Q: Dr. Eppley, Just wondering what i could do about my midface deficiency. I had a cross bite and underbite correct by braces and now feel like I should have had jaw surgery …Just wondering your views on my situation.
A: I could not tell you based on your current pictures alone whether you should or should not have had maxillary advancement and whether that degree of movement forward would have made a noticeable aesthetic improvement. But after having been orthodontically corrected, that is an irrelevant issue now. The more relevant question now is whether any form of midfacial onlay augmentation will create the aesthetic improvement you seek. Paranasal implants do replicate in some ways at the nasal base level what a mild to moderate maxillary advancement would do in terms of horizontal projection. The next relevant question is whether any augmentation above that level (which is not what a maxillary advancement achieves) would also provide aesthetic improvement (malar vs malar-infraorbital augmentation) with the paranasal augmentation. I will do some computer imaging and get that back to you on both paranasal and cheek augmentation. It is a question of whether paranasal implants alone are adequate or whether a more complete mid facial augmentation is a better approach.
Dr. Barry Eppley