jawsurgeryforums.com

General Category => Emotional Support => Topic started by: some1afterall on October 25, 2017, 09:39:09 PM

Title: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on October 25, 2017, 09:39:09 PM
This is my first post and I'm glad I have this outlet to vent. I was told I needed jaw surgery when I was 14 years old and 16 years later, I finally had the insurance and means to make it happen. Prior to jaw surgery I felt attractive and liked my face from the frontal view and my big smile. I was embarrassed of my profile and when I smiled big and showed a "horse like" smile with a lot of gum and large open bite. In November 2015 I started orthodontia and had double jaw surgery (le fort and BSSO) in august 2016. 6 months later I had a 4mm genioplasty. My braces came off August 2017.

The results have been devastating to me. My bite is closed and even, but the soft tissue and facial proportions, in my opinion, are not good. My face looks even longer than before and more masculine. My philtrum is longer and my nose wider, and my whole face looks longer. I am very depressed and don't know what to do. My lips also seem thinner.

I'm wondering if a smaller surgery like genioplasty reversal or modification or rhinoplasty or lip fillers could help to achieve a more feminine look, or if I'd have to redo my whole jaw surgery ;-/

Here are some pictures, pre-surgery is first, post-surgery is after
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: Lazlo on October 25, 2017, 10:55:02 PM
nah you're being paranoid. you don't even look different at all. nose, etc. looks the same. what looks better is you have less of that weird gummy smile. don't do any revisions at all.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: Framboise on October 26, 2017, 05:12:11 AM
Hello,
do you have more after photos please ?
I see no difference
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on October 26, 2017, 07:31:32 AM
here's a profile progression. right is original, middle is after double jaw surgery, left is after genioplasty. I have worried that even thought the genioplasty was only 4mm it made me look less feminine.

Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on October 26, 2017, 09:49:35 AM
here's another after with chin
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on October 26, 2017, 10:00:58 AM
here's another after with chin

Please confirm if this photo is actually an 'after' or before.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: tdawg on October 26, 2017, 10:03:32 AM
This seems like a great result to me. You can tell from the profile pictures that you had so much strain before during lip closure which now seems to be resolved. In addition you have a straight, orthognathic profile. Dont change anything.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: Framboise on October 26, 2017, 12:29:17 PM
On the last photo, you still have a little gummy smile, is it normal ?

I agree with tdawg, regarding your profile, the results is amazing, especially the genio.
Now I understand you can't recognize yourself in a mirror, it can be very disturbing.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on October 26, 2017, 01:07:11 PM
On the last photo, you still have a little gummy smile, is it normal ?

I agree with tdawg, regarding your profile, the results is amazing, especially the genio.
Now I understand you can't recognize yourself in a mirror, it can be very disturbing.

We need her to confirm the last photo is actually of an 'after'.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on October 26, 2017, 01:37:14 PM
The last photo is an "after" photo.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: tdawg on October 26, 2017, 02:48:15 PM
The last photo is an "after" photo.

So here is the way I see it. I am in a similar situation as you were pre genioplasty. Basically there are two approaches to long face syndrome. Most surgeons impact the maxilla to get ideal incisor display at rest, and then move the lower jaw in essentially a straight line to make the bite fit. Surgeons like Gunson and Wolford do impaction with more counter clockwise rotation to change the mandibular plane angle which usually gives a better aesthetic result but is considered unstable by some surgeons. Surgeons who do the first method usually do a genioplasty to help make up for the difference. You and I both went to a surgeon that does more of the first method. They possibly slightly "under impacted" you to prevent the aging effects that an impaction can have, especially on women. Or you could have a hypermobile upper lip. The best way to tell would be to take a photo from the front with lips at rest. If you have normal incisor display(2-4 mm for a woman I think) then its a hypermobile upper lip.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on October 26, 2017, 02:54:45 PM
The last photo is an "after" photo.

OK. Thanx for clarifying. Then, it looks like you have some hardware (braces, appliances what ever..) and you are trying to hide them by lifting both your lower and upper lip upwards in your smile. Stretching the lower lip upwards would make the chin look longer and hoisting the upper lip upwards would of course, show more gum.

