Genioplasty or Jaw surgery?

[ImperialGalaxy]

Hi everyone!

I have what's called weak chin and recessed jaw. As a result, I have got overbite and overjet. When I smile, my lower lip sticks out because of the overjet. 
I am 19yo male but don't have a jaw line. 

Here's my side xray: https://prnt.sc/j7enpr 

It can also be seen that my upper jaw (or just the teeth?) is protruding, so I have something like a monkey mouth for the lack of a better word. 

I went to my orthodontist and he said my bite is pretty good and I just need a genioplasty to fix the chin. Then I said: wouldn't that leave a huge dent under my lips? He said: properly done genioplasty wouldn't. 

I can't really trust him because my lower lip already has an almost 90 degree "fold" and moving the chin alone will probably worsen it. I'm going to see an oral&maxillofacial surgeon soon.

I'm no expert but I can't help but notice that teeth in both jaws are sticking out. When I got braces 2 years ago, my orthodontist didn't remove any teeth. And I now think this was not the best choice.

I just want a normal class 1 bite, and I don't think genioplasty alone can help me achieve that. I feel like I need to remove some molars, get braces to fix the teeth and do jaw surgery along with genioplasty because jaw surgery will probably fix my 90 degree lip "fold" and protruding mouth (or maybe braces alone can?).. I'm confused.

Here's what I looks like a good bite: https://prnt.sc/j7euxh

Can someone with experience with this give me their opinion?

[haven]

Your lower incisors look tilted, was your overjet larger than it is now? My overjet was 3mm prior to braces and your ceph reminds me of mine.

It's likely possible to get a genioplasty since I've spoken to a surgeon that said it's doable, but they probably wouldn't advance you much or use some bone graft/paste to avoid deepening your "fold". It also depends on what your expectations are.

I don't think you should extract teeth and get braces alone. That would just make your dental arch smaller. I think it'd be strongly encouraged you get jaw surgery in the event you decide to extract teeth.

Do you have any pictures of yourself smiling?

[kavan]

Hi everyone!

I have what's called weak chin and recessed jaw. As a result, I have got overbite and overjet. When I smile, my lower lip sticks out because of the overjet. 
I am 19yo male but don't have a jaw line. 

Here's my side xray: https://prnt.sc/j7enpr 

It can also be seen that my upper jaw (or just the teeth?) is protruding, so I have something like a monkey mouth for the lack of a better word. 

I went to my orthodontist and he said my bite is pretty good and I just need a genioplasty to fix the chin. Then I said: wouldn't that leave a huge dent under my lips? He said: properly done genioplasty wouldn't. 

I can't really trust him because my lower lip already has an almost 90 degree "fold" and moving the chin alone will probably worsen it. I'm going to see an oral&maxillofacial surgeon soon.

I'm no expert but I can't help but notice that teeth in both jaws are sticking out. When I got braces 2 years ago, my orthodontist didn't remove any teeth. And I now think this was not the best choice.

I just want a normal class 1 bite, and I don't think genioplasty alone can help me achieve that. I feel like I need to remove some molars, get braces to fix the teeth and do jaw surgery along with genioplasty because jaw surgery will probably fix my 90 degree lip "fold" and protruding mouth (or maybe braces alone can?).. I'm confused.

Here's what I looks like a good bite: https://prnt.sc/j7euxh

Can someone with experience with this give me their opinion?

In GENERAL, when the lower lip is behind the upper lip, it's an indication for jaw surgery.
When the chin is way behind a line dropped from the lower lip, it's an indication for advancing the chin. When the orientation of ANS-PNS ('maxilla') is clockwise, it's an indication for some counter clockwise rotation and here it looks like a posterior downgraft to do it.

So, YES. You have some GENERAL indications for a double jaw surgery in terms of better aesthetic balance. The limiting factor to maximizing the aesthetics is getting the bite right.

When ever someone gets jaw surgery, getting the bite right takes PRIORITY. Sometimes the person has a 'lucky combination' where getting the bite right also maximizes the aesthetic outcome. Other times, getting the bite right precludes getting a 'perfect' aesthetic outcome. So, balancing the bite (getting the bite right) and balancing the jaws is a multi variable 'balancing act' of OPTIMIZATION. Optimization= BETTER aesthetic balance AND bite right. But not always 'perfect' aesthetic balance and bite right.

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[ImperialGalaxy]

Your lower incisors look tilted, was your overjet larger than it is now? My overjet was 3mm prior to braces and your ceph reminds me of mine.

It's likely possible to get a genioplasty since I've spoken to a surgeon that said it's doable, but they probably wouldn't advance you much or use some bone graft/paste to avoid deepening your "fold". It also depends on what your expectations are.

I don't think you should extract teeth and get braces alone. That would just make your dental arch smaller. I think it'd be strongly encouraged you get jaw surgery in the event you decide to extract teeth.

Do you have any pictures of yourself smiling?

I believe my lower teeth was less tilted before. I noticed this large slope only after my braces.
By smile I mean with no teeth showing. The upper teeth pushes my lower lip and its very uncomfortable because it's like the lower lip has no support underneath and it "folds" more.
Here's a picture (with xray so u can see the teeth position more clearly). https://prnt.sc/j7snhw

In GENERAL, when the lower lip is behind the upper lip, it's an indication for jaw surgery.
When the chin is way behind a line dropped from the lower lip, it's an indication for advancing the chin. When the orientation of ANS-PNS ('maxilla') is clockwise, it's an indication for some counter clockwise rotation and here it looks like a posterior downgraft to do it.

So, YES. You have some GENERAL indications for a double jaw surgery in terms of better aesthetic balance. The limiting factor to maximizing the aesthetics is getting the bite right.

When ever someone gets jaw surgery, getting the bite right takes PRIORITY. Sometimes the person has a 'lucky combination' where getting the bite right also maximizes the aesthetic outcome. Other times, getting the bite right precludes getting a 'perfect' aesthetic outcome. So, balancing the bite (getting the bite right) and balancing the jaws is a multi variable 'balancing act' of OPTIMIZATION. Optimization= BETTER aesthetic balance AND bite right. But not always 'perfect' aesthetic balance and bite right.

Thank you for the reply. Wouldn't anti-clockwise movement screw the upper teeth because it's already vertical, just sticking out? I guess If my orthodontist can move my upper teeth inside a bit, that will work..

[kavan]

Thank you for the reply. Wouldn't anti-clockwise movement screw the upper teeth because it's already vertical, just sticking out? I guess If my orthodontist can move my upper teeth inside a bit, that will work..

The CCW I drew was in direction of how ANS-PNS (maxilla) would be rotated to get closer to the orientation of the OTHER photo you posted of 'this is a good bite' which would be the direction of a posterior downgraft.

You wanted to know if you were a candidate for the maxfax surgery. My illustrations on your ceph showed; YES.