Author Topic: Sliding Genioplast Advice & Surgeon Suggestions? (PICS)  (Read 3925 times)

CaptainButtnaked

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Re: Sliding Genioplast Advice & Surgeon Suggestions? (PICS)
« Reply #15 on: January 10, 2021, 03:11:09 AM »
For my consult on the 13/01/21. This is what I've come up in terms of preparations. These will be the examples and questions I will present in the consult.

Health

Goal: To relieve negative health symptoms

Chance are if you or someone your know snores their jaws are probably recessed

Negative symptoms/Health Complications – Bad Nasal breathing, Bad Sinus, Snoring & possible sleep apnea




Aesthetics

Goal: To improve aesthetic appearance of my lower third through improving chin height & chin projection.


Ideal Chin to philtrum Ratio (AKA Chin Height) – 2.0 to 2.3 (Overpowered chins aren’t a flaw in males)

https://imgur.com/a/vw9ghMJ (To provide examples for the surgeon)

What type of chin height improvement is realistically possible in my case?



Ideal Chin Projection - Chin in line with nasion on Frankfurt plane

https://imgur.com/a/RUqHO4F (To provide examples for the surgeon)

What type of projection is realistically possible in my case?


Will my lower lip sit higher or lower after surgery? (You want to avoid it becoming lower at all costs)

Can you provide me with examples of genioplasty’s and double jaw surgery you’ve performed on male patients?

Will I require braces to perform double jaw surgery?

What steps can be taken to reduce or eliminate step off?

How to prevent relapse in case of double jaw surgery?


kavan

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Re: Sliding Genioplast Advice & Surgeon Suggestions? (PICS)
« Reply #16 on: January 10, 2021, 12:15:17 PM »
Apologies.

My reply was abrupt and thoughtless, and I came across as an entitled punk.

Since reading what you posted previously about my chin projection and my lower jaw (Also my upper jaw which I will get to later) my head was in a bit of spin, was honestly pissed off and it has taken a while to set my ego aside. Which ultimately is for the best.

What I thought was going to be a simple genioplasty has now turned into either a mandibular osteotomy or double jaw surgery which not only cost more but both have longer rehab and preparation time with the potential for braces.

Regardless after researching it further I think you're 100% right. My chin already has forward projection and would not likely gain much from a sliding genioplasty.

Aside from aesthetics, my family from my father's side (Myself included for snoring) all suffer from sleep apnea, bad snoring and bad nose breathing with bad sinuses. which are all symptoms of a recessed jaw, they also have the facial features to back this theory up.

Out of the two surgeries Mandibular Osteomy and double jaw surgery I'm opting out for the double jaw surgery. This is because my teeth already align and have never had chewing issues. It would mean a lot if you could give me your interpretation of my scans.

https://imgur.com/a/8U48qo2

It'd mean a lot if you could give me some feedback and your opinion on what you think an appropriate direction to go is.

Cheers.
This is an APPROXIMATION. It's ONLY an approximation. It isn't an exact ceph analysis. The GREEN contour line is an APPROXIMATION of what I THINK you might want; the lower jaw along with the lower lip to come 'forward' either along the inclination of the MPA or along a higher inclination than the existing 20 deg. but NOT a LOWER one. Your OP and MPA angles don't suggest CCW rotation.

Your DESIRES reflect AVOIDANCE of double jaw surgery 'because your teeth are (already) aligned'. You mention a (possible) MEDICAL reason (apnea) for surgery.
The REALITIES of maxfax surgery, especially when apnea is included in the mix often do involve double jaw surgery. In the event a SINGLE JAW (lower) only can be accommodated, 'forward' advancement would involve the lower teeth moving with it and out of place with the present alignment IF adjustments to the teeth (bite) were not made to accommodate a single jaw advancement and sometimes that involves plucking out 2 pre-molars in order to push some of the lower front teeth backwards in order to accommodate a single lower jaw advancement.

Another issue in maxfax surgery involves a DESIRE for ONLY one thing along with an AVOIDANCE of another thing; wanting to hold one thing CONSTANT (for it not to change) but for ONLY an ISOLATED thing to change. Sometimes those desires are on target with a surgery to accommodate. Other times not. That sort of thing is explored with a maxfax surgeon who can evaluate ALL of the measurements and has the tools to do a DISPLACEMENT analysis as to whether or not desire for 'this' but avoidance for 'that' can be accommodated.

That said, the GREEN contour line APPROXIMATES what you might want with a single lower jaw surgery. It does NOT predict whether or not that can be accommodated in the absence of doing anything to the upper jaw, nor does it predict a single jaw surgery in the absence of adjusting the teeth to achieve it. IF the green contour line reflects close to what you'd like to achieve, it could be used as a very BASIC APPROXIMATION to ask a surgeon IF 'something like that' can be done with single lower jaw surgery.

What I said in my first post to you still holds: There is no preclusion for having an isolated genio request accommodated by a surgeon. It's just that a jaw JUT OUT doesn't replicate one.

