Regret double jaw surgery and genie for open bite and retrognathia

[some1afterall]

This is my first post and I'm glad I have this outlet to vent. I was told I needed jaw surgery when I was 14 years old and 16 years later, I finally had the insurance and means to make it happen. Prior to jaw surgery I felt attractive and liked my face from the frontal view and my big smile. I was embarrassed of my profile and when I smiled big and showed a "horse like" smile with a lot of gum and large open bite. In November 2015 I started orthodontia and had double jaw surgery (le fort and BSSO) in august 2016. 6 months later I had a 4mm genioplasty. My braces came off August 2017.

The results have been devastating to me. My bite is closed and even, but the soft tissue and facial proportions, in my opinion, are not good. My face looks even longer than before and more masculine. My philtrum is longer and my nose wider, and my whole face looks longer. I am very depressed and don't know what to do. My lips also seem thinner.

I'm wondering if a smaller surgery like genioplasty reversal or modification or rhinoplasty or lip fillers could help to achieve a more feminine look, or if I'd have to redo my whole jaw surgery ;-/

Here are some pictures, pre-surgery is first, post-surgery is after

[Lazlo]

nah you're being paranoid. you don't even look different at all. nose, etc. looks the same. what looks better is you have less of that weird gummy smile. don't do any revisions at all.

[Framboise]

Hello,
do you have more after photos please ?
I see no difference

[some1afterall]

here's a profile progression. right is original, middle is after double jaw surgery, left is after genioplasty. I have worried that even thought the genioplasty was only 4mm it made me look less feminine.

[some1afterall]

here's another after with chin

[kavan]

here's another after with chin

Please confirm if this photo is actually an 'after' or before.

[tdawg]

This seems like a great result to me. You can tell from the profile pictures that you had so much strain before during lip closure which now seems to be resolved. In addition you have a straight, orthognathic profile. Dont change anything.

[Framboise]

On the last photo, you still have a little gummy smile, is it normal ?

I agree with tdawg, regarding your profile, the results is amazing, especially the genio.
Now I understand you can't recognize yourself in a mirror, it can be very disturbing.

[kavan]

On the last photo, you still have a little gummy smile, is it normal ?

I agree with tdawg, regarding your profile, the results is amazing, especially the genio.
Now I understand you can't recognize yourself in a mirror, it can be very disturbing.

We need her to confirm the last photo is actually of an 'after'.

[some1afterall]

The last photo is an "after" photo.

[tdawg]

The last photo is an "after" photo.

So here is the way I see it. I am in a similar situation as you were pre genioplasty. Basically there are two approaches to long face syndrome. Most surgeons impact the maxilla to get ideal incisor display at rest, and then move the lower jaw in essentially a straight line to make the bite fit. Surgeons like Gunson and Wolford do impaction with more counter clockwise rotation to change the mandibular plane angle which usually gives a better aesthetic result but is considered unstable by some surgeons. Surgeons who do the first method usually do a genioplasty to help make up for the difference. You and I both went to a surgeon that does more of the first method. They possibly slightly "under impacted" you to prevent the aging effects that an impaction can have, especially on women. Or you could have a hypermobile upper lip. The best way to tell would be to take a photo from the front with lips at rest. If you have normal incisor display(2-4 mm for a woman I think) then its a hypermobile upper lip.

[kavan]

The last photo is an "after" photo.

OK. Thanx for clarifying. Then, it looks like you have some hardware (braces, appliances what ever..) and you are trying to hide them by lifting both your lower and upper lip upwards in your smile. Stretching the lower lip upwards would make the chin look longer and hoisting the upper lip upwards would of course, show more gum.

Basically, it doesn't look like a surgery to address a gummy smile would do. It looks like more of an effort on your part to contort your smile to hide something.

[some1afterall]

hypermobile lip? I know that my philtrum seems lengthened after the le fort, but it may be that I had an open-over bite previously that made the upper lip paper shorter and more curved. I have some teeth show at rest, probably around 4mm.

the genioplasty was a secondary surgery, done 6-months after the le fort and bsso electively. I did it to enhance my profile, however, what I didn't realize is that moving the chin forward would potentially make my frontal view appear longer. When my chin was slightly recessed it had the appearance of my face being shorter from front view, and in my opinion a more feminine.

All in all, I've had a difficult time adjusting to the changes. I had idealistic expectations and wasn't prepared for the results to be nothing short of everything I dreamed of ;-/

It's nice to hear I'm not totally crazy and there are other jaw surgery patients that have thought of and had some of the same feelings and questions...

[kavan]

hypermobile lip? I know that my philtrum seems lengthened after the le fort, but it may be that I had an open-over bite previously that made the upper lip paper shorter and more curved. I have some teeth show at rest, probably around 4mm.

the genioplasty was a secondary surgery, done 6-months after the le fort and bsso electively. I did it to enhance my profile, however, what I didn't realize is that moving the chin forward would potentially make my frontal view appear longer. When my chin was slightly recessed it had the appearance of my face being shorter from front view, and in my opinion a more feminine.

All in all, I've had a difficult time adjusting to the changes. I had idealistic expectations and wasn't prepared for the results to be nothing short of everything I dreamed of ;-/

It's nice to hear I'm not totally crazy and there are other jaw surgery patients that have thought of and had some of the same feelings and questions...

IMO, you had unrealistic expectations to expect to look just like you did to YOURSELF from the front but ALSO have GREAT improvements to the profile.

The surgery you got was aimed at reducing the gummy smile, fixing your bite and giving more jaw/chin balance to offset the CONVEX profile. It acheived that.

Unless you can hold a side mirror as to focus on the PROFILE and wish and want your old profile back, your regret is self negating, self conflicting and irrational.  The rational outlook would be to APPRECIATE the profile improvements and NOT deny them or block them out in
in favor or nursing regret about the frontal changes.

Although there are things you could do to further improve, the fact that you're regretting a good outcome due to being 'attached' or 'used to' a look from the front that did NOT look good from the SIDE is not a good indicator for me to suggest any. You need to resolve the CONFLICT
you have about self negating unrealistic expectations you had as to appreciate the WHOLE change
 before entertaining anymore surgery, lest you get attached or 'used to' one thing that will look different to you if you get another thing you don't like changed.

[girl]

So here is the way I see it. I am in a similar situation as you were pre genioplasty. Basically there are two approaches to long face syndrome. Most surgeons impact the maxilla to get ideal incisor display at rest, and then move the lower jaw in essentially a straight line to make the bite fit. Surgeons like Gunson and Wolford do impaction with more counter clockwise rotation to change the mandibular plane angle which usually gives a better aesthetic result but is considered unstable by some surgeons. Surgeons who do the first method usually do a genioplasty to help make up for the difference. You and I both went to a surgeon that does more of the first method. They possibly slightly "under impacted" you to prevent the aging effects that an impaction can have, especially on women. Or you could have a hypermobile upper lip. The best way to tell would be to take a photo from the front with lips at rest. If you have normal incisor display(2-4 mm for a woman I think) then its a hypermobile upper lip.

This, definitely. Along with palate expansion, especially in cases where there's an open bite.