jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: needadvancement on June 24, 2016, 08:51:47 AM
-
This is supposed to be the end of my journey. Some of you remember my treatments(wilckodontics last year) my goal was to get camouflage treatments to improve the couple of aesthetic things that bothered me since I was a kid.
Monday I'm gonna get a SG with a significant vertical and forward movement. As you can see in the photos below I lack a lot of vertical height on the chin and both lips are way in front of the chin. Hoping to get that fixed(along with other things that I think this simple surgery will do for my face but I don't want to get my hopes up).
http://i.imgur.com/gUhCLSq.jpg
http://i.imgur.com/UHw9hLD.jpg
http://i.imgur.com/yy2YA4h.jpg
Keep in mind I stil have facial hair in those pictures so trust me when I say my chin looks even more pathetic clean shaven(haven't shaved the beard in like 3 years so I will do that again soon).
But I am preparing for the worst. A lot of things could go wrong and I am taking a gamble. This isn't a world renowned surgeon, just a good maxillofacial surgeon near my home who has gained my trust(did a good job with my corticotomy, wisdom teeth removal etc.) and with him I get most of the costs covered by insurance. I decided to do this instead of traveling and spending a lot of money on this. I will keep updating this.
-
great decision. good luck
I'm also going to see a maxfac near my home, i don't have the money to travel and go to a "famous" surgeon. is this really thar bad? lol
-
Look I agree you need an SG but I really wouldn't get it done by a regular Oral Surgeon.
You definitely want a Surgeon who is very comfortable with doing this procedure. It's not THAT simple of a procedure. Where are you from?
-
Look I agree you need an SG but I really wouldn't get it done by a regular Oral Surgeon.
You definitely want a Surgeon who is very comfortable with doing this procedure. It's not THAT simple of a procedure. Where are you from?
Maybe it's just my s**t luck but "the best guy in the state" did statistically the safest jaw surgery on me and left me with absolutely MASSIVE nerve damage.
So you never know.
Op had corticotomy. It's not trivial, few surgeons do them, so he should be competent. (OTOH, a world class surgeon told me it's not stable).
-
Maybe it's just my s**t luck but "the best guy in the state" did statistically the safest jaw surgery on me and left me with absolutely MASSIVE nerve damage.
So you never know.
Op had corticotomy. It's not trivial, few surgeons do them, so he should be competent. (OTOH, a world class surgeon told me it's not stable).
You had double jaw surgery? What movements did you have?
-
You had double jaw surgery? What movements did you have?
No, that's the irony. Lf1 only. The only reason I agreed to have surgery was because I had never heard of anyone with permanent upper lip numbness.
-
Look I agree you need an SG but I really wouldn't get it done by a regular Oral Surgeon.
You definitely want a Surgeon who is very comfortable with doing this procedure. It's not THAT simple of a procedure. Where are you from?
He has done SG's just not seperately he does them together with regular BSSO's. North Europe and here it's an implant country so I would need to travel abroad for a reputable cosmetic surgeon but I always hated that idea.
-
He has done SG's just not seperately he does them together with regular BSSO's. North Europe and here it's an implant country so I would need to travel abroad for a reputable cosmetic surgeon but I always hated that idea.
Zarrinbal is a short flight away.
-
I probably would have if I went for a BSSO or chin wing but since it's a SG I compared risks and benefits(most costs covered, it's near home and I know the surgeon well) and decided on this. If it turns out to be a mistake I will definitely let it be known so others won't make the same mistake. If it's the right move I'll certainly let it know as well :D
-
I probably would have if I went for a BSSO or chin wing but since it's a SG I compared risks and benefits(most costs covered, it's near home and I know the surgeon well) and decided on this. If it turns out to be a mistake I will definitely let it be known so others won't make the same mistake. If it's the right move I'll certainly let it know as well :D
Mistake in what sense? Genioplasties are probably safer than BSSOs but nerve damage is still possible, the muscles may not be reseated properly and you may end up with ptosis, which looks really ugly. The lower lip may be drawn forward too much, so you end up showing a lot of lower teeth when talking -this is really ageing.
Your whole lower third looks short and your occlusal plane very flat. Do you have good tooth show? Has your surgeon ruled out the possibility that you have short face syndrome (you would then need cw rotation and both jaws advanced).
-
Mistake in what sense? Genioplasties are probably safer than BSSOs but nerve damage is still possible, the muscles may not be reseated properly and you may end up with ptosis, which looks really ugly. The lower lip may be drawn forward too much, so you end up showing a lot of lower teeth when talking -this is really ageing.
