Hello everyone,

On my recent trip to Korea for voice surgery I heard about some of the chin/jaw work being carried out there. In particular a procedure called anterior segmental osteotomy. That got me thinking. I have a protruding mouth. It's not very obvious in photos but when I see videos of myself talking it's very obvious - all paving-slab teeth and gums. I was thinking for a long time about getting braces, but I'm now wondering if they'll really do very much. Here's a example of the sort of thing I had in mind.

http://t-www.idhospital.com/data_/bfaf/20121203141845_3.jpg

http://t-www.idhospital.com/dolchul/clinic/img/3_img3.gif

Sorry if this question has been asked before. I'm fairly new to the whole FFS thing.
Has anyone had this done? Is it a bad idea? Is straightening your teeth a better way to feminize your face? 

Quote from: Charlotte on June 28, 2014, 11:32:29 AM
Hello everyone,

On my recent trip to Korea for voice surgery I heard about some of the chin/jaw work being carried out there. In particular a procedure called anterior segmental osteotomy. That got me thinking. I have a protruding mouth. It's not very obvious in photos but when I see videos of myself talking it's very obvious - all paving-slab teeth and gums. I was thinking for a long time about getting braces, but I'm now wondering if they'll really do very much. Here's a example of the sort of thing I had in mind.

http://t-www.idhospital.com/data_/bfaf/20121203141845_3.jpg

http://t-www.idhospital.com/dolchul/clinic/img/3_img3.gif

Sorry if this question has been asked before. I'm fairly new to the whole FFS thing.
Has anyone had this done? Is it a bad idea? Is straightening your teeth a better way to feminize your face? 

Hi Charlotte, this is a really interesting topic to me. At the moment I have got braces on top and bottom, I may still have that other procedure as well. Getting your teeth straightened with braces will not address a protruding lower jaw, as you probably already know. It will improve your smile [I hope!!]. Can you give me any information on what actual procedures they can do to the chin and jaw, are they experienced and proficient in what they do, and most importantly the cost? If you cant, can you let me know an e mail address or a web site that I can go to, to find out for myself? Thank you

Quote from: GeorgieGirl on June 28, 2014, 12:11:44 PM
Hi Charlotte, this is a really interesting topic to me. At the moment I have got braces on top and bottom, I may still have that other procedure as well. Getting your teeth straightened with braces will not address a protruding lower jaw, as you probably already know. It will improve your smile [I hope!!]. Can you give me any information on what actual procedures they can do to the chin and jaw, are they experienced and proficient in what they do, and most importantly the cost? If you cant, can you let me know an e mail address or a web site that I can go to, to find out for myself? Thank you

Hi GeorgieGirl,
Here are a few of the clinics I've heard of:

http://eng.regen.co.kr
http://en.e-dream.co.kr
http://eng.idhospital.com/

Regen was the one I was looking at myself. All the clinics offer a wide wide range of chin/jaw work. For a protruding mouth they give you three options: Anterior segmental osteotomy (ASO), "two jaw surgery", and "three jaw surgery" (!) which is two jaw surgery combined with ASO. The thing which really interested me was that the work was done on the *upper* teeth, something I'd not seen before.

I've not really done any due diligence on this yet but I was very impressed with the highly advance medical treatment I got for voice surgery.

I don't think this is particularly related to FFS, but simply a cosmetic procedure, as a protruding mouth isn't a gender marker.  Straight or crooked teeth are also cosmetic and maybe even functional dentistry procedures, but are not gender dependant and hence not classed as FFS as far as I'm aware, correct me if I'm wrong. I have noticed most thread enquiries regarding Korea don't tend to be FFS enquiries, rather cosmetic. It is interesting though and I'm sure useful for some with interest in such procedures.

Quote from: calicarly on June 29, 2014, 04:43:49 AM
I don't think this is particularly related to FFS, but simply a cosmetic procedure, as a protruding mouth isn't a gender marker.  Straight or crooked teeth are also cosmetic and maybe even functional dentistry procedures, but are not gender dependant and hence not classed as FFS as far as I'm aware, correct me if I'm wrong. I have noticed most thread enquiries regarding Korea don't tend to be FFS enquiries, rather cosmetic. It is interesting though and I'm sure useful for some with interest in such procedures.

