jawsurgeryforums.com
General Category => Aesthetics => Topic started by: some1afterall on January 31, 2018, 04:34:27 PM
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Hi there, I posted a while back about being unhappy with my sliding genioplasty, chin looks too strong, esp from the frontal view.
I had BSSO and Le Fort 1.5 years ago and separate sliding genioplasty 1 year ago, both with Kaiser. I am no longer a Kaiser patient, so can't ask the original surgeon to reverse the genioplasty. I've reached out to several well known maxillofacial surgeons and it seems like nobody is willing to take on JUST a sliding genioplasty revision/reversal. They will only accept me for consult if I'm willing to consider revising the ENTIRE surgery. I believe my BSSO/Le Fort are stable. There's been a very slight movement horizontally with settling, but my bite is closed and I have no real pain or issues with function.
Any ideas??? I'm in the California SF Bay Area.
The other thing I've considered is paying out of pocket with individual Kaiser secondary insurance and seeing if I'd be able to get the genio reversed with the original surgeon. I'm unsure if I could pull that off though...
Any ideas?
Thanks.
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Hi there, I posted a while back about being unhappy with my sliding genioplasty, chin looks too strong, esp from the frontal view.
I had BSSO and Le Fort 1.5 years ago and separate sliding genioplasty 1 year ago, both with Kaiser. I am no longer a Kaiser patient, so can't ask the original surgeon to reverse the genioplasty. I've reached out to several well known maxillofacial surgeons and it seems like nobody is willing to take on JUST a sliding genioplasty revision/reversal. They will only accept me for consult if I'm willing to consider revising the ENTIRE surgery. I believe my BSSO/Le Fort are stable. There's been a very slight movement horizontally with settling, but my bite is closed and I have no real pain or issues with function.
Any ideas??? I'm in the California SF Bay Area.
The other thing I've considered is paying out of pocket with individual Kaiser secondary insurance and seeing if I'd be able to get the genio reversed with the original surgeon. I'm unsure if I could pull that off though...
Any ideas?
Thanks.
Post pics please
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http://s38.photobucket.com/user/RLC_85/library/?sort=3&page=1
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I've spoken to four Bay Area surgeons regarding a genioplasty but I'm looking to speak to a few more before I make my decision. You mind sharing yours and I'll give you mine? None of mine are from Kaiser.
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Who have you consulted with?
Avoid Schendel.
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Who have you consulted with?
Avoid Schendel.
Is he bad or something? I thought about getting a consultation with him, but opted instead of going to ones referred to by some orthodontists I visited and those I found myself.
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Is he bad or something? I thought about getting a consultation with him, but opted instead of going to ones referred to by some orthodontists I visited and those I found myself.
Yeah he's unethical.
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hi haven, I've talked to Deschamps-Braly. Gunson will book a consult for a full revision. I left a message with Dr Karas, but he never called me back.
Who have you spoken with?
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IMO, you look quite good as you are. A revision may be an improvement, but one that only you will notice.
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someone,
I must have already said this on one of your other threads but I would NOT go for a full revision. Just find someone who can revise the CHIN. There is justification for just revising the chin because you got that done AFTER the bi max in a separate surgery. So, it's not even as if it was planned in to the 'whole' of the bi-max surgery.
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Yeah he's unethical.
Maybe there's a reason he's in Palo Alto 😅
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hi haven, I've talked to Deschamps-Braly. Gunson will book a consult for a full revision. I left a message with Dr Karas, but he never called me back.
Who have you spoken with?
I'm over in the Tri Valley, but spoke with Dr Luque in SF, Dr Khalil (Berkeley), Dr Beckley (Livermore) & Dr Vareenki (Tracy). I never had surgery. Just braces for a little over a year. I also spoke to two orthodontists and my original one as well.
They all seem to agree that getting any sort of jaw surgery is overkill in my case. Some said I could look into a genioplasty if I really wanted to, but to not go too overboard with the procedure.
I'm still undecided really. Im thinking I might try to see Gunson. If he turns me down I'm over it. I understand my "flaw", but i think I have BDD because the surgeons say there's wrong with how i currently look.
Did you need a referral to see gunson? His website has a cosmetic section with genioplasty mentioned. Braly good? He came up in my searches but I never called his office.
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See my posting in surgeon leads for Deschamps-Braly for more on this topic...
