jawsurgeryforums.com
General Category => Aesthetics => Topic started by: Glassjaw on October 10, 2023, 04:13:17 PM
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I sort of swore to myself that i wouldn’t post here again before having surgery, but here we are. Here are my pics: https://imgur.com/a/Wcqeqr0
So, in short: i grew up with a crossbite that f*cked up my face a bit. I already had a rhinoplasty 5 years ago, but was not/am not satisfied with the results. I was planning to have a private BIMAX surgery at the end of my orthodontics treatment (which just ended). I just had a consultation with the surgeon who was supposed to operate me here in my native country, and it pretty much confused me further more than clarified anything.
The surgeon basically told me what some others on this forum and elsewhere have told me before, that certain measurements on my face are already perfectly fine and that she does not recommend the BIMAX surgery for me. She said that if i wanted to have surgery then she recommends a genioplasty (with an implant).
I must say I wasn’t very convinced by this consultation. For one, she recommended a chin implant and i have heard mostly bad things about them, as compared to a more invasive surgery where the bone of the chin is moved. She also told me that i should have shaved before the consultation, so that it would have been easier for her to assess my situation. I underwent 3 different types of x-rays/scans before going to the consultation and have a very light beard. It was pretty insulting to hear that i should have shaved on top of this. Why the hell didn’t you inform me before the consultation/ why don’t you have a shaving kit in the clinic if this is so important? It seemed amateurish. She also kept taking measurements from my face with a handheld ruler, putting it against the scan pics on the computer screen. Maybe this was just an ”artistic quirk” of hers, but it wasn’t exactly convincing, it seemed to me that she wasn’t quite familiar with modern technology.
The thing is, i met with a male surgeon before her (working/operating within the same clinic!) who told me i should NOT get a genioplasty, because the result could look a bit ”silly”, and i should perhaps go for a BIMAX instead, IF I decide to have surgery. Although he also told me that there are always such great risks involved that i should basically be a bit crazy to do it..
Some people indeed claim that in cases similar to mine: ”Genio may lengthen your face or create an unpleasant step off in profile, make your chin pointy. You may end up looking different, but no better.” (a quote from an another thread) And i see their point. In any case, i feel very confused about my situation, i’m perfectly aware of my imperfections but keep getting mixed messages about what to do about them.
My own opinion:
I feel that my nose is still a big part of the problem. The tip was actually slightly collapsed and downward pointing before the rhino and the angle of the tip is still not quite there. Having a bimax surgery could solve this problem by lifting the base of the nose. BIMAX is absolutely not required if all i want to do is lift my nose, but then i feel that doing this by having an another rhinoplasty + genio would just make the other problems more apparent. (as it did the first time)
The other problems: my face already looks a bit elongated from certain angles as a result of the crossbite causing slight recession in the mid/lower face area, and having genioplasty could add to the problem. I also feel that if i wanted to address the maxillar recession with suborbital implants, it would look stupid without addressing the jaw area first. Addressing this problem is not on the top of my list, but that is just because of the other problems i’m having, and i’m afraid that if i had the genio, (and possibly the another rhino), the recession in the orbital rim area would suddenly become so apparent that it would have to be addressed. (except that in this point we couldn’t)
So, it’s a complicated question since the affected areas include everything below my eyebrows + my nose. The one rhinoplasty i already had convinced me that if i want to fix my face for good, i need to put ”all in” and not half-ass it again, so i will not go under a knife again unless i’m absolutely convinced it’s the right way to go.
Here are my options as I see them:
1) Having a genioplasty and possibly an another rhino COULD solve most of the issues i’m having. They could just as well complicate things further and mess up my face for good.
2) A SUCCESSFUL BIMAX surgery + suborbital implants (in my view) would definitely solve all the problems i’m having, with a significantly greater nerve damage risk involved as compared to the genio route. Needless to say, a surgery that addresses so many areas on my face at the same time would be quite complicated. There is only very slight horizontal projection needed, it’s as much about the CCW rotation. One must also be careful not to mess up the nose, as i have a big nose and the nostrils widening too much as a result of the surgery would pretty much destroy my looks.
