Double-Jaw Surgery + Genio this Tuesday, please help! (before pics)

[newfacenewlife]

Over five years in the making and finally this Tuesday I will have the surgery I've been hoping for since I was 16, I'm now 21.

When I was 15 a friend next to me in class looked across to me and literally said with no mean intentions 'yo man, you have no chin'. I laughed, but it struck a chord in me because it's something I'd never acknowledged as I thought I was just 'normal'. From that point on I discovered what an overbite was, I got braces when I turned 16 in 2011 and hoped to have mine fixed. There's a lot worse overbites out there but it does become noticeable to people after a while. Anyway, turns out that my original orthodontist made it way worse with the NHS 'camouflage' treatment, eventually she gave me the option to refer me to a specialist orthodontist/hospital where they can offer surgery. I've learned to live with my face by holding certain positions with my lower jaw which feel so normal now I do it unintentionally, as my face has matured and I've turned from teenager to man it's nowhere near as bad as when I was a chubby teen. I'm pretty confident, I have a slight issue with opening my mouth a lot when I speak as well as a major issue with eating in front of people unless I'm 100% comfortable, that's the biggest one. So I'm looking forward to me being totally confident in my jaws natural positioning, eliminating these confidence issues.

I'm having a Lefort 1 to advance my upper jaw by 4mm I believe, as well as raise it and rotate by 2mm (sorry for lack of technical terms). I'm having a BSSO to advance my lower jaw by 8-10mm (sorry I cant remember the exact figures but those are roughly correct, I'm pretty certain), finally I'm having a genioplasty. I feel blessed this is more than I could have hoped for, but I'm also terribly worried about the outcome aesthetically. I've heard a Lefort I can give a chimp like appearance to people especially those with very large philtrums (upper lip) such as myself. Here's some pics of my unnatural and natural positions, the first three are unnatural and the last three my natural closed bite position.

http://imgur.com/a/AqZMh

This seems like major surgery so I'm getting more and more scared, more and more so about the outcome because I wont be able to change my face back and I'm quite happy with it, but I hate my jaw. Aesthetically speaking will this almost certainly improve my looks? I've just got my first ever girlfriend too and I'm smitten! I don't want to come out looking worse off aha. Would really appreciate some input guys, thanks!

[PloskoPlus]

You're leaving this too late to get our input. Your upper lip is long. You should have had a lip lift 6 months before surgery and then you'd be able to get more ccw rotation via posterior down graft AND anterior impaction.

[newfacenewlife]

You're leaving this too late to get our input. Your upper lip is long. You should have had a lip lift 6 months before surgery and then you'd be able to get more ccw rotation via posterior down graft AND anterior impaction.

I've always felt in good hands, my upper lip area has been considered throughout the pre-surgery process and development. I know tere will be an upper impaction of 2mm or so. Surely my surgeon who has performed hundreds of jaw surgeries isnt going to leave me looking worse off? he's doing the extra work such as the Lefort I to give me the best treatment possible, it was optional.

I doubt I could have had a lip lift, this is NHS treatment for my overbite. Not ultimately for cosmetic purposes although it's obviously considered important

[PloskoPlus]

I've always felt in good hands, my upper lip area has been considered throughout the pre-surgery process and development. I know tere will be an upper impaction of 2mm or so. Surely my surgeon who has performed hundreds of jaw surgeries isnt going to leave me looking worse off? he's doing the extra work such as the Lefort I to give me the best treatment possible, it was optional.

I doubt I could have had a lip lift, this is NHS treatment for my overbite. Not ultimately for cosmetic purposes although it's obviously considered important

Your don't have a gummy smile.

[Trader]

I hate to say this, but I think you should delay your surgery until you get a better idea of your surgeon's plan as well as his capabilities.

You seem to have a very steep occlusal plane, which means that you'd need a lot of counterclockwise rotation to achieve a balanced profile and a healthy airway. 2mm of impaction at the front isn't going to cut it -- you need a good amount of lengthening of your posterior maxilla. I suspect your surgeon may not be comfortable with this, which will lead to compromised results.

[newfacenewlife]

I hate to say this, but I think you should delay your surgery until you get a better idea of your surgeon's plan as well as his capabilities.

You seem to have a very steep occlusal plane, which means that you'd need a lot of counterclockwise rotation to achieve a balanced profile and a healthy airway. 2mm of impaction at the front isn't going to cut it -- you need a good amount of lengthening of your posterior maxilla. I suspect your surgeon may not be comfortable with this, which will lead to compromised results.

Oh jesus I can't call it off now I'm hours away from it, I mean I'm not looking for perfection. Just a better bite and slightly improved aesthetics. I'm quite happy with how I look ultimately.

Here are some shots of my teeth

http://imgur.com/a/v5GSq

I really just dont want a chimp limp or anything, I have a convex philtrum which apparently is preferred.

Im so nervous now.

