DJS vs. BSSO
I’m currently 6 weeks into the decomp process (Invisalign on top, braces on bottom), undoing camouflage orthodontics from 15 years ago in preparation for surgery. My surgery will be performed next year by a well regarded reconstructive cranio/maxillofacial surgeon at a major hospital in California. He has been extremely attentive, detail-oriented regarding both function and aesthetics, and very communicative throughout the process, which I’ve appreciated after reading so many stories from people who only meet with their surgeon once or twice before surgery.
During my initial consults with both my orthodontist and surgeon, DJS + possible genioplasty was discussed as the most likely plan. However, after CT scans at both the orthodontist’s office and the hospital, the conversation has since shifted toward lower jaw advancement only, with possible genio.
DJS is not completely off the table, but during my most recent check in my surgeon explained that he really likes where my upper jaw currently sits. He specifically mentioned liking my upper lip support and smile arc, and felt that the functional improvement from advancing the lower jaw alone would already be significant (I have a large overjet and deep bite, even after having camouflage ortho performed). He also indicated that if he were to touch the upper jaw, that movements would be minimal, and that the additional functional benefit from doing so would likely be minimal as well.
When I asked whether moving both jaws would create a better aesthetic result (more balanced profile, etc.), he didn’t seem to feel there would be much aesthetic gain either. Genioplasty will likely be an “on the table” decision after the lower jaw is advanced, which I’m comfortable with and trust his judgment on. My orthodontist also wholeheartedly agrees with leaving the upper jaw alone.
I’ve spent hours searching this subreddit for people who underwent only BSSO or BSSO + genio, but it seems much less common than DJS. I’m curious whether anyone else went into this process expecting DJS, only for the plan to shift to BSSO alone. If you had only BSSO (with or without genio), did you ever wish you had also had upper jaw surgery? I also have to admit, the thought of a slightly easier recovery is definitely appealing, I just want to make sure I won’t end up regretting a more conservative approach later on.