Genio or Jaw surgery? [PICS] Two surgeons with opposing views.

[Ezra]

Hi! I've posted here before and sadly, I have not come to a conclusion. You guys helped me so much (Hi Kavan), but I'm afraid I'm still torn.

My orthodontist says both plans are great. When I ask for his advice he starts talking about measurements and numbers which don't help me too much. I'm very visual.

Surgeon A plan: Drop-Down Genio with grafts to be buttressed between where it was cut. He will add a fat graft to my labiomental fold for smoother look. He doesn't want to do advancement as he believes I will look "concave". He gave me the extra option of lowering my upper jaw as well for tooth show. Had a lip lift so may I not need this now, not sure.


Surgeon B plan: Advanced the lower jaw forward. This includes molar extraction to create space. He gave me the extra option of bimax, not sure I want to pay for that but I will if it’s the best option aesthetically.


- What will achieve the best aesthetic result? Drop-down genio or lower jaw advancement? Or Bimax?

- I am cool with any nose changes caused by bimax.

- My main concern with Plan A is the lack of forward advancement. Do you think the drop down genio is sufficient enough for my face? Or is my chin not only small, but recessed as well?


PICS
https://imgur.com/a/dEvP3qn

CEPH PICS
https://imgur.com/a/8CdmqAN

I have braces now so my upper lip is protruding more than normal.

[kavan]

i already gave you my take some time back. Surgeon A plan is same as mine was.

[april]

Had a lip lift so may I not need this now, not sure.

And how did that go? Are you happy with the results? How bad is the scar?
You're very good looking as is. I would go for Plan A.

[haven]

There's another member on here who had a similar type of genio to what was suggested to you and I thought his results were good. He had 4x4mm movements, but no sort of material was used for his fold. What's the deal with the fat graft? Is it meant to be permanent or something?

IMO I'd just advise you to do the genio if you're set on doing something. You reminded me of Danielle Radcliffe for some reason, haha.

[Ezra]

And how did that go? Are you happy with the results? How bad is the scar?
You're very good looking as is. I would go for Plan A.

Excellent. I feel it’s more youthful looking and my lips and nose are more harmonious. Barely any scar, went to Dr. Talei who is an expert at this. I have braces so it’s hard to tell the final result, as the braces mess with my lips.

[Ezra]

There's another member on here who had a similar type of genio to what was suggested to you and I thought his results were good. He had 4x4mm movements, but no sort of material was used for his fold. What's the deal with the fat graft? Is it meant to be permanent or something?

IMO I'd just advise you to do the genio if you're set on doing something. You reminded me of Danielle Radcliffe for some reason, haha.

Thank you. I wish I could see his pics. The reason for the fat graft is that it is permanent. The surgeon did some photo edits and the fold looked worse. He said he could use filler. I told him filler is expensive and you have to keep coming back, so he said fat graft.

[haven]

Thank you. I wish I could see his pics. The reason for the fat graft is that it is permanent. The surgeon did some photo edits and the fold looked worse. He said he could use filler. I told him filler is expensive and you have to keep coming back, so he said fat graft.

You could probably ask him, and he'd be happy to share. His username is needsadvacement. I asked him about it and he had no reservations showing me his images. Maybe see if there are alternatives to not using any materials? I'm not not an expert but fat can be fade away, or that's what a surgeon once told me. How much are they planning to advance you?

[Ezra]

You could probably ask him, and he'd be happy to share. His username is needsadvacement. I asked him about it and he had no reservations showing me his images. Maybe see if there are alternatives to not using any materials? I'm not not an expert but fat can be fade away, or that's what a surgeon once told me. How much are they planning to advance you?

Thank you, I sent him a message. I’ll ask my surgeon about any other materials besides fat. I can’t find the mm of advancement in my paperwork. I need to make sure we agree on the mm haha.

[haven]

Thank you, I sent him a message. I’ll ask my surgeon about any other materials besides fat. I can’t find the mm of advancement in my paperwork. I need to make sure we agree on the mm haha.