Basically, it doesn't look like a surgery to address a gummy smile would do. It looks like more of an effort on your part to contort your smile to hide something.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on October 26, 2017, 05:24:22 PM
hypermobile lip? I know that my philtrum seems lengthened after the le fort, but it may be that I had an open-over bite previously that made the upper lip paper shorter and more curved. I have some teeth show at rest, probably around 4mm.

the genioplasty was a secondary surgery, done 6-months after the le fort and bsso electively. I did it to enhance my profile, however, what I didn't realize is that moving the chin forward would potentially make my frontal view appear longer. When my chin was slightly recessed it had the appearance of my face being shorter from front view, and in my opinion a more feminine.

All in all, I've had a difficult time adjusting to the changes. I had idealistic expectations and wasn't prepared for the results to be nothing short of everything I dreamed of ;-/

It's nice to hear I'm not totally crazy and there are other jaw surgery patients that have thought of and had some of the same feelings and questions...
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on October 26, 2017, 06:55:21 PM
hypermobile lip? I know that my philtrum seems lengthened after the le fort, but it may be that I had an open-over bite previously that made the upper lip paper shorter and more curved. I have some teeth show at rest, probably around 4mm.

the genioplasty was a secondary surgery, done 6-months after the le fort and bsso electively. I did it to enhance my profile, however, what I didn't realize is that moving the chin forward would potentially make my frontal view appear longer. When my chin was slightly recessed it had the appearance of my face being shorter from front view, and in my opinion a more feminine.

All in all, I've had a difficult time adjusting to the changes. I had idealistic expectations and wasn't prepared for the results to be nothing short of everything I dreamed of ;-/

It's nice to hear I'm not totally crazy and there are other jaw surgery patients that have thought of and had some of the same feelings and questions...

IMO, you had unrealistic expectations to expect to look just like you did to YOURSELF from the front but ALSO have GREAT improvements to the profile.

The surgery you got was aimed at reducing the gummy smile, fixing your bite and giving more jaw/chin balance to offset the CONVEX profile. It acheived that.

Unless you can hold a side mirror as to focus on the PROFILE and wish and want your old profile back, your regret is self negating, self conflicting and irrational.  The rational outlook would be to APPRECIATE the profile improvements and NOT deny them or block them out in
in favor or nursing regret about the frontal changes.

Although there are things you could do to further improve, the fact that you're regretting a good outcome due to being 'attached' or 'used to' a look from the front that did NOT look good from the SIDE is not a good indicator for me to suggest any. You need to resolve the CONFLICT
you have about self negating unrealistic expectations you had as to appreciate the WHOLE change
 before entertaining anymore surgery, lest you get attached or 'used to' one thing that will look different to you if you get another thing you don't like changed.

Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: girl on October 26, 2017, 07:33:11 PM
So here is the way I see it. I am in a similar situation as you were pre genioplasty. Basically there are two approaches to long face syndrome. Most surgeons impact the maxilla to get ideal incisor display at rest, and then move the lower jaw in essentially a straight line to make the bite fit. Surgeons like Gunson and Wolford do impaction with more counter clockwise rotation to change the mandibular plane angle which usually gives a better aesthetic result but is considered unstable by some surgeons. Surgeons who do the first method usually do a genioplasty to help make up for the difference. You and I both went to a surgeon that does more of the first method. They possibly slightly "under impacted" you to prevent the aging effects that an impaction can have, especially on women. Or you could have a hypermobile upper lip. The best way to tell would be to take a photo from the front with lips at rest. If you have normal incisor display(2-4 mm for a woman I think) then its a hypermobile upper lip.

This, definitely. Along with palate expansion, especially in cases where there's an open bite.
 
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on October 26, 2017, 07:57:26 PM
So here is the way I see it. I am in a similar situation as you were pre genioplasty. Basically there are two approaches to long face syndrome. Most surgeons impact the maxilla to get ideal incisor display at rest, and then move the lower jaw in essentially a straight line to make the bite fit. Surgeons like Gunson and Wolford do impaction with more counter clockwise rotation to change the mandibular plane angle which usually gives a better aesthetic result but is considered unstable by some surgeons. Surgeons who do the first method usually do a genioplasty to help make up for the difference. You and I both went to a surgeon that does more of the first method. They possibly slightly "under impacted" you to prevent the aging effects that an impaction can have, especially on women. Or you could have a hypermobile upper lip. The best way to tell would be to take a photo from the front with lips at rest. If you have normal incisor display(2-4 mm for a woman I think) then its a hypermobile upper lip.

