Med-CT vs Dent-CBCT?

I I'll I'll I'll record it and uh I'll put it I'll put it up on YouTube yeah yeah yeah that's all good so that you can rewatch it and you know just remind yourself of everything that taking the backs you know just realign you know make sure that the key Parts you know cool sounds good to me so what I'm doing is I'm trying to line up the underside of your eye with where I imagine your ear hole to be and you can see your ear gota the top of the year hle you can sort of draw a circle to be yeah Straight Ahead there yeah Y and then when I um look at it from the front so whoever you got to do the CT is done a very good job oh sweet they've actually listened to how we do it or how we yeah I printed out the instructions and gave it to them uh what's funny is I'm sure this happens in Australia too A lot of people had I think 64 slices or something like that didn't have the the 128 so I had to actually go to the hospital and uh I think I showed up like three places that at 64 before I could find the 128 I like yeah yeah no it's it's hard to find isn't it yeah yeah so if if you do a deep dive into it you you can get the the best CT scans in the world but of course if they don't have the best CT scan in the world um uh they're going to tell you that there is good enough yeah yeah so I I was definitely asking it's got to be 128 it's got to be8 no matter what and then I saw one of them was like 300 CT or slices or something like that and I was just like okay well he didn't say 300 so we're just going to not do that one um and and so we we we're looking to minimize radiation dose as well and so it's uh it's it's reasonably important to you know get it get it yes was definitely important to me I was I remember it was so funny I was looking at CT scan stuff and I was like uh you know I know it's safe relatively you're always like you know radiation though is it is it really you know am I if you go if you go to a dentist they they often con you into having a dental scan or a dental cone yeah the CB CT yep that's that's got three times the radiation of this CT scan yeah no I saw that and that was like uh I know I and I totally understood it because as far as I understand it too if I'm right I believe the 128 slice machine actually uses even less radiation than the 64 if I remember exactly exactly so it it so so what they're using less radiation and gaining more data from it yeah and the data they they get is quite new on so it's like when you look at light you've got the range of colors from Red through to Blue and you've got ultraviolet infrared so all the different wavelengths gives a different property and it's the same with x-ray you can have a range of frequencies and and some get absorbed by tissues and some just penetrate yeah and and so you can get different nuances according to the machine and you can't do any of that with con beam it's it's it's a hopeless terrible technology yeah yeah I remember there are some people you know they said that the cbc2 I guess a common problem that happens with it is it doesn't even get the full Imaging of what's going on in that jaw area or it's very easy for it to not do it properly and especially if they're not you know the the the professionals that are trained I definitely saw that being an issue it's funny I remember after getting the CT scan I immediately was like uh get going to get an oxie B and stuff I was like I got get the antioxidants going as fast as possible so well um I'm glad that you complied yes yes but as I say we wrote a book to try to explain why we want it so didactically one way as opposed to another all right now this is this is pretty um Central now you can see it goes through the back of your head some of the muscle attached uh a little bit more on your right than the left your your uh left brain case is a little bit bigger than your right uh maybe because you're right-handed um yeah and uh just just looking at the anatomy you you you can play over your left jaw joint there occasionally clicking and um we can have a look inside and just just looking at how it's spaced in there is a little it's a little bit of a a close there so you may may have torn the uh the uh the the disc just in this area but overall it it's it's in a nice nice spot you can see where it's just rubbing just just y y right right in there kind of closer to the ear hole there like you were saying um but having said that you're you're right George Jo um uh You' you've definitely lost the miniscus um in in here you can see that it's quite close in here so I would say that you probably had an episode of clicking uh on your right uh when you were younger go and that's since resolved and and the same issue is is probably just starting to happen on your left side interesting you can see uh your your overbite uh there um and the overbite actually represents how far your front teeth sit over your lower front teeth so it's a what we call a deep overbite but this is called an overjet it's it's how much space there is between your front teeth here against your your front teeth there yes and you can see just just uh lining it up with the center of your phas um so I just uh look at it from the front um so I've got this Center Line going pretty much directly between uh your um nasal bones there and just through your your forehead there it goes well and truly through the midline suture of your cranium down the back this is this is about as symmetrical as we can um uh we can make it uh for you consider considering that there's just a little bit of Left Right asymmetry you can see you got a little bit more brain on