OVER-correction of long upper jaw/gummy smile??

[Guest guest]

Hi all,

I think I finally figured out what's looking so odd to me as I try

to adjust to my new frontal appearance. I had a long upper jaw/gummy

smile (corrected by LeFort I, approx 5 mm upwards) as well as the

genio to bring my chin forwards (not sure how many mm). It's now

been 6 weeks, and I'm still somewhat swollen (the bruising is very

nearly gone -- finally!). But today I realized that when I speak, my

upper teeth are now practically HIDDEN -- it's ONLY my lower teeth

that are visible when I speak. Similarly, when I smile, it's mostly

my lower teeth that show, and maybe ONLY 2 or 3mm of the uppers -- so

not only is my gummy smile gone (which was the point), but it seems

like about half my upper teeth appear " gone " as well (which *wasn't*

the point, to my knowledge)! Only when I smile as big as I can -

- almost " snarling " to lift my upper lip -- can you see the entirety

of my upper teeth (and a *tiny* sliver of my gums).

This seems/appears really unnatural to me -- it's normal to see most

or all of the upper teeth when people speak and smile, isn't it? Has

anyone had a similar issue after a LeFort? Is this something that

may still be related to swelling (and so will improve over the coming

months)? If it's not related to swelling, has anyone had it

corrected (either by having your ortho bring down level of your front

teeth a little lower, or -- horrors! -- another surgery?) I'm seeing

my surgeon later in the week for an appointment, but I wanted to get

any feedback from people here who might have had similar

issues/concerns.

Thanks!

Sara

[Guest guest]

Sara,

I'm afraid your suspicions are entirely correct. I had lower

advancement/genioplasty ten years ago and my surgeon

decided to omit moving the upper jaw back which would have

corrected my lip incompetence. Anyway, that correction was no

where near the degree of improvement in my looks that I had

hoped for, so I have subsequently had another genioplasty that

brought the chin where it should be. But back to your problem

and why I'm sharing with you. In my quest to correct my lip

incompetence I consulted with an oral surgeon this fall about

possible solutions and the only real solution for me would be to

go with the LeForte procedure and raise my upper jaw but not

move it back as that would then require subsequent moving

back of the lower jaw as well which would be completely

counterproductive. However, I have really only a slight gummy

smile and he said that to fully correct the lip incompetence, I

would then wind up with no upper teeth showing. Unfortunately it

sounds to me like you have the situation that this surgeon

warned me to avoid.

>

> Hi all,

>

> I think I finally figured out what's looking so odd to me as I try

> to adjust to my new frontal appearance. I had a long upper

jaw/gummy

> smile (corrected by LeFort I, approx 5 mm upwards) as well as

the

> genio to bring my chin forwards (not sure how many mm). It's

now

> been 6 weeks, and I'm still somewhat swollen (the bruising is

very

> nearly gone -- finally!). But today I realized that when I speak,

my

> upper teeth are now practically HIDDEN -- it's ONLY my lower

teeth

> that are visible when I speak. Similarly, when I smile, it's

mostly

> my lower teeth that show, and maybe ONLY 2 or 3mm of the

uppers -- so

> not only is my gummy smile gone (which was the point), but it

seems

> like about half my upper teeth appear " gone " as well (which

*wasn't*

> the point, to my knowledge)! Only when I smile as big as I can

-

> - almost " snarling " to lift my upper lip -- can you see the entirety

> of my upper teeth (and a *tiny* sliver of my gums).

>

> This seems/appears really unnatural to me -- it's normal to

see most

> or all of the upper teeth when people speak and smile, isn't it?

Has

> anyone had a similar issue after a LeFort? Is this something

that

> may still be related to swelling (and so will improve over the

coming

> months)? If it's not related to swelling, has anyone had it

> corrected (either by having your ortho bring down level of your

front

> teeth a little lower, or -- horrors! -- another surgery?) I'm seeing

> my surgeon later in the week for an appointment, but I wanted

to get

> any feedback from people here who might have had similar

> issues/concerns.

