Is a 1mm genioplasty worth it?

[lilaboy]

im getting a genioplasty with my bimax. 1mm forward and 2mm down. i ve talked with some other guys and they too think that i need more. i agree. question is, why is my surgeon giving me 1mm only, there must be a reason. I have a before/after morph of my surgeon which i link here:




should my chin be at the same line as my lip for the best optical result?

[IconVillage]

1mm is nothing

[Sergio-OMS]

im getting a genioplasty with my bimax. 1mm forward and 2mm down. i ve talked with some other guys and they too think that i need more. i agree. question is, why is my surgeon giving me 1mm only, there must be a reason.

1 mm is not significant.  Don't do it, you will suffer from the inherent side effects from the procedure with not benefit from it.

[GJ]

you will suffer from the inherent side effects from the procedure with not benefit from it.

What side effects?

[kavan]

That's a modest diagonally downward genio to help address 'short chin' which you have and to also help decrease the overly acute lower lip to chin groove when added to the BSSO advancement. You're the guy who's posting history is perpetual uncertainty right? You  would be worrying that it was 'too much' or give a pointy chin if it were any more right?

[Post bimax]

im getting a genioplasty with my bimax. 1mm forward and 2mm down. i ve talked with some other guys and they too think that i need more. i agree. question is, why is my surgeon giving me 1mm only, there must be a reason. I have a before/after morph of my surgeon which i link here:


https://imgur.com/a/2crPhsD

should my chin be at the same line as my lip for the best optical result?

What are your bimax displacements? For example, if the bimax yields a 4mm vertical movement at the pogonion, an additional 2mm is a 50% increase, which is significant. However if you want a larger movement based on the morphs then you need to ask for it.

[Post bimax]

What side effects?

Well there are definitely additional risks the genioplasty poses independently. I remember “Odog” had some serious issues with chin tightness which affected his speech.

[LeFort 3000]

NO. 10mm is the minimum movement to have any visible effect on the face and even that often feels lacking. Soft tissue and skin eat alot of the movement. You will be worse off than before all things considered

[Post bimax]

NO. 10mm is the minimum movement to have any visible effect on the face and even that often feels lacking. Soft tissue and skin eat alot of the movement. You will be worse off than before all things considered

This is totally false. Not sure where you got this idea, unless this is meant to be facetious. 10mm is a relatively LARGE movement that will have drastic aesthetic impacts.

[PloskoPlus]

NO. 10mm is the minimum movement to have any visible effect on the face and even that often feels lacking. Soft tissue and skin eat alot of the movement. You will be worse off than before all things considered

Change becomes noticeable from 2 mm.

[kavan]

NO. 10mm is the minimum movement to have any visible effect on the face and even that often feels lacking. Soft tissue and skin eat alot of the movement. You will be worse off than before all things considered

NO. There is NO magic number for 'minimum movement or no movement at all'.
In fact, surgeons who bring the chin point out along the vector of the BSSO often add a very minor chin advancement to complete the final aesthetic.

In this case the poster has SHORT chin (short lower 1/3rd) and the genio is NOT the type you are probably thinking of (sliding genio that goes vertically up and horizontally outward) It's a DIAGONALLY DOWNWARD genio which separates the chin segment from having direct contact with the rest of bone and there would be a GAP of bone separation to move it diagonally DOWNWARD. Any more than a 1mm GAP and a bone buttress would be needed to fill the gap. The BSSO, itself will be doing most of the advancement. But since he is a LOW ANGLE patient (low MPA), the BSSO alone would not give him the little extra length to the chin whereas the chin needs to go a tad DOWNWARD to even out the look. Hence for his chin to go 2mm DOWNWARD and to be separated from rest of chin leaving a GAP to do that, the gap left has to be small enough for it to fill in. Again, it's not the type of genio people usually think of for which the focus is the OUTWARD displacement.

[InvisalignOnly]

I had a 2mm genioplasty and for me it was totally worth it. This kind of movement is about changing the shape of your chin, rather than simply moving it forward. Kavan explained this in detail and much better than I could, so I'm just adding my two cents to say I had a similar case and for me it was the best solution. Most of the advancement in my case came from advancing my lower jaw. You have a deep labiomental fold so I can see why your surgeon doesn't want to do a larger movement in that area.

[LeFort 3000]

This is totally false. Not sure where you got this idea, unless this is meant to be facetious. 10mm is a relatively LARGE movement that will have drastic aesthetic impacts.

Ive had multiple osteotomies on my face, probably more than most people here. By now I know very well how procedures look on paper vs how they end up in real life. I will reinstate that 1cm should be always the minimal aim for any significant movement. I would advise anyone to not get downtalked into small movements by surgeons if you want to see results. Except its something like what kavan pointed out or whatever. I would still pressure to get bigger movements, 2mm can easily be lost on bone resorption and displacement alone.

Change becomes noticeable from 2 mm.

It absolutely does and will not. Its barely even noticeable on CT, let alone in real life under all the soft tissue adaption. Average male head size is 23x20cm, 2mm of 200mm is a 1% change. Its gonna do f**k all for aesthetics really

NO. There is NO magic number for 'minimum movement or no movement at all'.
In fact, surgeons who bring the chin point out along the vector of the BSSO often add a very minor chin advancement to complete the final aesthetic.

