Chin implant or sliding genioplasty?

[chinnychinchin]

So I wanted to reward myself after having donated a kidney. I have an overbite due to an underdeveloped jaw which is why my profile is so unbalanced. I also wouldn't mind some height. I've been researching ever so fiercely later and I'm torn between a sliding genioplasty and a chin implant. I want something that looks the most natural. Also, I'm somehow able to position my lower jaw forward if I needed to, but I can also recess my chin quite a bit if I want my back teeth touching. I've attached both images of how I can position my lower jaw which can have quite a dramatic difference in appearance. So what do you guys recommend? I live in the Los Angeles area and would also like some recommendations, thanks This will be first surgery

Pics: http://s1295.photobucket.com/user/laundrysheet/library/Chinny%20Chin%20Chin
Password: jayleno

[overbiter]

Your mandible is underdeveloped and you have no chin. You will probably need BSSO and a genioplasty. You should see Arnett and Gunson for their opinion.

[overbiter]

Doing cosmetic surgery on the chin alone would be insane in your case.

Your lower jaw is severely recessed (possibly microgenia even?) and needs to be treated with some sort of BSSO / DO / grafts.

Nah, he doesn't have microgenia, he just has a severely recessed jaw. You're right about the surgery he needs though.

[chinnychinchin]

Thank you guys for the responses, I guess it is severely recessed! Other than Arnett & Gunson, anyone else? I want to get a few consultations in from different doctors before deciding. I've also been hearing good things about are Dr. Schendel in Pacific Palisades and Dr. Mendel in Santa Ana.

Regarding the BSSO, how much do surgeries like this typically cost, and does insurance usually cover this type of procedure?

[chinnychinchin]

Thanks for the info kizarq. It sounds like a long process. I've had braces for about 4 years when I was younger, do you think that will affect this? I don't have crowding and have had at least 4 teeth pulled. Also my 4 wisdom teeth have been removed. Do you think a condition like this could be connected to neck pain/aches?

[Tiny]

Thanks for the info kizarq. It sounds like a long process. I've had braces for about 4 years when I was younger, do you think that will affect this? I don't have crowding and have had at least 4 teeth pulled. Also my 4 wisdom teeth have been removed. Do you think a condition like this could be connected to neck pain/aches?

Hey there.  Join the club - 4 teeth removed here too.  Our profiles are very similar.  Do you have a deep bite, too?  Your lower face looks short, like mine.  FYI, I was recommended a BSSO plus lefort1 with CCW rotation and a downgraft

Poor you, you got f**ked by orthos like a lot of us.  You will have to 'undo' your previous ortho work - it will take about a year. 

I actually recommend that you go for an implant and a little submental liposuction now, if you can afford it.  It will improve your appearance while you wait for surgery, and the healing time is short - 2-3 weeks.  I did it and I'm glad I did - it made a huge difference!!!!  It really improved my face and confidence a lot.  At the surgery you can keep the implant or get it removed and get a genio

[chinnychinchin]

Tiny! Glad I found a "twin". Do I really have to expect 1 year of braces? That'll be extremely frustrating, especially at my age (28). My bite is quite deep, about 1/10" back. Do you have a before/after you can show me, very interested to see your results. Which doctor did you end up going with? Why did you need a CCW rotation? Will consider the chin implant if it really will end up being a year of orthos, wow.

[Optimistic]

Hey there.  Join the club - 4 teeth removed here too.  Our profiles are very similar.  Do you have a deep bite, too?  Your lower face looks short, like mine.  FYI, I was recommended a BSSO plus lefort1 with CCW rotation and a downgraft

Poor you, you got f**ked by orthos like a lot of us.  You will have to 'undo' your previous ortho work - it will take about a year. 

I actually recommend that you go for an implant and a little submental liposuction now, if you can afford it.  It will improve your appearance while you wait for surgery, and the healing time is short - 2-3 weeks.  I did it and I'm glad I did - it made a huge difference!!!!  It really improved my face and confidence a lot.  At the surgery you can keep the implant or get it removed and get a genio

If someone has had a number of extractions what can be done to prevent their face changing over time? Implants?

[Optimistic]

Tiny! Glad I found a "twin". Do I really have to expect 1 year of braces? That'll be extremely frustrating, especially at my age (28). My bite is quite deep, about 1/10" back. Do you have a before/after you can show me, very interested to see your results. Which doctor did you end up going with? Why did you need a CCW rotation? Will consider the chin implant if it really will end up being a year of orthos, wow.

