Alternatives to jaw surgery?

[babyjaw206]

First time poster here. I have my first consultation with a maxfax surgeon in a couple of weeks but would also like to get feedback from members of this forum.

After over 20 years of being self-conscious about my jaw/chin area I've finally resolved to do something about it. I've always been fine with the way I look from the front even though I know my facial proportions aren't perfect. My main concern has always been the lower third of my face, especially in profile. Shortly after my braces came off in high school I began jutting my lower jaw forward constantly to make it look stronger. This causes strain on my jaw, but I think the worst part is the psychological space it takes up. Just the constant awareness of it is exhausting.  As I get older, it's clear that a lack of bone structure in the chin/jaw area is causing me  to look prematurely jowly even though I take good care of my skin. I also have extra skin/fat under my neck even though I'm in good shape
and not overweight.

Despite my braces as a teen, I still have an overbite. I've had my wisdom teeth out but no other extractions. I have a dead tooth in the front that I haven't done anything with because it's only mildly discolored.

Based on the research I've done, it sounds like there is a compelling case for me to go the route of jaw advancement surgery (not sure if I'd need just the lower or both). However I'm concerned about going that route on a couple of fronts.

First off, my husband and I are planning to try for our second child this year, and I'm not at a point in my life where I want to push that timeline out while I wait months or even years for orthodontia and surgery.  I'll probably have to wait another two years at least to be ready to start the jaw surgery journey, if that's the route I end up going.

Secondly, I'm concerned about undergoing a surgery that could potentially cause a permanent change in my
appearance for the worse.

Ultimately it may be worth it to correct the underlying structural issues, both from a functional and aesthetic perspective, but I just don't know that I'm there yet.

Other options I've considered are a chin implant, neck lipo, and sliding genio. In some ways I'd rather err on the side of something that wasn't drastic enough, but that still kept me looking like "me", even if it meant being further away from ideal proportions. I've also thought about doing chin fillers as a one-time thing to "test drive" what a chin implant might look like.

I'd welcome any personal experiences or feedback.

I've attached some pictures for reference. The first ones are with my jaw pushed out like normal, the second ones are
my real bite if my back molars touch.

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NOTE from mod: The user requested deletion of her photos. That is why they are gone.

[miwe13]

I think neck lipo would be my first step. Not as involved. I find so often aesthetic issues being corrected that could have been done by weight loss. Hell I wanted better cheek bones but as I lost weight I liked what was starting to emerge. Of course neck fat can be random and doesn't always go up or down with body weight always. It could make a huge difference for you if your skin has laxity...sharper edges and lines from side and front. When I saw your pics its the first thing that came to me. As for the more complicated surgeries I will let the experts on here chime in. But IMO after neck lipo I would follow with sliding genio or do them at the same time which can make a big difference in appearance especially the jowls.

[tim06]

You have a receded chin. You should consider to get a chin implant, or better a sliding genioplasty to correct it.
A sliding genioplasty was performed on me and I could go home after the surgery. I had some pain but after like 2-3 weeks I was back to normal and it just costs about $4,000-$5,000 depending on your country.

[kavan]

You would benefit by advancing the lower jaw in addition to the chin which usually resolves to double jaw surgery, the upper jaw needing to be shifted to accommodate movements and/or rotations to the lower jaw.  The 'alternative' is what you've been doing for 20 years which is jutting your jaw forward.

[babyjaw206]

Would it be crazy to consider a chin implant to tide me over for  the next 2-3 years until I was ready for jaw surgery? It seems like appearance-wise it would be better than doing nothing.

[ditterbo]

I see a little lower lip recession relative to the upper, but withstanding any functional reasons, it's not that bad?

 Before any ceph info, most of her problem, to me, looks to be from an overly small chin. Ergo an SG or chin implant would solve a large majority of the recession. Do you like how advanced your chin looks jutted forward though, or is it still too recessed for you?

The under-chin area will change depending on what you do to the jaw/chin, so wouldn't necessarily bother with that right now.

[babyjaw206]

It’s just a tad more recessed than I’d like it with my jaw pushed forward. I’m not looking for perfect alignment though.

[ditterbo]

Perhaps a custom chin implant then because you need to really see how much augmentation your going to get beforehand in planning stage, and you are also lowering your chin bone when you jut forward. A custom chin implant might be able to provide that downward augmentation you're mimicing - 99% of off the shelf chin implants won't. Shooting in the dark here but if the chin implant can extend/taper to your jowl area, that might?? improve the jowling as well. Stuff to research.

Also go silicone instead of medpor for ease of removal in case you choose jaw surgery later.

[kavan]

Would it be crazy to consider a chin implant to tide me over for  the next 2-3 years until I was ready for jaw surgery? It seems like appearance-wise it would be better than doing nothing.