Both options have their pros and cons, but i would say that all in all the risk is about the same. It's just a different kind of risk. If i go with the genio route and it's unsuccessful i will mostly risk time and money along with some mental health (all of which i have already lost more than enough because of these problems). Then again if i have the BIMAX and they botch it I could lose my health and as a result pretty much everything.
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Dont get bimax.
if i were you i would get infraorbital / midface implants and thats it
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Definitely don't get genio.
But also don't get bimax.
My opinion is based of the fact that both surgeons advice against it and if I look at the pictures I think there is so little to gain but so much to loose!
However I understand how it feels for you.
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Definitely don't get genio.
But also don't get bimax.
My opinion is based of the fact that both surgeons advice against it and if I look at the pictures I think there is so little to gain but so much to loose!
However I understand how it feels for you.
What is there to lose with genio? I know that there are risks but those are much smaller than with Bimax.
So the other surgeon told me to get Bimax, not genio, the other one told me to get genio, not Bimax, and that's the reason you think I shouldn't have any surgery at all? So if i got a third opinion and they said something different you would change your mind?
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Dont get bimax.
if i were you i would get infraorbital / midface implants and thats it
If i were to get such implants now wouldn't my jaws start to appear even more backwards?
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This does not sound like a strog recommendation:
.Although he also told me that there are always such great risks involved that i should basically be a bit crazy to do it..
Ok about the genio.. I just don't see it personally. Maybe you can explain in a few bullet points how it would improve your looks?
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You clearly need bimax, what is your occlusal plane like? Hopefully you can get CCWr.
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This does not sound like a strog recommendation:
Ok about the genio.. I just don't see it personally. Maybe you can explain in a few bullet points how it would improve your looks?
It isn't a strong recommendation for a BIMAX. But there isn't anything stopping me from having the surgery either, health or structure-wise. He was just saying that in his opinion it's a risky procedure. Apparently 30% of people who undergo it never fully recover neurally and 2% get permanent nerve pain. I get that my problems are quite mild in comparison to some others, and it's impossible to say if the end-result is going to be good anyway, so it's quite a risk to take just for a "possible" reward.
It's crystal clear that a genio COULD improve my looks. It's just very important to do it right. If there is no CCW rotation of the chin then i could end up with the "long face" effect. If there is too much rotation then that doesn't look good either.
- A genio would make my side profile much more symmetric
- It would make me appear more masculine from all sides
- I could finally get rid of the beard (if you see my photos there are a few where i don't have it, and you can see why i keep it in the first place) which i don't myself like at all. I can't grow a thick beard and what i can grow is much lighter and redder than my hair, which makes me look like a "mongrel".
What i'm really considering here is whether i should go with a chin-wing genio or the recular one. I refuse to even consider implants, since i've heard so much bad things about them.
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You clearly need bimax, what is your occlusal plane like? Hopefully you can get CCWr.
Nice to see that it's "clear" at least to someone, since even professionals seem to have completely opposite opinions.
You can see my occlusal plane from the x-ray photos. There is some space for a mild CCW rotation. In my opinion the BIMAX operation (if i decide to have a one) should be a combination of slight CCW rotation and ever so slight advancement. I don't want to end up with a "muzzle", but the risk is real.
That said, there are quite many attractive people who have this strongly prognathic appeareance.
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Nice to see that it's "clear" at least to someone, since even professionals seem to have completely opposite opinions.
You can see my occlusal plane from the x-ray photos. There is some space for a mild CCW rotation. In my opinion the BIMAX operation (if i decide to have a one) should be a combination of slight CCW rotation and ever so slight advancement. I don't want to end up with a "muzzle", but the risk is real.
That said, there are quite many attractive people who have this strongly prognathic appeareance.
Make sure you get a genio as well, for like 2mm of vertical lengthening and maybe 4mm of advancement.
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- A genio would make my side profile much more symmetric
Symmetry on what plane? You get what I mean?
