Sliding Genioplasty - US or UK

[SJay]

Hi,

I'm considering a sliding genioplasty, or possibly jaw surgery, for a weak chin. I'm happy with the length and width, but severely lacking in projection.

I've consulted with Dr Paul Johnson (UK) and Dr Jamali (NYC). My bite's okay, so Paul Johnson thought a genioplasty alone would suffice. He seems knowledgeable and very experienced, but he doesn't provide simulations and didn't seem to do an awful lot of planning. I've had botched surgery in the past (not jaw), so I'm extra careful these days. Anyway, I got a second opinion with Jamali. He said we could move my teeth back a little then move the lower jaw forward, but we could probably achieve the same result (cosmetically) with a genioplasty alone. My only reservation is that he doesn't have that many years experience, although he did say he does about 30-40 genioplasties a year. I'm also in contact with Arnett and Gunson, and I'm currently awaiting a consultation date.

I know there are a lot of people on these forums far more knowledgable about this than me, so I'm posting x-rays. If any of you have any advice, or experience with the mentioned surgeons, then please do let me know.

Thanks!

[SJay]

Thanks for your response!

I've never had any troubles with my breathing, so I don't think I've got sleep apnea. Plus, I filled out the sleep apnea questionnaire with A&G and got a very low score, so I'm hoping that's all good. I'm hoping that a genioplasty will suffice, but ultimately I want it fixing properly.

I've been in braces for the past 18 months and my bite is now correct, so they'll be coming off shortly. I never had an under-bite or over-bite, but both upper and lower teeth tilted forward and touched at the tips (rather than having the uppers sit just in front of the lowers). I did have 4 pre-molars pulled, which I have now learned can make the problem with my weak chin worse... I wish I'd known sooner. Anyway, I obviously aren't that keen on starting more ortho work!

So I'm hoping genioplasty alone might suffice, although I may need quite a significant advancement, say 8mm or so. I'm concerned this may look a little silly, creating a deep mentolabial fold or even a step off. I sent my xrays and photos to Gunson yesterday, so I'll wait and see what he thinks.

[SJay]

So I spoke with Dr Gunson yesterday, who was really friendly. I didn't have to say too much, he immediately knew what the problem was and offered a few potential solutions. He said the best fix would be double jaw surgery, but a genioplasty alone would also offer a reasonable cosmetic result. He also noted a few issues I have with my lips, which no other doctors picked up on, and said he could address those too. I think I have some lip incompetence, which can be improved by tweaking the muscles in the lip? I don't know much about this, so if any of you can point me in the right direction regarding further info, that would be appreciated!

 Overall, he was very pleasant, knowledgeable and reassuring.

[SGseeker]

So I spoke with Dr Gunson yesterday, who was really friendly. I didn't have to say too much, he immediately knew what the problem was and offered a few potential solutions. He said the best fix would be double jaw surgery, but a genioplasty alone would also offer a reasonable cosmetic result. He also noted a few issues I have with my lips, which no other doctors picked up on, and said he could address those too. I think I have some lip incompetence, which can be improved by tweaking the muscles in the lip? I don't know much about this, so if any of you can point me in the right direction regarding further info, that would be appreciated!

 Overall, he was very pleasant, knowledgeable and reassuring.
[/quote

Hi SJ, I just had SG with Dr. Gunson on Thursday. Let me know if you have any questions over PM. Good luck on your search.