Author Topic: Considering sliding genioplasty not sure if candidate  (Read 5191 times)

BlueShark7

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Considering sliding genioplasty not sure if candidate
« on: April 04, 2014, 09:49:28 PM »
Hey everyone,

I'm 25 years old and considering sliding genio. I had overbite correction as a teenager (11mm) and it is now 3mm with 1mm overjet. Orthodontist at the time decided surgery would be necessary but then after treatment thought the result didnt warrant surgery as it was successful enough. However, I feel like my lower jaw/chin is recessed in proportion to the rest of my face and if a sliding genio could advance chin 4-5 mm and lengthen same that it would put things in better balance.

I am happy with the shape of my chin/jaw, just not the position.

Would I be a candidate judging by my picture?

Any input appreciated, thanks in advance.
« Last Edit: June 20, 2014, 09:34:11 PM by EvK »

sean89

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Re: Considering sliding genioplasty not sure if candidate
« Reply #1 on: April 04, 2014, 11:23:46 PM »
Your chin is very good, its your jaw that is very slightly recessed.

BlueShark7

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Re: Considering sliding genioplasty not sure if candidate
« Reply #2 on: April 04, 2014, 11:44:47 PM »
Your chin is very good, its your jaw that is very slightly recessed.

Thanks for reply. Surgeon I saw for tmj said bsso completely overkill for my bite etc but I didn't mention anything about a genio. That's why I'm kinda wondering if I'm stuck cos jaw surgery would be too much I guess but genio might not be good either because chin shape is there.

notrain

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Re: Considering sliding genioplasty not sure if candidate
« Reply #3 on: April 05, 2014, 12:16:15 AM »
i agree with what sean said. how did they correct 11mm overjet, did you have extractions ?

BlueShark7

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Re: Considering sliding genioplasty not sure if candidate
« Reply #4 on: April 05, 2014, 12:26:33 AM »
i agree with what sean said. how did they correct 11mm overjet, did you have extractions ?

 Not sure what my overjet was but overbite was 11mm, corrected with functional appliances like twin blocks when I was about 11-12 and then braces.

notrain

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Re: Considering sliding genioplasty not sure if candidate
« Reply #5 on: April 05, 2014, 12:51:55 AM »
i think you are confusing overbite and overjet:

overbite = how much the upper incisors overlap the bottom incisors vertically. a 11mm overbite would be the upper incisors biting into the lower gums, drawing blood.

overjet = how much the upper teeth are in front of the lower (the proverbial buck teeth sticking out).

see here: https://www.google.de/search?q=overbite+overjet&espv=210&es_sm=122&tbm=isch&tbo=u&source=univ&sa=X&ei=-rU_U9vqGIvfOOGOgOAJ&ved=0CDIQsAQ&biw=960&bih=497

BlueShark7

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Re: Considering sliding genioplasty not sure if candidate
« Reply #6 on: April 05, 2014, 01:12:18 AM »
i think you are confusing overbite and overjet:

overbite = how much the upper incisors overlap the bottom incisors vertically. a 11mm overbite would be the upper incisors biting into the lower gums, drawing blood.

overjet = how much the upper teeth are in front of the lower (the proverbial buck teeth sticking out).

see here: https://www.google.de/search?q=overbite+overjet&espv=210&es_sm=122&tbm=isch&tbo=u&source=univ&sa=X&ei=-rU_U9vqGIvfOOGOgOAJ&ved=0CDIQsAQ&biw=960&bih=497

I had both. But yes my top teeth completely over lapped my bottom teeth because my jaw was too small. Twin blocks while I was still growing helped my lower jaw grow more as my orthodontist put it and restricted my maxilla from overthrowing. I may be wrong but I was always told I had an overbite or "undershot jaw" as my parents put it

notrain

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Re: Considering sliding genioplasty not sure if candidate
« Reply #7 on: April 05, 2014, 01:27:38 AM »
consult with a good maxfac. those functional appliances more often then not cause the otherwise normal upper jaw to end up recessed as well. it is entirely possible you need bimax advancement to correct the previous ortho treatment, because you had a large jaw discrepancy and now a normal bite, it is likely that your orthodontic treatment fixed the bite but messed up both jaws.

your profile is pretty retrusive looking overall, but without a ceph (side xray of skull) it is impossible to tell.

i am pretty sure, however, that you are not a candiate for a genioplasty. you will likely need some form of jaw surgery and braces.

