Do I have a recessed jaw - pictures

[carli]

Hello everyone,

This is my first post on the forum. I decided to join and post my situation because i see there are people that are well educated about this topic. I will try to keep this as short as possible.
I don't know exactly what my diagnosis is, but I will try to explain. Although my guess is that my lower jaw is recessed. I think that mouth breathing as a child affected my facial development. I am just not certain to what degree. I didn't mouthbreath all the time, but what I did have since I can remember is lip incompetence. This has caused me to have open mouth posture during most of my life. This might have been caused by inherited deviated septum, but I can't guarantee.

Also, my teeth were never alligned properly when I was a kid. They were all separaed and had huge spaces between. My gums were also ugly (for the lack of a better term). I got fixed braces at age 15 and my teeth is now alligned quite well. I also got laser gum correction so the gums follow the shape of my teeth. Also, my bite is good with very small overbite and overjet. I do have a slightly gummy smile which doesn't concern me really.
My main concern is my profile, since I have big protruding lips and a small chin.  Also, I have a slight chin deformity since birth, as one side of my chin hangs lower than the other. When I have some facial hair, I am satisfied with my look, but I want to have the option to go for a shaven look if needed.

I had a short consultation with one of the best max fax surgeons in my country a week ago. He said that since I have a severly crooked nose and broken septum inside, that should be my top one priority. Regarding the jaw stuff, he said that my bite is good and definitely don't need a surgery just to correct my bite. For the chin deformity and lip incompetence he said that I need to come see him clean shaven, and with x rays of my jaw. But, from what he can see, he thinks that the lower part of my face is slightly too long, and that bringing the chin up and forward might fix my lip incompetence.  I haven't done that yet. I am obbsessing about all the options for weeks now, and researching google almost all day. I want to get my chin fixed, but I am scared that I should do bimax surgery. I can't stand the idea of that, and what is bugging me the most is the big amount of metal screws and plates that I should live with for the rest of my life. I am hoping that genioplasty might be the option for me, after which I would request my surgeon to take out the metal when the bone is healed. Anyway I have to have a surgery on my chin to fix the annoying asymmetry that I have, so why not just advance it a bit.
I would like to hear your opinions about my issues.

Cliffs:
-   Had lip incompetence and some degree of mouth breathing since I was a child
-   Inherited asymmetric chin, deviated septum and crooked nose
-   My chin is weak, not sure which surgery I should get
-   Surgeon said to fix my nose, that my bite is good and to do x rays to give better advice on the recommended procedure
-   Hoping that genioplasty would be the option since I don't want to do a full jaw surgery and have so much metal in my body
-       Feeling extremely depressed finding out that I may have looked much better with correct mouth posture and orthotropics

https://www.dropbox.com/s/gl18rppqgo0mc7q/IMG_4676.PNG?dl=0
https://www.dropbox.com/s/dlzkiyx89nvde1h/IMG_4690.PNG?dl=0
https://www.dropbox.com/s/ecv3go587ov64l9/IMG_4689.PNG?dl=0
https://www.dropbox.com/s/eu3nj2lppn6cyhg/IMG_4687.PNG?dl=0
https://www.dropbox.com/s/b8qlf74c5lqk15y/IMG_4691.PNG?dl=0

P.s. My chin looks way less recessed with the chin hair I have. Since I have not been clean shaven for 4 years, I can't show you what it looks like without the facial hair.

Kind Regards.

[Jilkster]

"with one of the best max fax surgeons in my country"

Who, and how did you determine they are one of the best?

[kavan]

Recessed jaw= NO

Long chin= YES

Mouth breathing: YES.  Mouth breathing due to difficulty closing lips due to chin orientation.

Long chin, aesthetic problem from front=YES

Long chin with lip incompetence and mouth breathing= sliding genio, FORWARD and UP along diagonal cut of sliding genio.

Crooked nose=YES

Deviated septum and/or crooked nose bone= PROBLEM= Rhinoplasty.

[carli]

"with one of the best max fax surgeons in my country"

Who, and how did you determine they are one of the best?

He is very well known in my country. A professor with a lot of experience. I would rather not say the name.

[ditterbo]

Recessed jaw= NO

Long chin= YES

Mouth breathing: YES.  Mouth breathing due to difficulty closing lips due to chin orientation.

Long chin, aesthetic problem from front=YES

Long chin with lip incompetence and mouth breathing= sliding genio, FORWARD and UP along diagonal cut of sliding genio.

Crooked nose=YES

Deviated septum and/or crooked nose bone= PROBLEM= Rhinoplasty.

LOL that does remove any question of whether you're ""attacking"" someone or not.

[carli]

I want to thank everyone for help. You helped a lot 

I have a few more questions. I know these don't have a one answer fits all, but I would still like to know your opinions.

1)Do you think that sliding genio can also deal with the asymmetric crooked chin or will there be some bone shaving involved?
2)Should rhinoplasty and genio be done at the same time or is it better to do them separately? I heard its better to spend less time under general anesthesia at once  but I don't know enough about that so I may be wrong. I also hate the idea of surgery so I would like to do everything at once.
3)I would REALLY like to remove metal hardware from my chin once I have done a genioplasty. How dangerous or complicated is that? I read that there may be metal debris from titanium and elevated blood levels of titanium. on the other hand I read that rarely someone removes hardware after jaw/chin surgeries so I find that a bit strange.
4)Since my bite is pretty good, do you think that my face would have developed much differently if I had lets say taped my mouth during night and concentrated on keeping my lips shut all the time and never breathed through mouth.

I apologize for so many questions, but if someone has the time to answer, I would be very thankful

Kind Regards and I hope all of you have a great New Year's eve!

P.s. English is not my mother tongue so try not to  mind the mistakes I may have done while writting.