It is interestingly the opposite of what I have heard most surgeons say. They often said that if you have excess skin, you would probably benefit more from djs than a facelift. Dr. Z also said that djs can often achieve better results than facelifts ever can.
Would say my approach is not to technically correct the calculated recession but rather to get aesthetic benefits from the surgery. Therefore, one could go beyond normal as long as it does not lead to undesirable appearance. Dr. Z, for example, gave his recommendation without looking directly at the X-Ray but based on the Soft Tissue. I know that actually a DJS is meant to fix recession, whereas there are doctors who perform it just for an aesthetic point to get a more harmonious facial profile/face. For example alot of Surgeons actually do a DJS even on not receded x-Rays.
And I think it would look better if everything below the nasal base was more forward and it would have the positive side effect of tightening excess skin.
Would you say I would benefit more aesthetically from a facelift than from a DJS? Do you have any idea how I could get rid of the nasobial folds? And what I could do about the roundness that is visible from the front?
edit: you are right that my chin is from the front asymetrical but it somehow never bothered me and i think its not that noticeable on soft tissue level. I just find that my left side is better looking then the right so maybe there is some causality
Well, if what I say sounds to you like it's the OPPOSITE of what you heard most surgeons (maxfax) say, consider that I'm NOT trying to SELL YOU on surgery and I'm not selectively LEAVING OUT parts of information that would be directly applicable to you. So, YES, I'm telling you something that the doctors DON'T seem to be telling you
As to Dr. Z, he is referring to a 'reverse face lift' something that is applicable to someone (older) with soft tissue VOLUME LOSS to the face whereas the volume loss sags more on people who don't start out with good bone structure. VOLUME LOSS is a key factor in the AGING face. Muscles shrink/atrophy and fat padding is lost. Most of the volume loss is to the SOFT TISSUE and some to the bone structure and this volume loss shows itself as sag and droop and more so on people who don't start out with good bone structure. So, ya, a reverse face lift is of good benefit to THAT type of person.
Seems like he left out the part about VOLUME LOSS to someone who has TOO MUCH (soft tissue) volume and already has pretty HEFTY bones.
Did Dr. Z also leave out the part about one side of your chin being BIGGER than the other side? Guess what happens when someone has some asymmetry to the chin and the chin goes forward with a BSSO and/or genio? The asymmetry one didn't see before gets MORE noticeable.
Assuming that the left side of the frontal ceph photo where the chin is BIGGER is the RIGHT side of your face and you like the LEFT side of your face better, then you should consider that a HEFTY bone structure (that you already have) is going to factor into the volume you see on the face. People with a hefty or large bone structure--even if there is some recession to it-- generally have HEFTY soft tissue; bigger muscles.
So, your face is HEFTY because your BONES are HEFTY and hefty bone structure is good but also associated with bigger and stronger MUSCLE tissue as in MORE muscle VOLUME. You don't have 'gravitational' sag and droop due to VOLUME LOSS (muscle atrophy, fat loss) coupled with poor bone support as do older candidates benefiting from a 'reverse face lift'. Again, YOU DON'T HAVE 'EXCESS SKIN' or sag and droop associated with volume loss or weak bone structure. Most likely, you have THICK STRONG MUSCLE TISSUE which is consistent with having BIG and STRONG BONES!
Yet it sounds like you are consulting with doctors (including Z) that are extolling the virtues of reverse face lifts but leaving out selective parts of information such that it is more applicable to people with aging faces with VOLUME LOSS and weakened bone structure than it is to those with HEFTY bone structure and THICK muscle tissue around that.
Hence, when you get your HEFTY bone structure and THICK muscle tissue shifted MORE FORWARD you will see MORE heftiness to the face. So, if you wanted to look more like a foot ball player or wrestler to have more 'BIGNESS' to the face, that would be a great surgery to do that. But the message I'm picking up from you is that you want a more chisled look where your 'bones pop out' (kind of like models have). Well, bones pop out more and show 'chisel' with THINNER soft tissue. But with thick soft tissue, that's going to pop out with the bone advance. So, that goes in direction of MORE HEFTY than more chiseled.
As to 'face lifts', as I said prior, the type would resolve to doctors who do very DEEP tissue reconstruction, some of which involve shaving excess muscle and using very advanced techniques and strong vectors to 'girdle' or 'corset' the muscle tissue to hug closer to the bone. So, that stuff is limited to highly specialized plastic surgeons and outside of the venue of this board.
Moral of story:
Got thinned out soft tissue from muscle atrophy and fat loss that is actually sagging due to aging along with WEAK bone structure? Then a get a 'reverse face lift'.
Already have HEFTY and STRONG bone structure and THICK muscle tissue along with it and also want to pronounce all of that out MORE to look more like a foot ball player or a wrestler, then pronouncing all that more forward will do that for you.