Would I benefit from jaw surgery?

[notrain]

Hi,

I'd like to know if my situation warrants looking into jaw surgery (link to pictures below):

- had adenoids removed as a child
- had an overbite corrected with braces over the course of 3 years (age 14-17).
18 months of those were fixed braces (traintracks). I never wore headgear.
- no extractions, except for wisdom teeth at age 27 (I'm 30 now).
- I have a weak lower jaw / recessed chin
- light crowding of bottom teeth, teeth are straight though.

I included more pictures than necessary so you can disregard bad ones. I am pretty unhappy with my lower face, it's "weak" looking and I don't really have a decent chin or jawline regardless of bodyweight. I once dieted down to 9% bodyfat while lifting weights and despite having a sixpack, it didn't really help.

I read around the forums and saw public pictures, some were of obviously deformed looking people and some looked better than I do. So I really don't know where I stand, if you think I'm trolling after you looked at my pictures, I apologize. I just really don't know but I'm seriously looking for advice.

I'm going to see my dentist in 3 weeks for regular cleaning. I can ask him to give me copies of my x-rays (they do those every 5 years) if that helps.

WRT to breathing problems, I don't really know how it is during the night. No one I shared a bed or room with has ever complained, though. I'm going to record myself sleeping once I shake off the cold I caught a couple of days ago. I can easily breathe through my nose when I'm awake.

Anyway, here's the link to the pictures (all taken within this year): http://imgur.com/a/qo7By

The selfies probably suffer from lens distortion because I used my mobile phone too close to my face.

[notrain]

Thanks for your input. My plan is to broach the subject with my dentist the next time I see him and after that to make an appointment with a surgeon. I just want to get some opinions beforehand, especially from normal people who either had jaw surgery or are thinking about getting one.

I probably want to make sure I am not insane for even thinking about this. When I posted the thread I wasn't too sure all this isn't just in my head :/.

As far as functional issues go: It's entirely possible I have several, but have gotten used to them over time. For instance, whenever I have the slightest hint of a cold, my nose is blocked. That could have something to do with this.... or not. I also wake up with an extremely dry throat occasionally and have to drink a glass of water immediately. Could be I was mouthbreathing or that the air in the room I was sleeping got dry from artificial heating during the winter.
The only thing I do know is that my adenoids were removed as a child because I was indeed mouthbreathing. But in germany with its socialized healthcare, every child sees a pediatrician multiple times a year and he caught it really early and I had them removed right away and could breathe normally after.

[notrain]

Okay, I understand. No problem.

I live in germany, so I don't know about decent surgeons. Yet.

My bite is decent as far as I can tell.

To be perfectly honest, even if I didn't get any functional improvement, I'd still do it just for the aesthetic improvement. If my insurance covers it, I'll get surgery (provided I'll find a surgeon with good results and reviews in my area).

The vision what I should have looked like if my jaws were where they are supposed to be is already eating at me. I don't think I can just ignore this issue, if it really turns out (after a consult) something is very wrong with me.

[notrain]

I realize that it is a complex and risky procedure. I won't rush into it.

But - as you can imagine - someone finding this forum likely has subconciously perceived something wrong with their appearance for a long time. In my case, I tried virtually everything. Endurance sports to diet down to low BF%, weightlifting to build muscle... Always thinking I could finally fix what I perceived I was lacking. At least now I know what's been bugging me all these years. I just can't not do something about it now.

[overbiter]

If you really want to look better you should ditch the dyed blonde hair and leather jacket lol. Don't give up on the jaw surgery though, make the dream a reality.

[Tiny]

I agree that you'd benefit.  My profile isn't that dissimilar to yours either but I was advised 7-9mm of advancement

A genio alone will improve things but it will leave you with a significant sub-labial fold

You would also benefit from chin lipo at the same time as your jaw surgery, I think.  I've had that done and it makes a big difference on the right patient

[notrain]

If you really want to look better you should ditch the dyed blonde hair and leather jacket lol. Don't give up on the jaw surgery though, make the dream a reality.

The hair was done to me by my ex-gf who broke up with me shortly after she dyed it. Maybe she planned it that way. Anyway I am back to my natural hair color long ago. No chance on ditching the jacket tho, I love that thing.

