@zygoarch What is CW and ZSO? You look like your top teeth are narrow, but can’t tell... only in the bottom photo do they look narrow. You appear to have a canted smile, but t could be camera angle. Dr. Sue Lee has a great grasp on canted smiles.

I’d honestly work with her and a local dentist who does orthodontia or an orthodontist. Her stuff has to be combined with braces and you have to watch for retruding of the maxilla generally, but considering your front teeth piling up on the bottom, you need some widening of mandible. Nobody widens an adult mandible like Dr. Sue Lee.

Don't do a single damn osteotomy procedure until you sorted out your bite. Osteotomies can lock in cranial strains and asymmetries which you exhibit. Slow expansion can sort out some of your facial problems.