BlueShark7

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Re: Considering sliding genioplasty not sure if candidate
« Reply #8 on: April 05, 2014, 01:38:18 AM »
consult with a good maxfac. those functional appliances more often then not cause the otherwise normal upper jaw to end up recessed as well. it is entirely possible you need bimax advancement to correct the previous ortho treatment, because you had a large jaw discrepancy and now a normal bite, it is likely that your orthodontic treatment fixed the bite but messed up both jaws.

your profile is pretty retrusive looking overall, but without a ceph (side xray of skull) it is impossible to tell.

i am pretty sure, however, that you are not a candiate for a genioplasty. you will likely need some form of jaw surgery and braces.

Thanks for input. I saw maxfac surgeon last week because tmjs painful and if he would consider jaw surgery. He was adamant no. I didn't even bother mentioning a genio because he didn't at all seem concerned with form, just function. I am getting a second opinion next month. If bsso was out of the picture, I'm interested in your reasons for genio not being an option? Even if it is just a cover up kind of thing?

notrain

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Re: Considering sliding genioplasty not sure if candidate
« Reply #9 on: April 05, 2014, 04:26:57 AM »
if you haven't already, consult with a maxfac who is also qualified in aesthetic / plastic surgery. otherwise he will probably be mostly focused on the bite and not on harmonizing the face.

with regard to the genio: you already have a good chin. it is pronounced and has a nice shape. it is just too far back. doing a genio would make it too long and pointy, maybe even give you a witch profile.

the issue are your jaws, which is sadly not easily rectified. you would need at least two premolar extractions in the lower jaw to create some linear overjet for advancement.

let me explain: when you were young and had that 11mm overjet, that 11mm was a somewhat accurate reflection of your skeletal issue. this means, to fix your skeletal base, you are looking at least at a 8-10mm bsso of the mandible. But, as most of us here, you will likely need bimax to fix the full extend of the issue.

that being said, even with the deformity, you are pretty good looking.


DrBirbe

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Re: Considering sliding genioplasty not sure if candidate
« Reply #10 on: April 07, 2014, 12:50:29 AM »
Hi
A genioplasty would improve your chin projection but at a cost of deepening your labiomental fold.
Do you have bite pictures?
Dr. Birbe
MD, DDS, PhD.
Oral and Maxillofacial Surgeon.
Diplomate of the American Board of Oral and Maxillofacial Surgery
Clinica Birbe Medical Director
www.birbe.org/en

BlueShark7

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Re: Considering sliding genioplasty not sure if candidate
« Reply #11 on: April 08, 2014, 03:19:16 AM »
if you haven't already, consult with a maxfac who is also qualified in aesthetic / plastic surgery. otherwise he will probably be mostly focused on the bite and not on harmonizing the face.

with regard to the genio: you already have a good chin. it is pronounced and has a nice shape. it is just too far back. doing a genio would make it too long and pointy, maybe even give you a witch profile.

the issue are your jaws, which is sadly not easily rectified. you would need at least two premolar extractions in the lower jaw to create some linear overjet for advancement.

let me explain: when you were young and had that 11mm overjet, that 11mm was a somewhat accurate reflection of your skeletal issue. this means, to fix your skeletal base, you are looking at least at a 8-10mm bsso of the mandible. But, as most of us here, you will likely need bimax to fix the full extend of the issue.

that being said, even with the deformity, you are pretty good looking.

Thanks notrain. I am concerned about my chin jutting out too much if I got it, but would this happen if the cut was made so it was a lengthening genio, rather than just horizontal.

As for bimax, I'm not keen on extractions and without insurance I don't know if I'll ever be able to afford bimax + braces in this lifetime. So if there was another solution that would better balance my profile, even if it isn't the ideal, then that is what I would go for.

Hi
A genioplasty would improve your chin projection but at a cost of deepening your labiomental fold.
Do you have bite pictures?

Thanks for reply. Would a lengthening genio, say 4-5mm + forward 4-5mm avoid chin jutting out and getting a deep labiomental fold?

I don't have camera with me, but maxfac surgeon measured overbite as normal at 3mm and 1mm overjet as normal.