jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: newchin on December 26, 2014, 11:46:10 AM
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I had a genioplasty and jaw angle augmentation with HA paste in may and im so disappointed with the results. The jaw angles are different on each side, with my left side looking like something is bulging out of my cheek. From the side it looks like its been places in the centre of my jawline rather than the back, and its lower down over all on that side. I had a revision at the beginning of this month to trim away some of the paste on that side and now the swellings gone down its exactly the same as before with no noticeable difference. Not sure where this leaves me now, im so low on funds and this has cost me so much more in travel and accommodation than i initially expected as it was done in belgium.
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First, who was your doctor?
So first there are plenty of people with that sort of asymmetry, but your concerns are valid.
Here's what I suspect. EVERYONE is asymmetric. You were probably before the surgery but it wasn't apparent due to your recessed jawline. You should have just stayed with the genio. In any case, what I suspect is that the doctor put an equal amount of HA paste on either side, and since one side was already asymmetric it gave that side a bigger bulge. Again, you don't look too bad from the photos, but yeah it's noticeable. I have a few recommendations, but I want to know who your doctor was first.
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Yeah i do think a lot of people have small asymmetries but as you can see from the xray, i think the problem comes from how it was distributed. I used to scrutinise myself closely as it was a big decision to go for the surgery and id over analyse whether i should get it or not. I never noticed any asymmetry before the surgery at all but like you said it may be due to recession and it not being apparent. The surgeon was Mommaerts
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So what would you suggest? fillers are too temporary and costly over time im hoping theres a more permanent solution
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If you look around on the forum then you'll see that Mommaerts has a lot of unhappy patients (some of them were pretty much butchered by him). That doesn't necessarily mean that he screwed up your surgery, but there's a good chance that he did. Asymmetrical jaw angles is not an easy thing to fix though. If I were you then I would get the HA paste taken out and go for a chin wing instead. The problem you're going to face with a chin wing is that the surgeon is going to very limited in how much of a jaw angle improvement he can achieve if symmetry is important to you.
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Thing is i dont have a lot of money right now. If i saved up for another surgery im scared the time it will take will mean the paste will be irremovable. Id consider custom implants over wing, after this i dont want anything that will be too permanent to remove. Symmetry is super important i think as any asymmetry just detracts too much from any improvement.
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There are people on this forum who have had their HA paste removed over a year after their surgery.
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ahh well thats a relief! i guess ill just have to save and see what i can do. I may be moving to the US early next year so maybe there will be some more better equipped surgeons over there
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Unfortunately, there are very few surgeons in the world who have any experience with HA paste. Arnett and Gunson are the only two in the US that I know of, but I have no idea if they're good at removing it.
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I do prefer the left side with the most projection but im just so scared to have more added and possibly end up with it going wrong again. The asymmetry was pretty apparent to me straight away as i could feel the hard lumps around 2-3 weeks after, i posted on here asking whether it was still moldable at that time. I may try some long lasting fillers like voluma to add to the right side and see if it looks ok. If it does, maybe i could consult with another surgeon to have more added. Honestly i think Mommaerts did what he could, and maybe my expectations were too high. I just was so relieved to finally be able to afford to have this done and when it came out how it has i was just so let down. I get anxiety now and have trouble sleeping, i realise how stupid and vain that sounds but i cant hide it, its on my face. May be better to invest in a balaclava or paper bag ::)
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What did Mommaerts say before the surgery? Did he mention your existing asymmetry and did he say anything about what kind of result you should expect?
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I didnt really have any noticeable asymmetry beforehand to speak of. On the xray, all those lumps and bumps on the left hand side are HA, I meant it when i said i scrutinised my face a lot before i went ahead with the jaw angles and there wasnt any difference between each side of my face that i could see. I know the same amount was used on each side but on the left side you can see a large amount of the material is lumped up towards the back whereas on the right its evenly spread. I have a delve at the side of my chin on the left where it hasnt been spread down. I didnt really have that much of a recessed jaw to begin with, i just wanted some accentuation of the wings and a little more definition.
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There was asymmetry. The left side of your jawline is convex whereas your right side is concave, even in your picture. However, it was hardly noticeable 1) since you had a lot more soft tissue coverage (since the tissues are now stretched/now cover a stronger augmented jawline and chin, your bone structure and with that irregularities/asymmetries became more apparent) 2) with augmentation any existing asymmetry always becomes more noticeable/apparent as Lazlo mentioned too, since you are adding mass to existing asymmetries.
In your case more seems to be added to the side that already had more projection (the left side of your jawline) and thus the asymmetry is exaggerated a bit more.
i honestly dont see any asymmetry in my before pic? :-\ and i weighed around 20lbs less back then than i do now so id expect it would have been more apparent. I also cant see the asymmetry of my own mandible through the HA? could you show me if i sent you the original pic? All the light grey stuff along the jawline is HA, i compared it to an old xray at the dentist from beginning of the year but i couldnt get a copy as it was on that acetate plastic and not on their system.
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"and i weighed around 20lbs less back then than i do now so id expect it [the asymmetry] would have been more apparent."
Well, you have a lot of extra projection in the chin, and extra projection along your jawline/at the mandibular angle after your surgery: of course if you have more projection your tissues will stretch out more over that extra projection, and any irregularities/asymmetries become more apparent.
Aside the fact that adding mass to an area will make existing asymmetries more apparent, as mentioned. Given the fact more HA seems to be added to the left side, those asymmetries are exaggerated eve more.
It seems like my only option for a permanent solution would be to have more added :( not sure of who to go to, arnett and gunson have been mentioned, is there anyone else who deals with HA closer to the UK?
