few mm of forward growth (before I had compensation ortho, my underbite was only a few mm)
undoing compensation ortho would bring my full face forward
Cons as I see it (tell me if you're wrong):
I already have a bit of asymmetry, MSE could make it worse, idk how they correct for asymmetry
Might make prognatism worse
Might not be as huge of and improvement as full bimax, but my bimax movements wouldnt be huge so maybe this would be better
MSE + face mask + chin wing osteotomy + undo compensation ortho
Pros as I see it (tell me if you're wrong):
same as above, but better ramus and significantly better gonial angle after
Cons as I see it (tell me if you're wrong):
also same as above, but I don't know how invasive chin wing osteotomy is, or where to even get it.
let me know what you think I should do given my scans, and what other options I may have
Are you having any health issues? If you are experiences no health problems and your only goal is to look better cosmetic operations may be more helpful for you than MSE or Lefort.
I don't think lefort would help you much. Your crossbite is quite apparent, but I see you have no incisor crowding which is great, means your jaw isn't super narrow. Can you really not fit your tongue up there on the palate? Honestly the most I would recommend by these pictures is a simple palate expander and then dedicated mewing and correcting of whole body posture.