Your whole lower third looks short and your occlusal plane very flat. Do you have good tooth show? Has your surgeon ruled out the possibility that you have short face syndrome (you would then need cw rotation and both jaws advanced).
Mistake in the sense of what you just mentioned and not liking the results, but like you said it could still happen with a well known surgeon. He did say that nerve problems are only usual for people who get double jaw surgery and I should be fine. Also very little tooth show and my lips protrude, so apparently I have more 'room' than average for vertical advancement for the soft tissue. I don't know why my chin turned out so short, at this point I'll take any improvement.
-
Mistake in the sense of what you just mentioned and not liking the results, but like you said it could still happen with a well known surgeon. He did say that nerve problems are only usual for people who get double jaw surgery and I should be fine. Also very little tooth show and my lips protrude, so apparently I have more 'room' than average for vertical advancement for the soft tissue. I don't know why my chin turned out so short, at this point I'll take any improvement.
I mean upper tooth show.
-
I mean upper tooth show.
Oh, not much no. I do "need" a BSSO but I somehow adapted and never had problems like TMJ or sleep apnea. I could always get it in the future though and this surgery wouldn't change that.
-
Oh, not much no. I do "need" a BSSO but I somehow adapted and never had problems like TMJ or sleep apnea. I could always get it in the future though and this surgery wouldn't change that.
Jaw surgery which changes the vertical dimension of the face ie. Fixing a short or a long face usually has the most dramatic effect. I hope you are not missing out. Good luck on Monday anyway.
I'm just concerned that you may be underwhelmed by the result and if god forbid you have complications, you may be too afraid of having the surgery that you really need afterwards (sort if where I'm at now).
-
Jaw surgery which changes the vertical dimension of the face ie. Fixing a short or a long face usually has the most dramatic effect. I hope you are not missing out. Good luck on Monday anyway.
I'm just concerned that you may be underwhelmed by the result and if god forbid you have complications, you may be too afraid of having the surgery that you really need afterwards (sort if where I'm at now).
I appriciate what you're saying and it's true, the best results would come from a bsso type of jaw surgery. But I believe that I can reach a satisfying improvement from this though I understand the limitations. The positives I see are: quick fix, my wallet won't notice it, it's in my hometown, if it's done properly I could reach the finish line and move on with life. Thank you.
-
Weird start of the day. I woke up too early from having some flu symptoms, was so worried I almost called the hospital to let them know. I went back to sleep, had a strange dream about zombies and woke up a few hours later feeling much better and the runny nose is gone. lol what the hell.
-
Just read this. Gamble for sure, but eh maybe you'll luck out. All the 'comfort' things you bring up (easy travel, cost, convenience) ring little alarm bells as things I prioritized over 'top' surgeon quality, and here I am with supposed motor nerve damage from a simple chin implant, when I really should have gotten bimax + sg. Think I'm up for an even riskier surgery now??
-
I'm so messed up from all the meds and general anesthesia but I am home resting. My lips and teeth have no numbness but cant tell much else due to tight bandage. Talk to you guys later.
-
It's a very good thing to have sensations back so early, congrats, the most difficult part is behind you.
Pain can be disturbing the first few days, but it so worth it :)
-
I'm so messed up from all the meds and general anesthesia but I am home resting. My lips and teeth have no numbness but cant tell much else due to tight bandage. Talk to you guys later.
Good sign. The less intense the initial numbness the less likely it is to be permanent.
-
I'm so messed up from all the meds and general anesthesia but I am home resting. My lips and teeth have no numbness but cant tell much else due to tight bandage. Talk to you guys later.
(http://1.bp.blogspot.com/-gBOoWjU3wDI/UFdS9Y-9_wI/AAAAAAAADCQ/q-psML1GNqU/w1200-h630-p-nu/slow-clap-gif.gif)
Sounds great man, please post pics when you fully recover and all that
-
Thanks for the comments. I Feel 10x better today. A lot of swelling on the lower half of the face while the chin is strapped tight with the bandage, so I really can't tell what the result is going to be, that's gonna take a while. But I can see an increase in vertical height and the mentolabial fold decreased.
http://i.imgur.com/IvGpsmF.jpg
http://i.imgur.com/KjsxZPy.jpg
I don't feel any nerve problems anywhere, I think he used a different technique. The incision wasn't below the teeth but right between the incisors, I think he peeled down the gums to get down to the chin bone, similarly to the corticotomy he did last year. Maybe this avoided damaging any nerves? He said beforehand that since braces finished I still had black triangles, so I guess he tried to fix them while performing the SG at the same time. I will get to talk to him next monday.
