New here, looking for advice

[metallaces]

The picture will speak for itself, I have a recessed chin and weak jawline. I have an appointment with a maxillofacial surgeon in a few months for a consultation. What kind of procedures am I looking at? Plastic surgeon i saw last year seemed to think sliding genio was a good approach, but will it be enough?

My bite it perfect so Ive got no functional need for jaw surgery, fyi

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[Lestat]

maybe a chin wing.

[boyo]

BSSO with orthodontic decompensation would be the proper (but expensive and time-consuming) way of doing it. 

[kjohnt]

BSSO with orthodontic decompensation would be the proper (but expensive and time-consuming) way of doing it.

This, except bimaxillary advancement, as the maxilla is obviously recessive as well.  So generally, both jaws will be cut at the bone and moved forward.  Specifics such as amounts per jaw, rotation, genioplasty (I speculate no), etc. cannot be answered from this picture alone and are best answered by the surgeon.

[metallaces]

This, except bimaxillary advancement, as the maxilla is obviously recessive as well.  So generally, both jaws will be cut at the bone and moved forward.  Specifics such as amounts per jaw, rotation, genioplasty (I speculate no), etc. cannot be answered from this picture alone and are best answered by the surgeon.

Is orthodontic prep really necessary if I get bimax advancement? Won't my bite be in the same position if both upper and lower jaw are moved forward?

[kjohnt]

Is orthodontic prep really necessary if I get bimax advancement? Won't my bite be in the same position if both upper and lower jaw are moved forward?

Most need decompensation prior to surgery for correcting incisor inclinations.  Since you appear to be class II jaws but you say your occlusion is good (class I), this will mean uprighting lower incisors and/or proclining uppers into proper positions, giving you a class II bite to match your jaw discrepancy.  Because of the increased overjet, your mandible would be moved forward that much more relative to the maxillary movement.

There would likely then also be some mild adjustment to molar and premolar inclinations so everything fits unless the surgeon decides to handle the transverse plane... depends on if and what needs done and to what extent.

Again, I'm just giving my best answer with the little info we've been provided.  It is just speculation.  Your consultation will provide you with better and more specific answers.

[metallaces]

Most need decompensation prior to surgery for correcting incisor inclinations.  Since you appear to be class II jaws but you say your occlusion is good (class I), this will mean uprighting lower incisors and/or proclining uppers into proper positions, giving you a class II bite to match your jaw discrepancy.  Because of the increased overjet, your mandible would be moved forward that much more relative to the maxillary movement.

There would likely then also be some mild adjustment to molar and premolar inclinations so everything fits unless the surgeon decides to handle the transverse plane... depends on if and what needs done and to what extent.

Again, I'm just giving my best answer with the little info we've been provided.  It is just speculation.  Your consultation will provide you with better and more specific answers.

Ahhh i see. Thank you for the very thorough answer. I had braces for 3 years as a teen and invisalign for 2 as an adult so I'm really hoping to avoid them again, not to mention the cost... I have consult appointments booked with both an orthodontist and a maxillofacial surgeon. Will post results in case there's any curiosity or interest )

[kjohnt]

It seems counter intuitive at first, but the fact that you had braces prior almost certainly means you will need them again.  This is because your orthodontist likely tipped your teeth such that they masked your skeletal discrepancy, i.e. "compensated" for it.  The primary goal of presurgical orthodontics is decompensation, or putting your teeth into correct postions within the arches.  This is done regardless of how the upper teeth will fit the lowers, because that will then be fixed via surgery.  This means the braces will make your occlusion worse prior to surgery.

[CCW]

Don't get an isolated genio. Your chin looks normal, but you lack projection because your jaws are recessed. A genioplasty wouldn't improve your jawline definition and would worsen your already deepish mentolabial fold. You might end up with a witch's chin.

If your bite is "perfect" and you have a Class I molar relationship, you'll probably need counterclockwise rotation (w/ posterior maxillary downgrafting). Most people need bimax to fully correct their dentofacial deformity and many/most skeletal Class II patients need or benefit from counterclockwise rotation.