First post here - please advice of auesthitics of jaw

[GJ]

Yes - i guess it can be both . Muscles - because of my illness - i didn't use my facial muscles sometimes for monthes (!) - i didn't talk or smile - cause it hearts. So yes - atrophy could have happened. And from what i know - the bone needs active pressure on it - to keep rebuliding - so this might explain SOME of it. I'm sure there is a reason behind all this - cause my look deterorates dramaticly every few monthes..  I've ordered some special splints from the web - to excersise my jaw (we'll see -i doubt if it can ever REALLY do a dramatic change that i need).
Totally right about the medications - from a healthy 32 yo guy - being 10 years on different meds - yes- totally can be from meds. I'm also sure the meds accelerates my hair shedding. I totally noticed it- some DRAMASTICALLY increased my hair shedding. I totally had VERY unique big harmonic bones on face and it's like beneath average now - and decreased in like 50% my face shrunk.
Thanks for your thoughts on this GJ.

BTW - anyone knows plastic surgerons in Europe (not ths US  - can't travel there) That have great auesthetic eye - and know about implant s ? Thanks all

Can you try getting off the meds and rebuilding muscle tone?
I'd try that before anything because it's a cheap and natural approach with a proven track record. I recently lost weight and gained muscle tone and look much younger/better.

[tie]

THis is an 48 years old guy from my country - he is a show host on TV.
I'm sure he has some work done - but still - that's the proof so many people today don't lookl "old" at 40...40 isn't the death line of look.

[tie]

People lose bonemass after the age of 35. This can go quite fast. Combine this with sagging skin and soft tissue loss due to ageing, and the face can change dramatically. Facial beauty is about millimeters here and there.

I mean, look at most 40 year old men. Even the very good looking men can turn into bad looking rapidly past a certain age. Women age drastically beginning at the age of 30, men a couple of years later (35). From there on, it usually goes quite fast.

He has bad ageing genetics, combined with some other thing maybe. I do believe he can rebuild bonemass though. How to do it is another question. Most people don't care about their looks anymore past a certain age, but if you do, and looks has been a major part of your identity, life can become a nightmare. I totally understand OP.

Thing is, implants are a very tricky and delicate procedure. Very very few surgeons know the art. Most of them are conmen who don't know anything about aestethics and this guy seems to need some changes in different parts of his face.

Thanks Ben for that . Yes - my looks is totally a thing that's devestating me.. totally .. more over when that change of shape is so rapid and quick.
If you know of any PS in europe you know of that does implants and also understand auesthetic needs - i'll be glad to hear.  Totally agree - facaill beauty is totally about militers sometimes ..many people don't even aware of this. Even though in my case - over time - i know i'll know about few Centimiters not milimiters of change to get some of my pleasing look Many thanks Ben

[ben from UK]

Thanks Ben for that . Yes - my looks is totally a thing that's devestating me.. totally .. more over when that change of shape is so rapid and quick.
If you know of any PS in europe you know of that does implants and also understand auesthetic needs - i'll be glad to hear.  Totally agree - facaill beauty is totally about militers sometimes ..many people don't even aware of this. Even though in my case - over time - i know i'll know about few Centimiters not milimiters of change to get some of my pleasing look Many thanks Ben

I think people sometimes underestimate what 2 or 3 millimeters of implant around the whole jaw and chin can do. I wouldn't be surprised if alot of people that put in 10 millimeter of jaw on both sides, thinking 'the bigger the better', are dissappointed with the results. It's not only about width, or maybe less about width than about angularity and natural looking results. But I might be wrong and maybe it depends on the face. Looking at your younger face, it's the angularity and sharpness that does the trick, and the harmony of the face.

I don't know any good implant surgeon in Europe. Or maybe one. I think his name is Dr. Nimo in Rotterdam (not sure). An asian guy. I base this only on the results I saw in his office. I never had work done with him. Maybe he isn't good and he showed me just lucky results. I think alot of asian surgeons have a better aestethic eye than other surgeons. I might be wrong though.

