jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: MrRochester on March 22, 2014, 12:21:20 PM
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My surgeon's office gave me this morph of how I might look after chin surgery. It is 8mm horizontal advancement and 2-3mm vertical. I am just wondering if the vertical increase is a mistake. Here is the morph he gave me http://imgur.com/a/6FBi0 (http://imgur.com/a/6FBi0)
Sorry to make another thread (my last I promise), but I really want to make certain I do the right thing when I have my surgery in less than a couple of months.
I was looking at this study http://www.angle.org/doi/full/10.2319/050111-311.1 (http://www.angle.org/doi/full/10.2319/050111-311.1)
and my chin already roughly corresponds to around AX or AJ (link to picture below - too big to insert as image and don't want to resize). It seems on the longer side of normal to begin with.
This is the front of my face up close http://imgur.com/a/RXJC5 (http://imgur.com/a/RXJC5)
Maybe this is all a bad idea, but I'm scheduled pretty soon. I'd be happy with even a very slight improvement, which is why I might take a very conservative approach to minimize the risk of greatly unbalancing my face.
http://www.angle.org/na101/home/literatum/publisher/pinnacle/journals/content/angl/2012/00033219-82.1/050111-311.1/production/images/large/i0003-3219-82-1-88-f01.jpeg (http://www.angle.org/na101/home/literatum/publisher/pinnacle/journals/content/angl/2012/00033219-82.1/050111-311.1/production/images/large/i0003-3219-82-1-88-f01.jpeg)
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I think you dont need the increase in vertical length. Looks too long imo.
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I wouldn't trust those morphs from Mommaerts. Just look at the morph he gave me and what the actual result was.
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8mm is hardly conservative for a genio, even a chin-wing.
Anyway - because of the angle of your jaw (a little steep) then simply moving things forward (BSSO or sliding genio) will automatically increase the height in the chin - and it will make the slight steepness more obvious What would give you a better result would be this sliding genio with CCW
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8mm is hardly conservative for a genio, even a chin-wing.
Anyway - because of the angle of your jaw (a little steep) then simply moving things forward (BSSO or sliding genio) will automatically increase the height in the chin - and it will make the slight steepness more obvious What would give you a better result would be this sliding genio with CCW
Pretty sure I'm going to cancel with Mommaerts. I was thinking of getting a 4-5mm advancement not the 8mm in the morph so that's what I meant by conservative. However, after reading all the negative reviews, I don't think I'll be comfortable having surgery with him.
I'm not sure what I'm going to do. I have like 25k in my bank account reserved for plastic surgery, but I don't like any of my options regarding my jaw/chin. It's a tradeoff and it seems like neither implants, SG, or chin wing offer pure aesthetic improvement. There is always a tradeoff and you create new flaws (minor though they may be) when you correct existing ones.
As for Kizarq's suggestion, I appreciate it, but there's no way I'm going to endure braces and actual jaw surgery. That's not a realistic, viable option. I'm 27 and regardless of what I decide to do, it's happening within the next six months or never so I can move on with my life.
Maybe I'll just get a nose job and that'll be that. I haven't been dissuaded from that yet at least.
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Pretty sure I'm going to cancel with Mommaerts. I was thinking of getting a 4-5mm advancement not the 8mm in the morph so that's what I meant by conservative. However, after reading all the negative reviews, I don't think I'll be comfortable having surgery with him.
I'm not sure what I'm going to do. I have like 25k in my bank account reserved for plastic surgery, but I don't like any of my options regarding my jaw/chin. It's a tradeoff and it seems like neither implants, SG, or chin wing offer pure aesthetic improvement. There is always a tradeoff and you create new flaws (minor though they may be) when you correct existing ones.
As for Kizarq's suggestion, I appreciate it, but there's no way I'm going to endure braces and actual jaw surgery. That's not a realistic, viable option. I'm 27 and regardless of what I decide to do, it's happening within the next six months or never so I can move on with my life.
Maybe I'll just get a nose job and that'll be that. I haven't been dissuaded from that yet at least.
If you have a bad bite that requires surgical intervention to fix, fix it. The jaws are the foundation of your face. Everything else is camouflage. Plenty of people in their 30s wear braces. I am 36.
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I agree. You said you had 4 premolar extractions and orthodontics. This means you now have 2 recessed jaws, you need bimax and genio.
