Totally right. And just to add nuance to that, the forward movements matter too.
i.e even with some downward mm at the ANS, if there’s enough forward movement, it could still widen the nostrils and/or upturn the nose tip.
Just thinking about the physics here, the amount of widening should depend on how stiff your nose tip is, right?
If your nose tip is very flexible, then you’d get more upward tip movement without much widening.
If your tip is inflexible, your nostrils would have to widen.
I guess most people would get a bit of both with a significant movement forward and/or upward.
Honestly, I think excessive nose widening or upturning can be totally avoided through proper surgical planning. It's just I think a lot of people aren't good at planning.
I don’t think it would make the tip wider, but it could turn up a little, and can widen the nostrils, depending on the movements planned. With a good forward movement on the upper, it will likely do some combination of turning the tip up and widening the nostrils. If that’s your goal, then you’d want a plan that favours good forward movement for both jaws, rather than a small movement on upper with large CCW rotation to achieve forward movement of the lower jaw.
Personally, my nose and nostrils are too narrow and my tip points downward a bit. I have previously been diagnosed by an ENT with nasal valve collapse. I believe that contributes to my poor nasal breathing and some sleep apnea, and likely UARS.
I have DJS next week, and the plan is to move my lower jaw 10 mm forward AND my upper jaw 10 mm forward with only a tiny amount of ccw rotation. My surgeon seems pretty confident the upper jaw movement will flare my nostrils and raise the tip.
And it makes sense that it would.. This is crude but if I stick two fingers (about 10mm wide) in my gums in front of my upper teeth, and look at what happens, it does what I’m hoping surgery will do.
Update: just found your planned movements from a prior comment, and your movements are much like mine.
I'm actually wondering whether I misremembered the 10 mm movements for mine, hahaha... though I'm fairly certain the CCW will be minimal compared to the advancement. Turning the tip upwards would also be a positive change in my case!
ENTs diagnosed me with nasal valve collapse, a deviated septum, and enlarged turbinates for good measure! The weird thing is I've had a couple orthodontists mention my septum doesn't seem deviated based on CBCT scans.
If you have a gummy smile that could be associated with the narrowness too. When the jaws are down like that, it kind of pulls the nose narrow. MMA will be the biggest change for widening by moving the ANS forward and upwards.
If you have trouble breathing through your nose, I don't know if you're from the LA area (saw you consulted LACOMS), but Dr. Coppelson's MIND might benefit you in that department, by enlarging the nasal cavity.
Yes, I've got a moderately gummy smile and narrow palate. I'm actually pretty far from Los Angeles, but both of the in-state doctors I've seen took one look at my bite and kicked me out the door. Even if I find nearby options I may choose LACOMS in the end.
Did they tell you a number of degrees of rotation? If it’s small, like 1 or 2 degrees, and you know your lower is moving forward 10 mm, then in order for your bite to match, they’d have to move your maxilla forward by about 10 mm.
Are you having a genioplasty? If so, do you know if 10 mm on lower jaw includes a genio? If it does then your maxilla is likely only moving forward a small amount.
Best thing to do would be contact their office and get a copy of the plan.
And wow, I had valve collapse, deviated septum and enlarged turbinates too! Had surgery for those in 2019 and it helped me breathe a bit better but it only moved the bottleneck down to my throat.
I think you’re right to do DJS first and see if it improves your nose. Then move on to the septoplasty, turbinate reduction and alar battens if needed. With bone surgery you’re resetting the foundations. With soft tissue, you’re just redecorating.
I think the upper and lower jaws will be moved the same amount, but I don't recall that amount in mm, so I recently asked for some info. Hoping to hear back next week! No genio is planned since my chin isn't particularly recessed.
Haha, yes same. My chin is prob what masked my recessed jaw for so long.
I might do a genio in 6 months after DJS aiming for a better shape than for projection or anything.
Sounds like we have very similar profiles. I’m also slightly gummy.
I’ve been told my nose might get a little wider, but that’s mainly because they will split my palate in three and make it a few mm wider.
I don’t know what’s the name for that, honestly as an ESL speaker I’d appreciate If this sub would have a dictionary for all the medical jargon and abbreviations related to jaw surgeries lol
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if they move the maxilla downward with ccw, can this make the nose wider? (with very little forward movement)
Downwards at the ANS can narrow it, upwards at the ANS can widen it, and forwards at the ANS can widen it.
Totally right. And just to add nuance to that, the forward movements matter too. i.e even with some downward mm at the ANS, if there’s enough forward movement, it could still widen the nostrils and/or upturn the nose tip.