your left than you do on your right um but generally this this is this is you yeah yeah yeah that's definitely me now the the dental midline is ever so slightly of uh your true facial midline yeah um but you can see that it's going through the the the spine or what we call the nasal spine um but you can see that the middle of the nasal spine is deviated to this way to to your left side and then then you've got the the septum you can see how it really deviates to the right side oh yeah that's that's totally how it works with like my nose right now I can I mean I I I know it goes to the right and that's that's the funny part about that and you can see that the the nasal bones there go to the left as well so um it it's it's not necessarily because of trauma or anything but sometimes people um when they're three or four they can um bump their nose just in this area here uh on on the edge of a table or or the bed or something and and and it buckles it it buckles the cartilage and then the the buckling here then develops the bone and and and and that may account for why it's deviated this way but having said that there will be more air flow on your left side yes I definitely not breathe good to the left side of my nostrils I know that much and because you've got two Airways um the left side will have made the balloon in here a little bit bigger than this side and you can sort of see the difference um here it's a it's a bit Fuller than it is here yes and I I would say that's true I I I think uh whenever I've kind of like analyzed more of the right side of my face I've kind of felt like there was more developments going on um I mean even when I look like at my nose right here with the left side nost like I know that this left side nostril is definitely harder to Brea in than my right side so it is kind of interesting to see like these these asymmetrical factors not just about the jaw and what's going on here but I mean even you know things like the cranium and whatnot or you can see now that in your lower Dental midline it's uh well off to the right here and and so um it you what we would say is shorter on one side uh than the other but the both sides are short anyway yeah yeah the other thing is that you're you're starting to wear uh see this tooth is wearing a little bit more uh than maybe its counterpart here um only because of the of the Bad Bite so one one of the features of the Bad Bite is that um it causes this abnormal toothwear pattern uh to to develop um it would have would have been nice if the invisaline had been able to push this tooth a little bit further forward and maybe this one and this one here yeah and that's kind of where I was dissatisfied with the invisible L is I just didn't feel like I was it was going the wrong way and maybe it's just because the way that they organized their treatment plan um but I definitely did notice that that was one of the things I was kind of hoping would be a little bit more different and uh didn't seem like it really moved or changed that part of it that much okay so now we'll just have a look at your vertebral column here um we've got four of the vertebrae and we can see that um you got nice spacing here uh it's not not bad uh nice spacing these are the what we call the zyo poal joints um but occasionally you might get a bit of arthritis here and that can give you contribute to that occasional um headache or um General Facial Pain the the brain doesn't really tell you that it's coming from a joint it might say it's coming from an ear or a joint if it's painful but if you if you if you look um is a little bit of a Twist you can see The Twist uh there it's not quite in the center line and um and but that's that's a common finding it could be just positional where you were uh on on the itself but you can certainly start to see the asymmetry in the in the jawer itself so uh this side's longer but shorter this side's shorter but longer and you can see the height difference in the uh the base of the jaw on that side uh so so we're going to try to symmetri FY it all up I'm going to hide this High uh hide the the the vertebral column and I just want to have a look at your Airway now cuz um cuz you are very interested in that um give me just one moment here I'm going to turn my AC down a little bit cuz it is absolutely hot in my room okay that's all right gets hot in summer doesn't it there we go all right did you did you actually get to read my book I did not get to read your book yet no uh I've been procrastinating I was looking for a new keyboard board and uh I have this this Logitech that my a and my V keys are not working right now and so now I'm like staring at my Amazon cart and uh I'm just like I I got to I got to pull the trigger so um I'm probably going to end up getting here uh probably immediately after this honestly so I will say I was on your YouTube Heavy I watched a lot of those videos did you well you can see um where your nostrils are here there your nostril and you see the air air flow so we imaged the air itself and on the smaller side the the the side where you have le lesser air flow you can see these two sacks one is much bigger on your left than it is compared to your right and and the air sack itself it's like a balloon and as it inflates just like a balloon have you ever done paper mâché uh yes been a while since I have but I've done right so you put the the newspaper over the balloon and the bigger the balloon the the bigger the shell does that make sense and and what it expands is um is this part of the upper draw just that part there and you can see how much of a it it it's