If he gets an SG now, wouldn't that interfere with a bimax surgeon's surgical planning? Lets take Gunson for example, who only does 3mm SG's less you force him to like 5. An 8mm preexisting SG would either reduce your jaw advancement and/or double down on revision genio risks to muscles and nerves, no?
My ceph looks very similar but living with a botched 12mm chin implant for the time being (mentalis muscle rests too high).
Also, do you not recommend Dr. Posnick for big CCW and posterior maxillary downgraft cases? I've heard him call a Gunson surgical plan "deforming".
OP, did the doc who took that x-ray make you slide your lower jaw back as much as physically possible before taking the shot?
A/G don't take chin projection into account when deciding jaw movements -- they consider the chin only after they determine the maxillomandibular movements needed for an ideal bite. Thus, having too large a chin will have no effect on the amount of jaw advancement that A/G will recommend. It's just one more thing that make them ahead of the curve
I will say, though, that as great as A/G are, I don't always agree with their belief that a man's chin should project a few milimeters short of the TVL and lower lip. Men with very well-developed faces typically have chins that project further than what A/G recommend. I think a big chin looks great on an individual who has well-positioned jaws (obviously, it doesn't look so good if it's a compensation for a recessed lower face). Remember, male attractiveness is often a result of having exceptional features -- exceptional height, exceptional muscle mass, exceptional jaw, chin, and cheekbone development. A/G's standards are merely based on the average of a bunch of class 1 profiles. And while focusing on averages is fine -- especially for something functional like a bite -- it's often desirable to be above average in more cosmetic traits like height or chin projection.
For cases require large CCW rotations with large posterior maxillary downgrafts, A/G are really the only viable option. By large, I am referring to downgrafts greater than 5 or 6 mm. If you need less than that, another surgeon would probably be fine, provided they have at least some experience with the movement.
