Open Septorhinoplasty and Bimaxillary Facial Surgery

As a warm and successful professional young woman in her twenties, Priya felt that her overall facial appearance impacted her confidence both
personally and professionally. She was not happy with her long face and self-conscious that her lower jaw jutted forward. She felt that her face
was out of proportion and she also complained that her bite was mis-aligned. Additionally, Priya was very unhappy with her nose. She felt it was
beaked, over projected, and that the tip was droopy and bulbous. She also had decreased airflow through her nose resulting in nasal sounding
speech.
It was decided to address all these issue in a staged approach which involved:

1. Orthodontic preparation to put the teeth in the correct position.
2. Bimaxillary Facial Surgery.
   This involved a Maxillary and Midface Osteotomy with advancement of these structures with a modified Le Fort I Osteotomy and
   Septoplasty as well as a Bilateral Sagital Split Osteotomy of the mandible to take the mandible back and therefore balance out the facial
   disproportions.
3. Open Septorhinoplasty
   Approximately a year later nose surgery was undertaken to give Priya the nose she always wanted. This involved reforming her nose
   completely. The tip was refashioned from being droopy and bulbous to being pretty, upturned, refined and fitting her face. The beakiness
   of the nose was re-fashioned so the nose was straight. The broadness of the nose was also addressed, and the nose straightened. Normal
   breathing was restored, and the nasal speech receded.

Below are the photos BEFORE the commencement of any surgical treatment:

PRE-SURGERY ORTHODONTIC PREPARATION VARIOUS POSITIONS

Intra-oral photos showing theorthodontic preparationrequired to co-ordinate the top and bottom dentition for the forthcoming double jaw surgery.

PRE-SURGERY PHOTOGRAPHS -FRONTAL VIEWS

Pre double jaw Bimaxiallary Osteotomies and Pre Septorhinoplasty, showing long face, sunken in midface, projecting lower face and large broad nose.Pre double jaw Bimaxiallary Osteotomies and Pre Septorhinoplasty, showing excessive gum and tooth show, exacerbating long facial appearance, tipping down on smiling of the nose tip.

POST-SURGERY PHOTOGRAPHS -FRONTAL VIEWS

6 months Post Open Septorhinoplastyand 2 years post double jaw surgery with Bimaxillary facial osteotomies.

3 YEARS POST-SURGERY-PROFILE VIEWS

Pre double jaw BimaxiallaryOsteotomies and Pre Septorhinoplasty, showing long face, sunken in midface, projecting lower face and large broad nose, from start to finish of her treatment.