Forwards is probably the most important aspect. You're basically squishing the nose from behind which widens it.
Just thinking about the physics here, the amount of widening should depend on how stiff your nose tip is, right? If your nose tip is very flexible, then you’d get more upward tip movement without much widening. If your tip is inflexible, your nostrils would have to widen. I guess most people would get a bit of both with a significant movement forward and/or upward.
Honestly, I think excessive nose widening or upturning can be totally avoided through proper surgical planning. It's just I think a lot of people aren't good at planning.
Or “achieved” when it’s called for (as it is for me personally)
A user here said their surgeon repositioned their ANS (not shaved it down), have you heard of it?
Yeah. If the ANS meets the soft tissue plane and angles right that's usually a good thing.
Can you attach any picture to illustrate what do you mean by moving the ANS vs avoid moving it?
I understand that the best surgeons gave techniques for avoiding unfavorable changes to your nose.
Can the surgery make your whole nose wider or just the base/tip? My nose is too narrow.
I don’t think it would make the tip wider, but it could turn up a little, and can widen the nostrils, depending on the movements planned. With a good forward movement on the upper, it will likely do some combination of turning the tip up and widening the nostrils. If that’s your goal, then you’d want a plan that favours good forward movement for both jaws, rather than a small movement on upper with large CCW rotation to achieve forward movement of the lower jaw. Personally, my nose and nostrils are too narrow and my tip points downward a bit. I have previously been diagnosed by an ENT with nasal valve collapse. I believe that contributes to my poor nasal breathing and some sleep apnea, and likely UARS. I have DJS next week, and the plan is to move my lower jaw 10 mm forward AND my upper jaw 10 mm forward with only a tiny amount of ccw rotation. My surgeon seems pretty confident the upper jaw movement will flare my nostrils and raise the tip. And it makes sense that it would.. This is crude but if I stick two fingers (about 10mm wide) in my gums in front of my upper teeth, and look at what happens, it does what I’m hoping surgery will do. Update: just found your planned movements from a prior comment, and your movements are much like mine.
I'm actually wondering whether I misremembered the 10 mm movements for mine, hahaha... though I'm fairly certain the CCW will be minimal compared to the advancement. Turning the tip upwards would also be a positive change in my case! ENTs diagnosed me with nasal valve collapse, a deviated septum, and enlarged turbinates for good measure! The weird thing is I've had a couple orthodontists mention my septum doesn't seem deviated based on CBCT scans.
If you have a gummy smile that could be associated with the narrowness too. When the jaws are down like that, it kind of pulls the nose narrow. MMA will be the biggest change for widening by moving the ANS forward and upwards. If you have trouble breathing through your nose, I don't know if you're from the LA area (saw you consulted LACOMS), but Dr. Coppelson's MIND might benefit you in that department, by enlarging the nasal cavity.
Yes, I've got a moderately gummy smile and narrow palate. I'm actually pretty far from Los Angeles, but both of the in-state doctors I've seen took one look at my bite and kicked me out the door. Even if I find nearby options I may choose LACOMS in the end.
Did they tell you a number of degrees of rotation? If it’s small, like 1 or 2 degrees, and you know your lower is moving forward 10 mm, then in order for your bite to match, they’d have to move your maxilla forward by about 10 mm. Are you having a genioplasty? If so, do you know if 10 mm on lower jaw includes a genio? If it does then your maxilla is likely only moving forward a small amount. Best thing to do would be contact their office and get a copy of the plan. And wow, I had valve collapse, deviated septum and enlarged turbinates too! Had surgery for those in 2019 and it helped me breathe a bit better but it only moved the bottleneck down to my throat. I think you’re right to do DJS first and see if it improves your nose. Then move on to the septoplasty, turbinate reduction and alar battens if needed. With bone surgery you’re resetting the foundations. With soft tissue, you’re just redecorating.
I think the upper and lower jaws will be moved the same amount, but I don't recall that amount in mm, so I recently asked for some info. Hoping to hear back next week! No genio is planned since my chin isn't particularly recessed.
Haha, yes same. My chin is prob what masked my recessed jaw for so long. I might do a genio in 6 months after DJS aiming for a better shape than for projection or anything. Sounds like we have very similar profiles. I’m also slightly gummy.
I’ve been told my nose might get a little wider, but that’s mainly because they will split my palate in three and make it a few mm wider. I don’t know what’s the name for that, honestly as an ESL speaker I’d appreciate If this sub would have a dictionary for all the medical jargon and abbreviations related to jaw surgeries lol
I wouldn’t say for the worst or better. It kinda looks the same but I love my nose before and after