Dilemmas in treating a patient with severe bialveolar protrusion and a hyperdynamic lip

A black woman with severe bialveolar protrusion and a hyperdynamic lip on smiling was treated with molar and premolar extractions and orthognathic surgery, including a maxillary 3-piece LeFort, a maxillary segmental osteotomy, a mandibular segmental osteotomy, and a midsymphyseal ostectomy of the mandible.