created a bigger volume here than has created here yeah yes yes and and the other thing it does is um it it it inflates uh the cheekbone itself interesting right so so the cheekbone on this side is overall just smaller than this side but I I would say to you they're both small but one side is smaller than the other does that make sense and that's contributing to the sense that it's it's small overall but it's also contributing to the fact that it's asymmetrically yes yes I definitely like I'm looking at it and I I see this like this asymmetry again like up in that area and it's something I've even like kind of like felt out between know just pressing on my cheekbones looking at them um it's particularly noticeable especially if I'm getting like a profile view and seeing my right side profiles over my left side now the colored bits this Central bit is all we're operating on we're not operating on the cheekbone but later on we can augment that cheekbone with bone I think I've seen that Peak is or or something like that well I can do it with Peak and but I can actually get a a a lot more volume with with um what we call zombie bone zombie bone okay zombie bone so zombie bone is is donated bone and um but it's it's just the bone itself and and we can fill this with bone but we can't do it at the same time as what we're going to discuss that would probably be weird so down the track um you'll notice after the surgery uh it will be all rather nice here but you'll feel that you don't have cheekbone and it will accentuate the fact that it's ASM does that make sense does make sense to me and I I think I remember uh seeing something on the website and one of the YouTube videos um I think it was it was in regards to the titanium plates that you use to hold the Jaws in the place and then uh when patients would come back uh 6 months or so later and they had a something similar going on uh that's when they make the decision to uh do the cheekbone augmentation to even out that asymmetry if if I'm correct that I believe exactly exactly you've spoken correctly there um now looking now again at this air flows so we've established that it's asymmetrical and it's deviated so one of one of the aims of the surgery is to um UND deviate the base of the septum but I can't UND deviate the top of the sept no one on this planet can yes I remember you telling me um the one of the issues with septoplasty um is they want to remove turbon knes and uh as far as I understand I don't think there's any issues with the turbon knes themselves they're they're occupying this volume here so if you remove them all of a sudden you get a big tunnel of air the problem is is that the turbonet has a function uh which is to warm and humidify the air so people talk of an empty nose syndrome when they have turbant removed it's not it's not a pleasant feeling so we want to keep the turbulent but we want to increase the volume around the turb so Pi the furniture but make the room bigger yeah so I I did have a question real quick too just regarding this because I know uh I I personally I'm not interested in set the plasty this little you know thing under my nose doesn't bother me that much um in in the case of uh like nose shape and stuff so in correcting uh asymmetry from jaw and whatnot uh is does rhino plasty fall in that category of removing furniture or is that a different kind of thing no RH a plasty is removing furniture from the room okay okay gotta so so I will attempt to symmetri FY your nose as much as I possibly can yeah and and you've got a great nose just it's probably the most prominent feature I'd say just about right but but it it it looks big but it isn't it's the rest of you that's small and that's kind of like the the takeway that I was getting to I was looking at a again Instagram your your Instagram specific um YouTube videos where I would see some people they' go through with like imdo and if they're younger or maybe they did go for the BX or something like that and uh the the tilting of the nose afterwards I remember you shared the one photo of the um Greek lady who she said she wanted to get rhinoplasty and I said that's a terrible I don't know why she would do that which is's beautiful so um that's interesting and uh I kind of I kind of I see that now the before and afters of those surgeries and their results good good I'm glad glad you're seeing the nuances yeah like all over that YouTube so so I I really want to um make both Airways bigger and but I can't inflate this cuz it's it's already set you know like the is set so um so now we're going to go where they connect you can see where they connect and they form this common pipe work and then it's incredibly narrow yes right there is where it's its narrowest part yeah and it's so narrow that it's blocking off just in those two two areas there too interesting so when you're lying on your back like this my tongue is going further back yeah so there's a muscle that literally connects here to here and it measures 34 mm which is a a normal length for basically everybody but it's Contracting to pull this bone up just like like the end of a tent hitching the the the strut of the tent upwards to open the space in the tent so you can slide the sleeping bag in yeah no it's it's kind of funny cuz I remember even looking after uh you know I got the CT scan and stuff done you know blocked Airway CT scan compositions and stuff like that to get an understanding and uh it's funny you know doing cycling or practicing singing whatever it is I notice it I I do think I notice it on a subconscious level and even sometimes acknowledge it