He's not a nice guy and doesn't make you feel comfortable. But that doesn't say anything about someone's skill. He works with silicone I think. I personally don't like silicone and prefer Peek, but it depends on the size of the implant as well.

In my opinion, the area that should be targeted with implants when it comes to angularity is really the lower boarder of the jaw. I see alot of implant designs going high up, pushing the masseter outward, ruining the shadows and ogee line and creating a bloated face. Not good.

[tie]

Can you try getting off the meds and rebuilding muscle tone?
I'd try that before anything because it's a cheap and natural approach with a proven track record. I recently lost weight and gained muscle tone and look much younger/better.

No - i don't think i can , i've been on and off the meds for years.. i've started taking them again - they are for pain - i can't quit them. They give me only 30% relief but it's better than nothing .
When you say build muscle tone - you mean in the face ? A specfic method to gain muscle tone in the face ? Thanks

[tie]

I think people sometimes underestimate what 2 or 3 millimeters of implant around the whole jaw and chin can do. I wouldn't be surprised if alot of people that put in 10 millimeter of jaw on both sides, thinking 'the bigger the better', are dissappointed with the results. It's not only about width, or maybe less about width than about angularity and natural looking results. But I might be wrong and maybe it depends on the face. Looking at your younger face, it's the angularity and sharpness that does the trick, and the harmony of the face.

I don't know any good implant surgeon in Europe. Or maybe one. I think his name is Dr. Nimo in Rotterdam (not sure). An asian guy. I base this only on the results I saw in his office. I never had work done with him. Maybe he isn't good and he showed me just lucky results. I think alot of asian surgeons have a better aestethic eye than other surgeons. I might be wrong though.

He's not a nice guy and doesn't make you feel comfortable. But that doesn't say anything about someone's skill. He works with silicone I think. I personally don't like silicone and prefer Peek, but it depends on the size of the implant as well.

Thanks. I'll tell you something . A few years ago, after my face has changed.. When i was looking at my self in the mirror - i like .. hm.. i don't know the word... "pulled" my chin a bit down and to the left . .. just a bit.. and imagine my mandible angle less rough and i looked totally fine totally ...or strech a bit the skin near my eyes horizotly - i would have returened to look more than OK .. i could have seen "myself" again.. just in 2-3 streches of the face.
In the last year- i've even lost that. To see a bit of my old "me" - i need to pull my chin -i think 2 cm down.. and to the left ..to get more firm.. defined face . I wonder if it's even possible to pull the chin that low.. and what will be with the teeth .. it will create a terrible gap . It's really just a fantasy i guess.
You are totally right... i used to know how in many cases .. just a slight milimeter or two of change... or slight angle change - can make a person look totally different for the better.
you have also spoted the right thing - In my younger years .. till age 32 the angle of my mandible was very harmony and firm and THIS angle has totally changed . I've even showed my pics to a plastic surgeon about 3-4 years ago - and he looked at my face and totally saw that the angle has changed and he was shocked but he didn't know what to advice me .
I Do hope i'll be able to find and understand or find a total doctor than will have sensitive eye to understand the change i've had - and know what to do to make me more pleasable to the eye so even when i'll end the saga of the pain i deal with - i'll be able to live my life - since my dyspohria is really extreme to the exatant i can't deal with it sometimes.
Thanks Ben !

[GJ]

Do you have any old TMJ scans to compare with new ones? The only way I can think the jaw angle changing is something in the TMJ.

[ben from UK]