For too much anterior gum show and long front teeth with that, they can do an anterior impaction which IS CCW. Although posterior downgrafting also is a method for CCW in cases where the anterior maxilla can stay pretty much as is, if you look at her before photos, she also has posterior gum show. So, posterior downgrafting would just give MORE of that.

As to 'hyper mobile' lip, it looks like she is altering her lip posture in the last photo she gave, perhaps to hide what looks to be some kind of hardware or braces in her mouth.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on October 26, 2017, 09:30:29 PM
Thanks for your replies, they have given me things to think about.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: PloskoPlus on October 27, 2017, 03:13:00 AM
Vertical changes from the front can be very hard to adjust to. I think your result is quite good.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: tdawg on October 27, 2017, 05:24:19 AM
Also another thing to consider is that in the photo you most recently posted you are wearing a hat and a hood, which hides your hair and I think has an aging effect. I think your result is probably as good as you could get with the typical approach that most surgeons take.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on October 27, 2017, 07:39:34 AM
here's a post djs/genio/braces pic from front with hair.

[attachment deleted by admin]
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on October 27, 2017, 01:28:07 PM
here's a post djs/genio/braces pic from front with hair.

OK. So that shows an improvement to the gummy smile and better balance. The chin does not look 'long' either. You just got 'used to' looking at it when it was RECEDING into the background in frontal view. It's just more prominent in the foreground which is just a universal law of perspective where objects brought CLOSER to view will look larger than they did when they were further away. There is nothing aesthetically 'objectionable' to 'regret' with where your chin is now.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: girl on October 28, 2017, 01:03:26 PM
You look nice in this picture.

As you didn't get the SARPE done, I would consider adding some veneers to the back to reduce the buccal corridors. That might make your face seem less "long" to you as well.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: JigJaw_:/ on February 23, 2018, 02:47:21 AM
This is my first post and I'm glad I have this outlet to vent. I was told I needed jaw surgery when I was 14 years old and 16 years later, I finally had the insurance and means to make it happen. Prior to jaw surgery I felt attractive and liked my face from the frontal view and my big smile. I was embarrassed of my profile and when I smiled big and showed a "horse like" smile with a lot of gum and large open bite. In November 2015 I started orthodontia and had double jaw surgery (le fort and BSSO) in august 2016. 6 months later I had a 4mm genioplasty. My braces came off August 2017.

The results have been devastating to me. My bite is closed and even, but the soft tissue and facial proportions, in my opinion, are not good. My face looks even longer than before and more masculine. My philtrum is longer and my nose wider, and my whole face looks longer. I am very depressed and don't know what to do. My lips also seem thinner.

I'm wondering if a smaller surgery like genioplasty reversal or modification or rhinoplasty or lip fillers could help to achieve a more feminine look, or if I'd have to redo my whole jaw surgery ;-/

Here are some pictures, pre-surgery is first, post-surgery is after
I think you look great. Nothing manly at all about the chin. You're pretty.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on March 07, 2018, 10:22:39 PM
Thank you. I think I look okay sometimes when I’m smiling and from certain angles, but the front view with expressionless face I like the least.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: Lazlo on March 08, 2018, 02:37:48 AM
your results are fine you look better.


problem is jaw surgery is like such a friggin primtive cave-age procedure by this time.

i mean there will be future people who look back on this time and say stuff like: "They did what? Tie cement brackets to your teeth with wires and f**king then saw your jaw open and remove teeth and you'd be in this s**t for years??? And you'd looose sensation in your lip" And some faggot with a saw would saw your jaw without actually imaging exactly where all your nerves were cause he'd be doing it blind some crap called a bsso bulls**t"

In fact, I can't believe we're still living in such horribly primitive times. We think the 19th century was ghastly but we're just as bad given the way things should be going.