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I'm sorry for your result. These are the facts:
1. You did NOT have a prior asymmetry before your surgery. Even the most symmetrical people appear to have asymmetry in x-rays - ignore the x-ray.
2. Mommaerts screwed up your surgery. Accept this before you can move on. He did NOT do the best he could, as you say it, or if he did, he's an incompetent bastard.
I'm not sure if my experience helps you, but I had a prior surgery with him gone VERY wrong. I ended up with an asymmetry (and MUCH else unfortunately) and basically spent a whole year wearing thick beard and saving for a new surgery.
When I finally had the surgery, the surgeon spent 6-7 hours operating, a big part of itremoving the HA. The surgeon said my bone was "SOFT" underneath and he had never seen anything like it.
Mommaerts HA concoction and the way he applied it resulted not only in asymmetry but a lot of structural damage.
You did well to ask him 2-3 weeks after the surgery for correction - as always, he ignored his patient and their concerns.
As GS above said, there are many devastated Mommaerts patients around on the forums, some of them here.
I hope you and I and other people like us serve at least as a lesson and warning to others. Go to Mommaerts and not only you'lll end up functionally and aesthetically screwed, but you'll have your concerns ignored by the ego-maniac once that happens.
Feel free to ask me any sensitive questions via PM.
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I'm sorry but that is incorrect, and your X-Ray clearly shows otherwise. Yes, there is obviously more HA at the left side. However, you can easily distinguish the HA from your own mandible in the X-Ray and (draw a horizontal line through your chin, and it is apparent:) you already had quite a bit of asymmetry prior to the surgery in your jawline. As Lazlo mentioned (and he is certainly correct): if you have a recessed jawline it is likely you didn't notice the asymmetry prior to surgery, but it was clearly there. Your X-Ray does not lie.
That aside. You look (very) good imho. I would not worry too much. Yes there is some asymmetry: everyone has some asymmetry. As mentioned, it is not looking exceptionally asymmetric. Just search for a surgeon that you trust to add some extra HA to the right side and you should be fine and have great features/bone structure.
Frankly I'd just go back to Mommaerts and have the asymmetry corrected. I can tell right now even from photograph, not the x-ray that the jawline is asymmetrical and more developed on the right side (of the photo, I suppose that's your left mandible). Idiot Mommaerts didn't take this into account. This is why more and more I'm realizing for any procedure a practice skull in 3-D should be made (pretty expensive about 5 grand) but it's a good way for the surgeon to practice the cuts or whatever they're doing. I would build up the lesser side than the right. Honestly I have no idea why you had surgery in the first place, your jaw was fine, why the f**k did you want these stupid angles pointing out? And your chin looked fine too, not recessed at all. It is interesting though that M. was able to augment the angles to the degree he did with HA paste, I've frankly never seen that done before so dramatically. Regardless, you look fine now too and most people would not notice. Now that some of us on this board are so hyper aware we notice the minutest details. It's funny, I look at people's jaws all the time, and I'll tell you, from a clinical point of view, most people are f**king deformed! lol
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If really MM f... up his surgery, then how he became so famous... Am I really lucky I got strange feeling just before surgery with him and came here...
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Frankly I'd just go back to Mommaerts and have the asymmetry corrected.
I did, had my revision beginning of this month and iv came out looking exactly the same :(
Honestly I have no idea why you had surgery in the first place, your jaw was fine, why the f**k did you want these stupid angles pointing out?
Didnt want anything drastic just some definition, i didnt even know it was possible till he proposed it. In contrast to my upper face i had a really small looking lower face.
And your chin looked fine too, not recessed at all.
It was definitely recessed, so much so that 2 other surgeons i consulted with told me a chin implant wouldnt give me enough projection and that id need to have a genioplasty. The genioplasty came out mostly ok tbh but it does veer to one side slightly when im smiling etc
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If really MM f... up his surgery, then how he became so famous... Am I really lucky I got strange feeling just before surgery with him and came here...
I would have freaked and backed out if i had found this board before i had my surgery.
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I would have freaked and backed out if i had found this board before i had my surgery.
It's a shame that this forum doesn't appear higher up in the search results on Google. I wish someone would link to this forum on lookyourbestuk.com because that place still promotes Mommaerts like none of this ever happened.
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lookyourbest is actually what led me to go with MM. I just wish Id never done it at all i have such bad anxiety over it now
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You should warn other people then if you have an account there. You are not the first to have had a failed surgery with Mommaerts and you're not going to be the last one either if people keep silent about their bad experiences with him.
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It's a shame that this forum doesn't appear higher up in the search results on Google. I wish someone would link to this forum on lookyourbestuk.com because that place still promotes Mommaerts like none of this ever happened.
To get those threads on page 1 of Google, you'll need to post links on a variety of sites (e.g. 'comments' sections on blog posts + other PS/Jaw forums). Perhaps try one of the subforums on LYB - just getting the link in there will improve page rankings. Anyway, LYB is full of comment spam - I doubt any links will be noticed for a good while.
One day, when I come to write my review, I'll be sure to target my doc's top Google search terms. 8)
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You can certainly remove HA paste, just as you can remove bone. You just shave it down. It's just more surgery and every time soft tissue is cut, it gets a little more f**ked up when it doesn't heal like new. There's a study on pubmed claiming the resorption was the biggest problem with HA paste, up to 20-25% of cases in the short term. Long term resorption rates remain to be seen but there will likely be some. It's bone like but it's not bone so probably won't change at the same rate as bone underneath. The product is too new and sample size too small to know what 20-40 years will do to it. Natural bone resorbs too so it's not a relative disadvantage, just that what looks good at 20 may not look good enough anymore at 40 or 60. Aesthetics has a shelf life. The only real permanent solution is to not have had problems to begin with. You can thank your parents for that.