would i be a candidate for bimax?

[beleriand]

I'm not sure if you can tell just from external pics.  These are from 18 years ago, when I had rhinoplasty and chin implant (Terino Square large).  Obviously, my mandible is underdeveloped.  I had orthodontics to fix my bite, so it is normal.  I feel like my biggest issue is this like concavity in my mid face around my nose, the paranasal area, deep nasolabial folds, and under the eye.  Also, when I smile, my teeth don't fill my mouth.  There's space on the edges.  I don't know if this is indicative of a recessed mandible.  I'm deeply unhappy with the way I look and to this day cringe whenever I see pictures of myself.

https://imgur.com/a/d71dlvA

[PloskoPlus]

Yes you're recessed.

[beleriand]

Yes you're recessed.

Maxilla as well?  And, do you think I could expect a drastic improvement in appearance with the right surgeon, or at least the possibility? 

[ArtVandelay]

Yes, bimax retrusion.

[beleriand]

Thanks.

[Movebone]

that implant actually doesn't look bad...put that back in after your bsso and you'll have a handsome profile.

[beleriand]

I made this post a while ago.  It wasn't really financially feasible for me to explore any surgical options at the time.  But I've thinking this whole time that I needed bimax.  Today I consulted with Dr. Ramieri in Italy.  He didn't flat out say "no, you don't need it" but he did say "what I can offer you is custom genioplasty, otherwise you would need premolar extractions and a year of braces to decompensate the bottom incisors" but he said it as though that weren't a real possibility, or something I wouldn't be interested in, or a bad move on my part.  I also saw an orthodontist who was like "absolutely do not get jaw suregery. your profile is perfect."  So I just don't know what to think.  I mentioned to Dr. Ramieri that I had trouble breathing through my nose thinking there might be some discussion of airway, but he was just like "rhinoplasty revision will fix that."

My ceph:

 

I think my head was unnaturally tilted back when it was taken.  I assume something like that isn't going to throw a surgeon off?

[kavan]

Can't see why you would want to have bimax. Your profile is in good balance with the chin implant. You certainly can get away without bimax.

[beleriand]

I was under the impression I was recessed.  I'm very odd looking.   My face seems to lack structure.  Honestly, I was surprised by my ceph because pre chin implant I basically had no jaw.  I wasn't expecting to see as much bone as there is.

   

I was 18 in that picture.  I mean,  PloskoPlus and ArtVandelay seemed to think I was recessed and when I jut my mandible forward I look way better frontally.  But maybe maxillomandibular recession isn't the issue.

[kavan]

maxfax/bimax surgery does not correct an overly obtuse chin to neck angle which is what you have. You have soft tissue excess to the anterior neck triangle. That is something in the venue of plastic surgery, in particular an advanced type where they need to work deep to the superficial neck muscles with objective of tightening things up so the soft tissue 'hugs' the outline of the mandible more to form a less obtuse cervical neck angle as in a 'sharper' one.

If Dr. Terino is still in practice, go back there and consult about 'obtuse neck'.

[beleriand]

I appreciate the advice.  Thank you.