What surgical technique do I need? Images included.

[JigJaw_:/]

How did you know/hear about Dr. Hobar? He seems to be well established, esp. here in the Dallas metroplex. Checked out his website, he has a couple dozen genioplasty before/afters.  Looks like decent work. Some of his male patients seem to have definitely got that extra chin they were looking for.  A little standoffish from PS at the moment. The other guy was supposed to have also had a keen eye. I've talked with one already, but- the more I check in with my inner risk/reward evaluation...the more my brain is telling me to go with a max fax doctor bc they will have superior knowledge.

[kavan]

How did you know/hear about Dr. Hobar? He seems to be well established, esp. here in the Dallas metroplex. Checked out his website, he has a couple dozen genioplasty before/afters.  Looks like decent work. Some of his male patients seem to have definitely got that extra chin they were looking for.  A little standoffish from PS at the moment. The other guy was supposed to have also had a keen eye. I've talked with one already, but- the more I check in with my inner risk/reward evaluation...the more my brain is telling me to go with a max fax doctor bc they will have superior knowledge.

Never mind 'how'. Please accept that I DO know who's who in the field. Your other PS was just a 'garden variety' type. Putting in a button implant is the easiest type to place and mark of run of the mill PS unless, it's the only thing that will work.

[JigJaw_:/]

Was only curious.

[PloskoPlus]

I don't see fish bowling. You see that more in CONVEX profiles than balanced ones. He has the latter. His face can be divided into '1/3rds' so his bottom 1/3rd= his middle 1/3rd. However, he does have more length than width with respect to the yellow and red lines. But there is no balance for that. Nor is it really a cosmetic 'defect'.

So the "long midface" effect is due to the eyes being close set, which is a bit of a shame since the eye shape is nice.

[PloskoPlus]

The cant may be hard to resolve - may need both jaw surgery and some kind of soft tissue work to resolve.

[JigJaw_:/]

Besides a couple ncbi articles...I can't find very much information covering lip "cant" issues/corrections. I don't really understand it all that well. My old oral surgeon never mentioned it; perhaps it was just part of the original game plan for evening things out. I'd relish the idea of being able to resolve the smile (lip issues) and chin w/out bimax surgery, if it can be done.  I've got to first get my chin situation resolved, so bi max would be down the road; at that time...who knows if docs would recommend it less perform it.

[kavan]

So the "long midface" effect is due to the eyes being close set, which is a bit of a shame since the eye shape is nice.

But only relative to the vertical measure.

[PloskoPlus]

But only relative to the vertical measure.

But does one eye width fit between the eyes?

[kavan]

But does one eye width fit between the eyes?

YES and that's a good question. So, technically, he does not have 'close set' eyes. I think people might just be 'used to' seeing the (horizontally) 'long' eyes of male models where basically, the inter-pupil distance is longer than average, longer than the norm and with that the (vertical) distance from the the eyes to the corners of the lips is very close to being same.  They too have 'one eye between the eyes' but the inner to outer canthal distance is much LONGER than the norm. Hence, so will be the IPD. So, it's basically the 'off the charts' (positive) deviation from the NORM regarding the length of the eye and IPD that makes their midface look 'compact' even though their midfaces might be technically longer than the norm too.

[JigJaw_:/]

Kavlan,
Okay, then I have a stupid question: if I had a lip lift in combination with the genioplasty osteotomy, , theoreticaiiy would it help reduce that eye to lip corner ratio that is creating some of the visual distortion? I still see myself as having a shorter lower third, but it could just be subtle combinations of several factors that I've yet to completely accept. For years now I've created a narrative for the other.
I think if I had a bigger overall head size it would be less obvious.
I also made an appointment with the doc you suggested, but he isn't available until mid November.

[kavan]

Kavlan,
Okay, then I have a stupid question: if I had a lip lift in combination with the genioplasty osteotomy, , theoreticaiiy would it help reduce that eye to lip corner ratio that is creating some of the visual distortion? I still see myself as having a shorter lower third, but it could just be subtle combinations of several factors that I've yet to completely accept. For years now I've created a narrative for the other.
I think if I had a bigger overall head size it would be less obvious.
I also made an appointment with the doc you suggested, but he isn't available until mid November.

