Hello. I'm hoping you guys can help me out. I have always had a recessed mandible, and the angle of my jaw from ears to chin has always seemed to be very severe/long. Around 14, I had a palate expander to space out my upper teeth and I got braces and elastics to "correct" my "overbite". Correct me if I'm wrong (Im still in the research stage) but it seems the elastics moved my maxilla back to line up with my recessed mandible, instead of the modern approach to orthodontics where appliances help to bring the mandible forward to line up with the maxilla.
Ok, so I'm 28 now, my bite is now normal, but Im wondering what I can do to fix my severe class II profile. I was told that a genioplasty would be my only option, but Im worried that that would make my chin longer and stick out in an unaesthetic way. I was thinking I would need double jaw surgery with some kind of rotation to make the lower third of my face less long. Please help me to understand whats wrong with my face. I look ok from the front (long face, but fairly proportional), but as you can see- I am severely disfigured from the side. Can I do anything to fix this?
A sliding genio can lengthen the face, but you can ask that most of the movement be forward and not down.
I have heard that you can go forward and up to some degree, but I don't see how it would work so well. It seems like you would have a really weird notch in your jawbone where they made the cut.
I had my mandible swung forward and my maxilla brought up. Minor genio that was mostly forward but a little bit down. Vertically my face is pretty much in perfect thirds now. However it does look longer than I think is ideal partially because I have a high forehead and a skinny face, so proportional for me is going to be on the long side.
My ideal female face is probably something like this:
She is pretty proportional vertically. But she also has a very short forehead which means she can also have a shorter feminine face.
I look more like this post-op
Angie's pretty vertically proportional too, but in my mind her longer skinnier face just isn't as pretty or feminine. But I've got a forehead almost exactly like hers so I mean what can you do. My cheekbones also aren't quite as wide or well-defined as hers, so it does make my face look a tad longer than hers though we might be the same height vertically
Anyway, to answer your question...you're worried about lengthening...in my case it was not the genio so much that made my face look longer it was swinging the mandible forward. My face looked deceptively shorter pre-op because you basically couldn't see a clear line for my lower jaw. It was all shadowed from the front. The genio's impact on the front was minor compared to the mandible being forward now.
I think profile does matter. Most people with significantly weak profiles can't help it showing up in the front somehow anyway. If you have a weak profile your whole lower jaw will sort of be shadowed in the front which will make your upper face look a lot larger.
Genio can improve the profile but with how steep your ramus is I doubt you would be happy with the improvement. Like I said, I had my maxilla moved up, and my mandible swung forward plus a small genio...from the profile the ramus angle is definitely shorter and more parallel to the ground. But from the front I still look a little long even with all that upward movement! Without moving other things up and forward I don't think you will be happy with a genio. You may look worse from the front honestly.
I am surprised by how good your bite is. I had a pretty good bite, better than probably most who go into jaw surgery, but still had some issues (I also had braces, expander, and elastics in my teens which I believe did more harm than good.) Your current bite looks perfect though. I think your profile issues cold benefit from jaw surgery but you're going to have a hard time convincing anyone reputable to do that on your perfect bite.