What do you think would improve my facial harmony? (PICS)

[purplish]

Hello! I had jaw surgery, silastic chin implant removal and sliding genioplasty about 3 years ago and I'm quite self-conscious about how I look now. It made my nose really wide and crooked, my teeth protruded (and they were large to begin with), my chin asymmetrical/bunched up and way too big for my face, and my cheeks/malar fat pads really saggy. Overall the surgery made me look quite masculine and harsh. Aesthetically speaking, my actual side profile has improved but at the expense of nearly every other major feature on my face.

 I have a few consults lined up regarding chin reduction but I wanted to get a few other opinions. I've heard great things about side wing osteotomy (I prefer bone rather than implants due to a bad past experience with a chin implant) and I'm really keen on getting my chin redone.

I don't think my expectations are unrealistic or too high. I just know what I dislike about my face and would like to explore my options. If there's something that simply can't be done I will accept it and try to move on, but I just want my feminine features back... I'd be willing to get jaw surgery again if it fixed my problems (though I highly doubt that it would). What are my options?

I've attached some candid photos of myself which I believe highlight the features I like the least. Please excuse how bad my hair/makeup looks in these. I do know how to put myself together... these photos just provided the best example of my concerns.

Thank you for reading.

http://imgur.com/a/2cVXi

[purplish]

Your profile in the final pictures is excellent. Almost model tier.

Front-on your face looks too long and narrow in the first two pictures. But in the third picture it looks wider and your chin looks broad and masculine. You don't look great in any of those three pictures. Not sure what to suggest due to how different you look from each angle.

I took the first two photos from close up (to capture detail) so there may be some lens distortion. While I do have a long and narrow face, I also have a broad and masculine chin... so it's a bit of both. I understand as it's hard to judge when all of the photos look different. I wish it were just an easy fix haha. Thanks for answering anyway.

[CCW]

Did you have an upper jaw surgery and a genio? This looks like a case of improperly treated long face syndrome where the surgeon was lazy and only/mostly concerned with "fixing" the bite and did a genio to camouflage the length of the face and convex profile. Does your face look flatter than before? The genio seems to have been rather aggressive particularly with the vertical shortening because the mandibular plane angle visibly changes near your neck. You need bimax with counterclockwise rotation to fix your issues and should see Gunson or Wolford for a consultation.

[ppsk]

to me it looks almost as if you need some jaw rotation procedure.

as said before, your profile looks great. However, your jaw is incredibly steep. I think your best bet would be to straight up consult an experienced maxfac surgeon as to what they think should be done.

I'm no expert, but if i had to guess, I'm definitely going to say some form of rotation or ramus lengthening.

[PloskoPlus]

IMO skin quality is your main problem. I would not bother with more surgery.

[purplish]

Did you have an upper jaw surgery and a genio? This looks like a case of improperly treated long face syndrome where the surgeon was lazy and only/mostly concerned with "fixing" the bite and did a genio to camouflage the length of the face and convex profile. Does your face look flatter than before? The genio seems to have been rather aggressive particularly with the vertical shortening because the mandibular plane angle visibly changes near your neck. You need bimax with counterclockwise rotation to fix your issues and should see Gunson or Wolford for a consultation.

I had double jaw surgery with supposed CCW and genio. I went to Dr Schendel and Jacobson who were supposed to be among the best. I complained about these issues and they insisted it was swelling...even a year or two after surgery. I tried getting my records from them and they gave me the runaround for about 2 months (lying and saying they had mailed them or that they weren't available to talk, but they were available when I pretended to be a new patient). They finally gave me my records after my mom sent a letter saying that she'd seek legal action if we did not get the records and they sent it like 3 weeks later.

I am so disheartened. I did schedule consults with Deschamps-Braly and Wittenberg but this feels a bit hopeless. I/my parents spent a lot of money on my jaw surgery and now we are being ignored by the surgeon. On top of that I've developed TMJ. I'm wondering if I should even bother with surgery/spending more money at all.