In this case the poster has SHORT chin (short lower 1/3rd) and the genio is NOT the type you are probably thinking of (sliding genio that goes vertically up and horizontally outward) It's a DIAGONALLY DOWNWARD genio which separates the chin segment from having direct contact with the rest of bone and there would be a GAP of bone separation to move it diagonally DOWNWARD. Any more than a 1mm GAP and a bone buttress would be needed to fill the gap. The BSSO, itself will be doing most of the advancement. But since he is a LOW ANGLE patient (low MPA), the BSSO alone would not give him the little extra length to the chin whereas the chin needs to go a tad DOWNWARD to even out the look. Hence for his chin to go 2mm DOWNWARD and to be separated from rest of chin leaving a GAP to do that, the gap left has to be small enough for it to fill in. Again, it's not the type of genio people usually think of for which the focus is the OUTWARD displacement.

there is no magic number, but the movements needed to provide aesthetic improvement are tied to the facial/head size which are more or less similar among most people.

anyway what you provided sheds another light to the discussion. You are alot more educated on this matter so I will just take this as fact in this context. If you are already getting operated on you might go with "only the 2mm". But dont expect those 2mm to have noticible aesthetic improvements, thats what I can testament.

[kavan]

Ive had multiple osteotomies on my face, probably more than most people here. By now I know very well how procedures look on paper vs how they end up in real life. I will reinstate that 1cm should be always the minimal aim for any significant movement. I would advise anyone to not get downtalked into small movements by surgeons if you want to see results. Except its something like what kavan pointed out or whatever. I would still pressure to get bigger movements, 2mm can easily be lost on bone resorption and displacement alone.
It absolutely does and will not. Its barely even noticeable on CT, let alone in real life under all the soft tissue adaption. Average male head size is 23x20cm, 2mm of 200mm is a 1% change. Its gonna do f**k all for aesthetics really
there is no magic number, but the movements needed to provide aesthetic improvement are tied to the facial/head size which are more or less similar among most people.

anyway what you provided sheds another light to the discussion. You are alot more educated on this matter so I will just take this as fact in this context. If you are already getting operated on you might go with "only the 2mm". But dont expect those 2mm to have noticible aesthetic improvements, thats what I can testament.

You would need to read the OP's past posts and look at his cephs if he still has them up. You can't apply your OWN face/chin situation to someone elses you have not taken the time to evaluate, especially to someone who is overly concerned about getting a LONG chin with the surgery. So, basically, you told someone who is afraid of getting a long point chin to go for at least 10mm. If he followed your advice, he'd end up with a DEFORMED looking chin. OK.

The OP has a history of confusing himself and being 'on wrong side of door' as to displacement proposals. On one hand, he wants 'more'. But on the other hand if that's proposed, he gets afraid his chin will be too long or 'pointy'.

 MOST of his advancement is with the BSSO which will bring his chin forward along the vector of the BSSO. But BECAUSE he has a LOW MPA, his CHIN needs to come a little bit more DOWN than the BSSO will take someone's chin with a LOW MPA.

The 1mm he's concerned will not be 'enough' is basically the amount needed to bring his chin DOWN by 2mm. It's NEEDED for a modest DIAGONALLY DOWNWARD genio so his chin does not remain STILL TOO SHORT even with the BSSO and also needed to increase his OVERLY ACUTE groove between the lower lip and chin. If he didn't get the 1mm to bring the chin vertically down by 2mm, his chin would look weird with a straight down 2mm drop.

So, please NOTE that the OP is a CONFUSION GENERATOR and probably confused a good handful of people on here, including himself by leading people to believe the 1mm he was worried about 'not being enough' was with the sole goal of just ADVANCEMENT whereas the 1mm is NOT toward that goal. It's toward the goal of providing a MODEST increase in chin length where the chin is to be moved in a DIAGONALLY DOWNWARD direction.

[lilaboy]

That's a modest diagonally downward genio to help address 'short chin' which you have and to also help decrease the overly acute lower lip to chin groove when added to the BSSO advancement. You're the guy who's posting history is perpetual uncertainty right? You  would be worrying that it was 'too much' or give a pointy chin if it were any more right?

yes im "that" guy unfortunately. Btw "CONFUSION GENERATOR" was really funny because its true
But im afraid that i did not understand your answer correctly. You say it will decrease my lip to chin ratio, which is good, but is a 2mm vertical movement enough to fix my short chin to make it aesthetic. And should my chin meet the line i draw on the morph or is it good as it is? Im again trying to understand uncertain things, i know, but i cant help.

What are your bimax displacements? For example, if the bimax yields a 4mm vertical movement at the pogonion, an additional 2mm is a 50% increase, which is significant. However if you want a larger movement based on the morphs then you need to ask for it.

i dont remember the exact movements but im getting 2mm LF1 and 6-8mm BSSO, and 1 degree CCW iirc


yes as kavan said "....the 1mm he was worried about 'not being enough' was with the sole goal of just ADVANCEMENT whereas the 1mm is NOT toward that goal. It's toward the goal of providing a MODEST increase in chin length where the chin is to be moved in a DIAGONALLY DOWNWARD direction."
Problem i see with this is that f.e. i cant close my lips after too much vertical genio, maybe there are more risks etc.