No worries dude. Ask the surgeon if there's a chance of your lower lip becoming thinner as a result of the procedure. That's a common side effect, but it's seems to be more of a complaint with people who has thin lips to begin with and you don't seem to have a thin lips.

I saw that you're from Socal? You mind sharing which surgeons you spoke to. Looking into one myself 🤗

[PloskoPlus]

Your chin bone looks perfect. I would not mess with it.

How many mms was your lip lift? How long was your lip to begin with?  Has your tooth show improved? Do you have much numbness?

I think your whole lower third needs lengtheing. Genio will just give you a pointy chin.

[Ezra]

Your chin bone looks perfect. I would not mess with it.

How many mms was your lip lift? How long was your lip to begin with?  Has your tooth show improved? Do you have much numbness?

I think your whole lower third needs lengtheing. Genio will just give you a pointy chin.

I don’t remember the mm. I believe it was about 4mm? Tooth show improved for now, but because I got the lip lift when having braces, it’s hard to tell. But he will revise if needed in the future. I don’t regret it. I’m happy with it. No numbness.

So are you recommending lower jaw surgery or full bimax?

[PloskoPlus]

I don’t remember the mm. I believe it was about 4mm? Tooth show improved for now, but because I got the lip lift when having braces, it’s hard to tell. But he will revise if needed in the future. I don’t regret it. I’m happy with it. No numbness.

So are you recommending lower jaw surgery or full bimax?

What is your decompensated overjet?  Have you seen Gunson? Perhaps lower jaw only with extractions.  I think your upper lip looks too full and everted now.  It should not be bigger than the lower, especially in men. Advancing the lower jaw would balance that nicely.  You could also consider a lip reduction (often both a lip lift and a lip reduction are done at the same time time to keep the vermillion between the 2 lips in balance).

Just advancing the chin would leave it too pointy and possibly make the lower lip too thin.  You have a nice projecting chin bone as it is.

[haven]

What is your decompensated overjet?  Have you seen Gunson? Perhaps lower jaw only with extractions.  I think your upper lip looks too full and everted now.  It should not be bigger than the lower, especially in men. Advancing the lower jaw would balance that nicely.  You could also consider a lip reduction (often both a lip lift and a lip reduction are done at the same time time to keep the vermillion between the 2 lips in balance).

Just advancing the chin would leave it too pointy and possibly make the lower lip too thin.  You have a nice projecting chin bone as it is.

Wont his last upper molars not make contact with any of his lower teeth if he does lower extractions and BSSO?

IMO you don't really need BSSO. There's nothing abnormal looking about your face, and no one IRL is analyzing your face like on here, unless something is wrong with them.

 You probably run the risk of your chin looking pointy if you advance it horizontally; probably why they only suggested a downward movement.

[kavan]

You have a LOW ANGLE to the mandibular plane and SHORT chin. You really don't have recession of the mandible. You don't really have recessed chin either. You have SHORT chin.

 The type of genio I suggested (which 'A' also suggests) brings the chin diagonally forward and down which will visually camouflage your low MPA and of course directly address the short chin.
Your frontal view would look better balanced with a longer chin


Plan B would involve EXTRACTION of teeth and for what?..to bring forward a LOW mandibular plane. It's your face but extraction is better justified when the mandible is truly recessed and your's isn't.

[Ezra]

What is your decompensated overjet?  Have you seen Gunson? Perhaps lower jaw only with extractions.  I think your upper lip looks too full and everted now.  It should not be bigger than the lower, especially in men. Advancing the lower jaw would balance that nicely.  You could also consider a lip reduction (often both a lip lift and a lip reduction are done at the same time time to keep the vermillion between the 2 lips in balance).

Just advancing the chin would leave it too pointy and possibly make the lower lip too thin.  You have a nice projecting chin bone as it is.

I haven't seen Dr. Gunson. But I will be getting a third opinon and he would be a good option to get that from. My upper lip is swollen and the braces are hitting the back of it. It looks much worse than it will in the future. I'll keep that in mind though. I don't know what my decompensated overjet is...  Here is some info.