-
Thanks for sharing pics man. Good to hear you don't have any nerve damage
-
Thanks, no nerve damage at any point so I guess I dodged that bullet. I do see that my lower lip has rolled in a bit which I anticipated beforehand and actually wanted a bit since it used to hang lower than I liked. It looks a bit off though and there's still a lot of swelling at this point, not completely satisfied with the projection in profile but I think it will look better once swelling decreases. Vertical height looking good so far.
4.5 days post:
https://s31.postimg.org/m3m01bmyz/4_5_days_post_SG.jpg
-
Yeah it's too early to tell but the front already looks much better than before
-
(https://s32.postimg.org/dgi2pxi2d/scannen0002.jpg)
https://s32.postimg.org/dgi2pxi2d/scannen0002.jpg
Latest ceph. It looks conservative, it was about 4 mm forward/4mm down but since it was done in both directions the surgeon didn't want to make the gap too big. I like the result so far but I'm thinking if he should have advanced it forward a bit more. Would appriciate any thoughts.
-
Looks great man, stoked for you. And no nerve damage is great.
-
Thank you. Two weeks post-surgery, most swelling is gone.
(https://s32.postimg.org/jymwalb51/GEDC0759.jpg)
I don't feel as satisfied now. My chin was so non-existent before that this improvement has only made me look 'normal'. I am thinking about getting another SG as a couple more MM's would make the satisfying difference.
I am wondering if my lower lip would become even thinner though. I also got a bit of the 'pointy chin' look from the front now. Can the chin bone be shaven into a less pointy shape and then brough forward to fix this? Anybody got experience with two SG's in a row?
Everything else was a walk in the park. Much easier surgery than I thought, should have done this YEARS ago.
-
Thank you. Two weeks post-surgery, most swelling is gone.
(https://s32.postimg.org/jymwalb51/GEDC0759.jpg)
I don't feel as satisfied now. My chin was so non-existent before that this improvement has only made me look 'normal'. I am thinking about getting another SG as a couple more MM's would make the satisfying difference.
I am wondering if my lower lip would become even thinner though. I also got a bit of the 'pointy chin' look from the front now. Can the chin bone be shaven into a less pointy shape and then brough forward to fix this? Anybody got experience with two SG's in a row?
Everything else was a walk in the park. Much easier surgery than I thought, should have done this YEARS ago.
Did they do a multi-segment osteotomy on your chin ? Or just take the chin with the single cut and move it forward and down?
-
Did they do a multi-segment osteotomy on your chin ? Or just take the chin with the single cut and move it forward and down?
The latter. I will be asking my surgeon if he can do that(what is it called when they cut the chin in half and spread it to create width? T something I think..) I'm thinking it would only get more pointy with another SG.
-
I found a reputable JS clinic which offers a very diverse chin osteotomy. Apparently I can get the horizontal and vertical advancement as well as a widening component where they cut the chin piece in half as well. Got a consultation booked, will make a new thread in a couple of weeks so this one is finished.
-
I got a SG during bsso & Lf1 and was also left with kind of a pointy chin as well. mine overadvanced a bit. i have a feeling 2 sgs would be tough given risk of numbness and mentalis strain
-
I got a SG 9 months ago and I also get that feeling that it could have been advanced further,or my chin widened with a transverse osteotomy or some kind of onlay. Maybe braces to recreate an overjet that has been previously corrected, then BSSO?
Anyway, keep us updated ;)
Many people get that feeling after a first SG
-
I got a SG 9 months ago and I also get that feeling that it could have been advanced further,or my chin widened with a transverse osteotomy or some kind of onlay. Maybe braces to recreate an overjet that has been previously corrected, then BSSO?
Anyway, keep us updated ;)
Many people get that feeling after a first SG
I actually took special notice of your posts before going into this, so I did anticipate that it could become pointy or that I'd be dissatisfied with the advancement. So I gotta thank you for bringing that realistic concern into this site because I am not devastated or even unhappy right now. But still, once it happens you're still stuck into the mindset of surgery-planning, and I was hoping I would have been freed from that mental prison after the surgery.
-
I don't see the pointiness.