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If you have a bad bite that requires surgical intervention to fix, fix it. The jaws are the foundation of your face. Everything else is camouflage. Plenty of people in their 30s wear braces. I am 36.
My bite is fine despite my jaws being poorly positioned. Maybe it's because I wore braces for 7 years, and teeth were extracted and flared out. I have no functional issues and don't even mouth breathe (I've recorded myself using a webcam while I browse the internet to see if there's a point at which I mouth breathe and I don't). The surgery would be purely cosmetic, and I'd have to arrange with an orthodontist here in America to then have surgery in Europe (since I don't think any US surgeon would perform it and it would be prohibitively expensive without insurance coverage anyway). So I don't really think that jaw surgery is practical in my particular case. I think I'll just have to settle for nothing
BTW, here is a morph of my face I really like. I'm going to ask if a different surgeon if this can be achieved through implants (or maybe chin wing). http://imgur.com/a/e4mg7#1 (http://imgur.com/a/e4mg7#1)
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I agree. You said you had 4 premolar extractions and orthodontics. This means you now have 2 recessed jaws, you need bimax and genio.
I had two upper teeth extracted. I believe they were bicuspids.
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My bite is fine despite my jaws being poorly positioned. Maybe it's because I wore braces for 7 years, and teeth were extracted and flared out.
This is just f**king terrible! I remember classmates in high-school wearing braces for what seemed like forever, and this made me averse to the whole idea as an adult When I consulted with my surgeon he told me that braces only take a long time when you need to close spaces after extractions. So that's what they all had! f**king terrible!
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No, but if I ever catch up, I'll ask if they had extractions. It would not have made sense for them to be in braces for so long otherwise. I'm pretty sure the orthos' fees are always per treatment, rather than per visit or treatment length. So I don't understand what's in it for them with these ludicrous extraction-based treatment plans? Why not give the option of surgery? Ego? Granted I was in high school 20 years ago, so maybe surgery is much more common now.
My orthodontist told my parents I needed jaw surgery, but they declined. I think he is a bit of a perfectionist and viewed being limited to braces to fix my bite issues as a challenge.
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i noticed two things from your pictures:
- you have weird discolorations below your eyes. did you ever get yourself checked for sleep apnea or are you wearing some sort of make up in these pics ?
- both of your jaws are recessed but the actual discrepancy between them doesn't seem too big (you'd probably need 6mm upper and 8mm lower advancement and a genio). this would mean you would not have to wear braces for that long. maybe 3-6 months. did you ever seriously consult a surgeon for jaw surgery? i think a short time in braces and jaw surgery would be worth the aesthetic difference compared to a chin wing.
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The eye discoloration is a side effect from using Latisse. It is slowly fading.
I'm not sure that upper jaw surgery is necessary since I would be very satisfied with the result in this morph http://imgur.com/a/e4mg7#0 (http://imgur.com/a/e4mg7#0) which should be obtainable through sliding genio/chin wing.
I live in America where cosmetic jaw surgery is not usually performed. I would have to get braces and then go to Europe for my surgery. This is not practical really. It would also be incredibly expensive in America since I'm uninsured (probably wouldn't be covered anyway).
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Do u have any X-rays ? I think your before picture isn't bad either. You just look more mature / masculine in the morph.
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Do u have any X-rays ? I think your before picture isn't bad either. You just look more mature / masculine in the morph.
Here are my x-rays http://imgur.com/a/fEmSD (http://imgur.com/a/fEmSD)
Here is a morph of what I might look like after sliding genioplasty without a nose job. Not sure if I look more attractive or not. http://i.imgur.com/vZU0tn2.png (http://i.imgur.com/vZU0tn2.png)
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the morph looks good. i still would not make hasty decisions wrt to chin wing. consult with a good maxfac and ask how long braces treatment would supposedly take.
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the morph looks good. i still would not make hasty decisions wrt to chin wing. consult with a good maxfac and ask how long braces treatment would supposedly take.
I can't even get chin wing. Triaca is too expensive, Zarrinbal never responds to phone calls or emails, and Mommaerts is not a surgeon I'm willing to let perform on me. I'm going to have to get regular sliding genioplasty here in America it seems.
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I can't even get chin wing. Triaca is too expensive, Zarrinbal never responds to phone calls or emails, and Mommaerts is not a surgeon I'm willing to let perform on me. I'm going to have to get regular sliding genioplasty here in America it seems.
