What about the downsides to jaw surgery though? Won't I have complications when I'm older? Won't I have a loss of general strength of the jaw? They are sawing bone and screwing it into a new place. Couldn't TMJ become a problem after?
It seems with implants though the jaw itself isn't really "touched" the only issues I've heard of are the small eating away of bone in that area. Which is still def a huge problem
Again, it's really hard to say anything about your case without pictures. I do think that the people here will give you better advice than the vast majority of orthodontists and plastic surgeons, so it's in your best interests to post as much info as possible.
Some people who are upset with their weak jaws/chins may only need a few millimeters of advancement or augmentation. These are the ones who can benefit substantially from camouflage procedures. However, if you're deficient by a centimeter or more -- which isn't uncommon among people who are upset with their facial structure -- then the effects of camouflage are limited. I still think that camouflage procedures can offer substantial improvement, but they can't fix the functional problems that almost always occur with underdeveloped jaws (namely, a small airway). Since jaw surgery offers greater more cosmetic improvement and correction of functional problems, it's a clear choice for people with large deformities.
Jaw surgery can be risky. The strength of the bone post surgery is a non-issue. The bigger issues are nerve damage, relapse, and bite/joint problems. A lot of the risk depends on the type of movements. For instance, certain movements like maxillary advancement or impaction or linear mandibular advancement are relatively low-risk. Movements like maxillary downgrafting are more unstable. If you post pictures, we can tell you what kind of movements you'll likely require.
