jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: DC77 on April 24, 2017, 04:23:24 PM
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My surgeon has said that I could have an advancement genioplasty where he would rotate the chin aswell as move it forwards to give me more length to the lower part of my face.
I have a Class 2 skeletal 2 over bite with deep labiodental fold (see pics on Overbite forum)
I know the best solution would be bimax and possible genioplasty. However my bite doesn't bother me and some improvement with a lower chance of numbness does appeal? My main issue is a short face from front on, my chin hides my recessed jaw at the moment.
Is there any reason not to do a genio with a bite that is not class 1, other than it is does not provide the absolute best functional solution. My surgeon is experienced in both jaw surgery and genios. I would not pay for the surgery as I have been told it would be funded by the NHS in the UK? Any thoughts appreciated
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Genioplasty has functional impact the back of the chin bone is connected to genioglossus muscle which will bring tongue forward and normally helps with sleep apnea.
Since its not a concern for you it might not have any functional impact in your case
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An SG can help with mild OSA IF the doctor performs the surgery in such a way to affect the position of that throat bone. Typically though doctors don't really see an SG as treatment for OSA for how little it helps.
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Had same issue as you, Class II (10mm overbite), recessed chin.
Don't necessarily think you need an advancement genio, just consider having the BiMax to advance the lower jaw, then the chin will follow. There are lots of options for the genio if you choose to have it done, they can slide it up and to the right, or just advance forward, or genio reduction. The genio serves no functional purpose, and you will have numbness for over a year. Consider the benefits of correcting your malloclusion, because it can affect the way you talk, breathe, chew food, appearence, smile.
I've read and heard that with the genii there is less chance of permanent numbness than
With lower jaw surgery, when comparing each in its own (not jaw and genii yogether). Where have u heard the numbness lasts over 1 year?
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i think it is a decent compromise sometimes-maybe post pics?
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i think it is a decent compromise sometimes-maybe post pics?
His pictures are here: http://jawsurgeryforums.com/index.php?topic=5342.0
His chin could even arguably be considered ideal. It may need a little bit of lengthening in the vertical direction.
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His pictures are here: http://jawsurgeryforums.com/index.php?topic=5342.0
His chin could even arguably be considered ideal. It may need a little bit of lengthening in the vertical direction.
Yeah imo as far as projection is concerned it should line up somewhere between the upper and lower lip, but it should always be a little bit more projected than the lower lip.
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Here are some more photos, I have braces on my teeth in these..
(http://i68.tinypic.com/24b2g3r.jpg)
(http://i65.tinypic.com/2eaq995.jpg)
(http://i66.tinypic.com/167qq1e.jpg)
This last one shows what it might look like if I had surgery possibly a genio
(http://i66.tinypic.com/2nhixxe.jpg)
sorry if they are a bit big
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dc given your situation i would strongly advise against genio---you have a big chin but a small jaw, classic situation where sliding genio/chin implant would make you look uglier.
just my opinion
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I agree. That morph is most likely overly optimistic. Unlikely that a genio would fill in the mentolabial fold like that. Could you not just get a BSSO?
Yes probably is optimistic. The surgeon suggested that he could rotate the chin as part of the genioplasty to increase vertical height while not having the chin too prominent.
However if I had a BSSO Ive got a wisdom tooth right on the nerve where he needs to cut. He says which he feels would increase my chance of significant permanent numbness on the lip - the X ray showing this is on the previous photos. I think actual numbness of the lip like that when you having a filling at the dentist (as opposed to maybe altered sensation) would be difficult for me to accept
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Yes probably is optimistic. The surgeon suggested that he could rotate the chin as part of the genioplasty to increase vertical height while not having the chin too prominent.
However if I had a BSSO Ive got a wisdom tooth right on the nerve where he needs to cut. He says which he feels would increase my chance of significant permanent numbness on the lip - the X ray showing this is on the previous photos. I think actual numbness of the lip like that when you having a filling at the dentist (as opposed to maybe altered sensation) would be difficult for me to accept
tough call but the lip alignment would stay the same with the genio.
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tough call but the lip alignment would stay the same with the genio.
