How are my results? Long face syndrome + Overbite

[Estephany2507]

Hi everyone!

Six weeks ago, I had orthognathic surgery to correct an overbite and long-face syndrome. While I’m happy with the functional results, and I feel I look better overall, but I’m unsure if the final result is optimal.

My procedure included a maxillary impaction (CCWr) + advancement, mandibular advancement (15mm one side, 13.5mm the other), and a 5mm genioplasty (exact maxillary measurements unclear).

One of my main goals was reducing my lower facial third, but I've noticed that my facial thirds didn’t change at all, which is a little bit frustrating since one of my expectations was to remove that vertical excess I initially had. I can't quite understand how from the the front view, my face is still showing the same length I had even with vertical excess when I had a CCWr to remove that excess in the first place. I have asked my surgeon about this, but he told me that I shouldn't be focusing on that, since it'll make me overthink (which is something that is happening, but mostly because I can't see the actual measure and what has been achieved in these terms).

Now my post-op face appears more square, with a longer-looking chin, making it seem even lengthier from the front. I also feel it gives me a more masculine appearance. My profile has improved, but my concern is how I look from the front.

I’m unsure whether my bone structure was always like this and I’m just now noticing it due to the mandibular advancement, if it’s purely a matter of swelling, or if my mandible was over-advanced and should have been better balanced with the genioplasty (this might sound unreasonable given my severe recession, but please bear with me—I’m not very knowledgeable on the technical aspects of the procedure, I swear it's a genuine question).

I’m going through a challenging period of acceptance, as I had different expectations for the outcome (more in terms of how it would look from the front). I've asked for feedback from my family and friends, but only my dad has told me I look good (though I feel he just says that to make me feel better, since he said the same during the first post-surgery days, when I looked like a literal balloon lol). My mom said I looked better from the front before surgery, and my friends who know I had the procedure simply don’t comment on it at all—almost like when someone gets a weird result, and people prefer to stay silent to avoid making them feel bad. When I ask them directly how I look, they either dodge the question or just say I look "very swollen" or "just different".

Pre and post op photos

I know that at six weeks post-op, there’s still swelling that will subside. However, from what I’ve seen in photos of other patients, most final results are already quite visible at this stage, so I’m concerned that my face may continue to look like this (tbh I feel like I resemble Handsome Squidward).

I’m asking in this forum because I’d like to hear your 100% honest and unbiased opinions. When people are asked these kinds of questions, they often offer reassuring comments just to be kind. But I truly want 100% honest feedback because if there’s an issue with my result, I’d like to explore possible solutions. I'm aware that my case was on the severe side, so ultimately, I want to know if the job my surgeon did was good. I'm especially hesitant about this cause I've heard about one case of my surgeon (after my surgery) with a patient who went from a class 2 to a class 3 because of an overadvancement. So, if anyone has technical knowledge about the surgery and its impact on aesthetics, or if they can tell me if my surgeon indeed did a good job and it's just me and my perception, I would be incredibly grateful for your insights.

When choosing my surgeon, I focused on finding someone whose past results aligned with what I wanted (I’m attaching photos of their previous work). As you can see in the second image, that was the type of outcome I was hoping for, but I don’t understand why something similar wasn’t achieved in my case.

Surgeon past cases

I also have my CT scans pre-op and post-op in case anyone can help me check it! Thank you so much in advance!

[kavan]

As I told you prior, the 'length' you saw/measured to the front of your face/lower '1/3d' was most likely due to the recession to the jaw and chin causing so much DROOP below the chin such that the droop projected to the front perspective as extra 'length'. People with a LOT of recession at both the jaw and chin have a LOT of SLACK/droop under the chin which is probably something you erroneously incorporated into your length measurement.

It doesn't matter that your prior erroneous measure which incorporated the slack under chin kicked up what ever measure it did and it doesn't matter that post surgery outcome kicks up a similar measure. What matters is that excessive slack under your chin (due to recession of both jaw and chin) has be TRANSFERRED to a place where it looks infinitely better.

Prior you didn't post any frontals. But despite IMGUR giving me problems when trying to load it, I did manage to get a good glimpse of your photos, pre and post surgery. Now that you've assured that you really want an honest opinion and not just one from people trying to 'kind', I'll give my honest opinion:

You looked terrible in the before frontal shots; extreme mentalis strain (dimpled chin) and multiple chins under the first one kicking up excess length from the front. But that's all water under the bridge because the surgeon corrected those extremely visible deviances from good aesthetics in what ever surgery he performed to transfer all that slack to a place where it now looks infinitely BETTER.

It's like this: If I measure something that looks 'too long', it can look that way because  I put it in the WRONG place. But if I find the RIGHT place to put it, its length isn't an issue anymore when it blends in with the surroundings. For example: 'Looks too long for the mantle would look better near the window in the corner of the room.'

[Tomasjohn]

Totally unbiased and honest opinion:

I basically have to fully agree with kavan.

I think in the before pictures you don't look good due to the recession. It was quite an obvious and severe flaw. Maybe it was different in real life.

The after pictures show a massive improvement. Objectively.  Compared to the before i can't see any negative change at all. I really have to say it again: Massive improvement.

It's a big change. It has only been six weeks. Normally you go through a stage of acceptance. Just give it time. You improved.