>

> Thanks!

> Sara

[Guest guest]

,

It sounds like we may have pretty different situations, since I still

do think the LeFort was in fact necessary for my case. My overbite

and especially my lip incompetence were significant -- my lip

incompetence was something like 11+ mm, and even with both these

procedures, I still have a 2 or 3 mm incompetence (still a vast

improvement!), which we knew was a possible outcome. It was clear to

me, my ortho, and two oral surgeons that a genio was just not going

to be sufficient for my case.

So I'm not questioning the necessity of the LeFort *itself* in my

case -- I'm just curious if perhaps the LeFort might have just been

taken up slighlty too far (maybe by a mm or 2), or if what I'm seeing

as slightly " weird " might really just be swelling. Anyone out there

who did opt for the LeFort have a similar experience?

Sara

> >

> > Hi all,

> >

> > I think I finally figured out what's looking so odd to me as I

try

> > to adjust to my new frontal appearance. I had a long upper

> jaw/gummy

> > smile (corrected by LeFort I, approx 5 mm upwards) as well as

> the

> > genio to bring my chin forwards (not sure how many mm). It's

> now

> > been 6 weeks, and I'm still somewhat swollen (the bruising is

> very

> > nearly gone -- finally!). But today I realized that when I

speak,

> my

> > upper teeth are now practically HIDDEN -- it's ONLY my lower

> teeth

> > that are visible when I speak. Similarly, when I smile, it's

> mostly

> > my lower teeth that show, and maybe ONLY 2 or 3mm of the

> uppers -- so

> > not only is my gummy smile gone (which was the point), but it

> seems

> > like about half my upper teeth appear " gone " as well (which

> *wasn't*

> > the point, to my knowledge)! Only when I smile as big as I can

> -

> > - almost " snarling " to lift my upper lip -- can you see the

entirety

> > of my upper teeth (and a *tiny* sliver of my gums).

> >

> > This seems/appears really unnatural to me -- it's normal to

> see most

> > or all of the upper teeth when people speak and smile, isn't it?

> Has

> > anyone had a similar issue after a LeFort? Is this something

> that

> > may still be related to swelling (and so will improve over the

> coming

> > months)? If it's not related to swelling, has anyone had it

> > corrected (either by having your ortho bring down level of your

> front

> > teeth a little lower, or -- horrors! -- another surgery?) I'm

seeing

> > my surgeon later in the week for an appointment, but I wanted

> to get

> > any feedback from people here who might have had similar

> > issues/concerns.

> >

> > Thanks!

> > Sara

[Guest guest]

Hi Sara,

I had a LeFort I also (as well as BSSO and genio), and before my

surgery my surgeon specifically asked me whether I wanted a less

gummy smile. More than anything he didn't want to over correct it,

because he felt that in my case not showing enough of the upper teeth

when I smiled would make me look " old. " So I guess over-correction

with the kind of results you describe is a possibility. On the other

hand, if you're still swollen, I would think that the problem being

swelling is a distinct possibility too, your lip would probably gain

a larger range of motion when the swelling is gone, wouldn't it? But

I would ask your surgeon about it if you get the chance, it will set

your mind at ease hopefully. Those sorts of things can be really

upsetting to just be stuck wondering about!! Sorry I can't be more

helpful.