[purplish]

to me it looks almost as if you need some jaw rotation procedure.

as said before, your profile looks great. However, your jaw is incredibly steep. I think your best bet would be to straight up consult an experienced maxfac surgeon as to what they think should be done.

I'm no expert, but if i had to guess, I'm definitely going to say some form of rotation or ramus lengthening.

Thank you. I will keep that in mind. I'm trying to book consults but it feels like a clusterf**k. I thought I had it all figured out once and for all when I went to Schendel then look what happened :/

[purplish]

IMO skin quality is your main problem. I would not bother with more surgery.

I realize that, but I'm doing more than most people do for their skin. It's genetic acne. Nothing I can really do but try to fix the scars, which I am doing. The reason I asked about jaw surgery is that this is a jaw surgery forum.

[ditterbo]

Seems you're not getting much feedback specifically with your cheeks/nose.  I'd suggest to show like for like photos, one against the other, before vs after, with different profile shots (however possible that is).

Also, I'm curious how many mm your maxilla was brought forward?  I've heard people complain their cheeks look haggard from this surgery, as though bringing the maxilla forward stretches the malar pads / cheek area out (I don't know).  Also a hunch with your OP doc, I'd try to get exactly what your surgical plan was from him for verification purposes.  CCW - you've said that CCW rotation would actually help puff out cheeks, right?  I wonder how much is 'too little CCW' to be noticeable whatsoever.

If you'd humor me, was there anything wrong with your chin implant prior to removal? Living with a chin implant myself but my smile has been somewhat hampered since.

[purplish]

Seems you're not getting much feedback specifically with your cheeks/nose.  I'd suggest to show like for like photos, one against the other, before vs after, with different profile shots (however possible that is).

Also, I'm curious how many mm your maxilla was brought forward?  I've heard people complain their cheeks look haggard from this surgery, as though bringing the maxilla forward stretches the malar pads / cheek area out (I don't know).  Also a hunch with your OP doc, I'd try to get exactly what your surgical plan was from him for verification purposes.  CCW - you've said that CCW rotation would actually help puff out cheeks, right?  I wonder how much is 'too little CCW' to be noticeable whatsoever.

If you'd humor me, was there anything wrong with your chin implant prior to removal? Living with a chin implant myself but my smile has been somewhat hampered since.

I'll try to find some pre op photos and post them soon. My chin implant was too square for my liking and also wore away at the bone which was very painful. I couldn't lie down on my face the entire time I had it. I'm sorry to hear that yours changed your smile.

[PloskoPlus]

I had double jaw surgery with supposed CCW and genio. I went to Dr Schendel and Jacobson who were supposed to be among the best. I complained about these issues and they insisted it was swelling...even a year or two after surgery. I tried getting my records from them and they gave me the runaround for about 2 months (lying and saying they had mailed them or that they weren't available to talk, but they were available when I pretended to be a new patient). They finally gave me my records after my mom sent a letter saying that she'd seek legal action if we did not get the records and they sent it like 3 weeks later.

I am so disheartened. I did schedule consults with Deschamps-Braly and Wittenberg but this feels a bit hopeless. I/my parents spent a lot of money on my jaw surgery and now we are being ignored by the surgeon. On top of that I've developed TMJ. I'm wondering if I should even bother with surgery/spending more money at all.

I don't think Wittenberg or Deschamps-Braly do CCW rotation. My bet is they will suggest fat or implants.

[purplish]

Do you know of surgeons who are experienced with CCW?

[PloskoPlus]

Do you know of surgeons who are experienced with CCW?

Wolford, Gunson, Relle.

[purplish]

Wolford, Gunson, Relle.

Thanks, I appreciate it! Weren't people on here saying (a while ago) that Wolford really pushes condyles to their limits (or something like that)? Maybe I'm thinking of another surgeon...

[The Quest for Aesthetics]

It's impossible to really analyse your frontal pictures with all the camera distortion going on.

However your profile view looks really really great, really pretty. It does appear as if you could benefit from orbital decompression, and more upper midfacial projection (doubtless 'left behind' after movement of the maxilla).