What does triaca charge for a chin wing?
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What does triaca charge for a chin wing?
I'm not sure if Triaca is actively performing surgery or if Brusco, his assistant, is doing them these days. Here is a quote from the email he sent me. It's actually less than I remembered because I was adding in the hospital stay. Maybe I will consider him after all.
The price is 10000.- CHF for the surgeon and about 2500.- for the Anesthesia if the operation is performed on a outpatient base. If you prefer to stay 1 or 2 nights in the hospital, which is not mandatory, you would have to calculate about 8000.- CHF more.
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Some words of encouragement:
I think a SG may be the way to go. Your expectations are very, very realistic. Your lower lip does not sit noticeably behind your upper and you're not looking to change your jaw angles. Sure BSSO +SG would be ideal, but you're one of those cases where SG alone may work very well as well, given your expectations. I would be more concerned about your expectations around the nose job. That lowering of the nostrils that you showed there is very difficult to achieve to that degree.
Have you heard of a surgeon in Cleveland called Guyuron? He's one of the best rhinoplasty surgeons in the world and does a fair bit of sliding genioplasties as well - including complex revisions of both noses and chins. He's a plastic surgeon as well as a craniofacial surgeon, widely published and with a name immediately recognized by any surgeon in the field in US and even overseas. I've seen surgeons mentioning him and putting pictures of themselves with Guyuron on their web sites just to increase their own credibility. I think you could benefit from a consult with him. You can probably do both the nose and the chin for pretty much that preposterous amount in swiss franks that you quoted here for a SG only.
You're lucky you're in US. If only I were in your place. I would never leave US to do a surgery elsewhere, not even Germany which is scientifically and medically more advanced than any other European country.
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I tend to agree. You could probably get genio and rhino done by a reputable surgeon for a much, much cheaper price (and only one anasthesia) than paying all that money to fly to Europe and getting a wing osteotomy since it is projection you need more than anything. And i agree that you should definitely not get a BSSO. And you do not need vertical height added to your chin either.
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I tend to agree. You could probably get genio and rhino done by a reputable surgeon for a much, much cheaper price (and only one anasthesia) than paying all that money to fly to Europe and getting a wing osteotomy since it is projection you need more than anything. And i agree that you should definitely not get a BSSO. And you do not need vertical height added to your chin either.
Do you know what the advantage for me of chin wing over sliding genioplasty would be? I might try to schedule with Triaca tomorrow since I had no luck scheduling with Zarrinbal. I asked Triaca and he said:
"The advantage is that the line of the lower border of the mandible is not interrupted like in the normal genioplasty and that the soft tissue in the chin area is not detached but repositioned together with the bony segment, in order to produce the best possible sublabial fold and achieve natural lip competence."
I really don't see how the sublabial fold created by chin wing would be any different. You are still pushing out the soft tissue and sliding bone out. You're just doing it from further back along the mandible. Why would the resultant sublabial fold be any different? Maybe I'm not visualizing this correctly.
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Do you know what the advantage for me of chin wing over sliding genioplasty would be? I might try to schedule with Triaca tomorrow since I had no luck scheduling with Zarrinbal. I asked Triaca and he said:
"The advantage is that the line of the lower border of the mandible is not interrupted like in the normal genioplasty and that the soft tissue in the chin area is not detached but repositioned together with the bony segment, in order to produce the best possible sublabial fold and achieve natural lip competence."
I really don't see how the sublabial fold created by chin wing would be any different. You are still pushing out the soft tissue and sliding bone out. You're just doing it from further back along the mandible. Why would the resultant sublabial fold be any different? Maybe I'm not visualizing this correctly.
I don't understand either. Either way, a deep sublabial fold won't be the end of the world for me.
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Have you heard of a surgeon in Cleveland called Guyuron? He's one of the best rhinoplasty surgeons in the world and does a fair bit of sliding genioplasties as well - including complex revisions of both noses and chins. He's a plastic surgeon as well as a craniofacial surgeon, widely published and with a name immediately recognized by any surgeon in the field in US and even overseas. I've seen surgeons mentioning him and putting pictures of themselves with Guyuron on their web sites just to increase their own credibility. I think you could benefit from a consult with him. You can probably do both the nose and the chin for pretty much that preposterous amount in swiss franks that you quoted here for a SG only.
I've heard about him before but the before/after pictures on his website are pretty underwhelming. I can't even see any difference in most of the cases and one guy even ended up with a nose that was more crooked than it was before.
