Anyone had revision surgery with Gunson or Arnette?

[some1afterall]

Hi there - I had double jaw surgery + genioplasty at Kaiser Oakland and am not 100% satisfied with my results. I was wondering if anyone on here had revision surgery with Gunson or Arnette and if they were satisfied with their results and felt it was worth the $$$ and time and commitment.

[some1afterall]

I posted earlier with no replies - I know you'all like photos so here goes! I'm including links to frontal views, bite view and profile view. I have some asymmetries and I believe some unwanted aesthetic results (over impacted maxilla = longer philtrum, less teeth show), plus I'm unhappy with the genioplasty as it made my already long chin appear longer, especially from the frontal view and it curled my lower lip in making it appear thinner.

My nose is another story - lets not address is here. Mostly concerned with asymmetries in my cheeks, jaw, chin, teeth PLUS lips/mouth. I feel like my mouth has a generalized "pinched" look.

I'll be consulting with both Deschamps Braly & Gunson regarding FULL REVISION vs GENIOPLASTY reversal. I'm curious what they'll say... I definitely am not going through all of this again unless I have full confidence in my surgeon. Honestly I DO have intermittent jaw pain, but not disabling, at this time it's mostly dissatisfaction with the aesthetics of surgery AND looking forward into my future bone health and function. I'm in my 30's now, I could tolerate one more surgery go-around, I definitely don't want to have to consider it in my 50's, etc.

How much asymmetry and horizontal movement post-operatively is considered "normal"? DJS was 1.5 years ago. I wear clear retainers every night. There was some asymmetry of the mouth, lips, prior to surgery, as evidenced by pre-braces photo (sorry the chin is cut off).

http://s38.photobucket.com/user/RLC_85/library/?sort=3&page=1

[kavan]

I posted earlier with no replies - I know you'all like photos so here goes! I'm including links to frontal views, bite view and profile view. I have some asymmetries and I believe some unwanted aesthetic results (over impacted maxilla = longer philtrum, less teeth show), plus I'm unhappy with the genioplasty as it made my already long chin appear longer, especially from the frontal view and it curled my lower lip in making it appear thinner.

My nose is another story - lets not address is here. Mostly concerned with asymmetries in my cheeks, jaw, chin, teeth PLUS lips/mouth. I feel like my mouth has a generalized "pinched" look.

I'll be consulting with both Deschamps Braly & Gunson regarding FULL REVISION vs GENIOPLASTY reversal. I'm curious what they'll say... I definitely am not going through all of this again unless I have full confidence in my surgeon. Honestly I DO have intermittent jaw pain, but not disabling, at this time it's mostly dissatisfaction with the aesthetics of surgery AND looking forward into my future bone health and function. I'm in my 30's now, I could tolerate one more surgery go-around, I definitely don't want to have to consider it in my 50's, etc.

How much asymmetry and horizontal movement post-operatively is considered "normal"? DJS was 1.5 years ago. I wear clear retainers every night. There was some asymmetry of the mouth, lips, prior to surgery, as evidenced by pre-braces photo (sorry the chin is cut off).

http://s38.photobucket.com/user/RLC_85/library/?sort=3&page=1

You got replies to your FIRST post here where you showed the before and after photos. http://jawsurgeryforums.com/index.php?topic=7029.msg60460#msg60460

The surgery improved your profile. Gunson is a good one to consult with for some further improvements.

[some1afterall]

Thank you for your reply and reference to my earlier post. I have indeed ready thoroughly through my earlier posting. I guess what I'm getting at is I am unhappy with some of the attributes of my face and I'm trying to figure out if they were there previously or have been magnified or created by the jaw surgery. Things that are really bothering me are:

-thin, narrow, pinched look of my lips, especially at rest, when I'm not smiling
-dimpling, uneven texture, and length of my chin especially from the frontal view
-lengthening of my upper lip/philtrum, less teeth/gum show

I have consulted with a few different surgeons for rhinoplasty, blepharoplasty, and genioplasty reversal and I guess what I'm getting at is - I wasn't this unhappy with my appearance before the orthognathic surgery, so I'm unsure if it's the surgery itself that negatively impacted my physical appearance OR the fact that I'm more conscious of displeasing aesthetics now because I see myself under a microscope after the jaw surgery.

I don't want to spend time and money straightening this or lifting that, expecting my displeasure to be alleviated if it is, indeed, unhappiness with the jaw and chin structure itself, leading me to think maybe doing a full revision surgery with someone like Gunson who puts more energy into aesthetics than other maxillofacial surgeons.

On the flip side, I don't want to go through the whole process of braces and jaw surgery again unless a surgeon like Gunson could promise some improvements in the things that bother me most.

Maybe a few small things like lip enhancement or straightening my nose could go a long way? Or maybe reversing the genioplasty would improve my lower lip.

I'm really not sure.

[kavan]

Thank you for your reply and reference to my earlier post. I have indeed ready thoroughly through my earlier posting. I guess what I'm getting at is I am unhappy with some of the attributes of my face and I'm trying to figure out if they were there previously or have been magnified or created by the jaw surgery. Things that are really bothering me are:

-thin, narrow, pinched look of my lips, especially at rest, when I'm not smiling
-dimpling, uneven texture, and length of my chin especially from the frontal view
-lengthening of my upper lip/philtrum, less teeth/gum show

I have consulted with a few different surgeons for rhinoplasty, blepharoplasty, and genioplasty reversal and I guess what I'm getting at is - I wasn't this unhappy with my appearance before the orthognathic surgery, so I'm unsure if it's the surgery itself that negatively impacted my physical appearance OR the fact that I'm more conscious of displeasing aesthetics now because I see myself under a microscope after the jaw surgery.

I don't want to spend time and money straightening this or lifting that, expecting my displeasure to be alleviated if it is, indeed, unhappiness with the jaw and chin structure itself, leading me to think maybe doing a full revision surgery with someone like Gunson who puts more energy into aesthetics than other maxillofacial surgeons.

On the flip side, I don't want to go through the whole process of braces and jaw surgery again unless a surgeon like Gunson could promise some improvements in the things that bother me most.

Maybe a few small things like lip enhancement or straightening my nose could go a long way? Or maybe reversing the genioplasty would improve my lower lip.

I'm really not sure.

I'm not sure you need full revision of the bi-max surgery. More likely an isolated revision (not a 'reversal') to the chin. No idea what kind of cut you had for your genio but will say that the type of cut that advances out chin AND does not make it look longer in frontal is a diagonal cut where the chin is slide forward along that cut line such that there is both a combined horizontal advancement and vertically upward shortening.

[some1afterall]

Thank you for your reply. I'm seeing Deschamps Braly soon for a consult. He specializes in FFS, which usually involves altering the lower 1/3 of the face to appear more feminine, so it might be right up his ally. I think the overall stability of O'Ryan's surgery is good, my bite is good and I have minimal TMJ pain, it's just those damn aesthetics and getting used to my new presentation.