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Final Jaw Surgery Results/opinions

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ScottMalkinson:
Hey everyone,

So it's been about 5 months since I had double jaw surgery, so everything should pretty much look like what it's going to look like for the rest of my life. Functionally, the surgery went great. No numbness, pain, loss of function, teeth lined up great, etc. Aesthetically, I'm still not sure how things turned out. To me my face doesn't really look better, it just looks different. My eyes and midface still seem extremely hollow and recessed, and to me my lower third looks off. Its almost like my face got longer and thinner post surgery, at least that's how it looks to me anyway. I've attached some final before/afters and appreciate any thoughts, opinions, or suggestions. Thanks for the help!

Befores:
http://i.imgur.com/EvLdwtn.jpg
http://i.imgur.com/wPz9s5U.jpg
http://i.imgur.com/muSTQ0o.jpg

Afters:
https://imgur.com/mkHw8hp
https://imgur.com/nGLUOIT
https://imgur.com/uNDjLAw
https://imgur.com/qQP0Czd
https://imgur.com/w4zhmyz

kavan:

--- Quote from: ScottMalkinson on November 16, 2017, 02:20:43 PM ---Hey everyone,

So it's been about 5 months since I had double jaw surgery, so everything should pretty much look like what it's going to look like for the rest of my life. Functionally, the surgery went great. No numbness, pain, loss of function, teeth lined up great, etc. Aesthetically, I'm still not sure how things turned out. To me my face doesn't really look better, it just looks different. My eyes and midface still seem extremely hollow and recessed, and to me my lower third looks off. Its almost like my face got longer and thinner post surgery, at least that's how it looks to me anyway. I've attached some final before/afters and appreciate any thoughts, opinions, or suggestions. Thanks for the help!

Befores:
http://i.imgur.com/EvLdwtn.jpg
http://i.imgur.com/wPz9s5U.jpg
http://i.imgur.com/muSTQ0o.jpg

Afters:
https://imgur.com/mkHw8hp
https://imgur.com/nGLUOIT
https://imgur.com/uNDjLAw
https://imgur.com/qQP0Czd
https://imgur.com/w4zhmyz

--- End quote ---

There is no improvement to the areas that the surgery isn't aimed at improving. For example you still have recession to the orbital rim and cheek bone area.  Lefort 1 does not improve that area.  As to the long, up swept jaw, BSSO doesn't make that shorter, more angular or increase the width from posterior jaw to jaw. There is definitely improvement to what looks to be a lot of bi-max protrusion in the oblique photos though.

ditterbo:
I think some people over-hyped what you could expect from jaw surgery here, when you first posted.  But then idk if you shared your cephs? Better info in, better info out.  Your previous jaw issue looks pretty much normalized now, leaving you to naturally steer your eyes towards other deficiencies instead.  Seems to me you would benefit from some kind of augmentation to the jaw angles (personally I wouldn't bother with those risky things, think jaw angle implants are the only permanent solutions) and now your previous-to-surgery-noted recession to your mid-face. It was there before surgery but the jaw deformity was just one more thing to kind of distract you from honing in as much on the mid-face issue (at least from my pov). Maybe look into filler before considering anything more permanent? IMO there's no good solutions to the mid-face - they're money pits with long term higher complication risks and maintenance (filler/fat), or high risk upfront, crappier results long term (implants).

Maybe whoever familiar with Sinn's modified lf3 can chime in on how applicable that may be.

kavan:

--- Quote from: ditterbo on November 16, 2017, 05:35:25 PM ---I think some people over-hyped what you could expect from jaw surgery here, when you first posted.  But then idk if you shared your cephs? Better info in, better info out.  Your previous jaw issue looks pretty much normalized now, leaving you to naturally steer your eyes towards other deficiencies instead.  Seems to me you would benefit from some kind of augmentation to the jaw angles (personally I wouldn't bother with those risky things, think jaw angle implants are the only permanent solutions) and now your previous-to-surgery-noted recession to your mid-face. It was there before surgery but the jaw deformity was just one more thing to kind of distract you from honing in as much on the mid-face issue (at least from my pov). Maybe look into filler before considering anything more permanent? IMO there's no good solutions to the mid-face - they're money pits with long term higher complication risks and maintenance (filler/fat), or high risk upfront, crappier results long term (implants).

Maybe whoever familiar with Sinn's modified lf3 can chime in on how applicable that may be.

--- End quote ---

Great post. As to the modified Lf3, one of the first posts I made to him was to suggest he show his doctor on a skull model which parts to the upper midface he feels would look better if advanced.  (The doctor had--or used to have--this cool skull model where the parts were attached via springs and you could pull at it to displace bone parts.) I did not say 'modified L3'. I got BLASTED (by another poster) for saying something that could resolve to modified Lf3 (could have resolved to miface implants too) even though I didn't use the term; 'mLf3' or say 'implants'. So, glad someone else introduced this possibility.

ScottMalkinson:
Would a combination of like a chin wing, ZO/HA paste, and nose straightening have solid results? Just from the limited reading I've done on it a lf3 or modified lf3 is very risky and almost impossible to find someone willing to perform it.

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