Need help on my chin and jaw issues(surgery, ortho etc)

[needadvancement]

Hi guys, first off I have an issue with my protruding maxilla and also my chin, it's pretty recessed and short. I have no idea what caused this(maybe genetics since my brother and father have similar chins) but I'm pretty satisfied with my jaw. I have a tall, somewhat visible ramus and my jaw is pretty wide and matches my square head. With my chin though, it's almost non-existent. I'm so self concious about i, and also my mouth looks off. I have bimax protrusion/overbite where it's mostly my philtrum sticking out. I first thought about getting braces and if it would fix that and also make my chin look better somehow, but @ 24 it seems unlikely. I am going to an orthodontist soon and I'll also ask about surgery options(there seem to be so many options I don't know what I need or should pick) although I'll be honest, I'd rather avoid surgery for several reasons. If I can fix my mouth with braces, maybe I can live with my chin. But then again, I've read that getting braces and then later deciding for surgery would have made the ortho a waste of time and money?

http://imgur.com/a/dy0J9#0
I put some pictures there so you can see what I mean. My teeth are almost not visible when I smile and it's a narrow palate too. I like the way it all looks in the picture where I'm clean shaven though. I hope the facial hair doesn't distort the view too much.

[PloskoPlus]

Hi guys, first off I have an issue with my protruding maxilla and also my chin, it's pretty recessed and short. I have no idea what caused this(maybe genetics since my brother and father have similar chins) but I'm pretty satisfied with my jaw. I have a tall, somewhat visible ramus and my jaw is pretty wide and matches my square head. With my chin though, it's almost non-existent. I'm so self concious about i, and also my mouth looks off. I have bimax protrusion/overbite where it's mostly my philtrum sticking out. I first thought about getting braces and if it would fix that and also make my chin look better somehow, but @ 24 it seems unlikely. I am going to an orthodontist soon and I'll also ask about surgery options(there seem to be so many options I don't know what I need or should pick) although I'll be honest, I'd rather avoid surgery for several reasons. If I can fix my mouth with braces, maybe I can live with my chin. But then again, I've read that getting braces and then later deciding for surgery would have made the ortho a waste of time and money?

http://imgur.com/a/dy0J9#0
I put some pictures there so you can see what I mean. My teeth are almost not visible when I smile and it's a narrow palate too. I like the way it all looks in the picture where I'm clean shaven though. I hope the facial hair doesn't distort the view too much.

IANAD, but here are my 2 cents.  I don't think you have bimax protrusion.  Your chin has good horizontal projection, but it's vertically shortish. This could be an illusion created by the squareness of your jaw. Do you have pictures of yourself smiling casually, and smiling as big as you can? 

Mind you, I've seen cases where the jaw is square, the chin is very long horizontally (with a deep mentolabial fold like yours), but the mandible is actually short. So the treatment was to advance the mandible and shorten the chin horizontally.

[Tiny]

I would guess -

Vertical deficiency in the maxilla
Deep bite
Some overjet and mandibular recession
Steepish occlusional plane due to vertical deficiently of the maxilla

Surgically, you'd be looking at bimax - le fort with CCW rotation and a downgraft and BSSO to advance the lower.  It is difficult to fix a skeletal deep bite via orthodontics, extrusion of the molars is not stable in an adult patient.  If your deep bite is being caused by over erupted lower incisors then that can be fixed

IMO you're not a candidate for genio because your chin isn't recessed - your jaw is.  Your sublabial fold is already promient so genioplasty isn't a good idea

Luckily for you, your well developed ramus is giving you decent facial definition.

[needadvancement]

I'm sorry for the late response. Hopefully you guys will still notice this thread and add your thoughts. I appriciate the posts so far!

IANAD, but here are my 2 cents.  I don't think you have bimax protrusion.  Your chin has good horizontal projection, but it's vertically shortish. This could be an illusion created by the squareness of your jaw. Do you have pictures of yourself smiling casually, and smiling as big as you can? 

