Vertical Maxillary Excess
Q: Dr. Eppley, Do you think the vertical maxillary excess surgery would change my face a lot or would I still mostly look like me still? And is this something you practice?
A: The answer to your critical questions can be summed up like this. You have a ‘modest’ vertical maxillary excess problem from which all of your aesthetic concerns emanate. The reality is that orthognathic surgery is ‘drastic’, and while solving all of your classic vertical maxillary excess problems, runs the aesthetic risk of changing the way you look and has it own set of risks and complications. The outcome may be great or could turn out that you wish you never had it done because you look different. That is the risk of having a ‘big operation for a proportionately smaller problem’. Conversely a less drastic approach (e.g., gummy smile lowering vestibuloplasty and sliding genioplasty which is what I would do if I was you) is aesthetically safer but will leave you slightly under corrected…but without the risk of changing your appearance so dramatically.
In short, you do not have a perfect treatment choice. You basically to have to choose between these two approaches to vertical maxillary excess based on what risk tolerance you have. The only way to decide is how much do you want to change your bite. If it is of lower priority then don’t do the maxillary impaction surgery. If it is of high priority then maxillary impaction surgery is the only way to go and the risks would be worth it.
I can speak to these treatment choices well because I am trained and have performed many of each so I have a unique experience perspective.
Dr. Barry Eppley