Is Surgery Worth It?

[surgeryornot]

Hi everyone,

I'm one of the few on here who actually has a full custom wrap around jaw/chin implant. Before, I had a very feminine upside triangle jawline with no angles whatsoever and a high occulsal plane and also no chin. While the implant isn't perfect (still have high plane, high angles, and on side is bigger) it at least gives me a decent enough jaw and chin, despite jaw still being quite high and chin contributing to a deep labiomental fold.

Unfortunately, the implant is masking a more underlying problem of a deep overbite as well as asymmetrical one (class 2 on right and class 3 on left). Midlines are very off and I have a slight cant to the right. This is also contributing to some major TMJ, especially very loud click on right.

Already consulted with Gunson and he said I'm definitely a candidate but he's honest in saying if aesthetically I would look better than I do now if I opt for surgery (especially jaw angles as ha paste doesn't do this great). Also, removing the jaw implant and doing the surgery adds a whole other set of variables in terms of results, as this is rarely done.

I ask you guys, based on photos, should I go for it? Remove implant, do the braces and get the surgery? Or, should I just leave well enough alone. I should mention I do struggle with insecurity regarding my looks, so if I'm all likelihood I will come out looking better than now, I would probably do it.

Thank you!

http://m.imgur.com/a/HtVQf

[ditterbo]

Saw your pics before reading your post. I think you posted on here or somewhere else pre implants? Who did the implant work? The only thing I thing I think you stand to gain w/bimax over this is a big reduction in the labiomental fold.  Your smile looks kind of tight now from the implant btw, am I right?   Gunson is right you probably won't look any better, and that gonial angle is important imo.  You have TMJ pain or clicking or both or what? Your mid-face looks kinda flat to me, if anything that's where to look next. Have you not looked into orthodontics?

[surgeryornot]

Saw your pics before reading your post. I think you posted on here or somewhere else pre implants? Who did the implant work? The only thing I thing I think you stand to gain w/bimax over this is a big reduction in the labiomental fold.  Your smile looks kind of tight now from the implant btw, am I right?   Gunson is right you probably won't look any better, and that gonial angle is important imo.  You have TMJ pain or clicking or both or what? Your mid-face looks kinda flat to me, if anything that's where to look next. Have you not looked into orthodontics?

Haha, you got me. That was me. Was hoping people wouldn't be able to easily tell pre-implant face. Yaremchuk did the implant. To be honest, smile feels no different than it did before the implant. And yeah, Gunson said no guarantee I'll look better or if surgery can match what the implant achieves.

No so much pain, but heavy clicking as my bite asymmetrical and shifted to the right, something only jaw surgery can fix. What would you suggest for the midface? Looked into orthodontics but I worry about spending a year or two compensating just to have to undo everything again if I were to opt for jaw surgery down the line.

[surgeryornot]

Profile is solid. Front on I would be disappointed. Still looks potato and there's asymmetry. Did you ask for a sharp, tapered V shape jaw?

No-one here can tell you whether you will look better going the Gunson route.

I agree to an extent. My starting point though was literally zero angles (not covered by soft tissue, my anatomy just has no angles whatsoever on the corners). Believe it or not, the angles added 10mm of width! But you're right, might needed to go larger.

Based on my soft tissue though, not sure if a sharp jawline is even possible. I'm happy to just be rid of the feminine look with no jaw at all. That said, if I can improve it, I would.

[CCW]

I'd do it if you have the money and motivation even if was just to get rid of the implants and not having to worry about them in the future.

[爱]

I dint see the before pictures so I cant tell if you should start from scratch. Also you dint keep a picture showing your teeth bite or xray so noone can tell really.

But based on physical appearance alone, and if your mouth is closed i think you dont need to change a thing.

Yes, when you smiled i could see the upper teeth and they need alignment but i cant see the bite so i dont know to what extent can this be corrected with braces and then left alone.

[surgeryornot]

I dint see the before pictures so I cant tell if you should start from scratch. Also you dint keep a picture showing your teeth bite or xray so noone can tell really.

But based on physical appearance alone, and if your mouth is closed i think you dont need to change a thing.

Yes, when you smiled i could see the upper teeth and they need alignment but i cant see the bite so i dont know to what extent can this be corrected with braces and then left alone.

You're very sweet. I do wish for a nice looking jaw/face and perfect bite though, but not sure if jaw surgery alone can do it. Might be a trade off. I can try to find my ceph/xray so you can see my bite. Orthodontics can fix the the overbite to a limited extent and help with alignment but the asymmetry (midlines being off, the fact you can see more teeth on one side than the other), can only be fixed with surgery since it's a jaw problem.

I'd do it if you have the money and motivation even if was just to get rid of the implants and not having to worry about them in the future.

And that's where my problem lies. The uncertainty if taking out the implant and doing the surgery will be able to improve or even match the results of what I currently have. I would consider it a failure if I functionally am solid but come out looking worse than now. Also, Gunson is quoting 75k (yes more because of the implant variable), so is that worth the risk of looking s**ttier than now?

[surgeryornot]

My potential surgery ceph for those interested.

[attachment deleted by admin]

[ditterbo]

Dang maybe your orthodontic situation pushed it over the edge, but those movements are quite mild on the Gunson spectrum imo. Notice 0 changes to your pervious gonial angle with that advancement.  I've always wondered if jaw advancement tightens the lateral tissues though, creating a more defined jaw, albeit not bigger.

btw 5.2mm genioplasty? Did you coerce him for an extra 2mm?

[surgeryornot]

Dang maybe your orthodontic situation pushed it over the edge, but those movements are quite mild on the Gunson spectrum imo. Notice 0 changes to your pervious gonial angle with that advancement.  I've always wondered if jaw advancement tightens the lateral tissues though, creating a more defined jaw, albeit not bigger.

btw 5.2mm genioplasty? Did you coerce him for an extra 2mm?

Yeah, pretty sure my profile will be pretty strong, but I'll be back to having that upside down feminine triangle jaw with zero angles and probably even higher than now (implant actually dropped the angles a few mm also). Even Gunson said I almost definitely lose the width.

For the chin, not sure, but implant is 8mm on chin.

[surgeryornot]

Main thing that I won't know unless I do the actual surgery is how much CCW will help with the widening and angles.

[PloskoPlus]

Main thing that I won't know unless I do the actual surgery is how much CCW will help with the widening and angles.

Very little

[surgeryornot]

Any other thoughts here from everyone? Still struggling to make a decision.

Thanks.