Author Topic: 4mm max genioplasty  (Read 27951 times)

streo

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4mm max genioplasty
« on: August 17, 2012, 02:32:41 PM »
So I thought I'd spin off another thread over here in overbites.  I'm finding this topic quite interesting/encouraging as I myself will be having a 3-4 mm genioplasty, which I thought was small.  But CK had mentioned on more than one post that Arnett/Gunson do a 4mm MAXIMUM genioplasty (I'm assuming advancement).  

Any information or explanation as to why this is the case?
« Last Edit: August 18, 2012, 09:53:18 AM by streo »

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Re: 4mm max genioplasty
« Reply #1 on: August 17, 2012, 04:07:00 PM »
I have an extremely shallow labiomental groove, so I think I would need a significant larger genioplasty. I also don't want to end up with a prominent jaw and a weak chin, because that tends to look really bad. The opposite -- slightly recessed jaw, prominent chin -- looks much better, in my opinion.

streo

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Re: 4mm max genioplasty
« Reply #2 on: August 17, 2012, 04:21:42 PM »
I have ZERO problem deferring to the surgeons in this case.  Honestly this information really puts me at ease!

streo

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Re: 4mm max genioplasty
« Reply #3 on: September 04, 2012, 06:02:56 PM »
Some perspective...the headphones that ship with an iPod has a jack that is 3 millimeters in diameter.  Although I have yet to experience it, I know millimeters are like miles on the face, and I'm having a hard time believing that this will make much of a difference and that going larger than this is "bad planning".

But then again, I'm not a doctor...I've only spent a few minutes a day reading on subject matter to which doctors devote their entire life.

But still!!!

CK

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Re: 4mm max genioplasty
« Reply #4 on: October 22, 2012, 05:39:48 AM »
any surgeons share the view that 4mm genio is the maximum, anything beyond is evidence of poor planning prior to surgery?


streo

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Re: 4mm max genioplasty
« Reply #5 on: October 22, 2012, 06:34:59 AM »
any surgeons share the view that 4mm genio is the maximum, anything beyond is evidence of poor planning prior to surgery?



I thought about this quite a bit and the reasoning goes that if the occlusion in the front of the mandible/maxilla is ideally corrected, then the genio itself should "average out" in some way as far as maximum advancement.  This is just my speculation and not based on any surgeon's input.

treevernal

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Re: 4mm max genioplasty
« Reply #6 on: October 22, 2012, 08:35:35 AM »
The reason 4mm is generally the max is because the soft tissue in the chin starts to thin if the advancement is larger than that.  It says this on A&Gs website.

CK

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Re: 4mm max genioplasty
« Reply #7 on: October 22, 2012, 12:50:56 PM »
The reason 4mm is generally the max is because the soft tissue in the chin starts to thin if the advancement is larger than that.  It says this on A&Gs website.

but everyone's soft tissue is different, right?

and also, do other surgeons share this POV?

treevernal

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Re: 4mm max genioplasty
« Reply #8 on: October 22, 2012, 12:55:10 PM »
True, its prob just a general guideline

treevernal

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Re: 4mm max genioplasty
« Reply #9 on: October 22, 2012, 02:01:55 PM »
I read in one of their articles that 60% of their patients were female. 

Lazlo

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Re: 4mm max genioplasty
« Reply #10 on: October 22, 2012, 02:10:12 PM »
hmmm. the chin just seems like an essential feature, im not sure if an advanced jaw can still create the effect of a stronger chin. also, i think the real difference is gender, females tend to have softer tissue than men and a lot of showcased AG are female.



This is a very interesting thread and I have several observations to make.

For people with retrusive lower jaws (i.e. a weak looking jaw but perhaps no MAJOR functional problem, i.e. a class 1 or 2 occlusion) I have personally consulted with some maxillofacial surgeons and cosmetic surgeons who have suggested that a simple genioplasty would solve my cosmetic problems. In some cases the surgeon suggested a genioplasty with some grafting of bone from the hip to fill out the space. This produces the benefit NOT ONLY OF STRENGTHENING THE CHIN, but a genioplasty when advanced can also lengthen the appearance of the jawline itself.

Another advantage of a genioplasty(over a chin implant for example) is that not only can you project more horizontally with a genioplasty, but you can also vertically lengthen the chin through a genioplasty. If you go over to the "makemeheal" forums which are primarily devoted to cosmetic sugery you will find under "genioplasty" examples of several patients who have benefitted comsetically from genioplasty and they look really good, in some cases much better than patients who have had jaw surgery.

Clearly, this has to do with the the fact that they had their genioplasties performed by cosmetic surgeons(trained in the procedure) who were primarily concerned with aesthetics (genioplasties serve little to no functional benefits).  In fact, the ps I consulted with(he was also a craniofacial surgeon and was trained in doing jaw surgery too) actually drew out on a piece of paper what he said was the "most attractive" chin shape on most people society calls "pretty boys". I got a good chuckle out of that, but he was actually right when I looked at magazines afterwards. It was a somewhat protrusive chin with a soft curve and now I see it in the profiles of most male models. Apparently he said he could create that chin through a sliding genioplasty and intergrafting a bit of bone or bone filler into the gap. I've seen some of his after results and they were pretty awesome(on both men and women). His chin advancements were sometimes close to 15mm --and he never indicated anything about problems with this...though I haven't done a long term follow up on his patients.

It seems to me that if a genioplasty can indeed improve or help the cosmetic outcome of a jaw surgery it should be done. Also, it seems Arnett and Gunson are some of the most advancement surgeons in terms of using grafts etc. so hopefully they can create the same types of effects as the surgeon I consulted with. I guess you probably just have to ask.

Lazlo

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Re: 4mm max genioplasty
« Reply #11 on: October 22, 2012, 02:14:47 PM »
for those of you interested, this was the doctor and here are some examples of genioplasties(only genioplasties) he's performed. I'm guessing these are all upwards of 4mm projection --some of these people look like they had jaw surgery! But they haven't. And he showed me even better pics in his office (of only genioplasties).

I' myself will be getting jaw surgery because I do want to improve some functional things, but I'm also concerned about aesthetics and I think as CK mentioned it does seem to play a pretty important role in aesthetics.

http://www.plasty.ca/chin_reshaping_before_and_after_photos.html

Lazlo

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Re: 4mm max genioplasty
« Reply #12 on: October 22, 2012, 02:17:44 PM »
the genioplasty clearly improved everyone, but it's amazing what it did for the red-haired guy, he went from average, slightly odd looking to handsome, even model calibre. I think he also had a slight straightening of his bridge, but nothing more extensive(the tiip of his nose is unaltered, i'm not even sure about the bridge, but the chin really put the face together!)


treevernal

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Re: 4mm max genioplasty
« Reply #13 on: October 22, 2012, 02:24:35 PM »
Those are some impressive results no doubt.  But I do think lip support is a very important cosmetic consideration and when you only advance the chin, an already weak mouth can look even more so.  But...if your problem is merely a weak chin, a genio is probably a good choice.

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Re: 4mm max genioplasty
« Reply #14 on: October 22, 2012, 02:26:59 PM »
I've seen excellent results with large genioplasties and poor results from A/G where patients ended up with overprojected jaws and weak chins (e.g. http://i.imgur.com/dHywt.jpg). I think the 4mm max genioplasty rule is nonsense.