It can be faster if you opt for something like wilkodontics.

I don't know why you'd get a chin implant. Your problems go way beyond the realm of mere aesthetics. By the sounds of things there are a number of functional issues to fix. Plus, improving your actual bone structure will help with ageing. Implants also have risk of shifting, infection, rubbing away at the bone vs max fac work which produces more natural results and is by far the safer

[Tiny]

Tiny! Glad I found a "twin". Do I really have to expect 1 year of braces? That'll be extremely frustrating, especially at my age (28). My bite is quite deep, about 1/10" back. Do you have a before/after you can show me, very interested to see your results. Which doctor did you end up going with? Why did you need a CCW rotation? Will consider the chin implant if it really will end up being a year of orthos, wow.

- 1+ year or ortho is standard because you have to undo everything that was done before
- by deep, I mean that your upper teeth cover much of your lower teeth (in the vertical aspect)
- I need CCW because I have a steep plane, and am vertically deficient in mandible and maxilla as well as horizontally deficient in mandible
- i have not had my jaw surgery yet only implant/lipo

[chinnychinchin]

It can be faster if you opt for something like wilkodontics.

I don't know why you'd get a chin implant. Your problems go way beyond the realm of mere aesthetics. By the sounds of things there are a number of functional issues to fix. Plus, improving your actual bone structure will help with ageing. Implants also have risk of shifting, infection, rubbing away at the bone vs max fac work which produces more natural results and is by far the safer

I agree, also every chin implant before and after have come nowhere close to as natural looking as jaw surgery. Also, the more I've researched, the more I've begun to see familiar symptoms that come with a severely recessed jaw such as sleep apnea and how sometimes it's been hard to breathe.

- 1+ year or ortho is standard because you have to undo everything that was done before
- by deep, I mean that your upper teeth cover much of your lower teeth (in the vertical aspect)
- I need CCW because I have a steep plane, and am vertically deficient in mandible and maxilla as well as horizontally deficient in mandible
- i have not had my jaw surgery yet only implant/lipo

I don't think I have a deep bite then. So in terms of ortho, I'm assuming they will be moving my teeth backwards to accommodate the shift in my jaw? I feel like there's not enough teeth in my lower jaw to do that... Do you have your surgery scheduled?

I've booked a consultation for next Wednsday with Dr. Schendel. I've also scheduled one with Arnett & Gunson sometime later next month. Will keep this updated with what they end up saying. Thanks everyone for the info so far, you guys have a been a huge help 

[pekay]

Tiny! Glad I found a "twin". Do I really have to expect 1 year of braces? That'll be extremely frustrating, especially at my age (28). My bite is quite deep, about 1/10" back. Do you have a before/after you can show me, very interested to see your results. Which doctor did you end up going with? Why did you need a CCW rotation? Will consider the chin implant if it really will end up being a year of orthos, wow.

a forum member consulted with a surgeon in the Palo Alto area and apparently he offers bi-max surgery without requiring you to wear braces. He/she wasn't really impressed with his results though.

Here is the thread: http://jawsurgeryforums.com/index.php/topic,3801.msg24898.html

[PloskoPlus]

Don't worry about it.  Time flies, more so the older you are.  I'm 37 and have been in braces for the last 9 months.  The time just flew by.

[nrelax11]

Yea I agree, been in braces for 8 months and its gone by really quick so far

[jesterofmalice]

I actually recommend that you go for an implant and a little submental liposuction now, if you can afford it.  It will improve your appearance while you wait for surgery, and the healing time is short - 2-3 weeks.  I did it and I'm glad I did - it made a huge difference!!!!  It really improved my face and confidence a lot.  At the surgery you can keep the implant or get it removed and get a genio

That sounds quite tempting to me, too.
I've been going over millions of things in my head over recent months. I've spoke to a few orthos, but I guess I really need to speak to a maxofacial surgeon or someone next to help me get things clear in my head.
I'm sure that the ideal operation for me would be orthagnathic surgery. I have a deep bite, too.
However, I think I could get a some aesthetic improvement from submental lipo and possibly a small pre-jowel implant?
(I think I have small jaws, small chin, and the combination makes my face looks heavy and shapeless, as ther's not enough suipport for the underlying tissue)

Here's just a guess at how lipo may help me:


[attachment deleted by admin]