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I don't understand either. Either way, a deep sublabial fold won't be the end of the world for me.
What do you hope to get from chin wing that you cannot obtain through a regular sliding genioplasty?
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I've heard about him before but the before/after pictures on his website are pretty underwhelming. I can't even see any difference in most of the cases and one guy even ended up with a nose that was more crooked than it was before.
What about this surgeon?
http://www.facialsurgery.com/BAPgnc01xhb.html (http://www.facialsurgery.com/BAPgnc01xhb.html)
I'm considering seeing this guy
http://www.andrewgreensmithrhinoplasty.com.au/patient-results/ (http://www.andrewgreensmithrhinoplasty.com.au/patient-results/)
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What do you hope to get from chin wing that you cannot obtain through a regular sliding genioplasty?
IMO, your chin is not your problem. There are male models with a chin like yours. Brad Pitt's chin has bugger all horizontal projection. Your biggest problem is your eyes. This may be resolved with maxillary advancement (and mandibular as well since your bite is normal).
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How would a maxillary advancement emulate such orbital rim support that the eyes become better? Why do you think that?
The paper in the "scleral show" thread. Le Fort I will never yield the results of the Le Fort III girl you posted (BTW, do you have link to where that image comes from?), but at least it's something. My hunch is that maxillary advancement should have the most under-eye "tenting" effect on broad faces.
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What do you hope to get from chin wing that you cannot obtain through a regular sliding genioplasty?
I have a mandibular asymmetry that I would like to correct.
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I have a mandibular asymmetry that I would like to correct.
On the Jaw Surgery Blog there is a girl who is going to get BSSO on one side and IVRO on the other.
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I'm having sliding genioplasty surgery April 23rd. He's planning on 6mm horizontal advancement. He said that morph, http://i.imgur.com/FO6L7I0.png, (http://i.imgur.com/FO6L7I0.png,) is around 9-10mm and wouldn't look good as the sublabial fold will be too sharp and dimpled. He says an S-shaped chin curve would be better. He thinks 6mm will place me in normal range and make my face less convex. I was pretty surprised to hear him mention convexity without my prompting.
I'm a bit worried about the vertical reduction he's planning on, but he thinks 2mm reduction is a good idea to make my middle and lower third better balanced. Do you agree and should I have him reduce my chin height?
What's also interesting is that he told me my airway is severely restricted, and my upper jaw is recessed around 4mm and my lower a whopping 14mm. Still, the genioplasty should be an improvement even if it is very modest. I know a lot of you think I'm foolish for just getting chin work when I so clearly need jaw surgery, but I'm hoping I'll look better even if only by 1%.
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What's also interesting is that he told me my airway is severely restricted, and my upper jaw is recessed around 4mm and my lower a whopping 14mm. Still, the genioplasty should be an improvement even if it is very modest. I know a lot of you think I'm foolish for just getting chin work when I so clearly need jaw surgery, but I'm hoping I'll look better even if only by 1%.
Genioplasty is not a trivial operation. You may get numbness, lip thinning. And if you want to get jaw surgery later on, you'd have to revisit the chin.
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I'm having sliding genioplasty surgery April 23rd. He's planning on 6mm horizontal advancement. He said that morph, http://i.imgur.com/FO6L7I0.png, (http://i.imgur.com/FO6L7I0.png,) is around 9-10mm and wouldn't look good as the sublabial fold will be too sharp and dimpled. He says an S-shaped chin curve would be better. He thinks 6mm will place me in normal range and make my face less convex. I was pretty surprised to hear him mention convexity without my prompting.
I'm a bit worried about the vertical reduction he's planning on, but he thinks 2mm reduction is a good idea to make my middle and lower third better balanced. Do you agree and should I have him reduce my chin height?
What's also interesting is that he told me my airway is severely restricted, and my upper jaw is recessed around 4mm and my lower a whopping 14mm. Still, the genioplasty should be an improvement even if it is very modest. I know a lot of you think I'm foolish for just getting chin work when I so clearly need jaw surgery, but I'm hoping I'll look better even if only by 1%.
I think you're doing the right thing. Jaw surgery is so expensive and such a long process when you can get close to the end result with genioplasty alone, and in any case, you would need a genio anyway along with the bimax if you wanted 'perfection'. Good luck and don't forget to show me the results.