[PloskoPlus]

Oh jesus I can't call it off now I'm hours away from it, I mean I'm not looking for perfection. Just a better bite and slightly improved aesthetics. I'm quite happy with how I look ultimately.

Here are some shots of my teeth

http://imgur.com/a/v5GSq

I really just dont want a chimp limp or anything, I have a convex philtrum which apparently is preferred.

Im so nervous now.

You don't have a gummy smile. You do have a long lip. 2mm of impaction will not achieve much CCW, but may kill your tooth show. There are multiple users on this forum dealing with this.

[Trader]

Oh jesus I can't call it off now I'm hours away from it, I mean I'm not looking for perfection. Just a better bite and slightly improved aesthetics. I'm quite happy with how I look ultimately.

Here are some shots of my teeth

http://imgur.com/a/v5GSq

You can call it off at any moment before you go under. We're talking about a major surgery performed on your face. It's also an elective surgery, with no urgent need for it.

If you go through with this, you will get some improvement in your face. The actual horizontal lengthening of your lower jaw will probably only be a few millimeters, and the increase in your airway size will be similarly small. Almost all of the improvement in your profile will come from the sliding genioplasty, rather than the jaw advancement.

You have great features overall, and you could have amazing results with a proper counterclockwise rotation advancement. I think you're better off postponing surgery and getting it done correctly the first time, even if that requires waiting longer.

[PloskoPlus]

You can call it off at any moment before you go under. We're talking about a major surgery performed on your face. It's also an elective surgery, with no urgent need for it.

If you go through with this, you will get some improvement in your face. The actual horizontal lengthening of your lower jaw will probably only be a few millimeters, and the increase in your airway size will be similarly small. Almost all of the improvement in your profile will come from the sliding genioplasty, rather than the jaw advancement.

You have great features overall, and you could have amazing results with a proper counterclockwise rotation advancement. I think you're better off postponing surgery and getting it done correctly the first time, even if that requires waiting longer.

I agree.  Proper CCW will also mean less horizontal advancement of there maxilla. OP already has a wide nose.

[newfacenewlife]

You can call it off at any moment before you go under. We're talking about a major surgery performed on your face. It's also an elective surgery, with no urgent need for it.

If you go through with this, you will get some improvement in your face. The actual horizontal lengthening of your lower jaw will probably only be a few millimeters, and the increase in your airway size will be similarly small. Almost all of the improvement in your profile will come from the sliding genioplasty, rather than the jaw advancement.

You have great features overall, and you could have amazing results with a proper counterclockwise rotation advancement. I think you're better off postponing surgery and getting it done correctly the first time, even if that requires waiting longer.

I'm actually totally fine with my face other than my recessed mandible, so I would be pretty happy with the lower advancement and genio as that's all I was ever hoping for, but according to my surgeon the Lefort I will be the cherry on top. Thanks for the compliment, that means a lot. By any chance could you explain what you mean but a proper counterclockwise rotation advancement so I can mention it in the morning to my surgeon? I'd really appreciate it. But ultimately as I said, so long as I don't look worse off from this surgery I'd be over the moon, I just want a stronger chin and jaw area!

[CCW]

I'm actually totally fine with my face other than my recessed mandible, so I would be pretty happy with the lower advancement and genio as that's all I was ever hoping for, but according to my surgeon the Lefort I will be the cherry on top. Thanks for the compliment, that means a lot. By any chance could you explain what you mean but a proper counterclockwise rotation advancement so I can mention it in the morning to my surgeon? I'd really appreciate it. But ultimately as I said, so long as I don't look worse off from this surgery I'd be over the moon, I just want a stronger chin and jaw area!

Well, the thing is your jaw will still look recessed and your profile will stay convex if you don't get counterclockwise rotation.

Here's a guy who had a 12mm BSSO + 8mm genio. Barely any change at all and still very recessed because his occlusal plane was left steep.
https://www.reddit.com/r/SleepApnea/comments/3r5ema/i_had_an_mma_surgery_3_weeks_ago_here_is_my_update/

[newfacenewlife]

Well, the thing is your jaw will still look recessed and your profile will stay convex if you don't get counterclockwise rotation.

Here's a guy who had a 12mm BSSO + 8mm genio. Barely any change at all and still very recessed because his occlusal plane was left steep.
https://www.reddit.com/r/SleepApnea/comments/3r5ema/i_had_an_mma_surgery_3_weeks_ago_here_is_my_update/

Wait, I see a big difference there. It's not perfect by any means, but the guy seems very happy.

I've also seen generated images of how I'll look afterwards and it definitely improved my chin dramatically!

[ditterbo]

Have you gone through with the surgery newfacenewlife?

[newfacenewlife]

i have indeed!

very swollen at the moment but the results look promising and the surgeon + his team were very happy.

[ditterbo]

Please keep us posted (maybe in a new thread) on how things turn out.  Or start a blog.  Or nothing at all, up to you.