Not crazy. IMO, imprudent. If you are to get bi max, it's best to let them balance all the displacements in same surgery and chin displace is one.

[PloskoPlus]

Nice features.

You need jaw surgery, most likely with CCW rotation. You have a long midface and genioplasty alone will improve your profile but not change much from the front. CCW rotation will bring balance from the front.

[babyjaw206]

You have a long midface and genioplasty alone will improve your profile but not change much from the front. CCW rotation will bring balance from the front.

I know I have a long midface but am not looking to change that. My goal would be to have nothing else about my face change but my lower jaw and chin area.

[kavan]

I know I have a long midface but am not looking to change that. My goal would be to have nothing else about my face change but my lower jaw and chin area.

Well, bi max would not tend to change the 'long' midface (which is not really that long) too much anyway. But it's highly likely there would need to be some CCW to the upper jaw IN ORDER to advance the lower jaw so IT does not add extra length to the whole face. Then comes the diagonal cut to the CHIN where it's advanced both (horizontally) forward AND up so that the displacements there don't give extra length to the whole face either.

So, anything done to the upper jaw would be to correct the retrusion to both the lower jaw and the chin. IF the main GOAL is to correct the lower jaw and chin, then UNLESS your cephs show you can have a single jaw movement, movement of the upper jaw would be needed.

Basically, if you put a CONSTRAINT that your upper jaw is not to be moved or changed and if that's needed to address the retrusion of both the lower jaw and chin, then you must FORFIET the 'goal' of correcting the main imbalance you have. Your ceph would have to show you are one of the 'lucky ones' where they could move JUST the lower jaw and chin.

OK, let's say that your upper jaw would also need to be moved in order to advance your lower jaw (and also chin with that) in a maxfax surgery. PROBABILITY is on the side of that being the case. A CONSTRAINT on your part that the upper jaw should NOT be changed, PRECLUDES you from even having the 'goal' of the lower jaw being advanced forward.

If I were a maxfax, I'd say 'BY BY' to you or to come back when you understand the concept of one thing having to move for the other thing to move and look better. Why? Because you are NOT 'resolved' to correcting the salient problem. You're putting constraints on correcting it.

So, your constraints put you in the venue of plastic surgeons where you will probably find the 'garden variety' ones usually most active on Real Self who will be 'blind' to the recession to the jaw and be more than happy to give you a chin implant. (kind of like some of the other responses you got here) The blindness will most likely also spill over to the suggestion to remove fat from your neck where they too won't see the relationship of soft tissue being POOLED there because it's crammed into a small space which if OPENED via advancing the jaw forward, that loose HAMMOCK area would stretch and the pooled apparant excess would be re-uptaken by the advancement.

[babyjaw206]

If I were a maxfax, I'd say 'BY BY' to you or to come back when you understand the concept of one thing having to move for the other thing to move and look better. Why? Because you are NOT 'resolved' to correcting the salient problem. You're putting constraints on correcting it.

So, your constraints put you in the venue of plastic surgeons where you will probably find the 'garden variety' ones usually most active on Real Self who will be 'blind' to the recession to the jaw and be more than happy to give you a chin implant. (kind of like some of the other responses you got here) The blindness will most likely also spill over to the suggestion to remove fat from your neck where they too won't see the relationship of soft tissue being POOLED there because it's crammed into a small space which if OPENED via advancing the jaw forward, that loose HAMMOCK area would stretch and the pooled apparant excess would be re-uptaken by the advancement.

Point taken. A couple of follow up questions:

1. In your opinion, what are the real risks involved in masking this type of structural issue with plastic surgery?

2. You mention that it's extremely rare not to need both jaws moved. Do you think a surgeon would try to "sell" me by telling me I only need the bottom jaw moved if I express that as my desire? Or will most reputable surgeons be clear about the treatment they think is appropriate and refuse to operate on you if that does not match your expectations?

[Jilkster]

You have a receded chin. You should consider to get a chin implant, or better a sliding genioplasty to correct it.
A sliding genioplasty was performed on me and I could go home after the surgery. I had some pain but after like 2-3 weeks I was back to normal and it just costs about $4,000-$5,000 depending on your country.

And you also appear to have permanent nerve damage, no?

[kavan]

Point taken. A couple of follow up questions:

1. In your opinion, what are the real risks involved in masking this type of structural issue with plastic surgery?

2. You mention that it's extremely rare not to need both jaws moved. Do you think a surgeon would try to "sell" me by telling me I only need the bottom jaw moved if I express that as my desire? Or will most reputable surgeons be clear about the treatment they think is appropriate and refuse to operate on you if that does not match your expectations?

1: Having to UNDO what was best not done in the first place in order to do the right thing the second time around.

2: Most reputable surgeons would be clear about the treatment and show you on a ceph displacement proposal what the plans were and how they were aimed to change the profile contour.