on an actual level where I can tell there is definitely something that is blocking that lower area in some capacity whether it's from exhaustion or the other way around well you can actually see the muscle there can you see the muscle I do oh my go right so it it attaches to the inside of your chin just there and it comes all the way to this bone and you can measure it again it's you know 34 mm 35 there in that line and it's it's just like the bicep in your upper arm yeah yes yes pulling that forward to open this Airway and look where it funnels to that that little space so the width is only about 2 mm from there to there yeah that does not feel big enough yeah so that muscle only has to relax a little bit before it completely blocks off your Airway wow does that make sense that makes total sense I mean uh it's like I was saying like two years ago I used to be able to sleep on my back and uh it was fun but didn't didn't have any issues doing it and I look at that now I mean like I'm seeing like like you're playing the CT to me right now like with with how it's working and uh I mean I totally understand you know why I would switch to being a sid sleeper because it's not going to block my Airway and then exactly so so you're using you're using gravity to help hold your tongue forward but the the other thing you'll be doing is you you have to be opening your mouth to breathe through yes yes because lying asleep on your back with gravity or even on your side um it doesn't stop the relaxation of this muscle that occurs when you fall into sleep H does it does make sense I will tell you one other interesting thing about when I would fall asleep on my back in recent times so I would um I be laying back and um it it never lasted long I I'd say that after especially in the last year I've noticed it wouldn't last long I make it probably like 10 to 15 minutes and I just like I felt Not the Falling sensation quite like you know sometimes you fall you feel like you're falling you're like oh my gosh no don't want to fall I would feel that but in a way that was like my air felt relaxed but it didn't feel like I was getting air I think that's like a some way to describe that kind of sensation is um what I would feel when I would wake up and I'd be like I have to sleep on my side I have to there's no way I could sleep on my back right now that was just too much no well we're going to have to pull the inside of your of your jaw here as far forward as we can in order order to stretch that muscle yeah and you can see how much it drops the tongue the back of the tongue is dropped and it's contributing to this bit here the sense of fullness around your neck Goa and so by pulling this forward this will lift up and it will start to to take this away and it will give you a bit of a jawline yeah oh pleas that' be awesome I'll take it um but it is funny though cuz I I remember um I don't I remember what was I was watching but uh it was it was something along the lines of you know people before and after getting jaw surgery D jaw whatever it is they would I think every single comment I pretty much read about almost any type of jaw surgery uh whether it was going on Reddit I was looking at YouTube comments and stuff people that said they did it I don't think I saw almost a single comment that said my breathing wasn't better I don't think I saw a single one I think all of them said my breathing is better I can sleep and I'm waking up and I'm not sluggish and sometimes when I wake up I definitely I got to I got to get the the grease moving myself it's not just a a natural I'm awake I'm up get out of bed R let's get to the work so that's definitely something I've noticed well now we're looking at your jaw joints you see the jaw joints at the same level but they're slightly asymmetrical right but you see the considerable difference of this side your right side side in terms of height this is also called a curve of spay spwe you can look look that up where your front in sizes are high your back in back MERS are high but the these are dip and this is because of the smallness of the jaw itself yeah but you also see that it the bite itself isn't level and you can see how much higher it is on that psychop yeah and I feel that too so when I make it symmetrical I'm going to try to make the Moler symmetrical but it will accentuate the dip that you've got on your left side side right yes so no amount of Orthodontics is ever going to fix this yeah but let's have a look at your bite now and you can see that all your teeth meet on both sides yeah they don't they don't properly inter cuspate so the class two that point there in the blue has to be here it's like we call this a full premolar Class 2 on your right got the Circle of Death going and and on the on the left it's actually a normal custle relation so and I would say that's accurate um when I close my teeth I can I can even do it right now with my mouth closed I can feel like when I'm having these like like my left side this feels all right this feels good right side it's it's not right and I a plum yeah yeah and even the bottom of my teeth for example you know with my my two top teeth being more forward if I press my tongue I can't get my tongue to the top of my teeth if my teeth are closed so if I have my mouth completely shut it's not going now we talked before about you having had early joint disease on your right side there's a little bit of activity that represents uh a little bit of erosion or injury issues it's not osteoarthritis it's not rheumatoid arthritis it's just evidence that you've hurt it and it's repaired and