-

> > >

> > > Hi all,

> > >

> > > I think I finally figured out what's looking so odd to me as I

> try

> > > to adjust to my new frontal appearance. I had a long upper

> > jaw/gummy

> > > smile (corrected by LeFort I, approx 5 mm upwards) as well as

> > the

> > > genio to bring my chin forwards (not sure how many mm). It's

> > now

> > > been 6 weeks, and I'm still somewhat swollen (the bruising is

> > very

> > > nearly gone -- finally!). But today I realized that when I

> speak,

> > my

> > > upper teeth are now practically HIDDEN -- it's ONLY my lower

> > teeth

> > > that are visible when I speak. Similarly, when I smile, it's

> > mostly

> > > my lower teeth that show, and maybe ONLY 2 or 3mm of the

> > uppers -- so

> > > not only is my gummy smile gone (which was the point), but it

> > seems

> > > like about half my upper teeth appear " gone " as well (which

> > *wasn't*

> > > the point, to my knowledge)! Only when I smile as big as I can

> > -

> > > - almost " snarling " to lift my upper lip -- can you see the

> entirety

> > > of my upper teeth (and a *tiny* sliver of my gums).

> > >

> > > This seems/appears really unnatural to me -- it's normal to

> > see most

> > > or all of the upper teeth when people speak and smile, isn't

it?

> > Has

> > > anyone had a similar issue after a LeFort? Is this something

> > that

> > > may still be related to swelling (and so will improve over the

> > coming

> > > months)? If it's not related to swelling, has anyone had it

> > > corrected (either by having your ortho bring down level of your

> > front

> > > teeth a little lower, or -- horrors! -- another surgery?) I'm

> seeing

> > > my surgeon later in the week for an appointment, but I wanted

> > to get

> > > any feedback from people here who might have had similar

> > > issues/concerns.

> > >

> > > Thanks!

> > > Sara

[Guest guest]

Hey Sara. I can't say for sure what is causing your situation, but

I know that 6 weeks is still very early. I had my upper moved up

about 5 mm for a gummy smile as well, and I had the same problem

with only showing my lower teeth when I would talk or smile. It is

deceiving as you move along in recovery and see that the obvious

swelling is gone because it makes you think that this must be the

final result. But there is still a lot of internal swelling that is

not visible to you, but can wreak havoc on your facial expressions,

movement, etc. My smile relaxed as time went on, and now at 5 month

post op, it looks much more natural than it did at even 3 months

post op. As my smile started relaxing more, I actually got paranoid

that it was going to relax so much that it would be gummy again. I

show more gum on the sides of my smile now than in the front, which

I'm not crazy about, but my doc told me that the nature of my smile

line will always show some gum. If they raised it up anymore to get

rid of the gums on the side, less of my front teeth would show when

I smile. Just give it some time, but ask your surgeon at your next

appointment just to ease your mind.

--

>

> Hi all,

>

> I think I finally figured out what's looking so odd to me as I try

> to adjust to my new frontal appearance. I had a long upper

jaw/gummy

> smile (corrected by LeFort I, approx 5 mm upwards) as well as the

> genio to bring my chin forwards (not sure how many mm). It's now

> been 6 weeks, and I'm still somewhat swollen (the bruising is very

> nearly gone -- finally!). But today I realized that when I speak,

my

> upper teeth are now practically HIDDEN -- it's ONLY my lower teeth

> that are visible when I speak. Similarly, when I smile, it's

mostly

> my lower teeth that show, and maybe ONLY 2 or 3mm of the uppers --

so

> not only is my gummy smile gone (which was the point), but it

seems

> like about half my upper teeth appear " gone " as well (which

*wasn't*

> the point, to my knowledge)! Only when I smile as big as I can -

> - almost " snarling " to lift my upper lip -- can you see the

entirety

> of my upper teeth (and a *tiny* sliver of my gums).

>

> This seems/appears really unnatural to me -- it's normal to see

most

> or all of the upper teeth when people speak and smile, isn't it?

Has

> anyone had a similar issue after a LeFort? Is this something that

> may still be related to swelling (and so will improve over the

coming

> months)? If it's not related to swelling, has anyone had it

> corrected (either by having your ortho bring down level of your

front

> teeth a little lower, or -- horrors! -- another surgery?) I'm

seeing

> my surgeon later in the week for an appointment, but I wanted to

get

> any feedback from people here who might have had similar

> issues/concerns.

>

> Thanks!

> Sara