[notrain]

I agree that you'd benefit.  My profile isn't that dissimilar to yours either but I was advised 7-9mm of advancement

A genio alone will improve things but it will leave you with a significant sub-labial fold

You would also benefit from chin lipo at the same time as your jaw surgery, I think.  I've had that done and it makes a big difference on the right patient

I don't want to get a genio alone if the underlying issue are my jaws.

That's like pumping more air in the tires of your car when your suspension is f**ked.

I fully agree on the lipo suction, can they do that while they do the jaw surgery ?

[Tiny]

What on earth is the deal with Germans and blonde highlights?!      It's not the 1990s! 

TBH I'm more concerned about those jeans than the jacket 

Anyway, we are being a bit cruel - well done for posting your pics, most of us aren't brave enough to do this in the public forum

Can't see why they can't do the lipo with the jaw surgery.  For mine they used a very small cannula and made 3 incisions - one under each ear and under the chin.  They  don't need to even need to take out that much fat.  If you get private forum access then you can have a look at how much difference it made to my face (A LOT)

Take a trip to Belgium and consult Mommaerts and drink beer.  You are in a similar situation to me - skeletal overjet corrected with orthodontics. (although I was unlucky enough to lose 4 molars in the process)  I've been told that I will probably need upper with CCW to create enough overjet to advance enough but it depends on how much they can move my teeth with orthodontics.

[notrain]

What on earth is the deal with Germans and blonde highlights?!      It's not the 1990s! 

TBH I'm more concerned about those jeans than the jacket 

Anyway, we are being a bit cruel - well done for posting your pics, most of us aren't brave enough to do this in the public forum

Don't worry, I can take it.

Take a trip to Belgium and consult Mommaerts and drink beer.  You are in a similar situation to me - skeletal overjet corrected with orthodontics. (although I was unlucky enough to lose 4 molars in the process)  I've been told that I will probably need upper with CCW to create enough overjet to advance enough but it depends on how much they can move my teeth with orthodontics.

Do you know how I should have been treated instead?
surgery in my teens?
Just don't do anything and see how it would have played out?

By the way, my dentist was the one keeping my ortho from extracting teeth. He basically told him that extracting healthy teeth is always a bad idea and if he can't treat me with 28 teeth in my mouth he shouldn't be treating me at all. Too bad my ortho still managed to f**k me up .

Anyway I'll start consultations with surgeons in my area before I travel to Belgium, although it isn't even that far away from South West Germany.

[dantheman]

Hi notrain,

Welcome. Would you have an xray (lateral ceph) that you could post? I think it would help in identifying what the contributing factors are to your chin recession (bite, steep occlusal plane, deficient chin, etc.). I also don't have a profile that dissimilar from yours, being more predisposed to a double chin etc. I think that by losing weight I can improve my profile, however. Everyone is different and has different genetics for fat distribution on their bodies...

 As for sleep.. if you can breathe well through your nose, feel rested during the day, and don't have others telling you that you choke, snort, gasp, or have pauses in your breathing then I wouldn't investigate that end further. For straight up sleep apnea CPAP is still the gold standard as it is the least invasive form of treatment. I'm saying this because if you don't have sleep issues and don't have swallowing or chewing issues then I think that a straightforward genioplasty (or better yet a chin wing osteotomy) would serve you better. Everyone here will tell you that double jaw surgery strictly for aesthetic reasons is overkill and the risks don't make it worth it. Again, an X-ray would help.

[notrain]

Hi notrain,

Welcome. Would you have an xray (lateral ceph) that you could post? I think it would help in identifying what the contributing factors are to your chin recession (bite, steep occlusal plane, deficient chin, etc.). I also don't have a profile that dissimilar from yours, being more predisposed to a double chin etc. I think that by losing weight I can improve my profile, however. Everyone is different and has different genetics for fat distribution on their bodies...