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Hey y'all,
Checking in. I had a consult with one Bay Area surgeon who says reduction genioplasty - 10mm vertical height, + jaw tapering + another 2mm forward & some smoothing of bone spurs from my BSSO. I am encouraged by the treatment plan that only requires 2 weeks of downtime and is financially in my ball park, but don't want to cut corners, as I feel like I did with my original orthognathic surgery @ Kaiser Oakland.
I have a skype consult with Dr Jamali from NY this month. I am also scheduling an in-person consult with Dr Gunson in Santa Barbara, but he's super booked out... like until November.
Since I'm going down this road do any of you have ANY SUGGESTIONS FOR REVISION SURGEONS? I want THE BEST in their field.
I have to say I'm a little freaked out about aging effects of reduction surgery, as I already feel like jaw surgery gave me nasolabial grooves and lengthened my upper lip. If the doctor is removing 10mm of bone, does the skin adjust or will it just sag due to lack of bony structure? I've read about people my age having face lifts after jaw surgery. That sounds terrible!
Any thoughts?
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Adjustment to bone loss would depend on the elasticity of the skin to re model around it. Elasticity is usually a function of age or you could say 'time on earth' where how much time was spent doing stuff that decreases elasticity, sun exposure, weight fluctuations, pollutants etc.
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Gunson is the best. That's why he's so in demand.
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I’m consulting with Deschamps-Braly, Gunson, Jamali and Antipov. I want to hear everyone’s opinions and get a feel for how they approach things and their supporting teams before I make a decision.
It may be that the things I don’t like about my face just can’t be fixed... ie: long face, long chin, long philtrum, thin lips, tooth show at rest, chin dimpling, beginning of nasolabial folds-but either way I want to hear from some of the top experts in maxillofacial, craniofacial and aesthetic surgery.
Plus I want to make sure that these things won’t potentially get worse with another surgery - it seems like every modification of one thing changes the structure of another, soft tissue changes.
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you're wasting your time and money. as it is your chin looks much better than it used to.
you can't change your philtrum length. even lip lifts that leave you with a horrifying scar will not really improve it.
you're like the lookism guys who are on this site. you won't get radically better looking with this surgery.
besides, why do you care? You seem to be married with kids and stuff. Just devote yourself to your happy family life and kids. if you don't have functional problems just forget about this. revision surgery will reek havoc on your nerves, soft tissue, and you won't get any significant improvements.
surgeons will cut. that's what they do. they're paid to do it. you won't find anyone ethical enough to refuse you.
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Wow, Lazlo. Sounds like you have a very negative view of plastic surgery.
Thanks for your input.
I know surgery isn't the answer to many of the things I'm disappointed with about my appearance. It's easy to start analyzing and picking apart your face after undergoing one surgery with less than ideal outcomes.
I still have TMJ pain - that is manageable. I would not want to undergo DJS again unless someone like Gunson said I had major issues that might cause long-term problems.
I have consulted with multiple surgeons and believe it or not, the only thing anyone has recommended so far was a revision genioplasty and possible fat grafting... or maybe fillers.
Yes, I'm married with kids, but I also believe that one should live life to the fullest. I work in healthcare and see traumatic ends to people's lives all the time, and think people should ultimately be given the chance to like the way they look. We live in a culture of vanity and physical appearance DOES matter.
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As to the suggestion about her giving up because she has a family....?!? Doesn't sound like she's the one with Lookism-related hangups.
I empathise with you some1afterall, as a fellow long faced gal. In your pics, I saw a firm improvement - albeit not a "wow" change. But bear in mind that the top results tend to involve other PS surgeries and other structural modifications (contouring bone and adding bits here and there). Conventional "nuts and bolts" jaw surgeries cannot achieve equivalent changes.
Don't view your surgery as "failed" though. It gave you a base to improve upon, if you wish to.
My inclination would be to start on things with the least risk. You can do botox in the chin for the dimpling and try filler. A skilful injector could make your philtrum look less long and any filler will decrease tooth show. If you don't want to re-do the jaw, you could also explore implants. I have seen impressive results in the chin/jaw areas from individual and wrap around models.
Please avoid fat grafting. Don't be swayed in that direction because it cannot be reversed and the results are often lumpy.
