Questions about Genioplasty

[hallonsylt123]

Hello. I'm very new to this forum and dont really know that much about the jaw. I have a good bite with no problems but have long been unhappy about my looks and thought that my chin was the biggest culprit. I asked on reddit if they could evaluate my photos and they said that my chin is weak and not long enough vertically. They adviced genioplasty. In my country, genioplasty is not common for purely aesthetic reasons and I've only found one surgeon that does it.

During my consultation he declared that he thought 5 mm horizontal movement and 2 mm vertical movement would be the most we could do. In my eyes that seems quite low. Could that really be enough? He does seem like a conservative dr that usually does these operations for medical purposes. I want to have a strong jaw at the least. I have another consultation with him in a week where he will show me simulations. Should I insist on more?

Photos: Sorry for no xrays and stuff.  https://imgur.com/a/m9D3Eqd

[GJ]

He probably wants to limit it to 5mm horizontal because more than that and you risk having a large labiomental groove.
Gunson likes to limit genios to around 5mm or so for this reason, too. There are always exceptions, like if your groove is totally flat to begin with, but yours isn't. Something else a good doctor should consider as well is how the muscles will stretch with that movement. It can feel very tight in that area with the wrong movements. His recommendation seems reasonable to me. I think it would be an improvement, though I have no idea what your expectations are.

[kavan]

If it's a SLIDING genio then the VERTICAL movement would be UP. So, he's probably conveying to you that any more horizontal movement would come with UNWANTED vertical shortening.

[hallonsylt123]

He probably wants to limit it to 5mm horizontal because more than that and you risk having a large labiomental groove.
Gunson likes to limit genios to around 5mm or so for this reason, too. There are always exceptions, like if your groove is totally flat to begin with, but yours isn't. Something else a good doctor should consider as well is how the muscles will stretch with that movement. It can feel very tight in that area with the wrong movements. His recommendation seems reasonable to me. I think it would be an improvement, though I have no idea what your expectations are.

Thank you for answering. My dream would be to have a chin that doesn't slope upwards like mine. I'd ideally want to have a more of a right angle between chin and neck.  But I am ofcourse aware of the fact that there are limitations. I've tried to find before- and after pictures online that include how many mm's have been adjusted without any success. Together with the fact that surgeons online (eg: https://www.realself.com/question/berlin-ny-vertical-length-sliding-genioplasty-add-chin) seem to think that at least 5 or up to 12 mm of vertical is the norm, has me questioning my doctor. But I will ofcourse listen to him in the end.

Your thoughts on the horizontal movement seems reasonable. Do you have any thoughts on the vertical movemove of 2 mm?

Thank you again.

[hallonsylt123]

If it's a SLIDING genio then the VERTICAL movement would be UP. So, he's probably conveying to you that any more horizontal movement would come with UNWANTED vertical shortening.

I will have to make sure upon our next consultation that he has not misunderstood me then. I did open up with saying I think my chin is too short vertically. There is another name though, for a procedure to both highten and lengthen the chin?

Thank you.

[kavan]

I will have to make sure upon our next consultation that he has not misunderstood me then. I did open up with saying I think my chin is too short vertically. There is another name though, for a procedure to both highten and lengthen the chin?

Thank you.

I forgot the official name for it. But what it is is a DIAGONALLY DOWNWARD genio where there is BOTH horizontal advancement and vertical ELONGATION. However, it is the type of genio where they need to put in a 'bone buttress' between the cut because the cut is SEPARATED and removed from bone contact with the part it was cut from. A bone buttress is usually a medpore block. Sometimes a bone graft from the hip.