Disclosure: This feedback reflects the 'some' I can give in the time I have to volunteer to do so with reference to reply #14 in this thread. It is not an invitation to give feedback for 'all' of what you want to ask your surgeon in reply #15 in this thread.

Please. No PMs for private advice. Board issues only.

Rodin

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Re: Sliding Genioplast Advice & Surgeon Suggestions? (PICS)
« Reply #17 on: January 10, 2021, 12:24:02 PM »
The SNA and SNB values on that ceph seem very high (~90 degrees) which would normally indicate prognathism, despite not appearing so in profile. This seems like it would be due to variation in the nasion position or sella position in the skull base. The skull base angle appears lower than published norms. Does anyone know anything about cases like this? Steiner analysis does not seem to be accurate here and I have seen a couple similar scans before.

kavan

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Re: Sliding Genioplast Advice & Surgeon Suggestions? (PICS)
« Reply #18 on: January 10, 2021, 02:15:45 PM »
The SNA and SNB values on that ceph seem very high (~90 degrees) which would normally indicate prognathism, despite not appearing so in profile. This seems like it would be due to variation in the nasion position or sella position in the skull base. The skull base angle appears lower than published norms. Does anyone know anything about cases like this? Steiner analysis does not seem to be accurate here and I have seen a couple similar scans before.

That is basically correct. My approximation was 88 SNA, 86 SNB, 2 ANB where as norms are: 82 SNA, 80 SNB, 2 ANB. But this isn't something where his face should be pushed backwards due to that. Besides, no one actually 'sees' them the face. I drew them in to look at ANB which was normal. My very basic paint program doesn't allow me to selectively remove them. The green contour line relative to the red vertical is what those of us without X ray eyes see on someones profile.

ETA: Because the S-N line is pretty much a pure horizont and I think most people's S-N line is about 7 degrees inclined away from a pure horizont, THAT'S what is increasing the SNA and SNB angles. But I think they make adjustments for what he has. Like if we subtract 7 degrees, he fits into the norms.
« Last Edit: January 10, 2021, 02:28:17 PM by kavan »
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CaptainButtnaked

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Re: Sliding Genioplast Advice & Surgeon Suggestions? (PICS)
« Reply #19 on: January 12, 2021, 04:57:59 PM »
This is an APPROXIMATION. It's ONLY an approximation. It isn't an exact ceph analysis. The GREEN contour line is an APPROXIMATION of what I THINK you might want; the lower jaw along with the lower lip to come 'forward' either along the inclination of the MPA or along a higher inclination than the existing 20 deg. but NOT a LOWER one. Your OP and MPA angles don't suggest CCW rotation.

Your DESIRES reflect AVOIDANCE of double jaw surgery 'because your teeth are (already) aligned'. You mention a (possible) MEDICAL reason (apnea) for surgery.
The REALITIES of maxfax surgery, especially when apnea is included in the mix often do involve double jaw surgery. In the event a SINGLE JAW (lower) only can be accommodated, 'forward' advancement would involve the lower teeth moving with it and out of place with the present alignment IF adjustments to the teeth (bite) were not made to accommodate a single jaw advancement and sometimes that involves plucking out 2 pre-molars in order to push some of the lower front teeth backwards in order to accommodate a single lower jaw advancement.

Another issue in maxfax surgery involves a DESIRE for ONLY one thing along with an AVOIDANCE of another thing; wanting to hold one thing CONSTANT (for it not to change) but for ONLY an ISOLATED thing to change. Sometimes those desires are on target with a surgery to accommodate. Other times not. That sort of thing is explored with a maxfax surgeon who can evaluate ALL of the measurements and has the tools to do a DISPLACEMENT analysis as to whether or not desire for 'this' but avoidance for 'that' can be accommodated.

That said, the GREEN contour line APPROXIMATES what you might want with a single lower jaw surgery. It does NOT predict whether or not that can be accommodated in the absence of doing anything to the upper jaw, nor does it predict a single jaw surgery in the absence of adjusting the teeth to achieve it. IF the green contour line reflects close to what you'd like to achieve, it could be used as a very BASIC APPROXIMATION to ask a surgeon IF 'something like that' can be done with single lower jaw surgery.

What I said in my first post to you still holds: There is no preclusion for having an isolated genio request accommodated by a surgeon. It's just that a jaw JUT OUT doesn't replicate one.

Disclosure: This feedback reflects the 'some' I can give in the time I have to volunteer to do so with reference to reply #14 in this thread. It is not an invitation to give feedback for 'all' of what you want to ask your surgeon in reply #15 in this thread.

Just finished the consult.

Spoke to him about what I wanted to achieve some that looked like the jutting, ideal height etc. (Obviously lips won't allign)

Said I had a good base to perform it and can achieve what I want with the genioplasty.

He showed me something similar to what you did with my scans the only difference being no lip movement.

Thanks again for accepting my apology and taking the time to edit that scan.

I plan to go a ahead with the genioplasty and access my next plan of attack for looksmaxxing.

Cheers

kavan

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Re: Sliding Genioplast Advice & Surgeon Suggestions? (PICS)
« Reply #20 on: January 12, 2021, 05:05:56 PM »
Best of luck.
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