high mandible incline + vertical maxillary excess + open bite + SG = disaster?

[Purist]

I have met with a few surgeons over the past eighteen months to try and find a solution to fix my retrognathia (see attached). All declined to perform a BSSO stating a number of reasons.  Two surgeons recommended a two-tier genioplasty and a third surgeon was against any SG. A Le Fort with SG has also been suggested.

I've seen a number of posts on here stating that all of the above factors combined with an SG spells bad news. The result. a  long face.

It's put doubt in my mind about an SG and am about to call it a day altogether.  However, the retrusion is so bad I'm optimistic an SG would make at least some improvement.  Must admit,  a possible banana chin isn't helping matters either.

Any advice would be appreciated.


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[ditterbo]

Have you had braces before? Teeth extractions? What reasons did they give against bimax? Correct with that steep a mandibular angle, any chin augmentation will look weird from some angles (speaking from experience w/a chin implant, YMMV a bit I guess with an SG). 

[Purist]

Not had braces or extractions. Reason for not giving a BSSO was orthodontics related. Long roots and age (I'm in my forties). Three surgeons said due to the long roots the wisdom teeth extraction area would be weak.

[Vic]

Your bottom teeth are really protruded. You should get orthodontics to make the bottom teeth more vertical then have lower jaw surgery to move the jaw forward. Then get a chin wing

[ditterbo]

Not had braces or extractions. Reason for not giving a BSSO was orthodontics related. Long roots and age (I'm in my forties). Three surgeons said due to the long roots the wisdom teeth extraction area would be weak.

Those points have some merit perhaps but I wouldn't know outside of googling up on your circumstances myself.  People get bimax when they're older but the risk factors go up substantially I think.  That's all I got, hopefully a more well read person here can read your prognosis better.  Good luck!