Read the full account
I was referred in February 2024 after a diagnosis of mild to moderate obstructive sleep apnoea. The workup found the cause was skeletal: a severe transverse maxillary deficiency with bilateral posterior crossbite, a Class II maxillomandibular discrepancy with retrognathia, a maxillary cant and deviated dental midlines, together reducing my upper airway volume. Seven years of a mandibular advancement device had helped only partially. The plan was third molar extraction, surgically assisted maxillary expansion, orthodontic decompensation, then bimaxillary orthognathic surgery with a genioplasty.
The vocabulary that makes a plan precise for a surgeon is the same vocabulary that makes it invisible to a patient.
Here is the part that still strikes me. That first talk was February 2024. My surgery took place in the second half of 2026 - and the three-dimensional virtual planning was done only then, at the very end, after the expansion, after six months of consolidation, after the aligners and the fixed appliances. Every tool that could have shown me my own face arrived roughly two and a half years after the appointment where I had to decide. Not because anyone did anything wrong. That is simply where the tooling sits.
How the sketch was made
A 3D morphable head model fitted to my photographs, the skeletal movements my surgeon had described applied to it, and a generic soft-tissue response pushed through to the skin. Population averages, no patient-specific biomechanics, no claim of accuracy.
Why clinics, and not just me
Patients arriving at a first orthognathic consultation generally do not know that a genioplasty is a separate osteotomy from a BSSO, that maxillary advancement lifts the alar base, or that rotating the occlusal plane can change a profile more than advancing it. They are not incapable of understanding it. They have no mental model to attach the words to, and thirty minutes is not enough to build one out of speech alone. That is also why I wrote a plain-language glossary of the vocabulary, which clinics are welcome to hand to patients.
Surgeons already know this, which is why consultation time goes into drawing on paper, turning a monitor around, or reaching for someone else's before-and-after photographs of a different face with a different skeleton. JawSim replaces that last one. It puts the movement on this patient's face, in a couple of minutes, from photographs the practice already takes, at the stage where nothing else exists.