I mean there should be nano technologies and stem cell derived bones that grow your own for implants and grafts and f**king lasers that do precision cuts without disturbing your nerve and blood supply whatsoever.

Fifty years and that's where we'll be. I have so much envy for the kids of the future.

Also, lady, you're like me an older patient and jaw surgery always reeks more havoc on our faces, i can see your teeth are quite yellow from being in braces as an adult, that's not staining that's enamel loss. I have it too.

Honestly, I can confdiently say looking back 8 goddamned f**king years. I wish I had never gotten any of this into my head.

But I probably wouldn't have listened. f**k me.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on March 08, 2018, 08:51:26 AM
Lazlo,

What happened to you? You seem very angry and spiteful.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: Lazlo on March 08, 2018, 05:13:08 PM
Lazlo,

What happened to you? You seem very angry and spiteful.

jaw surgery happened and i wish i had never had it done. its a very awful procedure.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: jusken on March 12, 2018, 06:53:25 PM
Hey OP,

Your results are fine.  The remainder of the problem is the same issue I have and why I was so torn about my results post jaw surgery.  The issue is tissue loss.  You'd be surprised how much of a difference it would make.

I would highly recommend not doing anything about it or looking into it much though.  I spent a couple years looking into this (many consultations and thinking hard on it) and currently the solutions are terrible.  If you consult with doctors there will be many that might suggest things like fat grafting/dermal fillers/etc.  But, don't do it!  Your tissue loss is 100% evenly distributed like mine, and the only true solution would just be to magically gain fat everywhere in your face where it has been lost.  Also magical bone regeneration on your teeth (like mine as well) would be amazing!

The good news is it looks totally natural (though gaunt) and SO much better than putting soft tissue in targeted areas like all the idiot doctors are doing right now.  Certain ones of us have super fast, lean metabolisms and start to look gaunt in our 30's onward.  The only true solution is to live with it - or wait until some fantastic new soft/hard tissue regeneration comes along.  There are increasingly many companies investing in Biotech, and we or people of the future will be able to benefit from it at some point.

Hopefully that's not bad news for you...
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: jusken on March 12, 2018, 07:35:21 PM
This might be really bad form, but here's a quick paintover to illustrate this.  Let me know and I'll take it down immediately!

[attachment deleted by admin]
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: ditterbo on March 12, 2018, 08:02:04 PM
Are you implying your tissue loss came from the jaw surgery, jusken?
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: jusken on March 12, 2018, 08:24:15 PM
Are you implying your tissue loss came from the jaw surgery, jusken?

Nope 100% genetic for me.  I've always had a hyper metabolism and became very gaunt in my early 20's onward.  But I did get some bone loss after all the surgery/adult braces if that's what you're referring to.  Seems very common.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: ditterbo on March 13, 2018, 07:44:02 AM
Nope 100% genetic for me.  I've always had a hyper metabolism and became very gaunt in my early 20's onward.  But I did get some bone loss after all the surgery/adult braces if that's what you're referring to.  Seems very common.

Just curious, though I was referring to the tissue loss since I haven't heard of that post op.  Neither have I heard about bone loss post op - I've heard of adult braces hurting the teeth roots and interdental papilla. What bone loss is this you've experienced or that you say is common?  Thanks.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: jusken on March 13, 2018, 07:53:00 PM
Just curious, though I was referring to the tissue loss since I haven't heard of that post op.  Neither have I heard about bone loss post op - I've heard of adult braces hurting the teeth roots and interdental papilla. What bone loss is this you've experienced or that you say is common?  Thanks.

Different people definitely have different outcomes with adult braces.  Some don't experience much if any bone loss.

My black triangles are certainly related to tooth bone loss due to trauma/movement, which leads to alveolar crest bone loss, which leads to black triangles - gum recession.  There have been enough reports of this on here and online that I find it conclusive.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: april on March 13, 2018, 08:33:30 PM
Nope 100% genetic for me.  I've always had a hyper metabolism and became very gaunt in my early 20's onward.  But I did get some bone loss after all the surgery/adult braces if that's what you're referring to.  Seems very common.


