Discussion Does decrease in maxillary height translate to decrease in soft tissue?

[Deluded Normie]

I have ideal tooth show, no gummy smile.

Lets say that i get CCW rotation with 2mm impaction (just a random example, idk if thats what i need), would i need to shorten my philtrum 2mm as well to keep the same amount of tooth show that i had before the surgery?

I guess it also depends on how much advancement i get, right?

@Gebirgscel

 

[Hououin Kyouma]

I have ideal tooth show, no gummy smile.

Lets say that i get CCW rotation with 2mm impaction (just a random example, idk if thats what i need), would i need to shorten my philtrum 2mm as well to keep the same amount of tooth show that i had before the surgery?

I guess it also depends on how much advancement i get, right?

@Gebirgscel

I’d like for you to show me your face if you don’t mind before you start getting all that surgery

 

[Deluded Normie]

I’d like for you to show me your face if you don’t mind before you start getting all that surgery

I have a short ramus and high gonial angle, thats all you need to know.

 

[Neo]

I have ideal tooth show, no gummy smile.

Lets say that i get CCW rotation with 2mm impaction (just a random example, idk if thats what i need), would i need to shorten my philtrum 2mm as well to keep the same amount of tooth show that i had before the surgery?

I guess it also depends on how much advancement i get, right?

@Gebirgscel

I believe the CCW would make your lips bigger and decrease by making the philtrum more convex

 

[Gebirgscel]

I have ideal tooth show, no gummy smile.

Lets say that i get CCW rotation with 2mm impaction (just a random example, idk if thats what i need), would i need to shorten my philtrum 2mm as well to keep the same amount of tooth show that i had before the surgery?

I guess it also depends on how much advancement i get, right?

@Gebirgscel

I have a short ramus and high gonial angle, thats all you need to know.

Impaction doesnt change your gonial angle per se, it swings the mandible forward, giving the impression of lower gonial angle AND maybe also elongating your ramus

Maybe after the surgery (BSSO) the Masetter could remodel the ramus, but thats not the question

in general, advancement alone could curve out your Philtrum, making it appear shorter in vertical height (assuming your LeFort 1 would actually make a big impact on your profile and soft tissue lol)

You can decide later if you need a lip lift

 

[Deluded Normie]

Impaction doesnt change your gonial angle per se, it swings the mandible forward, giving the impression of lower gonial angle AND maybe also elongating your ramus

Forward and also upward, right?

 

[Gebirgscel]

Forward and also upward, right?

yes, thats the only logical movement if you impact in LeFort 1 style. But this doesnt mean that you can get proper occlusion. a standalone LeFort 1 IMPACTION only is very rare. The easiest approach would be straight advancement. Rotation is what differentiates normal to skilled surgeons, and its execution differentiates the skilled to the good surgeons

the mandible doesnt rotate at the Gonions. The Ramus and Mandible are interconnected, aswell as the mandibular notch (the bone when you open your mouth, which appears at the cheeks)

The mandible rotates at the TM-Joint
Which might be another reason of concern, especially for Cels who are seeking maxillary protraction