Hi calicarly, you do make valid points, but I can understand the questions being posed here. Its really about the Anterior Segmental Osteotomy v less invasive procedures. Really there is no way round it, if you've got a protruding lower jaw, then you need it adjusted by an appropriately qualified surgeon if you want to improve it. I believe that Charlotte may be reluctant to go under "the Knife", and is just hoping to hear of a less invasive way. Which of course there isn't,....... sorry Charlotte. Since you put this post up though Charlotte, I have been looking closer at S. Korea, and like what the possibilities might be. From what I've seen, I will be making Phone calls tomorrow to enquire about procedures and prices, for rhinoplasty, chin and jaw work, and any other procedures that they might do. It may not be classed as FFS officially by the Korean medical fraternity, but if it does the job and they do it well, who cares. Anyway I will let you, and any one else who might be interested, know how I get on.

Quote from: Charlotte on June 28, 2014, 11:32:29 AM
Hello everyone,

On my recent trip to Korea for voice surgery I heard about some of the chin/jaw work being carried out there. In particular a procedure called anterior segmental osteotomy. That got me thinking. I have a protruding mouth. It's not very obvious in photos but when I see videos of myself talking it's very obvious - all paving-slab teeth and gums. I was thinking for a long time about getting braces, but I'm now wondering if they'll really do very much. Here's a example of the sort of thing I had in mind.

http://t-www.idhospital.com/data_/bfaf/20121203141845_3.jpg

http://t-www.idhospital.com/dolchul/clinic/img/3_img3.gif

Sorry if this question has been asked before. I'm fairly new to the whole FFS thing.
Has anyone had this done? Is it a bad idea? Is straightening your teeth a better way to feminize your face? 

Hi again Charlotte, Can you tell me what was involved with your voice surgery. Do they use more advanced techniques, and has it more chance of lasting longer, or possibly even being permanent. How was the whole experience for you, and do you think it has been successful???

Sheesh, I'm going to wade in on this, as I'm not fond of this type of treatment.

First of all, have you had a full orthodontic consult with all treatment options explored?  There are a lot of options to explore before resorting to an osteotomy.

Second, the facial profile shown in that photo is what is know as bimaxillary protrusion.  That is common in (pardon my technical language) mongoloid and negroid populations, and is part of ones genetic make up.  Personally, I find it distressing that our sense of beauty has become so homogenised that the only acceptable facial profile is a straight one.  Nevertheless, if one wishes to change it, then there are many ways, depending on the situation.

1.  Dental arch expansion with orthopaedic appliances - if the dental arches are widened, protrusion is reduced.
2.  Reduction of tooth size - narrower teeth can be tucked in further, reducing lip protrusion.
3.  Premolar extraction if sufficient crowding is present.
4.  Palatal and lingual alveolar corticotomy (work on the bone holding the teeth in place) to allow further retraction of teeth, without having to involve work on the actual jaw bones.

Explore all these options first before going to something so radical.  I don't deny the fact that cosmetically, the result is pleasing, but there are risks in such a procedure
1.  Poor healing - the bones do not fuse back together after.  Lifetime of pain if it's really bad.
2.  Loss of tooth vitality - if the blood supply to the teeth is sufficiently disturbed, some or all of the teeth in the osteotomy may need root canal treatment, or may be lost,
3.  Long recovery period.
4.  Risk of alteration to the airway increasing the risk of obstructive sleep apnea.
5.  Poorly performed osteotomy will push the lower jaw back to a pathological position leading to long term jaw joint pain, possible muscular migraines, and compromised airway.

That's about as comprehensive an answer as I'm willing to give on the internets. 

Good luck with making your decision!

Hi everyone,
Thank you so much for your input into all this.  It's been really really helpful!


There's a thread on Susans about FTM 'giveaways'
https://www.susans.org/forums/index.php?topic=89399.20
people seemed to think it was hands, hips and small teeth. So I think for MTF it's kind of the reverse. No much I can do about hands and hips but I can fix my teeth! 

I need to get maximum bang for my buck. I'm not going to sugar coat it: I have an ugly mouth. I don't think a millimeter or two will be enough. The trouble is looking at before and after pictures on orthodontist's websites and I keep thinking that it may be a *technically* great result, but to the untrained eye it was an ugly mouth before and it still looks an ugly mouth after. For a start it's not going to make my giant central incisors smaller. My bunny teeth

One option is veneering my front 6 upper and lower teeth, or replacing them with dental implants. I know of a couple of girls who've done that.

GeorgieGirl, yes the voice surgery I had is permanent. Have a look at Jenny's video here:



and also her mega 50 page thread over on the voice surgery board and I've also got a thread going over there. 

