Feeling pretty down

[Luka2020]

 Hi guys,

I just need a place to share my concerns and nobody will understand me better than people on this forum.
I grew up with quite an unattractive face. I was a cute kid but I guess I had bad oral posture. It didn't bother me so much growing up, as I wasn't actually aware of how bad I looked.
So 3 years ago when I was 23 it really started bothering me and I got kind of obsessed over it. I wouldn't call it BDD since those are actual real flaws and not made up in my mind. I am not one of those guys who look like models and think they are ugly.

The thing that probably bothers me most of everything is that I fell like all this could have been avoided if I had good oral posture. Everyone in my family has great jaws except me. It would actually be much easier for me if it was just the way I was born and not influenced by me hanging my mouth open.
The thing that is stopping me from getting the very needed genioplasty is my family. I tried talking to them about it, but they don't even understand what I want and when I say that the doctor would cut my chin with a saw and screw it back on it sounds horrible to anyone outside of this jaw surgery community. I also wear a short beard ALWAYS to cover up my crooked recessed chin so they are not even aware of how it looks really.

The fact that is the most absurd is that they were fine with me getting a rhinoplasty (extreme deviation of the nose and poor breathing), and they are fine with me getting a secondary rhinoplasty soon because the first one left me with a concave nose and not perfect breathing. My father has a breathing problem and we actually plan to go for surgery to the same doctor on the same day. Rhinoplasties are considered normal, every second person has had either a septoplasty or a rhinoplasty. Genioplasty however is something strange to a regular person. At least in my country.

I am feeling very depressed. For the past 3 years I have been spending hundreds of hours researching everything about jaws, surgeries and in the end I still didn't get a genioplasty. My problems are:
- recessed and asymmetrical chin (biggest)
- vertical maxillary excess (although I don't have a steep ocl. plane)
- nose that was extremely crooked is now slightly concave and needs another operation
- bimaxillary protrusion
- lip incompetence due to VME and bimax protrusion
- hair loss still in early stages.

I would be pleased with just fixing my chin, nose and keeping my hair.
A possible option for fixing lip incompetence and maybe achieving some autorotation of the mandible would be braces with TADs but I am not very inclined to that option because I had braces for 2 rounds already and I am not sure of the amount of autorotation I would get.


I am of age where I should be pursuing a masters degree, finding a job and all that, but I just cannot help but think that I would live a much happier life if I had a genioplasty. I would be comfortable in my own skin. I would be much more confident and motivated to pursue my degree and other things in life. Apart from my chin being deformed, and other facial flaws, I couldn't be happier with other things in my life. This is sucking all my energy.

What do you think I should do? I tried psychotherapy, and although it is nice to talk to someone openly, I don't believe I will ever stop being bothered by my chin.

Should I just try to focus on other things and do the surgery later in life in my 30s? What do you think about TADs impaction and will it have any noticeable result on the projection of my chin?


Thank you guys!

[kavan]

I can't confirm each and every one of the (bony) problems you say you have. What I can tell you is that 'research' as to symmetry or asymmetry starts with using very SIMPLE analytical TOOLS to observe it. Here, you have acquired a scan of your skull structure which allows you to do that. Also here is skull model (model as in a CONSTRUCT) that I've included.

Since the skull model is one showing symmetry, we can draw straight forward lines through it (very simple analytical tools) to show it is symmetrical. Illustration included.

Same simple technique can be used to look at your skull scan. Illustration included.

Here we see the asymmetry to the pyriform aperture (pear shaped hole to the skull where the nose is). Due to that, a vertical dropped from the center of the top of the nose bone doesn't pass through the nasal spine and also the 2 front central incisors. It doesn't divide the pyriform aperture equally. Even if you drew a vertical that passed through the 2 central incisors and the spine of the nose, there still would be no equal division of the pyriform aperture.

So, as to 'what to do'. Entertain the idea (made from direct observation of the skull structure) that you have asymmetry that they might not be able to correct totally. That may have factored into to prior surgery to the nose. However, your nose in the PROFILE ceph is most certainly NOT 'concave'.

The asymmetry that is most observable is the lateral chin area. To that regard, a decision would need to be made as to which is the preferred side to try to match with the other. Custom implant would work if you wanted the shorter side to be as long as the longer side. Could get more tricky if you wanted the longer side to be as short as the other via bone shaving and cuts.

None the less, you now have an illustration with some lines that show the asymmetry which you can use as a spring board when consulting with a surgeon to inquire about asymmetry corrections and/or limits thereof to all areas.

[Luka2020]

Thank you Kavan for the useful information. Actually every aspect of my face from the eyebrows down is asymmetrical more than on the average person. After examining the pictures from my childhood, it is visible that the asymmetry was there since birth. It was just less pronounced before puberty. Chin was always kind of recessed/ mouth was protruded. I have an adenoid facies, and I just cannot drop the idea of how attractive I could have been if my face developed correctly. It is making me depressed.

As for my nose not being concave in the ceph - I agree, but that ceph was soon after the surgery and there was still a lot of swelling that made it look better. I would prefer it being completely de rotated with columella being parallel to the floor. However, the surgeon didn't change my nasolabial angle he just lifted the droopy tip slightly. De rotating the nose would take rib grafts which requires a much longer and more difficult recovery, and there is always a possibility of something going wrong again and I don't want to go on a 3rd nose operation.

Regarding the chin - the shorter side looks much better. This should definitely be done through a genioplasty.

[InvisalignOnly]

So you're 26 and moaning about your family? You really need to man up (even if you are a woman - I'm not sure from your post). If you want a genioplasty or whatever, just get it done, why do you care about your family? Or do you want them to pay for it? You're an adult, save up for it if you want it. Based on your post, what will make potential partners less attracted to you is not your face but your attitude.