Patient's Query
Hello,
I am a 28-year-old female, and I went through two surgeries to correct my gummy smile and receding chin. I also had lip incompetence before these two surgeries, but my issue is that this lip incompetence is still present.
I had SARPE (surgery-assisted rapid palatal expansion) performed last year, where my surgeon expanded my maxilla by mm, and DJS was performed on after that, where he did a maxillary impaction, MMA (maxillomandibular advancement surgery) with genioplasty.
My issue is, I still have lip incompetence, and when I smile big, there is still a lot of gum that shows. I do not know what is going on.
Kindly suggest.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern.
I am a maxillofacial surgeon and will be answering your query shortly. Please check your follow-up messages.
Thank you.
Patient's Query
Hello doctor,
I underwent sarpe surgery where he expanded my maxilla by 6 mm. He installed a KLS Martin RPE on my palate that I had to keep for one year. I started an Invisalign treatment after that, but my orthodontist considered that I could be ready for my DJS.
After my surgeon removed my palate expander (KLS Martin RPE), he did a maxillary impaction, a mandibular advancement, and a genioplasty. So, I am now more than seven months post-DJS.
I thought that my lip incompetence was because of the swelling at first, but now that my face has healed a lot, it seems that I cannot shut my lips together without having some sort of mentalis strain on my chin.
Please help.
Hello,
Welcome back to icliniq.com.
Yes, I have analyzed the X-ray (attachment removed to protect the patient's identity). It seems like your main problem is the mental strain, right? I want to confirm with you one main thing:
I want to specifically know this as it can be a game-changer for you to set the lip incompetence right. Whether the teeth are extracted or not. Also, one more thing, my diagnosis and treatment suggestions for you will depend on your bite as well. I want to ask-
These answers will certainly determine how you can proceed to get rid of lip incompetence. Lips are soft tissue, so when the jawbone is correctly set, in simple terms, your lips will automatically have an esthetic closure with the correct VDO (vertical dimension at occlusion). So I am waiting for these answers, my plan will be according to these.
I hope I cleared all your doubts.
Thank you.
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Answered byDr. Achanta Krishna Swaroop
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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