My dental + surgery plan

[jfbjfb]

My mouth may just be my biggest failo. As I am embarking on this looksmax journey I feel the need to fix it asap. Some of my issues:

• Narrow palate: an intermolar width of about 32 mm as of now, somewhat gingival smile and notorious buccal corridors.
• Downward growth: lack of chin projection, long lower third, and a gonial angle way outside the norm.
• Class 3: this is weird since at first glance I seem recessed and one would think I have a class 2. My mandible is still longer in the longitudinal plane than my maxilla.

So far I have consulted 2 orthos that propose me different treatments:

Ortho 1: focus is placed on aligning the teeth to fix it all with bimax.

• Braces for 10 months which would give me about 4 mm of transversal expansion.
• Bimax: segmented lefort 1, BSSO with ccw + genio.
• Keep the braces for 3 to 6 months more to finish it all.

---- Estimated time: ~15 months; Cost: 21k (6k for braces + 15k for bimax) ----


Ortho 2: expand as much as possible and try to avoid bimax.

• Corticotomy to expand the lower jaw.
• BAME (Bone Anchored Maxillary Expander) to expand the upper jaw. He told me that BAME is superior to MSE as it has a stronger connection to the bone through 20 mm screws. There is no screw drag, no arms to the first molars and no need to perform surgical assist. Commercially known as DS-Xpander, BAME was invented as such in 2022 by Dr. Armando Dias da Silva (I had never heard of it and I guess the same applies to most of this forum). More info here.
• Aligners to put everything in place.

---- Estimated time: ~24 months; Cost: 8k (2k for corticotomy + 1k for BAME + 5k for aligners) ----


I am not fully sure if the plan of the second ortho will be enough. I truly need Bimax, and even though the expansion is more than welcome, wearing the aligners for about 18 months seems too much for me. The treatment I would like to follow is a hybrid version of the two options described above:

• Corticotomy.
• BAME.
• Braces to prepare for surgery.
• Bimax.
• Keep the braces for the final alignment.

---- Estimated time: ~21 months; Cost: 24k (2k for corticotomy + 1k for BAME + 6k for braces + 15k for Bimax) ----

I think Bimax is non-negotiable in my case but I still have to decide if pre-expansion is convenient or if it will be a waste of money and time. Thoughts?

 

[racoon4]

53k in total, damn

 

[longjohnmong]

53k in total, damn

he was presenting three separate plans

 

[racoon4]

he was presenting three separate plans

over for retardcels

 

[Deleted member 16683]

expanding rarely has actually noticeable improvements unless you have subhuman palate and jaw/maxilla width

 

[jfbjfb]

expanding rarely has actually noticeable improvements unless you have subhuman palate and jaw/maxilla width

I do have a narrow palate and would greatly benefit from expansion. According to my ortho, the palate expansion is rather simple but it is conditioned by the lower jaw. Hence, corticotomy is very much needed in my case. I could even skip BAME and go straight for Bimax. He has done segmented leforts 1 with 8 to 9 mm of expansion, lifefuel