Sorry my misunderstanding what do you mean by the lip alignment, the labiomental fold?
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that the bottom lip does not meet with the upper one while it seems to do so in the morph!
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that the bottom lip does not meet with the upper one while it seems to do so in the morph!
yeah and why the heck is the morph zoomed in? makes the before/after much harder to gauge.
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I would even go further and say that if you have vertical height added, your lower lip might slightly roll in, making the discrepancy between your upper and lower lip even more exaggerated(uglier). It happened to me after my SG and seemingly most people although it does get better over time.
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yeah and why the heck is the morph zoomed in? makes the before/after much harder to gauge.
Sorry I was trying to crop the photo as the morph has changed my nose
and tightened up my neck, neither of which I would ever contenplate surgery for!
So the morph might be more realistic if BSSO was done you feel, but mayb an advancement genioplasty would be similar but not as much imorovement
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I would even go further and say that if you have vertical height added, your lower lip might slightly roll in, making the discrepancy between your upper and lower lip even more exaggerated(uglier). It happened to me after my SG and seemingly most people although it does get better over time.
Yep, agreed. Same thing happened to me.
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Yep, agreed. Same thing happened to me.
And it takes a highly skilled and knowledgable surgeon to be able to work with the nerves of the lips and improve the aesthetic look. Apparently there's a way of going about it that could either pull the lip down or 'roll it in' depending on what the patient needs, not many can actually do this with control. 9 out of 10 SG surgeons will just hope they didn't damage nerves and hope for the best so it is a gamble.
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And it takes a highly skilled and knowledgable surgeon to be able to work with the nerves of the lips and improve the aesthetic look. Apparently there's a way of going about it that could either pull the lip down or 'roll it in' depending on what the patient needs, not many can actually do this with control. 9 out of 10 SG surgeons will just hope they didn't damage nerves and hope for the best so it is a gamble.
Just to say my surgeon does lecture internationally on genioplasty, and has written book chapters specifically on this. If I did go ahead I would want him to do this as I feel he is experienced. But it does seem to be a procedure that is quite subjective, as opposed to the planning involved with actual
Jaw surgery.
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Just to say my surgeon does lecture internationally on genioplasty, and has written book chapters specifically on this. If I did go ahead I would want him to do this as I feel he is experienced. But it does seem to be a procedure that is quite subjective, as opposed to the planning involved with actual
Jaw surgery.
Sounds good, though the results and amount of surgeries he does are the most important Imo. And depends on if you think the minor risks are worth the potential reward. I think they are which is why I plan on getting another SG. Look at it this way, you should be good if your goal is to get to a better point aesthetically than you are at now. And once you make the decision it's better to forget about other mental distractions like other surgeries you "could be getting instead" like bimax, chin wing etc.
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I had jaw surgery 4 years ago to correct my overjet (10mm). Unfortunately it has now regressed almost back to where it was (8mm). They are unable to redo my surgery due to condylar resorption. They best they can do for me now is to put my braces back on (something as a 25 year old I am not exactly thrilled about as most of my friends got rid of their braces 10 years ago) to try and correct the overjet as much as they can. After the surgery my teeth no longer meet on the right hand side, so the braces will fix this for me too. They have also suggested genioplasty for me to rid me of my slight double chin effect I have as a result of my slightly receded chin. They mentioned that my nose also contributes to the imbalance of my face, so they did mention rhinoplasty for me too.
So whilst jaw surgery will fix the problem, i think genioplasty can be a good way to disguise the problem. If the bite of your teeth doesn't bother you, and you care more about the appearance of your profile, it could be a good less-extreme way to achieve your desired appearance. Unfortunately for me I don't have the choice!
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Genio will not give you the result in the morph. You'd need a BSSO to do that.
I have a deep overbite and everted lower lip. I didn't have the sub labial fold that you do and still had to get a bunch of filler in that area after my chin implant. So assume a genioplastly is going to make this worse. I also don't think it will make you better looking, unless you consider a jutting chin to be attractive.
If you don't want to do the BSSO, I'd recommend going in with a high density filler all around the chin, sub-labial fold, jawline and jaw angles. It lasts about 2 years.