Thanks. I'll tell you something . A few years ago, after my face has changed.. When i was looking at my self in the mirror - i like .. hm.. i don't know the word... "pulled" my chin a bit down and to the left . .. just a bit.. and imagine my mandible angle less rough and i looked totally fine totally ...or strech a bit the skin near my eyes horizotly - i would have returened to look more than OK .. i could have seen "myself" again.. just in 2-3 streches of the face.
In the last year- i've even lost that. To see a bit of my old "me" - i need to pull my chin -i think 2 cm down.. and to the left ..to get more firm.. defined face . I wonder if it's even possible to pull the chin that low.. and what will be with the teeth .. it will create a terrible gap . It's really just a fantasy i guess.
You are totally right... i used to know how in many cases .. just a slight milimeter or two of change... or slight angle change - can make a person look totally different for the better.
you have also spoted the right thing - In my younger years .. till age 32 the angle of my mandible was very harmony and firm and THIS angle has totally changed . I've even showed my pics to a plastic surgeon about 3-4 years ago - and he looked at my face and totally saw that the angle has changed and he was shocked but he didn't know what to advice me .
I Do hope i'll be able to find and understand or find a total doctor than will have sensitive eye to understand the change i've had - and know what to do to make me more pleasable to the eye so even when i'll end the saga of the pain i deal with - i'll be able to live my life - since my dyspohria is really extreme to the exatant i can't deal with it sometimes.
Thanks Ben !

Well, I mean, the changes speak for themselves. You can debate about minor changes, but everyone can see the drastic changes based on your pics. Still, I think aming to get the old face back is a bit too high. You were 8 years younger. There's skin change and soft tissue change, glowing younger skin, you can't completely go back to the previous state. But, sure, making cheekbones, jaw more angular, a hair transplant, and maybe lengthening of the chin, why not? Just follow your intuition and do what you think makes you happier.

[tie]

Do you have any old TMJ scans to compare with new ones? The only way I can think the jaw angle changing is something in the TMJ.

I have some pano scans over the years ... they did send me to MRI of jaw joint which they said it was OK. But i don't much trust them to read it good. When i come to think about it - that's what i though years ago just by looking at myself that my joint like my left jaw took itself from it's place and reposined itself in another spot
In about 2011 i did a full body scan and they saw something suspicious in my left mandibule , where my pain was. It was some kind of a bone spur in the jaw (which i could feel it externally - and doctors always dismissed me) .. this bone spur has now readuced it's size . But anyway -i've done many MRI's and they found nothing .. not in head not in jaw.
If something changing in the TMJ like you said.. and a TMJ surgery is needed to put the whole joint in place - it's different from all the surgeryies we are talking here , right ? I can imaging that if they put the joint in a diffrent spot, the correct spot it can change the whole shape of this side .. since the whole tmj is connected to the cheek.. chin etc...
Anyway according to oral surgeron here .. i don't have TMJ...or at least not something that needs attention.

[tie]

Well, I mean, the changes speak for themselves. You can debate about minor changes, but everyone can see the drastic changes based on your pics. Still, I think aming to get the old face back is a bit too high. You were 8 years younger. There's skin change and soft tissue change, glowing younger skin, you can't completely go back to the previous state. But, sure, making cheekbones, jaw more angular, a hair transplant, and maybe lengthening of the chin, why not? Just follow your intuition and do what you think makes you happier.

Thanks . About the " jaw more angular," , and lenghthening the chin - do you know (in your view) what are the procedures needs for that ? For the chin are we talking implant - as we talked ? And the angular jaw ?
And thanks for seeing all those things i also noticed

[GJ]

TMJ surgery is usually full replacement.

It would be pretty obvious on a scan. The TMJ would change shape and also be very small (sometimes pointy). CBCT is the best scan to see that.

If you can upload old photos of the joint (10 years ago) compared with recent that might help rule that in or out. I see what looks like weight change and atrophy in those photos, but if the angle has changed joint issue is possible.

I'm not sure what specific exercises you can do to tone your face. You can probably look that up and find info. I'd try that along with gaining muscle tone, then get a CBCT to rule out the joint. Standard pictures can be deceptive and are one of the worst diagnostic tools.

[tie]

Thanks GJ.
Not sure i have old scans available to upload . (yap. I never thought 10 years ago that i would need these 10 years after).
Anyway - lets' say the MRI for example have many many many slices, you know - it's a 3D which hundreds of pictures  .. How can i know which image to upload ? I guess it's the profile image ?
Unfortunetly - i did'nt do much CBCT to that area. I did many many many cbct's and scans for the teeth each year a PANORAMIC scan. too much radiation - i'm afraid now to ask for another CBCT of jaw. Even though i think CBCT will be much better than MRI in this case showing bones for example.