on the right side it's just starting in this area too okay so so these are the issues that I see with you the asymmetry of the jaw the asymmetry of your cheekbones in the upper jaw and the asy and the shortness more of this side in the blue body um but the shortness in the light blue body more more more magenda purple or whatever they call all right so what are we going to do with you okay the first thing I'm going to do is I'm going to just take away your lower jaw because I want to position your lower jaw so it's it's it's in a I'm just hiding your lower jaw and I'm just wanting to position your upper jaw so that it is perfect yeah so I'm going to look at it at the front and the first thing I'm going to do is I'm just going to align your upper jaw so it's dead on Center you can see you have chipped your tooth here it's a little bit longer on this side it's a little bit higher on this side yeah so let's let's just make it a position that is spot on for you yeah sweet now what what I want to do is I want to be able to move the right jaw to the right just a little bit I'm going to open up the Gap here because you can see that you got a little bit of crowding here and I want it's very hard to straighten up because you haven't got enough space between your two front te so I just want to create a little Gap a bit of a Madonna look so that after the surgery you know in the states or you can even just get our dentists to do it and just send it to you in the post um we just just going to move the right side Sor hold on I'm going to move it to the right a little bit oh boy so now we just got a millimeter G it's not it's not too far that's 3/4 of a millim but you can't get 3/4 of a millimet expansion like that using invisaline yeah and that's the problem I think that's one of the things that I didn't enjoy about the invisaline experience is that when I got to the end of it this tooth on the left it was more aligned of course but it couldn't next to the tooth on the right it was just not possible right so now you see that when we look on true lateral the left side here is not in the same position as the green yeah so what I want to do is I want to just move it forward a little bit like that and then I'm just going to drop it down and then that starts to get a little bit more of that line that go right okay you can sort of see that this tooth is well forward of this tooth yeah yeah so what I'm best able to do is rotate the back outward back out oh oh okay I see what's going on now does that make sense and now it's starting to get a little bit the Symmetry is starting to come a little bit more I'm starting to see this start to make sense yeah yeah I get this but now it's really flicked this front tooth forward do you understand yes and but you starting to see that everything is now getting closer and closer to being perfect yes yes I definitely start to get that like uh that idea of of the jaw having that symmetry on the upper level just looking at the way like the the MERS in the back start to you know organize itself so now when I measure to the midline here 18.9 I can see how close I am to symmetry yeah I'm still not there yet I'm still all right so now I'm going to take your right jaw and I'm going to move it back to the left side oh so so now I'm getting a little bit closer and I just have to see how close I am so I'm 0 2 of a millimeter out here but I'm still out here a little bit okay and I don't know if you can see but this side is more vertical and this comes in a bit yes yes I do Noti up there so now I'm just going to flick this out because this is the smaller side right you can start to see the body of this is much bigger than this okay so I'm opening up this Airway on your right I'm seeing that and that looks awesome and now it's starting to look like it's getting closer and closer to where we want it to be yeah and you start to see how I'm getting the Symmetry yeah I see I see it's starting to now come along at first we're kind of figuring out where the position is now I'm looking at these teeth and where they're standing out and it feels a lot lot closer to uh where where it's supposed to be for for symmetry now just take off the measurement and you'll see I'm getting closer and closer to perfection yes 98.5 98.6 15.8 15.9 wow 25.8 26.1 right but you can see the difference now of how I've spaced this a little bit yeah and now we can see where the invisaline can push this and bring this back pushes out to create the symmetry of your Forefront teeth yes and then the jar itself has yeah sweet uh that looks great already okay now can you see now I've created space in a direct front back line I'm not splitting the gum what splitting the the gum there I'm not no I'm split the top and that is the groove into which you're going to put the base of your septer I'm going to trim this away you can see how I've opened up your nasal Airway on that side yes and now can you see how this is symmetrical yeah yeah I that looks very symmetrical um and the bite symetrical and now you see the gum is symmetrical and this little chip that you've got here is almost level with this too and I I easily can see how the orthodontics then at that point play in and symmetrical the jaw symmetrical and uh if this feels all the right ways uh what I've kind of like seen from the videos I've watched and uh this process now you can see now how much more I've moved out this side compared to that h yes yes and and you can see now the groove into which I can start to push the septum to let to sit in that Groove does does that make sense yes it does looks like it's going to be a