Quote from: Charlotte on July 01, 2014, 02:16:36 PM

I need to get maximum bang for my buck. I'm not going to sugar coat it: I have an ugly mouth. I don't think a millimeter or two will be enough. The trouble is looking at before and after pictures on orthodontist's websites and I keep thinking that it may be a *technically* great result, but to the untrained eye it was an ugly mouth before and it still looks an ugly mouth after. For a start it's not going to make my giant central incisors smaller. My bunny teeth

One option is veneering my front 6 upper and lower teeth, or replacing them with dental implants. I know of a couple of girls who've done that.

I doubt it's the central incisors that are the issue.  Average width of a central is 8-8.5mm.   The laterals should be about 1mm narrower.  Chances ate your laterals are too small and it's a case of straightening the teeth, making space, and building up the laterals to the right size.

Avoid dental implants for as long as possible - they can have very nasty complications and don't necessarily last as long as some proponents would have you believe.

Quote from: luna nyan on July 01, 2014, 03:41:40 PM
I doubt it's the central incisors that are the issue.  Average width of a central is 8-8.5mm.   The laterals should be about 1mm narrower.  Chances ate your laterals are too small and it's a case of straightening the teeth, making space, and building up the laterals to the right size.

Avoid dental implants for as long as possible - they can have very nasty complications and don't necessarily last as long as some proponents would have you believe.

Ah! That makes sense. I measured my centrals and laterals, 11mm and 6.5mm (with an accuracy of probably +/- 1mm). Maybe I need to find a more agressive orthodontist. The one I saw just tried to sell me "Inman Aligners". I thought the reason dental implants were so expensive was because they lasted a lifetime? Perhaps I need to be more cynical.

Are you sure your centrals are 11mm?  They're rarely that wide...  But your laterals are definitely a fraction undersized compared to the average.

Shop around for an orthodontic provider, not necessarily an orthodontist.  A good one will give several treatment options, along with a likely final incisor position.

Dental implants are expensive because of r & d costs, and the costs incurred by the manufacturer in guaranteeing sterility.  Success rates 90-95% over 10 years, if well maintained, comparable to good crown and bridge work.  Keeping your own teeth as long as possible allows the fallback to an implant.  Implant failure fallback is another implant, usually involving a bone graft.

This kind of surgey can cause a large looking gap between the base of the nose and the upperlip, making your lower face look (much) longer.
Especially when this area is too flat.

Quote from: Dahlia on July 02, 2014, 07:08:16 AM
This kind of surgey can cause a large looking gap between the base of the nose and the upperlip, making your lower face look (much) longer.
Especially when this area is too flat.

That is a possibility, but is more dependant on the pretreatment position.   Most surgeons and orthodontist will consider the facial profile prior to treatment.

Hi all,
I just wanted to thank everyone who replied to this thread and to give a bit of follow up. Basically I just decided to go to a better local orthodonist. I decided the risk/reward was too high for the osteotomy.
Thanks again.

Charlotte

Quote from: Charlotte2 on July 26, 2014, 06:38:18 AM
Hi all,
I just wanted to thank everyone who replied to this thread and to give a bit of follow up. Basically I just decided to go to a better local orthodonist. I decided the risk/reward was too high for the osteotomy.
Thanks again.

Charlotte

I'm glad you decided against it Hun. It really isn't a gender marker at all, and if anything it sounds more like a racial marker . And the men and women I know with protruding mouths I have never seen them be shy or feel self counscious about em !

Quote from: Charlotte2 on July 26, 2014, 06:38:18 AM
Hi all,
I just wanted to thank everyone who replied to this thread and to give a bit of follow up. Basically I just decided to go to a better local orthodonist. I decided the risk/reward was too high for the osteotomy.
Thanks again.

Charlotte

You're welcome.  Good luck with your orthodontist - a good one who really understands what they're doing mechanically, as well as what possibilities treatment may do to tongue position and airway position is rare.  Most of them get used to doing things one way.  Be clear about your treatment objectives, and if you're thinking about getting your lateral incisors built up, get in touch with the cosmetic dentist who will do the build ups at the end.  Get the cosmetic dentist to make a target position/tooth size for your 6 upper front teeth to give to the orthodontist so that there are no excuses for where the teeth end up.  It's a bit more running around, but you'll get a happier result in the end.  Don't hesitate to get a few opinions.  Extra money spent consulting and planning will save you buyers remorse later.

I looked up the Inman aligners - they're just a modified form of the old spring hawley retainers I used to wear.  They might be more effective simply because of the properties of the nickel titanium springs/coils.