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Oral Surgery/maxillary set-back

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Question
after surgery
after surgery  

panorama
panorama  
hello,
i'm 26 years female physician
before three months i did maxillary impaction for gum smile
now the doctor said i need maxillary set-back surgery because i have maxillary protrusion and sever over-jet
he want to do the operation in 2 sessions
the 1st one to remove the plates he put during gum surgery with septoplasty (for nasal septal deviation)and turbinectomy and the second session to remove the premolar teeth and retract the maxilla backward

can u do it or not?
how much it cost?
do u have another treatment plan?
p.s. i wore braces when i was 13 and remove my 1st premolar on both sides but the maxilla advanced after 4 years

Answer
Hello Mays,

We would probably need more data to really assess your case including a full esthetic examination (frontal, profile, 3/4 views, smiling and at rest), a cephalometric X-ray in resting horizontal position etc...
I am not sure I understood the treatment plan of your surgeon.This does NOT seem right for me. First, in your kind of problem, you should only have had ONE single surgery for ANY kind of  3 dimensional repositioning of your maxilla including impaction, segmentation and retrusion if need be (which by the way you do not need!!!)You already have had 1st premolar removal and it would be a mistake to have the others removed as well. From what I can see, your overjet is due to the mandible which could be advanced. In any rate, you should see a very good surgeon who is familiar with Orthognathic surgery which does not seem to be the case. IN addition for optimal results, an orthodontic treatment is mandatory if you wish a stable result.

All the best,

Chawket MANNAI,DDS,Ph.D

Oral Surgery

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Chawket MANNAI, DDS,Ph.D Diplomate ABOMS

Expertise

I am a US board certified Oral & Maxillofacial Surgeon trained at UCLA and Parkland Memorial Hospital (Dallas) with more than 25 years of experience and will provide answers to all questions pertaining to the Oral& Maxillofacial Surgery region including Orthognathic Surgery, Trauma,TMJ, Implantology, tumour surgery (excluding cancer and Oral Dermatology),reconstructive surgery...

Experience

Extensive in all fields for the past 25 years hospital and office based.

Organizations
American Association of Oral & Maxillofacial Surgeons American College of Oral & Maxillofacial Surgeons British Association of Oral & Maxillofacial Surgeons

Publications
2006: Mannai Chawket Early implant loading in severely resorbed maxilla using xenograft, autograft, and platelet-rich plasma in 97 patients. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2006;64(9):1420-6. Bayonne, France. c.mannai@surgical.net 1998: Bell W H; Mannai C [An interview with Dr. W.H. Bell and Dr. C. Mannai. Interview by Colette Orival-Demange.] L' Orthodontie franšaise 1998;69(1):225-9. 1988: Abemayor E; Zemplenyi J; Mannai C; Webb D J; Canalis R F The fixation of malar fractures with the transnasal Kirschner wire. The Journal of otolaryngology 1988;17(4):179-82. Division of Head and Neck Surgery, Harbor-UCLA Medical Center, Torrance 90509. 1988: Wald R M; Abemayor E; Zemplenyi J; Mannai C; Lesavoy M A The transoral treatment of mandibular fractures using noncompression miniplates: a prospective study. Annals of plastic surgery 1988;20(5):409-13. Division of Plastic Surgery, Harbor/UCLA Medical Center. 1988: Di S; Bell W H; Mannai C; Seale N S; Hurt W C; Taylor J; Waite D E Long-term evaluation of human teeth after Le Fort I osteotomy: a histologic and developmental study. Oral surgery, oral medicine, and oral pathology 1988;65(4):379-86. Division of Oral and Maxillofacial Surgery, University of Texas Health Science Center, Dallas. 1988: Bell W H; Mannai C; Luhr H G Art and science of the Le Fort I down fracture. The International journal of adult orthodontics and orthognathic surgery 1988;3(1):23-52. 1986: Mannai C; Schwartz H C Juvenile nasopharyngeal angiofibroma presenting as a facial swelling. A case report. Journal of maxillofacial surgery 1986;14(6):329-31. 1986: Mannai C; Leake D; Pizzoferrato A; Ciapetti G; Sangiorgi C Histologic evaluation of purified bovine tendon collagen sponge in tooth extraction sites in dogs. Oral surgery, oral medicine, and oral pathology 1986;61(4):315-23.

Education/Credentials
DDS,Ph.D Fellow and Diplomate American Board of Oral & Maxillofacial Surgery Residency training:Harbor-UCLA MedicalCenter 1982-1985 Fellow OMFS Parkland Memorial Hospital Dallas Texas with William H.BELL

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