PLEASE HELP ME CHOOSE (pic inside)

[thereishope]

Hello!
I am 19, and am going to have surgery very soon. As you can see on the picture, I have a recessed chin, big ugly nose, and a somewhat recessed maxilla. I think I might have sleep apnea because I almost always wake up with a headache and a sore throat. Additionally, I am pretty tired during the day. Do you think my airway looks too narrow? Even though I might have sleep apnea, my biggest concern is the aesthetics of my face.
I have made 2 options but I don't know which of them I should choose.

1. suggestion(easiest): Chin wing to add projection to my chin and to lengthen my lower third + rhinoplasty. both with Dr. Z who I have had a consultation with.

2. suggestion: MMA with CCW rotation of the maxilla, genioplasty, and rhinoplasty with Dr. Raffini. followed by a chin wing with Dr. Z to lengthen lower third and decrease my gonial angles. Dr. Z didn't think that advancement of my jaws was necessary though.

I am in such a big dilemma! The 1. suggestion would be so much easier, but I am afraid my results will be suboptimal. And the 2. suggestion will take a lot more time, money, and energy..

Please offer me your guidance, so I will make the right choice! Thank you very much!





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[ptc]

If you have a big nose it is probably because your maxilla is recessed. Where are you getting the money for this surgery from by the way?

[thereishope]

I am going to have a sleep study done soon, and if I have sleep apnea the insurance will probably pay for the MMA, but otherwise savings and my mother

[ptc]

I'm surprised your mother is willing to pay for you to get the works done on your face, if it is mostly for aesthetics.

No one can really give you any good advice unless you post a decent profile picture. Just block out your eyes if you are worried about being recognised.

[thereishope]

She knows how important it is 
I will post a "normal" picture very soon then. I just thought the x-ray would be superior.

[David_D]

I imagine that the "right" answer would be determined by your own aesthetic preferences plus your willingness to undergo specific procedures.  If you want a different position for your jaws for aesthetic reasons, then I think that would indicate jaw surgery.

[mike888miller]

why not have the mma with dr z also?

what is the treatment plan you have with Raffini? how much movement of max man? any rotation?

[thereishope]

dr z was very reluctant when i suggested mma especially because my bite is fine + he is confident that the chin wing will provide me with the result i want
i dont have a treatment plan with raffaini and havent had my consultation with him yet. he has just seen my x-rays. therefore, i dont know how much advancement i would require. i should definitely get ccw rotation though

[LyraM45]

If you have issues with apnea, headache, etc..... why is just going for chin and nose work on the table?  I'd fix the functional issue first and see what changes that brings to your skeletal issues and how that impacts soft tissue.  Then after that do what you want to fix the soft tissue.  Less is more IMO.

[ditterbo]

As an American, can we get Dr. Z's opinion over email if we should get bimax or just a chin wing?  Like has he done that for folks here before? Not clear how OP got a hold of him.

[thereishope]

As an American, can we get Dr. Z's opinion over email if we should get bimax or just a chin wing?  Like has he done that for folks here before? Not clear how OP got a hold of him.

I am not sure if he can determine that without seeing you in person. I had my x-rays done a couple hours before my consultation, so he kind of examined them during the consultation. So, i didnt just send him my x-rays and asked wether he thought bimax or chin wing would be the right choice. During the consultation, he didn't mention bimax himself, and when i brought i up, he examined my jaw and said i didnt need it and chin wing would be a better choice.

[Trader]

For the best cosmetic and functional results, I strongly recommend jaw surgery with counterclockwise rotation. In fact, I strongly suspect that the increase in airway size will prove more rewarding to you in the long run than will any sort of cosmetic improvement.