- It would make me appear more masculine from all sides
How would this make you look better. You think your lower third does not look masculine enough? I know many very masculine looking unattractive people.
It's just my subjective opinion that you don't benefit a lot from it.
But to be fair, the pictures without beard are not the best quality so I can't really comment on them.
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Symmetry on what plane? You get what I mean?
How would this make you look better. You think your lower third does not look masculine enough? I know many very masculine looking unattractive people.
It's just my subjective opinion that you don't benefit a lot from it.
But to be fair, the pictures without beard are not the best quality so I can't really comment on them.
All of my mid/lower face down from the eyes is gradually receding. Of course the maximum effect of the recession is the most visible at the chin.
Yes i think my lower third does not look masculine enough. But it's not just about masculinity, it's about symmetry. More attractive people are generally seen as more masculine/feminine. I think the pictures without the beard show enough for anyone to see why i wear the beard. I think i could potentially benefit greatly from a genio, but is it enough in my case, that's a completely different question. But your opinion has been noted.
I guess i have no other choice but to book a third consultation although i'm getting a bit sick of this. Seems like some of these "highly-trained professionals" barely have a clue what they are doing. In the end i must make the decision by myself.
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My point was.. symmetrical side view? For me that doesn't make any sense. I mean try to answer the following:
- What aspect of your side profile should have two mirrored parts when divided in half?
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You clearly need bimax, what is your occlusal plane like? Hopefully you can get CCWr.
If he wants to get dogmaxxed sure he can get bimax and CCWr
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If he wants to get dogmaxxed sure he can get bimax and CCWr
He's not gonna get dogmaxxed from CCWr + Genio lol
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He's not gonna get dogmaxxed from CCWr + Genio lol
his midface is already behind, what do you think happens when you advance even more lol
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My point was.. symmetrical side view? For me that doesn't make any sense. I mean try to answer the following:
- What aspect of your side profile should have two mirrored parts when divided in half?
I
I meant a less recessed look. If you can't see what i mean from the photos then sorry, can't help you. Please don't waste my time with arguing about linguistic semantics.
his midface is already behind, what do you think happens when you advance even more lol
...it get's advanced?
"Dogmaxxation" is a real risk here, but the risk obviously depends entirely on the surgeon and their style. No alfaro for me thank you.
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As a conclusion, the three people who have given me their opinion on this thread so far had the following takes:
- Don’t get bimax, don’t get genio
- Get bimax, also get genio
- Get midorbital implants and nothing else
I found the last one to be perhaps the weirdest one. I do agree that I probably need to get some work done on this area, but it seems pretty clear that doing that without addressing the backwardness of the jaws at all would make my face appear quite round looking from the sides. Which wouldn't be a great look.
But anyways, it’s nice to see that (presumed) laymen seemingly can’t agree on the issue any more than professionals can.
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s**t, we have some incel commentary "dogmaxed" here. Bans in order?
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I've been thinking about a chin-wing. Perhaps to have a consultation with Zarrinbal or someone else. I could use a wider lower jaw and my gonial angles could be improved.
However my chin is asymmetric as it is, so I would pretty much definitely need a genio afterwards.
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I just wish there was someone I could turn to who would be competent enough to assess my situation as a whole without trying to sell me something on the side.
If anybody knows a guy like that then PM me about it. I'm willing to pay something for it. I'm done listening to these half-assed takes, whether they come from regular people
or professionals.
Some hot takes:
"Don't get bimax, you will look like a monkey" (said a professional surgeon). "Genio will fix nothing, the problem is your midface" (And so? Am i supposed to just do nothing about the rest of my face?). "Your horizontal lines are fine, no need for any surgery" (Are you blind?) "The problem is that you have thin lips" etc.
The more advice like this i get the more confused i get. It's crystal clear that a bimax, a sliding genio or a chin-wing could ALL improve my looks, but what exactly fits in my case without causing irreversible damage, that is the question. I do not want to do something i will end up regretting for the rest of my life.
Or maybe i just need to accept that there is no definite answer for my question, what exactly is the right procedure depends on the exact methods of the individual surgeon.