-
It honestly looks great from the last picture you posted. I would need to see more pics such as profile to judge completely though. It's easy to be too caught up in looks if you hang around this forum too much. Take a step back and reflect on it. You might be experiencing "post purchase dissonance".
One question. You said that the doc shaved down your gum when you had the SG, to correct something from the wilckodontics procedure. How did that turn out?
-
Doesn't look pointy at all wtf
-
which angle where you aiminmg for ie how did you gage how much mm advancement you would get? and how much did you manage to get?
-
.
I actually took special notice of your posts before going into this, so I did anticipate that it could become pointy or that I'd be dissatisfied with the advancement. So I gotta thank you for bringing that realistic concern into this site because I am not devastated or even unhappy right now. But still, once it happens you're still stuck into the mindset of surgery-planning, and I was hoping I would have been freed from that mental prison after the surgery.
Well, I'm glad my experience was useful to you at least.
As you pointed out, mine is well done, but not pronounced enough for me to finally feel "safe about it".
I know how disheartening it can be to still google the same things you did before the operation, and how thinking about operating once more for 2 or 3 mm or so feels like a gamble.
But it is also true that it might take two to feel at last ok with it,and you become more educated as a patient.
You also feel more alone as you go through the process for a second time, because people just don't get it anymore.
Anyway, you've got to keep going :)
-
Before and afters:
https://s31.postimg.org/bziyb6d9n/SG_before_after_profile.jpg
This is the first time I've actually looked at before and after pics side by side and the difference is much more obvious than just looking at sole before-pics. How soon the brain forgets lol. Doc did alright.
@rrrrttteww, gums are still swollen so I'm not sure yet..
@mike888miller, with photoshop I think 7mm forward and down looked best. I got 4x4mm from this surgery and he says tissue might not advance the same amount as the bone..
As for the pointyness, I think I should say narrow instead. But on pictures from a distance it seems to look ok..I don't know why the chin still looks small and narrow when looking in the mirror though.
-
You're right, mine is still narrow from some angles as well.
I think it has to do with the bone mass underneath, as my bone frame is thin in general (I'm a woman).
You should definitely seek thickness and width instead of some more projection.
The question is : how (without any implants).
Anyway, I'm looking forward to hearing about your next consult.
-
You're right, mine is still narrow from some angles as well.
I think it has to do with the bone mass underneath, as my bone frame is thin in general (I'm a woman).
You should definitely seek thickness and width instead of some more projection.
The question is : how (without any implants).
Anyway, I'm looking forward to hearing about your next consult.
I believe I have found that method(no implant for me ever). It's over 5 weeks untill I get to speak to that surgeon out of town, untill then I'm trying to read info on it but it's difficult to find anything. Bobbit has told me about a surgeon who showed results from this method which looked good so that's good.
But it is also true that it might take two to feel at last ok with it,and you become more educated as a patient.
You also feel more alone as you go through the process for a second time, because people just don't get it anymore.
So true. The surgery itself I don't worry about anymore, but yeah people will think it's crazy to do this since they already opposed the first one. Plus now I need to travel a couple hours from home to get it done and I don't know how I'll get somebody to come with me for help while keeping this somewhat secret. Oh well, minor stuff in the long run. You only live once right. I'm young and I want to get this done so I'll enjoy it for a long time. :)
-
I would want a bit more avdvancement honestly
-
is it just that i have a preference for like exaggerated kirk douglas cheeks or do most doctors advance too little? I noticed this of Arnett and Gunson especially, huge advances of jaws but very conservative genioplasty even when it was safe to produce a strong chin.
Dudes, check it out every good looking person has a huge chin: Bridget Hall, Angie Harmon, Angelina Jolie, Jared Leto, jason Statham etc. etc. any of these people I bet look a bit exagerrated and freaky in person which is why they register so well on camera.
-
is it just that i have a preference for like exaggerated kirk douglas cheeks or do most doctors advance too little? I noticed this of Arnett and Gunson especially, huge advances of jaws but very conservative genioplasty even when it was safe to produce a strong chin.
Dudes, check it out every good looking person has a huge chin: Bridget Hall, Angie Harmon, Angelina Jolie, Jared Leto, jason Statham etc. etc. any of these people I bet look a bit exagerrated and freaky in person which is why they register so well on camera.
You're so right, but a strong chin only looks good on a decent jaw.
Mine is slightly retruded, but has been camouflaged with extraction orthodontics when I was too young to care. I wis I knew then.
I've seen many exemples of people with too strong a chin on a weak jaw, and they didn't look that good.