I noticed gauntness on one side of my face after braces as a late teen. Not sure how to explain it as I have an identical twin who didn't experience this after the same orthodontics.
 
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: jusken on March 13, 2018, 10:21:17 PM

I noticed gauntness on one side of my face after braces as a late teen. Not sure how to explain it as I have an identical twin who didn't experience this after the same orthodontics.

I'm not sure the why that would happen for you, but I too have an identical twin and we had completely different orthodontic cases in our teens.  He had a very wide arch with only a couple years of braces.  I had 8+ years of braces, very open bite, extractions, and a narrow arch.

Anyway, hopefully we haven't gotten too off track in this thread.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on March 14, 2018, 09:42:52 PM
Wow-that’s very interesting. So you softened facial lines and basically gave me a virtual eyelid surgery: the result is I look much younger, more youthful.

I’m weary of undergoing more major surgery. I have a large, prominent nose and post-djs wider base + more nostril show but rhinoplasties have such varied satisfaction rates I just don’t think it’s worth it.

I consult with Jamali tomorrow and Gunson I’m April, but mostly for information. I have come out if djs with a closed bite, no numbness and intermittent, pain in my left tmj that I feel is bearable. I don’t want to have more regrets and possible disability.

Thank you everyone for your input.

Puts things in perspective to hear that other people had less than perfect outcomes and maybe things didn’t turn out all that badly.



[attachment deleted by admin]
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: jusken on March 15, 2018, 12:03:12 PM
That's smart that you're wary of additional surgeries.  I want to reiterate that I'm NOT recommending any additional surgeries to you.  I'm just trying to show you the problem.

The paintover shows a 'simulation' of what it'd look like if you had more soft tissue all over your face in all the right areas.  Your facial gauntness is very similar to mine.  The current solutions out there for correcting this are risky procedures that won't fully address this and cost you a small fortune.  You're likely to get a lumpy or distorted look, especially since (like me) you have a thin face and any irregularities would be more obvious.

Right now you look fine, and some day we'll hopefully have an ideal solution for solving these kinds of issues.  Doctors are very confident and you want a solution - but I'm warning you that it's currently VERY risky.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on March 15, 2018, 02:30:02 PM
Good for you for wanting to keep focus within the scope of this board which is basically bone cuts to the jaw area. Other cosmetic procedures can be entertained at a later time.


Now back to the focus on the CHIN. Your present photo seems to show some dimpling to the chin which often is an indicator of some strain to the chin muscles when closing the mouth. I would attribute that to the same thing you state as your ISSUE which is a poorly done genioplasty.

In your case, from what you said prior, the genio was NOT done DURING the maxfax surgery but rather at a later time. Since genios are part and parcel of the whole 'balance' of a maxfax surgery (when they are needed), SOMEONE (no pun intended about your screen name) made a poor choice not to plan it into the surgery but rather to have it at a later time. That's because they are part of the balance of the bi-max and need to be planned in DURING the same surgery.

A properly planned genio, especially for someone with Vertical Maxillary Excess (VME) or what can be called 'horsey' or 'long face' involves sliding the chin forward along a DIAGONAL cut.

A 'Forward' slide along a diagonal cut yields both a horizontal advancement and a vertical shortening. The vertical shortening is due to the chin segment being slid in UPWARD direction.

I think your dissatisfaction CAN be isolated to the CHIN and you should be seeking out someone who can do an ISOLATED REVISION genio. The rest of your bimax surgery is acceptable and THAT part doesn't need a do-over.

Any other cosmetic issues are not ones maxfax/bimax, chin genios correct and can be entertained and/or pursued later down the line.


Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: girl on March 15, 2018, 03:33:50 PM
That's smart that you're wary of additional surgeries.  I want to reiterate that I'm NOT recommending any additional surgeries to you.  I'm just trying to show you the problem.

The paintover shows a 'simulation' of what it'd look like if you had more soft tissue all over your face in all the right areas.  Your facial gauntness is very similar to mine.  The current solutions out there for correcting this are risky procedures that won't fully address this and cost you a small fortune.  You're likely to get a lumpy or distorted look, especially since (like me) you have a thin face and any irregularities would be more obvious.