fun recovery oh no no you'll be right you you you'll be able to instantly breathe oh yeah I'm so looking forward to that that is going to be awesome okay now remember I've got uh maybe maybe well you haven't read my book so you you don't know but we're now going to position your upper jaw relative to where it should be yeah it's an aspirational goal so what I want to do is I want to move that point there to this line here oh God that's a long way right that's a long way okay and then I'm going to put a rotation Point here and I just want to clock counterclockwise rotate this a little bit wow yeah amazing that's about as far as I can do it yeah I'm still short of this line but look how much I've had to advance it by yeah yeah but what it does highlight is just how small the cheekbones are yes now that I'm kind of like seeing this movement now I start to kind of see again where the the the cheekbones are smaller and now factoring in you know just how how it looks and what might need to be done after right so it's a long way forward but now it's in the position it should have grown if nature had been led to do its thing oh does that make sense yes this does make sense um yeah I totally see where these symmetry start start to fall in line and the movements that need to take place in order to get to that goal of the better breathing the better um you know turbon knes air flow and um just in general making this top overcrowding actually manageable by Orthodontics rather than just patch Solution that's not really going to get that to a better spot exactly well now I put your mandible back now it's going to illustrate just small with your lower jewelry you ready I'm ready we'll see what's going on here oh man it's pretty small yeah yeah it's kind of it's to me I think it's kind of funny to look at this to be honest with you just the movement and stuff um got a lot of work okay let's see what we can do now all right let's see if we can actually get it out that far yeah yeah let's let's take a look let's see what's going on here so that's our midline yeah I've moved it looks like you're not on the midline with your teeth it's more because this left tooth has to be moved towards the right yeah yeah yeah yep that makes sense because the canine is just as far away all the teeth are just as far away but this lower Dental midline has to be moved over right onto the midline yeah we're going to move it to the left one that's 1 mm 2 mm 3 mm 3.25 mm and now it's Mac bang in the middle yes yeah and I'm just going to rotate it now around this point rotate it round okay does that make sense so now it's starting to look pretty level you can see the jaw is level here too yeah chin is almost in the middle yes yeah that that's this is all starting to make good sense and now going to move it down 2 mm and now we're going to move it forward 1 2 3 4 how that 15 oh boy all right but that looks immediately starting to really see that symmetry come to life and really starting to see it um you know how it's supposed to look right but you can see that now these teeth are on almost the outside these are well on the inside so I just put a little rotation Point here oh yeah and you start to see that I'm getting symmetry but it's a hard Bang into that tooth yeah because that tooth need to have come for further forward yeah yes yeah all right so now I've got the roughness of it you can see that you're biting hard on this side but I have split your jaw into two hearts yes so now I'm just going to take the blue and I'm just going to rotate it down a little bit oh okay I think uh so the thing the term that's like a what counterclockwise tilt or something like that that's right it's a counterclockwise tilt okay I'm just going to move it forward a little bit now after the surgery you're going to be biting hard on this front tooth your teeth won't meet but as soon as that front tooth is moved forward it will meet gotta so then quick question in terms of the orthodontics then I guess we'll probably get to that but uh does that so is that something that starts immediately or is it something that's more um recovery kind of thing or the thing is you're going to find it very hard getting an orthodontist to sort of advise you um because they're not used to working with Australian surgeons you know yeah yeah and they they they're just going to look at you as a nutcase going to Australia anyway I can see that wow and now I'm just going to twist it out a little bit oh my god wow all right that is uh that is amazing now if I hide your upper jaw remember I said to you your bite was out on your lower jaw you can see now it's level yes yes slightly unlevel here but that's because you've worn this tooth down a lot yeah Y and I can feel that on my teeth and you know you remember when I said I'm accentuating this curve of spade yeah because it's it's a bit lower in these three teeth and it's on this side but it's yeah no I'm seeing on the side here both the sides I start to see that levelness that symmetry how it starts to level you know even out there right so these teeth look higher because these teeth are so worn down does that make sense and there dip is because the teeth are under erupted because of the original smallness of your jaw yeah yeah so so now I come back and I pull in your upper jaw and now we're going to play around a little bit with your jaw joint okay okay now you can see that this is getting there yeah yeah but you see how now it's not as full on this gel as it is on this yeah yeah okay so I'm going to get a rotation Point here and I'm going to rotate this out the jaw line itself