There is really no 'distortion'. People are just used to looking at male MODELS who's eyes are very 'long' (inner to outer canthus) and longer than the NORM and DUE to that type of 'off the charts' length that is LONGER than the NORM for the eye, their midface looks 'compact'. They have a type of ratio where the distance from outer PUPIL to outer PUPIL=the vertical to either the corners of the lips or the 'part' between the lips. It's DUE to the EYES. They also have BIG HEADS. They also have an S-N plane that is either horizontal or tipped forward where S is higher than the N point. (Sorry but you will just have to familiarize yourself with ceph land marks) which is what gives them the nice 'shadowing' above the eye. Upper orbit is the FRONTAL bone of cranium and it's the forward tipping of the cranium that gives the models the type of 'shadowing' to the upper eye.

Point I'm making here is that IF you are doing things to look more like a male model which is a common motivation I see with guys who start with pretty good bone structure already and then pursue a bunch of bone cuts, teeth work--what ever--it ISN'T going to happen. You and countless others pursuing things where on some level, perhaps subconcious or in the back of your mind, want to see the relationships/ratios a male model has, ISN'T going to happen. Models usually have relationships, especially with the eyes that CAN'T be reproduced via surgeries.


So, a lip lift, along with a corner lip lift with it (LLs lift the central part mostly) will make the labial ledge (distance from sub-nasa to top of upper vermilion border) which would be something to do IF one wanted:

a MORE upper tooth show
b a SHORTER labial ledge

But it's not going to kick up the same kind of ratio that makes a male model's midface look 'compact'IF that is your motivation for having it.

[JigJaw_:/]

Roger that-
Thanks for the elaborate answer, really helps. And yes, I do need to up my facial anatomy I.Q. Facial structure is much more complex than I ever gave time to contemplate. Definitely interesting. It's crazy how alike yet how dissimilar we can all be with only mm's of difference.
I'm not on any kind of "model quest",  or GQ mission impossible. I'm really just looking to enhance/modify whats already on the table to level life's playing field. I think that's what most of us are seeking. No qualms with those seeking aesthetic perfection, I'm just not. This forum is definitely a nice short cut to information.
Right now I just want to be sure I walk into my consults with a firm understanding of what to ask and know the limitations, styles, fixation procedures  etc. Seems genioplasty can differ quite a bit.
Btw, good tip on the upper lip. Cause that area of augmentation is esp. new for me. 

[kavan]

If you ask me, I think that part of the longer looking labial ledge is due to the vertically oriented central incisors and then the pile up of the THICKNESS of them (via veneers) to the TOP area. To demonstrate this, roll up a piece of wet tissue paper and place it HIGH on the teeth near the gums and see if your upper lip curls INWARD and looks longer. Then try at bottom of upper teeth and see that the upper lip curls OUTWARD and looks shorter.

Did you know that some people with OVER JETS--incisors that angle outward past the lower incisors, have shorter looking labial ledges or better looking lip prominence? The problem is that keeping (angled out) the over jet goes against the grain of standard dental practice where they want to push inwards for the teeth to meet better. With veneers, they always need to make it more thick towards the top.

So, although yours were made LONGER for more tooth show, the orientation of the central incisors is straight down and the thickness pile up of the veneers is close to top and that also contributes to the look of the longer lip.

LL would shorten the labial ledge and give MORE tooth show. But you would have to think about balancing that with the fact the guy made your veneers LONG to give more tooth show.

[Lazlo]

You don't need anything. A rhino will look HORRIBLE on you. You have a very gaunt soft tissue structure and close set eyes. And you can't change your features without making you look messed up.

I think you should grow a beard. Jaw surgery its true would do basically nothing for you. You don't look bad, you look fine. (as in okay).

You'll never be a model, that's just the truth. But I'm sure many will find you attractive. Make peace with yourself.

[JigJaw_:/]

Well put, and true. Although the long upper lip was obviously around from the get-go, the veneers did add a little bit to the exaggeration. If I do decide to execute on any kind of procedure to that area I'll be sure and toss those aspects in. Thanks