jaw surgery for someone with a good bite already

I have maxillary protrusion, a rather ethnic looking mouth (and there's nothing wrong with that) but I would just prefer having a flatter, retrognathic kind of upper jaw which isn't so full looking.

I already have a good bite, that is, my teeth are meeting vertically as they should. I am trying to get jaw surgery for purely cosmetic reasons obviously. I finally found a maxillofacial surgeon who appreciates the cosmetic concern behind such drastic reconstructive surgery...because other surgeons will find it unethical and only do it if its medically necessary. He appreciates it because he is one of the leading pioneers in Facial Feminization Surgery for transgendered women.

I haven't had a consultation with him yet but I think it will be a waste of time because I think he will take one look at my excellent bite and say "no. we would really have to flare out the teeth through orthodontics to prepare your bite for the surgery and this will change the perspective of chewing forever and you may suffer bone loss." I know this because others have told me this.

My question is, how do others who get jaw surgery for purely cosmetic reasons get accepted when their bite is already good? Because the pre-surgery orthodontic treatment will involve altering the good bite in detrimental ways you know.

[Howard Rosenberg, MD]

Maxillofacial surgery you describe is a commonly performed for cosmetic purposes.  If altering the position of your maxilla and/or mandible would result in a bite that is not good, then orthodontics is used to prepare the alignment of the teeth to fit perfectly after the bones have been moved.