okay and now these teeth start to look like each other they do this this looks a lot more like each other but I've made the bite here higher so now I'm just going to drop it down the back a little a little bit but now I've got this jaw line here just as wide as this yes and everything's starting to connect as well and this I've managed to tuck inwards in that direction wow this is this is good looks and the midlines in the middle yes yes yeah but you're biting hard on this tooth and you're biting hard on this tooth does that make sense that does make sense right now this part of your draw is the next bit oh boy fun part remembering we're trying to get an even height now you see how I've got that height there now spot on that's pretty cool isn't it yeah looks looks like it's going be it's now symmet right in the area so I'm going to try to do the same back here I think I think I've seen the terms I'm reading them over here the the bsso the bilateral Cal split osteotomy it is but it's on steroid all right the Arnold Schwarzenegger version of the bssr so I'm going to fold this out a little bit okay and as I fold it out I'm opening up the airway on the inside I'm stretching out to the side yeah I'm already kind of visualizing my head here the the muscles and and and the relaxing of it and it's this new opening of these Airways already starting to come into my head and I want to rotate it forward a little okay which shortens this distance to make that possible that I can actually Advance it that far does that make sense that does make sense and I'm going to do the same thing for the other side so I'm going to rotate it up a little bit actually I do it so you notice that I've got a lot more prominence here on this side than I do on this side yeah yeah yeah so now it's just as wide Yes again I'm seeing the Symmetry really starts coming to life the before and after and you see how now it's actually slightly longer here so I'm just going to rotate it up a bit yep so I'm reducing this distance yeah yeah yeah but this height I can't adjust as well but I'm going to rotate it in a little weird yeah so now I'm going to see if I'm symmetrical 51.7 oh nowhere near symmet so the solution is to rotate out some more all right 55 foot more right there yeah there it is 4.4 yeah so now I'm getting a symmetrical jaw yes I see all these pieces stting from the top out to the Ramis now adding up and then making sense with me not quite symmetrical yet are you happy with my job I think this is awesome this is uh like I said I watched a lot almost every video on your YouTube channel and to me again I the reason why I even first initially wanted to consult you is because um you know I saw these things online about uh you know you're you're great at what you do you understand um you know issues regarding uh you know how to design a face you have a book and everything and I think for me I mean I think it's easy to see you know working with a professional of some type in this field and to get you know kind of answers maybe it's not the right solution maybe you're kind of feeling like well you know like in my case for orthodonics I didn't really have somebody that I felt was giving me the upright answer about my teeth right I feel like what I'm getting right now are the answers to the solving of this breathing issue the solving of this asymmetrical issue but not in a way that I'm wondering what's Happening Here getting told like this is where the bite's going to be hard you're going have to figure this out with or orthodonics maybe it's through us maybe it's through somebody else it doesn't matter but these all feel like the correct answers based off what I've seen from your videos or watching just people's videos in general I haven't finished yet I haven't finished yet no no no no no keep going but see can you see how this is interfering here I do I do see how we got a little problem there and I feel I should give you a little bit more prominence it's here and straight yes and now it's in and I've got an even better bite and it's even more symmetrical yes and now it's even more symmetrical let's go and now I'd like just to tuck this in a little bit yep all right yep wow isn't that wow yeah it's just wow I mean so now I'm getting a very broad Jew yes yeah and I'm fitting in all the pieces they're congruent Mas up I can get this I know look look that just getting all the pieces nice yeah yeah it's getting pretty symmetrical yeah from when we started to looking at this now uh yes this this is symmetrical and this all feels this feels right to me this feels definitely right on the mark for what I looked at and kind of how I see my face and the issues that uh I face and and figuring this out this feels right okay now but I've got a problem Oh Boy where's your chin oh man got to got to get a a Genia poly a gen IOP there there it be we've got the chin in the center of your face too there's a big gap here there's a big gap here but the way we design the plates is to hold everything together yes so now it's in the middle it's symmetrical I've got gaps I've got gaps everywhere I've literally exploded demanda I was going to say this this is going to be a fun one it's a bit too over full here that front tooth is just in such the worst position yeah you see I'm like goang I'm trying to get this Gap as small as I can yeah so I brought that in a bit okay so now I'm getting a really symmetrical job yeah I see it on the on everything here is just really starting to just get put together starting I can already visualize the place uh I've seen you put on in the one video that I watched and