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You're above the threshold of "attractive". That's pretty much all that matters. Anything past that is diminishing returns. I don't think your face is long at all. 10mm vertical shortening sounds enormous. IMO, it will make your upper lip, your mid face dominate your face. You can vertically shorten the upper lip as well, but that will make the nose look longer. IMO lip lifts should be done when then nose is of average length or (better) short and high set. This stuff just snowballs. Maybe you're equating cuteness with beauty. IMO, cute doesn't age well. I'd talk to Gunson before doing anything. I think he will suggest a full blown revision "but only if you really really really really want it". Open bites relapse all the time. I think you've quite lucky in that regard. I'm sort of in a similar position - a lazy sloppy jaw surgery which produced a solid bite, ho hum aesthetics (and massive nerve damage). Doing a Gunson revision now would make me look better, I guess, but not enough to justify the risks (worse bite, most likely a numb bottom lip as well). If I could do it all over again, I would've avoided my
butcher "best guy in town" and gone to Gunson, but we're all wiser in hindsight.
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Did you ever end up speaking to Dr Jamali through Skype or fly over to NYC to see him?
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I had a Skype consult with Jamali and wasn’t that taken by him. Then again it was over Skype with exchange of photos and X-rays.
I had a good consult with Deschamps-Braly and I see Gunson in April.
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I’m thinking about paying Antipov a visit too.
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One of the reasons I skipped out on the Skype thing. I've done job interviews via Skype and they always feel awkward. I cant imagine it being any different speaking to a doctor. I think you'd said you would have to wait until the end of the year to see Gunson? Or I might have read someone else say that.
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A cancellation lead to an earlier appointment :)
I live in the California Bay Area, so having surgery in NY probably doesn’t make much sense anyways...
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hi haven, I've talked to Deschamps-Braly. Gunson will book a consult for a full revision. I left a message with Dr Karas, but he never called me back.
Who have you spoken with?
I had my really difficult revision with Dr. Karas. I know he's got some new people working up front this year, so definitely give them a call back during normal office hours. You'll need a referral from another treating dentist or orthodontist to see him.
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As to the suggestion about her giving up because she has a family....?!? Doesn't sound like she's the one with Lookism-related hangups.
I empathise with you some1afterall, as a fellow long faced gal. In your pics, I saw a firm improvement - albeit not a "wow" change. But bear in mind that the top results tend to involve other PS surgeries and other structural modifications (contouring bone and adding bits here and there). Conventional "nuts and bolts" jaw surgeries cannot achieve equivalent changes.
Don't view your surgery as "failed" though. It gave you a base to improve upon, if you wish to.
My inclination would be to start on things with the least risk. You can do botox in the chin for the dimpling and try filler. A skilful injector could make your philtrum look less long and any filler will decrease tooth show. If you don't want to re-do the jaw, you could also explore implants. I have seen impressive results in the chin/jaw areas from individual and wrap around models.
Please avoid fat grafting. Don't be swayed in that direction because it cannot be reversed and the results are often lumpy.
Hi Girl,
Thanks for your reply. What kind of jaw surgery and/or accessory surgeries have you had? and which have you been happy with the results? I know amazing things can be done with a skillful hand with botox and fillers, and they are temporary. In the future I may seek some accessory treatments.
I am definitely concerned about facial balance. I have strong facial features so changing something drastically could majorly put the rest of my face out of balance.
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You're above the threshold of "attractive". That's pretty much all that matters. Anything past that is diminishing returns. I don't think your face is long at all. 10mm vertical shortening sounds enormous. IMO, it will make your upper lip, your mid face dominate your face. You can vertically shorten the upper lip as well, but that will make the nose look longer. IMO lip lifts should be done when then nose is of average length or (better) short and high set. This stuff just snowballs. Maybe you're equating cuteness with beauty. IMO, cute doesn't age well. I'd talk to Gunson before doing anything. I think he will suggest a full blown revision "but only if you really really really really want it". Open bites relapse all the time. I think you've quite lucky in that regard. I'm sort of in a similar position - a lazy sloppy jaw surgery which produced a solid bite, ho hum aesthetics (and massive nerve damage). Doing a Gunson revision now would make me look better, I guess, but not enough to justify the risks (worse bite, most likely a numb bottom lip as well). If I could do it all over again, I would've avoided my butcher "best guy in town" and gone to Gunson, but we're all wiser in hindsight.
Who did your original surgery? Gunson did suggest a full blown revision with 5mm (not 10mm) of vertical chin reduction. I still haven't made up my mind. I had no nerve injury with my first surgery, but understand there's a higher risk with the multi-segment le forts.