Bimaxillary Surgery with Genioplasty: Front-to-Back Correction
A triple-jaw case planned to correct the front-to-back relationship of the jaws. The upper jaw was moved forward and up, the lower jaw was set back, and the chin was repositioned separately.
- Concern
- Wanted to bite better
- Procedure
- Le Fort I, BSSO, genioplasty
- Focus
- Anteroposterior: maxilla forward, mandible back
- Diagnosis
- Skeletal Class III with anterior crossbite
- Age range
- 20s
- Follow-up shown
- 6 months after surgery
Front-to-back correction
The upper jaw was planned 4.0 mm forward and 3.0 mm up. The lower jaw was set back about 5 mm at the lower incisor and B-point. The chin was then brought forward 2.0 mm and up 3.0 mm with a genioplasty.
Diagnosis & concern
Her main concern was her bite. In her words, she wanted “to finally bite better.” Her lower front teeth closed in front of the upper front teeth, and her profile was concave.
Severe skeletal Class III: the upper jaw sat back and the lower jaw forward, with the chin point set back. The bite was Class III with an anterior crossbite (lower front teeth 4 mm ahead of the upper). The upper dental midline sat 2 mm to the right, with a mild tilt of the upper jaw.
Recommended at consultation: Le Fort I osteotomy, bilateral sagittal split osteotomy and sliding genioplasty.
Surgical plan
The movements were planned on a 3D model from the CT scan, upper jaw first, and transferred to surgery with splints, cutting guides and patient-specific plates.
Before
Planned| Segment | Planned movement | Amount (from plan) |
|---|---|---|
| Maxilla (upper incisor) | Forward / up | 4.0 mm / 3.0 mm |
| Mandible (lower incisor) | Back / up | 4.7 mm / 3.2 mm |
| Mandible (B-point) | Back | 5.1 mm |
| Chin (genioplasty) | Forward / up / left | 2.0 / 3.0 / 1.0 mm |
| SNA / SNB | Change | +4.4° / −2.9° |
Procedure
- Upper jaw moved forward and up (Le Fort I osteotomy)
- Lower jaw set back (bilateral sagittal split osteotomy)
- Chin moved forward and up (sliding genioplasty)
- Fixation with patient-specific plates (visible on the 6-month X-ray)
Records
View clinical records
Follow-up: 6 months
Photographs before surgery, during pre-surgical orthodontics (braces), and 6 months after surgery, with a lateral cephalometric X-ray.
Individual results vary.
Where
Treated at Maxillo-Facial Surgery Institute, Irvine. Our Surgeons