Should I Go Forward With This?

[selucreh]

I've visited the most well known surgeon on my country.
He said I suffered from an excessive vertically grown upper maxilla, excessive gonial angle, and short mandible.

He said he could fix it with the following plan:




Do you think it's good?
People on another forum said it might be a little bit conservative, and that it should have a bit more rotation.
What do you think?

This is what the rest of my face looks, I really want to fix my flaws in my lower third so I can finally have some confidence and be good looking.

[JawKid7]

wtf u don't need surgery

[XXRyanXXL]

I don't see much CCW rotation in the proposed plan. It does look descent but not perfect.
You want a sharp jawline? Why not have him do an inverted-L osteo with the downgrafting and anterior impaction for rotation, then the chin won't have to come out as far (genio), and at same time, bring out the airway and provide upper lip support.
Many surgeons shy away from the inverted L.

[selucreh]

wtf u don't need surgery

I really do, look at my celph.

[selucreh]

I don't see much CCW rotation in the proposed plan. It does look descent but not perfect.
You want a sharp jawline? Why not have him do an inverted-L osteo with the downgrafting and anterior impaction for rotation, then the chin won't have to come out as far (genio), and at same time, bring out the airway and provide upper lip support.
Many surgeons shy away from the inverted L.

What is the difference between inverted L and normal BSSO?

[kavan]

It looks like his plan will decrease the mandibular plane angle by about 5 degrees. (You have a steep MP angle. Not a 'gonial' angle as you stated.) So, the plan includes CCW for that aspect.
However, since it is very steep, it will still be on the steep side even with an approx 5 degree decrease. The genio proposal will project out your chin but also elongate it such that it will look longer to you from frontal view so that even though the mandibular plane is made less steep via the CCW rotation to the maxilla, it won't look less steep in frontal due to the vertical displacement of the chin. It looks like type of genio where they would need to put some kind of bone buttress between the cut. It's not the type where the chin is slid onto itself or at least the diagram does not show that.

The BSSO in the proposal will pronounce out the jaw as to 'elongate it' but along an angle that will still be steep even when made about 5 degrees less steep by the CCW. It's not going elongate the ramus or give the posterior angle of the jaw a 'drop down'. 

It clearly gives some profile improvement. But if you are doing it expecting to have the jaw 'look' of a model or Brad pitt from the front, it won't do that. So, it depends on your motivation for getting it. Your upper view certainly would be considered good looking. Maybe post the whole face, front and profile for more feedback and cross reference to the computer plan.

[selucreh]

It looks like his plan will decrease the mandibular plane angle by about 5 degrees. (You have a steep MP angle. Not a 'gonial' angle as you stated.) So, the plan includes CCW for that aspect.
However, since it is very steep, it will still be on the steep side even with an approx 5 degree decrease. The genio proposal will project out your chin but also elongate it such that it will look longer to you from frontal view so that even though the mandibular plane is made less steep via the CCW rotation to the maxilla, it won't look less steep in frontal due to the vertical displacement of the chin. It looks like type of genio where they would need to put some kind of bone buttress between the cut. It's not the type where the chin is slid onto itself or at least the diagram does not show that.

The BSSO in the proposal will pronounce out the jaw as to 'elongate it' but along an angle that will still be steep even when made about 5 degrees less steep by the CCW. It's not going elongate the ramus or give the posterior angle of the jaw a 'drop down'. 

It clearly gives some profile improvement. But if you are doing it expecting to have the jaw 'look' of a model or Brad pitt from the front, it won't do that. So, it depends on your motivation for getting it. Your upper view certainly would be considered good looking. Maybe post the whole face, front and profile for more feedback and cross reference to the computer plan.

So should I ask the doc about doing more rotation and a more horizontal genio?
He also proposed using Gonial Angle Implants after the surgery btw, do you think it's a good plan or should I go for something else?

Here are other pics btw:

[PloskoPlus]

I wonder if you actually have bimax protrusion...

[selucreh]

I wonder if you actually have bimax protrusion...

I think I do.
You can see it clearer if you look at the ceph I posted above.

[kavan]

So should I ask the doc about doing more rotation and a more horizontal genio?
He also proposed using Gonial Angle Implants after the surgery btw, do you think it's a good plan or should I go for something else?

Here are other pics btw:

I wouldn't request more rotation as they can only do so much to the maxilla in that aspect and keep equilibrium with the lower jaw and teeth show. It's not as if they can counter clock rotate it THAT much to make the mandibular plane angle a LOT less steep. A genio that slides on ITSELF along an upward diagonal could be requested and that would not give length to the chin and also give more of the 'look' of CCW. If he's also offering IMPLANTS (jaw) which can give a DROP DOWN to the back angle, THOSE will make the MP angle LESS steep. Chin overlays could also be used in addition for further blending in chin with jaw.

ETA: Get the implants AFTER the surgery later down the line when the bone/cuts are HEALED. Not during the same surgery.

[selucreh]

I wouldn't request more rotation as they can only do so much to the maxilla in that aspect and keep equilibrium with the lower jaw and teeth show. It's not as if they can counter clock rotate it THAT much to make the mandibular plane angle a LOT less steep. A genio that slides on ITSELF along an upward diagonal could be requested and that would not give length to the chin and also give more of the 'look' of CCW. If he's also offering IMPLANTS (jaw) which can give a DROP DOWN to the back angle, THOSE will make the MP angle LESS steep. Chin overlays could also be used in addition for further blending in chin with jaw.

Doc had told me the reason he opted for that genio was to avoid having the face appear smaller.
My face is quite wide, and maybe it might ruin the porportions if there is no increase of chin height.

Do you agree that Jaw Implants in the back angle are a good idea in my case and doing this surgery + implants later on will help me achieve the defined jawline look I'm going for?

Here is my front ceph.

[kavan]

Doc had told me the reason he opted for that genio was to avoid having the face appear smaller.
My face is quite wide, and maybe it might be ruin the porportions if there is no increase of chin height.

Do you agree that Jaw Implants in the back angle are a good idea in my case and doing this surgery + implants later on will help me achieve the defined jawline look I'm going for?

Here is my front ceph.

Well, OK, then if the elongation of the chin he because he feels you need and the reason is your face is WIDE, well that makes sense.

I think the jaw implants, assuming they are the DROP DOWN kind to lower the posterior part of jaw and make the MP angle LESS steep than they can make it with bi-max and doing them LATER after the bone heals, is a GOOD idea. It will give you a better jaw line.

[selucreh]

Well, OK, then if the elongation of the chin he because he feels you need and the reason is your face is WIDE, well that makes sense.

I think the jaw implants, assuming they are the DROP DOWN kind to lower the posterior part of jaw and make the MP angle LESS steep than they can make it with bi-max and doing them LATER after the bone heals, is a GOOD idea. It will give you a better jaw line.

Thank you so much buddy!
I'll ask him about the chin, and see what he says.

Anything else I should be considering? I really want this to go well.

[kavan]

Thank you so much buddy!
I'll ask him about the chin, and see what he says.

Anything else I should be considering? I really want this to go well.

That about covers it for now.