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!

[ditterbo]

Camouflage orthodontics as in you had extractions?  Did you test for sleep apnea? How big is the genio (in mm)? 

I don't really know what your asking us here, but that could just be me. I think we'd have to see a smile shot, maaybe a ceph xray. Your surgeon would help.  From your lefort 1 description, they're treating a gummy smile as well, right?

You reminded me back in junior year highschool, a girl I never spoke to in class (just had no reason to) had to sit face to face with me once for some class exercise. First thing she said to me was "whoa, you look a lot different from the front".  I didn't really know what she meant, until 10 years later when a maxillofacial doc (Posnick) tells me I definitely should look into bimax surgery. 

[CCW]

My concern if I was you if he doesn't rotate your jaw enough you might end up with a really long face from the front and long down sloping profile. Because it appears your mandible angle is very steep.

This. He needs a lot of counterclockwise rotation to straighten the profile (posterior maxilla down and anterior up if you have a gummy smile), but I'm not sure NHS does that. You should probably ask about that, newfacenewlife. Chimp lip can happen with large straight advancements if the occlusal plane is steep.

[newfacenewlife]

Camouflage orthodontics as in you had extractions?  Did you test for sleep apnea? How big is the genio (in mm)? 

I don't really know what your asking us here, but that could just be me. I think we'd have to see a smile shot, maaybe a ceph xray. Your surgeon would help.  From your lefort 1 description, they're treating a gummy smile as well, right?

You reminded me back in junior year highschool, a girl I never spoke to in class (just had no reason to) had to sit face to face with me once for some class exercise. First thing she said to me was "whoa, you look a lot different from the front".  I didn't really know what she meant, until 10 years later when a maxillofacial doc (Posnick) tells me I definitely should look into bimax surgery.

Yeah I had four extractions, two upper and two lower. Nope, no issues with sleep apnea as of yet and I'm not sure about the genio although they was debating on whether to do it or not as well as the Lefort I. The surgeon opted to do it because he said he wanted to give me the best treatment possible but he gave me the choice. I'll upload a smile shot in a little while but I don't have a gummy smile at all. My surgeons name is Dr Heliotis and he's performed these surgeries hundreds of times so I'm very confident in him. I'm just really nervous about the outcome.

[newfacenewlife]

Jutting your jaw makes a big difference from the front.

I don't think it's possible that you will look worse unless the surgeon goes full retard.

What are you telling you girlfriend because you know.... girls don't like self-conscious guys and all. It's a tough world. Having a legitimate deformity and worrying about it makes you more unattractive.

Can relate to you both regarding copping comments from others at school. I remember every remark about my chin which would be like 6 incidents in 23 years of life.

My concern if I was you if he doesn't rotate your jaw enough you might end up with a really long face from the front and long down sloping profile. Because it appears your mandible angle is very steep.

She knows everything, I havent told her about any of my insecurities regarding it though. I've pitched it as more of a functional choice rather than aesthetic. Yes every comment cuts deep but my friends poke fun of me about it now which I've learned to deal with.

I'm pretty certain my orthodontist explained to me that they will be rotating my upper-jaw slightly!

[newfacenewlife]

This. He needs a lot of counterclockwise rotation to straighten the profile (posterior maxilla down and anterior up if you have a gummy smile), but I'm not sure NHS does that. You should probably ask about that, newfacenewlife. Chimp lip can happen with large straight advancements if the occlusal plane is steep.

I mean my surgery is tomorrow morning so I don't think I'll have a chance, I've been confident I've been in good hands all a long but pre-surgery nerves and doubts are kicking in. They've spoke about my upper-lip on a couple of occasions so I think they have definitely considered it. I've read on forums that chimp lip depends on the shape on the philtrum (convex being preferred?) which I believe I have. I hope so, having a chimp lip would be awful so surely they've considered that when these surgeries are considered for aesthetics almost as much as functionality.

[newfacenewlife]

Camouflage orthodontics as in you had extractions?  Did you test for sleep apnea? How big is the genio (in mm)? 

I don't really know what your asking us here, but that could just be me. I think we'd have to see a smile shot, maaybe a ceph xray. Your surgeon would help.  From your lefort 1 description, they're treating a gummy smile as well, right?

You reminded me back in junior year highschool, a girl I never spoke to in class (just had no reason to) had to sit face to face with me once for some class exercise. First thing she said to me was "whoa, you look a lot different from the front".  I didn't really know what she meant, until 10 years later when a maxillofacial doc (Posnick) tells me I definitely should look into bimax surgery.

Also, I think the genio is supplementing the lower-advancement because of my recessed chin which would still look very short even in it's new position. When I pull my teeth to the position they desire, the chins still very short. I'm hoping the genio will give me a normal and angular looking jaw/chin as opposed to a functional bite but still very narrow chin area.


+++ Smile shots:

http://imgur.com/a/v5GSq

[ditterbo]

Hope they do an alar cinch on you for your nose, there's a chance of that widening with lefort 1 i think.

Also agree with everyone here that you probably need a pretty strong CCW as opposed to a straight forward advancement.

[newfacenewlife]

Hope they do an alar cinch on you for your nose, there's a chance of that widening with lefort 1 i think.

I was told my nose could widen but not much. Ahh all these risks are just making me worry more I don't want to end up with more insecurities than  began with :/

[sensual_lips]

Hey cutie,

You will be very handsome when you have your jaw surgery, already cute and just as an idea not telling you to, But a rhinoplasty after your jaw surgery would make you look amazing. You only need a little front width reduced slightly and bump removed. This is my opinion not everyone will agree. Either way you have the canvas to be a real handsome dude! x

[newfacenewlife]

Hey cutie,

You will be very handsome when you have your jaw surgery, already cute and just as an idea not telling you to, But a rhinoplasty after your jaw surgery would make you look amazing. You only need a little front width reduced slightly and bump removed. This is my opinion not everyone will agree. Either way you have the canvas to be a real handsome dude! x

How lovely of you, thank you so much! I was offered the "nose job" so to speak, but I'm a boxer so it's pretty pointless haha. I had my surgery and I'm liking the potential final outcome, my heads like a melon at the moment so it's a slow process of discovery. thanks again though x

[kjohnt]

Without seeing xrays, it is only conjecture as to whether or not OP needs any CCW rotation at all.  We don't know his current occlusal plane angle.

[Vic]

Hi newfacenewlife, Where did you have your surgery done?

[jackwrench]

I guess it's been a couple of weeks since the surgery. Are you happy with the result? I'm considering Heliotis (I'm assuming you are talking about Manolis Heliotis, in UK) and would love to hear your opinion.

I'm actually in a really similar position myself. 21, had "masking" orthodontics in my teens that I'm not happy with. 4 teeth extracted as well. Ever since the braces came off I've been disappointed in my profile. I relate 100% so I hope you are satisfied with the surgey.