Right now you look fine, and some day we'll hopefully have an ideal solution for solving these kinds of issues.  Doctors are very confident and you want a solution - but I'm warning you that it's currently VERY risky.

Nope. She looks perfectly normal and does not need more all over her face. Very minor amounts in selected areas, I would say, which makes her no different to most people. And that can effectively be achieved with temp fillers. IMO, it's not very helpful to put forward that view before saying "nothing to be done about it".

As for the genio. I can't see your x-rays - did you have the diagonally cut genio mentioned by Kavan, or was a different type of cut used?

If it was the latter, I suspect revision options might be limited, unless it can be re-cut diagonally?
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on March 15, 2018, 04:42:52 PM
I believe it was a straight forward horizontal movement, 4mm plate... maybe slightly diagonal?

The proposal I’ve received for a revision would be a T-shape osteotomy which both shortens vertically and tapers the chin, these surgical methods were developed in Asian countries and are now employed often in female feminization surgeries...I’ve read some studies that show high levels of patient satisfaction and low levels of complications.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: jusken on March 15, 2018, 04:49:15 PM
Nope. She looks perfectly normal and does not need more all over her face. Very minor amounts in selected areas, I would say, which makes her no different to most people. And that can effectively be achieved with temp fillers. IMO, it's not very helpful to put forward that view before saying "nothing to be done about it".

As for the genio. I can't see your x-rays - did you have the diagonally cut genio mentioned by Kavan, or was a different type of cut used?

If it was the latter, I suspect revision options might be limited, unless it can be re-cut diagonally?

Well sounds like I'm digging a deeper hole with my opinions on this board.  I think she looks good, perfectly normal, and doesn't need anything tbh.  I made this clear I felt like.  Still, 'good' is a relative sentiment. Many will still look for problems or be more critical of themselves, especially after a change like jaw surgery.

To have the mentality that there HAS to be a solution now I think is a mistake many people on this board are prone to.  I have done a massive amount of research on soft tissue fillers of all kinds, and I wouldn't recommend them to anyone who is very critical of themselves.  It is risky regardless of the permanence of the procedure.  If you study aging and volume loss, you will understand that a targeted approach to fillers is flawed.  Many people end up looking slightly unnatural and regret it over time.

I do think an ideal solution to soft tissue regeneration is on the horizon - so to say that my stance is: 'nothing to be done about it' also isn't totally accurate.  Anyway, not trying to be overly aggressive, I honestly just want to get the information I've learned out there so people don't do things they'd regret!
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on March 15, 2018, 05:06:02 PM
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236372/

[attachment deleted by admin]
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on March 15, 2018, 05:36:59 PM
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236372/

1: The X ray does not show the type of genio with an UPWARD slide to the chin; the type that would make it look shorter in frontal but still give 'horizontal' profile projection.

2: The type of 'V' line genio proposed to you is for ASIAN with WIDE chins. Your lower face is already very NARROW. So narrow the chin more and it's going to look more narrow to you.

Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on March 15, 2018, 05:48:00 PM
Well sounds like I'm digging a deeper hole with my opinions on this board.  I think she looks good, perfectly normal, and doesn't need anything tbh.  I made this clear I felt like.  Still, 'good' is a relative sentiment. Many will still look for problems or be more critical of themselves, especially after a change like jaw surgery.

To have the mentality that there HAS to be a solution now I think is a mistake many people on this board are prone to.  I have done a massive amount of research on soft tissue fillers of all kinds, and I wouldn't recommend them to anyone who is very critical of themselves.  It is risky regardless of the permanence of the procedure.  If you study aging and volume loss, you will understand that a targeted approach to fillers is flawed.  Many people end up looking slightly unnatural and regret it over time.

I do think an ideal solution to soft tissue regeneration is on the horizon - so to say that my stance is: 'nothing to be done about it' also isn't totally accurate.  Anyway, not trying to be overly aggressive, I honestly just want to get the information I've learned out there so people don't do things they'd regret!

