Jaw/Chin implant vs Jaw Advancement?

[PloskoPlus]

Not really sure about that. I spoke with Dr. Stephen Schendel last week, another maxillofacial surgeon who primarily focuses on jaw/chin, and he told me my maloclussion was very mild and mandible advancement would only result in advancement of about 3mm, so not to even bother. He actually suggested implants.

He's not exactly the greatest max fac.  If you had CCW rotation, you'd end up with a very strong projected jaw. See Arnett and Gunton in california, wolford and Sinn in dallas.  They specialise in this.

[eastcoastian1]

He's not exactly the greatest max fac.  If you had CCW rotation, you'd end up with a very strong projected jaw. See Arnett and Gunton in california, wolford and Sinn in dallas.  They specialise in this.

CCW rotation? This is the first time I've even heard that mentioned.....

[eastcoastian1]

Will contact Arnett. Do you happen to know if this can be done without BSSO (meaning I can avoid the whole 1 year of braces)?

[PloskoPlus]

Will contact Arnett. Do you happen to know if this can be done without BSSO (meaning I can avoid the whole 1 year of braces)?

CCW requires double jaw surgery by definition. Even if you can get away with single jaw surgery, double jaw almost always gives a better result.

[ForeverDet]

For anyone who has the ability to analyze an x-ray, I've uploaded a scan of my lateral ceph CT for reference.

Hmmm am I going to have to take back everything I already said? s**t lol. Because here you absolutely see a deep mental-labial fold!

Seriously if this is accurate of how your bite and soft tissue actually sit normally then honestly a chin augmentation is probably wrong. However I've seen a few examples of a lengthening genio with advancement, there's a pic people always use of a tan guy with dark hair, which should avoid any aesthetic issues even tho it won't address the root dentoskeletal issue.

Edit: Avoid any headgear or night time wearing devices, most are bulls**t and dangerous.

I agree with seeing arnett/gunson for at least a consult, it may be eye opening. The cost is steep even for a consultation, 550 but it'll probably be the most comprehensive doc appt you'll ever have and well worth it if you can afford it.

And stay away from Wolford, one of the best docs out there for sure but he'll without a doubt want to do a Total Temporomandibular Joint Replacement with Prosthesis...even if your joints are fine and you just have clicking or some benign symptom. I spoke to him via e-mail years ago before i had surgery and after I told him that I had occasional clicking only, he suddenly acted concerned and suggested seeing him to look at my joints more. Yeah f**king right.

[eastcoastian1]

CCW requires double jaw surgery by definition. Even if you can get away with single jaw surgery, double jaw almost always gives a better result.

Hilarious. I actually just had a phone consultation With Dr. Gunson a few minutes ago that I had booked over a month ago and had completely forgotten about!

First off, WOW. What a doctor. He really, and I mean REALLY knows his stuff. By far the best surgeon I have consulted with thus far. Just from my photos and ceph, he was able to determine so much. He also has a very concise and articulate demeanor. Seems very trustworthy.

Anyway, he said unless my ceph was taken at an angle or my head was tilted, it's pretty much a straight forward case of a recessed/weak chin, mostly unrelated to the jaw. While there is a very mild steep angle, and a very mild recessed jaw and slight overbite (which he actually said looked healthy), he said there's really no reason to touch my jaws. He feels 6mm advancement of the chin via sliding genioplasty would be the way to go.

Again, this is only his first impression via information provided to him, but he seemed rather confident with that recommendation.

This is actually a huge sigh of relief for me to hear from a leading authority of jaw surgery that I really don't need it. Think I'm going to book an in-person consult and try to get the sliding genio done by that team.

[eastcoastian1]

Hmmm am I going to have to take back everything I already said? s**t lol. Because here you absolutely see a deep mental-labial fold!

Seriously if this is accurate of how your bite and soft tissue actually sit normally then honestly a chin augmentation is probably wrong. However I've seen a few examples of a lengthening genio with advancement, there's a pic people always use of a tan guy with dark hair, which should avoid any aesthetic issues even tho it won't address the root dentoskeletal issue.

Edit: Avoid any headgear or night time wearing devices, most are bulls**t and dangerous.

I agree with seeing arnett/gunson for at least a consult, it may be eye opening. The cost is steep even for a consultation, 550 but it'll probably be the most comprehensive doc appt you'll ever have and well worth it if you can afford it.

And stay away from Wolford, one of the best docs out there for sure but he'll without a doubt want to do a Total Temporomandibular Joint Replacement with Prosthesis...even if your joints are fine and you just have clicking or some benign symptom. I spoke to him via e-mail years ago before i had surgery and after I told him that I had occasional clicking only, he suddenly acted concerned and suggested seeing him to look at my joints more. Yeah f**king right.

I think the device used to take the scan also makes the fold more pronounced, since you're pressing your chin hard against.



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[mike888miller]

did he charge you for the phone call, or is the payment only for the next appointment?

[ForeverDet]

eastcoastian1 - It crossed my mind that it was being exaggerated a bit which is why I asked. And yes, Dr. G know his stuff. Not that I'm biased... he did my surgery after all If he says a genio is best and that opinion is the same after the in-person consult then awesome! I envy you for only needing a isolated procedure, it'll be soooo much easier recovery/cost/everything else wise. One is like being hit by a truck (double jaw surgery) vs punched by a 4th grader in the face (genio only).