But I think you can't go wrong by adding a little width, it looks better on most faces, that's why I thing need advancement is right by looking for a T osteotomy or something
-
You're so right, but a strong chin only looks good on a decent jaw.
Mine is slightly retruded, but has been camouflaged with extraction orthodontics when I was too young to care. I wis I knew then.
I've seen many exemples of people with too strong a chin on a weak jaw, and they didn't look that good.
But I think you can't go wrong by adding a little width, it looks better on most faces, that's why I thing need advancement is right by looking for a T osteotomy or something
Yes, a big feature all on its own looks grotesque. A big chin should come with a big jaw - mandible and ramus. It should also match the mouth. I've seen quite a few class iis with a big projected chin (nature's way of compensating for the poor profile) - looks bad.
-
is it just that i have a preference for like exaggerated kirk douglas cheeks or do most doctors advance too little? I noticed this of Arnett and Gunson especially, huge advances of jaws but very conservative genioplasty even when it was safe to produce a strong chin.
Dudes, check it out every good looking person has a huge chin: Bridget Hall, Angie Harmon, Angelina Jolie, Jared Leto, jason Statham etc. etc. any of these people I bet look a bit exagerrated and freaky in person which is why they register so well on camera.
Yeah it's just a personal preference. I always wanted a strong 'exaggerated' chin, my proportions aren't of some kind of ideal beauty standard, but then many people who fall out of those measurements or whatever are still highly attractive so it's true that beauty is in the eye of the beholder. I think the main motivation for anybody looking into surgery is simply to improve from where they started from.
-
just had a look at the foto
you look fanstic from the side. g, n, sn, pog, all where it should be. you have a great ante face, maybe even 4/3. cant see if pointy, would need a frontal shot slightly from the top or bottom.
weather or not you would look even better with a slightly more advanced Go, in my opinion, depends on your facial with. if you have fall within the ideal proportoins (ft to ft / zy to zy 80 to 85pc) , i would think about it. just always remember all the important raitios are inter-related and -dependent.
-
Great results mate.
Chin shape looks better as well ( more round and robust).
The lengthening and decrease in chin width has brought out some aesthetic angles to your jaw.
7mm forward would have looked better, but you've gained a lot with only 4mm.
Congratulations!
-
I had the same problem with the genio, in that it made my chin look smaller and more pointy. I'd going to go down the chin wing route now and hopefully get the projection i need and possibly widen it at the same time, too. Your's looks really good imo, though. It's got the sort of shape i wish mine had.
Why couldn't the genio produce enough projection?
-
I'm sure it could, it's just that mine didn't. It was pretty conservative - around 5mm i think. It improved my appearance somewhat but i wasn't happy with the projection or the shape. Interestingly enough, when i consulted with an orthodontist who works with one of the UK surgeons, after i'd already had the genio, i didn't tell her that i had it done and asked her about the possibility of lower jaw surgery and she said she thought i could do with just having a genio alone - so my chin still must have looked fairly recessed.
Why did you agree to only move it 5mm? Didn't you do morphs and measurements beforehand?
-
I rushed into things a bit, and i was worried about getting something done that would make me look vastly different. I went with a good surgeon who is well respected, so i just trusted his judgement. He did a great job, in that i recovered really quickly, minimal swelling and no numbness, but i do wish i waited longer and planned things a bit better now. He took photographs and measurements then gave me a detailed explanation of how it would turn out, but no, i didn't do morphs.
I seen another well-respected UK surgeon about a year after, and he agreed that the surgery was good, but that i could do with maybe one more genio - albeit a very small one but with the cuts made at an angle to make the chin appear a little wider. I was initially going to go with that before discovering the chin wing from reading on this forum, and i feel that that would be the procedure best suited for me.
Mind my ignorance, but is there any complications from having another sliding genioplasty or does it increase the difficulty of the procedure?
-
Thanks for the comments. I still can't figure out why it looks so different in front of a mirror. If the front looks like the photos in real life I would be more stoked.
Mind my ignorance, but is there any complications from having another sliding genioplasty or does it increase the difficulty of the procedure?
I guess it depends on how the first sliding genio went. In my case I had no complications, the only thing that happened was my lower lip has slightly rolled in, so I only worry if a second SG would make the lower lip look worse especially since my upperlip is protrusive. Also removing the screws from the first one might complicate things, it's crucial that the new screws don't hit teeth roots and obviously nerves etc.