I fail to see the reason to morph soft tissue filling on her face when:

1: This is a JAW SURGERY board.
2: It's pretty clear she is bothered mostly by her CHIN.
3: You're very much against soft tissue fillers.

It's like saying: 'Here, I've found all your flaws and fixed them in the morph by filling in the gauntness but there really isn't any reliable solution of even trying to fix those  areas with soft tissue fillers because they distort and leave the face lumpy.'
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: jusken on March 15, 2018, 05:58:01 PM
I fail to see the reason to morph soft tissue filling on her face when:

1: This is a JAW SURGERY board.
2: It's pretty clear she is bothered mostly by her CHIN.
3: You're very much against soft tissue fillers.

It's like saying: 'Here, I've found all your flaws and fixed them in the morph but filling in the gauntness but there really isn't any reliable solution of even trying to fix those  areas.'

I see your points, and I did consider this a risk before doing the morph.  To show someone an 'ideal' outcome that isn't currently attainable is frustrating.  But, look at the flip side:  to understand the problem is also to not make the mistake of looking for problems where there aren't any (or are minimal).  This was my goal here and I can see why there'd be a bit of backlash.  I am disheartened by people who undergo surgeries that were unnecessary.

This is a jaw surgery forum, and I have gotten jaw surgery and been through all that.  I am noticing a pattern between the OP's case and my own, where I started looking into additional procedures that would help - and almost went through with it.  In retrospect, I think I made the right choice.  I am trying to pass on that knowledge.

I think, despite the frustration, it's worth it to communicate this...  I do apologize if you don't see it this way.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on March 15, 2018, 06:04:41 PM
I’m not bothered  by the photo morphing if anyone cares.

And btw, my chin is quite boxy from frontal view when looking straight on.

I don’t know... I’m going to wait until I get Gunson’s Opinion.

I’m not terribly bothered by my appearance, I wish the aesthetic results were better, but I’m starting to accept it. I don’t want to drop >20k and go through another surgery unless it will make a huge improvement.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: some1afterall on March 15, 2018, 06:08:03 PM
Here is the type of osteotomy that’s been proposed. You can choose how narrow or wide of a strip you take out.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on March 15, 2018, 07:30:40 PM
I see your points, and I did consider this a risk before doing the morph.  To show someone an 'ideal' outcome that isn't currently attainable is frustrating.  But, look at the flip side:  to understand the problem is also to not make the mistake of looking for problems where there aren't any (or are minimal).  This was my goal here and I can see why there'd be a bit of backlash.  I am disheartened by people who undergo surgeries that were unnecessary.

This is a jaw surgery forum, and I have gotten jaw surgery and been through all that.  I am noticing a pattern between the OP's case and my own, where I started looking into additional procedures that would help - and almost went through with it.  In retrospect, I think I made the right choice.  I am trying to pass on that knowledge.

I think, despite the frustration, it's worth it to communicate this...  I do apologize if you don't see it this way.

It's just that she was not citing distress with her eye area or the thin face and after calling attention to those areas, you said the filler 'fix' was essentially hopeless to pursue.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on March 15, 2018, 07:32:48 PM
Here is the type of osteotomy that’s been proposed. You can choose how narrow or wide of a strip you take out.

That's not the type I'm suggesting but it's your choice and your face.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on March 15, 2018, 07:52:56 PM
I’m not bothered  by the photo morphing if anyone cares.

And btw, my chin is quite boxy from frontal view when looking straight on.

I don’t know... I’m going to wait until I get Gunson’s Opinion.

I’m not terribly bothered by my appearance, I wish the aesthetic results were better, but I’m starting to accept it. I don’t want to drop >20k and go through another surgery unless it will make a huge improvement.

Chin looks narrow to me and IMO contributes to the 'gaunt' look and will look more narrow and hence longer with that type of surgery. But if YOU think it looks 'boxy' or too wide, it's the same thing as telling the surgeon you WANT it to be narrower. IDK. Sometimes people just have to see on their face (after the surgery) WHAT their request actually looks like for them to realize their request lacked good aesthetic sensibility. So if it looks bad afterwards or you don't like it, very easy for the surgeon to tell you; 'Well, this is the surgery we do when a patient thinks their chin is too WIDE or boxy. 
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: girl on March 15, 2018, 08:02:02 PM
Well sounds like I'm digging a deeper hole with my opinions on this board.  I think she looks good, perfectly normal, and doesn't need anything tbh.  I made this clear I felt like.  Still, 'good' is a relative sentiment. Many will still look for problems or be more critical of themselves, especially after a change like jaw surgery.

