Sliding genioplasty or double jaw surgery?

[jaws]

Hello everyone, first time poster long time lurker. Known for a while but finally got x-rays taken that showed the visual evidence of recessed jaws and chin and wanting to change that with surgery. I have consulted with many maxillofacial surgeons and all agree on a sliding genioplasty but I'm wondering if I should get double surgery also to fix the recessed jaws even though I have a normal bite. I was wondering if their was any surgeries that also make the jaw or mandible wider since I have a narrow jaw. Thanks for your time and I have included pictures http://imgur.com/a/HZJko

[CK]

from the profile i can see the jaw is recessed but from the front it looks normal and so does your chin (imo.) do you lips seal naturally or are you tensing? do you live in a country that has uhc or america? i only ask because im not sure if jaw surgery is worth the risk for aesthetics alone, since you say you have a normal bite. your jaw is sort of narrow but it has the ideal "V" shape that syncs with your features.

[jaws]

I live in california. My jaws are recessed and I feel like my tongue is trapped or something because their very narrow and recessed.  My bite is fine but I feel "off" when I close my mouth like I have to try hard and I can feel mandible go back, and yea I am not going to lie I want it done because I believe it would look better cosmetically. I have a bunch of consultations set up. I was approved of sliding gneioplasty from insurance but that was before I noticed the mainroot of the problem was because of rethroghantia. Thanks for the help and would like more opinions if possible

[treevernal]

Your airway seems to be a nice size, much larger than my own.  Your face looks relatively proportional as well, bimax is an option but a genio could be a better option.  Def consult with more surgeons.  As others have said it's a personal decision that is entirely up to you.  Best to acquire as much info as possible before jumping in.

[Sharptoys]

I would be careful with an isolated genioplasty. While the anterior portion of your mandible shows relatively little contour, your short facial height and large soft tissue chin pad might make chin augmentation aesthetically troublesome.

IANAD. Consult a surgeon or other medical professional for better/accurate information.

[Lazlo]

I would say unequivocally that you need bi-max --functionally it will be much better, you clearly have retrognathic features and aesthetically advancing the lower jaw does give the appearance of the a width to the lower face(not a whole lot, but it would be enough in your case).

[jaws]

Ahhh everyone still has different opinions...but opinions nonetheless. Thanks for the input so far everyone, I have set up many consultations for the future so I will get various opinions. I'm wondering that since I got approved of the sliding genioplasty before I figured out my whole jaw was rethroghantic, would I get approved of bi-max surgery also?

[CK]

Ahhh everyone still has different opinions...but opinions nonetheless. Thanks for the input so far everyone, I have set up many consultations for the future so I will get various opinions. I'm wondering that since I got approved of the sliding genioplasty before I figured out my whole jaw was rethroghantic, would I get approved of bi-max surgery also?

depends on your insurance.

[treevernal]

Ahhh everyone still has different opinions...but opinions nonetheless. Thanks for the input so far everyone, I have set up many consultations for the future so I will get various opinions. I'm wondering that since I got approved of the sliding genioplasty before I figured out my whole jaw was rethroghantic, would I get approved of bi-max surgery also?

How did you get coverage for a sliding genio?  Isnt that 100% cosmetic?

[jaws]

Blue Cross and yea I was very surprised I got the sliding genioplasty covered by itself, the maxillofacial surgeon even said that it wasn't probably going to be approved so I was very surprised when it was.. The whole procedure wasn't covered but a good chunk of it was to clarify things also. Has there been any members on here who got there procedure approved or at least a good chunk of it from theor insurance and if so how much percentage wise?

[Marisama]

Blue Cross and yea I was very surprised I got the sliding genioplasty covered by itself, the maxillofacial surgeon even said that it wasn't probably going to be approved so I was very surprised when it was.. The whole procedure wasn't covered but a good chunk of it was to clarify things also. Has there been any members on here who got there procedure approved or at least a good chunk of it from theor insurance and if so how much percentage wise?

My insurance approved my jaw surgery.  It would have been free but I've decided to go with an out-of-network surgeon so it will still cost a good sum of money.  You can send me a personal message if you have any questions about insurance.  I was denied over and over again with one company, but was approved instantly with my current provider.

[Antbee]

I was approved instantly too. They only pay out a small portion compared to the actual fees though...still it's way better than nothing!

[Lazlo]

Just wanted to cite this example of what I'd say is an excellent sliding genioplasty by Dr. Joseph Niamtu(not a maxillofacial surgeon, but a ps who does genioplasties)
Doesn't look like this patient has a retrognathic profile but it is interesting that he has a small, slightly retruded chin and it has been ELONGATED as well as brought out.
There is no chin implant here. A complaint I've heard time and again from some Gunson/Arnett patients(male ones mostly) is that they don't come out with strong chins.
Why couldn't A/G or other docs do something like this? I wonder if some kind of graft or material was interposed between the cut to make the chin longer? Anyway, I think
it's a good result and patients could certainly take this pic to their docs when they consult if they like this result. Int. that the genioplasty also makes the lips sit more aesthetically.





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[Lazlo]

for those of you who are interested i got the above pic from this site. i should indicate that in fact joseph niamtu is lndeed listed as a "DMD" and it also indicates he's served on the some maxillofacial board,
but judging from the site his practice seems to be mostly cosmetic surgery and implants.

on this page he explains the indications for genioplasty versus chin implant. clearly the genioplasties look better when indicated. In my opinion, though, the mandibular implants look bloody horrendous.
I can't see the aesthetic advantage at all. That's just my opinion and I would never want those things in me.

http://www.lovethatface.com/cosmetic-facial-surgery-richmond-va/chin-surgery.aspx

[treevernal]

Yeah, that girl looked way better before the mandibular implants.