Author Topic: Considering Revision Years Later  (Read 2012 times)

David_D

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Considering Revision Years Later
« on: February 03, 2016, 11:45:45 AM »
I had my first orthognathic surgery in 2005.  I had two-jaw surgery to correct an underbite (Class III).  Then I had a revision to address lip incompetence with both jaws set back a bit in 2010.  I also had a sliding genioplasty chin reduction.

Now I'm very displeased with my smile in particular.  My face is very chubby and convex looking in a way that is not aesthetically pleasing to me.  I've had a neck lift and some liposuction to the perioral area.

Now, I'm considering buccal fat pad removal, more lipo, and a lip and corner of the mouth lift in the hopes of having a less "sad" look and possibly a more aesthetic smile.  I think that I really should first consider that I might have a structural issue.  Perhaps a good, cosmetically-oriented maxillofacial surgeon could augment, burr down, or otherwise address skeletal issues that are giving rise to the soft tissue concerns that I have.

Does anyone have any recommendations on this, and on who is a good cosmetic-oriented maxillofacial surgeon?

Me now, awkwardly forcing a smile:



Me now, front in repose:



Me at age 17, before any procedure:



Thank you all...

thinkingme

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Re: Considering Revision Years Later
« Reply #1 on: February 03, 2016, 02:41:11 PM »
i think u are perfect.

PloskoPlus

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Re: Considering Revision Years Later
« Reply #2 on: February 03, 2016, 03:23:05 PM »
Aesthetically the only thing off is your slightly longish midface. No fix for that I'm afraid. But you look borderline handsome as you are. Do you have any nerve damage from your jaw surgeries?

David_D

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Re: Considering Revision Years Later
« Reply #3 on: February 03, 2016, 05:45:48 PM »
Aesthetically the only thing off is your slightly longish midface. No fix for that I'm afraid. But you look borderline handsome as you are. Do you have any nerve damage from your jaw surgeries?

I have a lot of numbness in my lower lip, more so on my right side.  I also have some numbness in the chin, again more on the right side.  Otherwise, my bite is perfect.

What's sometimes challenging for me is that I don't have a sense of "owning" of this face - it's mine and I don't necessarily associated it with "me."

I do have a longish midface, which I think can be camouflaged with different things to some extent.

I think I'll work with the cosmetic surgeon I've been to before for my necklift to identify a plan of action.  I do think that reduction of the upper lip length, buccel lipectomy and some micro-lipo in the cheek mounds and along with the jawline would improve things from my own perpective.  Also, removal of hardware from the upper jaw might reduce some of the forward projection (2 mms perhaps).  When I had the lower jaw hardware removed, it slimmed my lower face a bit.

Also, losing 15 pounds would help - I don't like the idea of eating that little; still, that is a sure way to loss some facial mass.

While I think that my mandible could be sculpted a bit more to make it more natural-shaped and not so "U-shaped," at this point I think it's probably the soft tissue stuff that would help.

meepmeepmeep

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Re: Considering Revision Years Later
« Reply #4 on: February 03, 2016, 06:19:50 PM »
your transformation is pretty astounding. personally, i often prefer men with a longer mid face to the "bulldogish" compact mid face look. however i would say that yours is slightly flat. maybe some fillers to the area could help with projection? otherwise, i think you look fantastic.

p.s. you have an INCREDIBLE head of hair!

JimmyTheGent

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Re: Considering Revision Years Later
« Reply #5 on: February 04, 2016, 08:28:41 AM »
You went from having a long, kinda messed up face to a totally normal looking guy.  There's nothing you should do except focus on living life with your new highly improved face. 
The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

kjohnt

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Re: Considering Revision Years Later
« Reply #6 on: February 05, 2016, 12:14:36 AM »
I'll echo what others have said.  You've improved 90% and you're chasing that last 10%.  The costs (not just literal) get exponentially greater for a diminishing reward.  Move on, and keep rocking that 'do for as long as you can.