To have the mentality that there HAS to be a solution now I think is a mistake many people on this board are prone to.  I have done a massive amount of research on soft tissue fillers of all kinds, and I wouldn't recommend them to anyone who is very critical of themselves.  It is risky regardless of the permanence of the procedure.  If you study aging and volume loss, you will understand that a targeted approach to fillers is flawed.  Many people end up looking slightly unnatural and regret it over time.

I do think an ideal solution to soft tissue regeneration is on the horizon - so to say that my stance is: 'nothing to be done about it' also isn't totally accurate.  Anyway, not trying to be overly aggressive, I honestly just want to get the information I've learned out there so people don't do things they'd regret!

It's not your beliefs I was picking at. It was the "tissue loss" terminology that implied some kind of severe aesthetic problem, and also the fact you pointed out a bunch of flaws (that would make a self-conscious person feel worse) and later said these were unfixable by modern means.
 
Aside from that, a targeted approach to fillers isn't any more flawed than not doing any fillers. Because it will still go away unevenly.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on March 15, 2018, 08:15:04 PM
It's not your beliefs I was picking at. It was the "tissue loss" terminology that implied some kind of severe aesthetic problem, and also the fact you pointed out a bunch of flaws (that would make a self-conscious person feel worse) and later said these were unfixable by modern means.
 
Aside from that, a targeted approach to fillers isn't any more flawed than not doing any fillers. Because it will still go away unevenly.

I had similar response. But just want to say to Ken it's not a 'moderation' directive against pointing out other stuff if he wants to do that. Just sayin' I found it weird to suggest a correction that he felt could not be achieved.
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: jusken on March 15, 2018, 08:43:53 PM
Aside from that, a targeted approach to fillers isn't any more flawed than not doing any fillers. Because it will still go away unevenly.

I would take issue with this.  While there is definitely a bit of unevenness in aging, it's not the same as adding it back by eye-balling it.  Natural unevenness will always look better than filler in the wrong amounts/places.  This is a highly oversimplified way of looking at it.  Even working on a 3D model with an undo button would be difficult - let alone working with an unpredictable solution through a syringe (in the case of fat, can grow, resorb and change post surgery).


To the both of you:

I understand what you guys are saying, and while I didn't feel like I was being harsh (nor do I think my wording has reflected that tone), perhaps I misjudged it.  I suppose my outlook is: not every problem with how we look needs to be fixed.  The OP has a great feminine facial shape and features.  I believe most surgical recommendations should be for deformities, and generally aren't worth the risk for minor flaws as I see them in this case.  Nonetheless, the only minor flaws I see are soft tissue related. 

In other words OP, I would recommend against a chin procedure...
Title: Re: Regret double jaw surgery and genie for open bite and retrognathia
Post by: kavan on March 15, 2018, 09:46:58 PM
I would take issue with this.  While there is definitely a bit of unevenness in aging, it's not the same as adding it back by eye-balling it.  Natural unevenness will always look better than filler in the wrong amounts/places.  This is a highly oversimplified way of looking at it.  Even working on a 3D model with an undo button would be difficult - let alone working with an unpredictable solution through a syringe (in the case of fat, can grow, resorb and change post surgery).


To the both of you:

I understand what you guys are saying, and while I didn't feel like I was being harsh (nor do I think my wording has reflected that tone), perhaps I misjudged it.  I suppose my outlook is: not every problem with how we look needs to be fixed.  The OP has a great feminine facial shape and features.  I believe most surgical recommendations should be for deformities, and generally aren't worth the risk for minor flaws as I see them in this case.  Nonetheless, the only minor flaws I see are soft tissue related. 

In other words OP, I would recommend against a chin procedure...

I didn't think you were 'harsh'. I just found the aesthetic assessment with no 'solution' weird.