Hi dan,

I have to get the x-ray from my dentist first. I have an appointment there in 2 weeks. Maybe I am going to try and get the appointment rescheduled to a sooner time. Once I have medical records, I will donate the 10 bucks for private forum access and ask for this thread to be moved. I will post everything pertinent to my case once I start doing the legwork. As for weightloss: I did pillage the photo albums of my parents today, and I found pictures where I weighed 62kg @ 178cm height. Still have a potato face there. I also looked at pictures from my childhood. My overbite / malocclusion was developing around age 7 or 8 already and grew progressively worse. At age 13-14 I looked f**king ridiculous. Still, I think if I hadn't gotten braces, a simple lower jaw advancement would have sufficed. I also discovered that my small lower jaw is from my mothers side. She has the same profile as me, as does my sister (she'd need surgery too but is too old to bother with it I think).

As for sleep.. if you can breathe well through your nose, feel rested during the day, and don't have others telling you that you choke, snort, gasp, or have pauses in your breathing then I wouldn't investigate that end further. For straight up sleep apnea CPAP is still the gold standard as it is the least invasive form of treatment. I'm saying this because if you don't have sleep issues and don't have swallowing or chewing issues then I think that a straightforward genioplasty (or better yet a chin wing osteotomy) would serve you better. Everyone here will tell you that double jaw surgery strictly for aesthetic reasons is overkill and the risks don't make it worth it. Again, an X-ray would help.

Sleepwise, I don't really know how it would feel with perfect jaws. I don't have the tell tale dark circles under my eyes, but I don't know if I'd be more rested with a better airway. Sometimes I wake up tired, sometimes I feel refreshed. Again, if my jaws are the root cause for my problems, I'd rather get that fixed. But I want to consult with surgeons first and hear what they have to say. I won't get an unnecessary surgery.

WRT to my profile pictures: Those are selfies. I tried to stare at a point on the wall on the same height as my eyes are in my skull. But I also had to balance the mobile phone camera and hit the trigger on the screen, so it is entirely possible I am looking slightly upwards. Those pictures shouldn't be considered final evidence for anything. Once I have documents from medical professionals, I will post them.

[Tiny]

Still, I think if I hadn't gotten braces, a simple lower jaw advancement would have sufficed.

This is pretty par for the course for people in their mid 20s onwards.  10 years ago, jaw surgery wasn't so commonly done, especially in Europe.  Most skeletal overjets were "fixed" via orthodontics.  Those of us now getting advancement in our 20s and 30s therefore have to undo all our previous orthodontic work.

You're lucky with your dentist.  Most of us had teeth out

[notrain]

This is pretty par for the course for people in their mid 20s onwards.  10 years ago, jaw surgery wasn't so commonly done, especially in Europe.  Most skeletal overjets were "fixed" via orthodontics.  Those of us now getting advancement in our 20s and 30s therefore have to undo all our previous orthodontic work.

You're lucky with your dentist.  Most of us had teeth out

Yeah, I am trying my best not to get mad about what happened. I looked through all the old photo albums over the weekend (I am still down with a cold and bored) and now that I know how jaws affect facial growth, I felt my heart sink as I watched my own uglyfication over the years. But what's done is done. Still, I remember vividly how during our vacations in Italy I regularly got free ice cream, because I was naturally blonde and blue-eyed with a cute face. That stopped around age 10, lol.

I'll just keep telling myself that I am profiting from better imaging hardware and surgical technique that's available now.

Two questions:

- Why does it matter if you had teeth extracted? Do your jaws lack stability because of lacking teeth after surgery ? Did it change your bone structure more significantly while growing up ?

- I had my 4 wisdom teeth extracted (3rd molars). Is that bad ? To clarify: I have 28 teeth in my jaws, 14 top 14 bottom.

[PloskoPlus]

I used to think that Europe was "years ahead of us!".  However, a few months back I met a young Swede who recently had 4 or 5 teeth extracted, 4 years of braces, to make his lower arch fit under his upper arch.  Well, they cured his underbite allright.  Yet his lower jaw was by no means oversized, his upper face was flat with a droopy nose tip (uncharacteristic for Northern Europeans).  He would have been downright handsome with a more projected midface. This, in a country that pioneer titanium implants, vehicle safety and all sorts of medical technology.  I, of course, said nothing.