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Nora: Gonial augmentation / Wrap around / Malar Augmentation / Wrap around / PSI / Peek implants
Facial diagnosis
- Receding lower jaw
- Receding upper jaw
- Too short lower jaw
- Too short upper jaw
- Asymmetric face
- Too narrow upper jaw
- Open bite
Dental diagnosis
- Class II division 1
Treatment jaw surgery
- Advancement lower jaw (BSSO)
- Advancement upper jaw (Le Fort I)
- Chin surgery (Sliding genioplasty)
- Widening upper jaw (Smile distractor)
- PEEK implants engineered 8 months after the trimax osteotomies
Treatment aesthetic surgery
- Cheek augmentation
- Jaw angle augmentation
- PEEK implants engineered 8 months after the trimax osteotomies
About this case
When I first met Nora with her parents, I felt right away that by no means all would be achieved by one operation. The planning evolved like this: Transversal widening (smile distractor). Followed by non-extraction orthodontics. Trimaxillary advancement surgery (Lefort I advancement, BSSO advancement, sliding genioplasty advancement). The chin position was this way already advanced by over 15mm. Finally the facial bones were built up with the intention to create a face with totally normal looking features in flow and depth. Therefore PEEK implants were designed, realising normal vertical & lateral gonial dept and normal malar & infraorbital volumes. PSI (patient specific implants) were created with the help of a company making those implants in Peek, starting from our dicom files (bio engenering). The whole process including the orthodontics was realised over 18 months. The nicest thing as a surgeon having the opportunity to treat her was the trust that Nora gave me, and the trust the parents gave me as well.