how this is all kind going to kind of click together right so this is a very achievable distance it's a very achievable everything's Achi achievable now at that distance all very achievable and that looks symmetrical in a lot of ways this is this is awesome so now just going to move the chin just up now oh so now I've got a very nice overall achievable surgical advancement we right so this is all achievable yeah and now I could put in layer in your calvarium my dogs come in to my okay so now we've got this oh man this is awesome that's very very doable you've got a bad one single bad contact on that tooth gotcha so that after surgery you'll be biting only on that one too okay your jaw joints are still in the fossy I'll be but you see that I've relieved that bit of contact that was where it was rubbing just in there yeah I probably just pull that back a little bit with the engineering on this side I've increased the cont there a little bit but I I'll be bringing this Jewel back a bit just to open up this space a bit okay but that's very cheap Yeah Yeah from where we started this feels great this looks great um you know I I I remember looking at the profile just through the CT scan and I start to get an idea you know again from looking at the muscle looking at the airway these these papermache kind of air sack um how that air flow starts to move how these asymmetries start to get corrected and end up with results that solves two biggest problem so can you see how far forward on moving your JW yes oh my goodness we are we are definitely going uh that's like what that's got to be about 2/3 of an inch something like that so that is uh that's going to be fun 24 mm 24 mm yeah that's about uh What uh it's about 8 in an inch here so that's almost 1 inch of movement that's one in of movement wow that is that's going to be awesome looks like it's going to be a lot of fun to recover it will look it will look very different I was going to say um you know I've seen some some of these before and after results and some people totally different I mean um and not even just in the jaw area too I've seen it you know under eye areas um you know tip of the nose after you pointed it out to me I started noticing that a lot in people getting uh you know these types of surgeries and uh yeah this is definitely going to be a lot to say the least so well that's a very symmetrical Jewel and you're getting a lot of fullness in the gel area and the chin and jaw angles you could F you could fit your old jaw into this new jaw like it literally fits inside it wow so you can see how much widening you're getting across here wow wow that's awesome that is uh that's amazing wow this is uh this is amazing this is so interesting wow oh boy all right is this what you wanted to see yeah yeah I want to see as much as you you can show me and uh I mean I'm just a I'm already blown away so this is uh this is freaking awesome so we're moving from this to this wow that is going to be such a change and this is your face yes wow that's crazy I didn't even know you had the skin Bings like that that's that's so interesting so we're definitely filling out your lower jaw we're trying to make this as big as we can to match This Magnificent node yes please that would be awesome got the Circle of Death going on it's not the best simulation I was going to say I feel like it's going to be uh probably even sharper than that it you know this simulation software is actually terrible I don't know if that reflects the one in movement but uh so this is where you are now it this is still here in the simulator yeah that is so interesting it doesn't simulate it at all I was going to say I feel like I'm missing out this is not's possible yeah it's not it's not simulating at all this the that is that is a remarkable change yeah I mean I I can easily I mean this is a whole inch of movement I mean I can already imagine you know this upper lip area um an idea of how that's going to change I know a lot of people's lips do change when they go through this um you think about the lower jaw area here I mean you know just from the profile not going forward an inch you know oh my gosh and then obviously it's going down a little bit low too so I can't even begin to picture but uh I know it's defin going to be quite the change and wow it's going to be awesome okay now I've got another patient I've got to see now yes right so um I'll send you through estimates and costs and so forth to you cool all right that sounds good to me um you've answered all the the questions and everything so I'm I'm excited this is uh this is awesome so all right gosh dang that's okay yeah I'm super excited for this um I guess is that's prob I talked to Alex or you're going to send me a couple emails here and then um you said I think I remember seeing within the CT scan it's after you get it done it's uh I think it's a 3 months you have to uh do the scheduling or something like that yeah I can I can I I can work off this CT not a problem you just cannot you'll be biting high on that front tooth that front tooth will feel a bit Wiggly and saw and it will move on its own will settle more and more but you won't be able to eat anything more than soft food for the next 3 four 5 months until those teeth settle into each other and then do invisaline all right got let you go cool sounds good thank you so much k i really much appreciate your time and uh have a fantastic day in Australia organize organize another time to speak with me about the logistics of coming here okay cool that sounds good awesome thank you very much Paul I'll see you later bye bye