Third NYC area guy. It seems, to me, like A&G are way to go but they are across country and so expensive that I'm resigned to probably not get surgery. Aside from the gum recession likely caused by my flared teeth, I don't really have any health issues. I do stay in good shape so I'm sure that helps against sleep apnea. Also, I think being very serious about retraining my tongue, jaw and neck muscles to apply proper posture has been of help too. I seem to be able to often sleep with my mouth closed sometimes too now. I'm hoping that these posture changes, while unlikely to change anything structurally, will help me remain good functionally.
I'm also fortunate to have decent beard growth that I use to mask some of my recession (chin) and don't have severely recessed jaws or poor looks that really impact my daily life. So, it just isn't worth it to pay so much for surgery that has so many risks.
Still, if you guys figure out an in-network or more inexpensive surgeon that applies the right aesthetic principals... then I'll open my mind to it again!
Also, I do sometimes just consider a sliding genioplasty only. I know that double jaw surgery will negative impact the look of my cheekbones (since they are recessed along with jaws) so unless I get extreme CCW without significant anterior movement (avoid concave cheeks)... just don't even know if I'll like my looks anyway. At least the sliding genio alone allows my cheek hollows and some semblance cheek projection while still helping to hide my recession.
Anyway, sorry for the rambling. Good luck to all you who keep on searching!