Mind you, I've seen cases where the jaw is square, the chin is very long horizontally (with a deep mentolabial fold like yours), but the mandible is actually short. So the treatment was to advance the mandible and shorten the chin horizontally.

Well here's some more pictures of my bite and also one where I smile as big as possible. the picture actually shows my teeth more than I expected but I usually smile less broad than that and my teeth aren't really visible.
http://imgur.com/a/CyZuV#5

I would guess -

Vertical deficiency in the maxilla
Deep bite
Some overjet and mandibular recession
Steepish occlusional plane due to vertical deficiently of the maxilla

Surgically, you'd be looking at bimax - le fort with CCW rotation and a downgraft and BSSO to advance the lower.  It is difficult to fix a skeletal deep bite via orthodontics, extrusion of the molars is not stable in an adult patient.  If your deep bite is being caused by over erupted lower incisors then that can be fixed

IMO you're not a candidate for genio because your chin isn't recessed - your jaw is.  Your sublabial fold is already promient so genioplasty isn't a good idea

Luckily for you, your well developed ramus is giving you decent facial definition.

Wow I have a lot to learn, I think I'm gonna have to google most of those terms lol. Interesting what you said about the sublabial fold, I was never aware of this feature but I guess that this explains why I never felt like my chin looks weak from the front even thought it lacks projection from profile. Also what you described sounds like a very evasive surgery. Could you elaborate on what you said about over-erupted lower incisors?

[Optimistic]

I would guess -

Vertical deficiency in the maxilla
Deep bite
Some overjet and mandibular recession
Steepish occlusional plane due to vertical deficiently of the maxilla

Surgically, you'd be looking at bimax - le fort with CCW rotation and a downgraft and BSSO to advance the lower.  It is difficult to fix a skeletal deep bite via orthodontics, extrusion of the molars is not stable in an adult patient.  If your deep bite is being caused by over erupted lower incisors then that can be fixed

IMO you're not a candidate for genio because your chin isn't recessed - your jaw is.  Your sublabial fold is already promient so genioplasty isn't a good idea

Luckily for you, your well developed ramus is giving you decent facial definition.

I'd be surprised if he really needed all that. Nothing he posted seems THAT bad to warrant such invasive surgery.

[needadvancement]

^And also I would probably not be willing to go through that and that's not even counting the costs since insurance wouldn't cover me as I don't have any health problems with this.

I feel like the only thing I can claim is that I feel like I don't have full potential when it comes to breathing. My recessed jaw isn't allowing me to breath as easily and deeply as I could, but only slightly. I could be wrong though.

Also I do have crowding and a crossbite which are making it difficult for me to clean some of my teeth, and my lower front teeth are grinding and pressuring my upper front teeth which I hear can become a problem.
So:
-crowding
-cross bite
-overbite

Man I hate my protruding philtrum. I will adress this to an orthodontist soon.

[Tiny]

-overbite

Man I hate my protruding philtrum. I will address this to an orthodontist soon.

Lip eversion comes with a deep bite.  I have it too but I'm a woman so it doesn't look that bad (from the front at least)

Consult more than one ortho.  Hopefully you don't need surgery but some orthos try to fix stuff with braces that really cannot be fixed

[needadvancement]

Lip eversion comes with a deep bite.  I have it too but I'm a woman so it doesn't look that bad (from the front at least)

Consult more than one ortho.  Hopefully you don't need surgery but some orthos try to fix stuff with braces that really cannot be fixed

I see what you mean. Lets say for example(Just guessing here since I'm not as knowledgable about this as others) I get a palate expander for 4 molars on the top jaw and on 4 teeth on the bottom(they are very crossed, I think you can see on the pictures on my link how much they are turning inward compared to the rest of my teeth) and with that space they push my protrusive front teeth more inward with braces without having to pull teeth? In my head and limited knowledge this seems like an ideal way to make my mouth less protrusive but again I could be way off on the possibilities for a 24 year old male.

http://imgur.com/a/KLd79#0
I snapped some more pictures to show my bite better, I appriciate all the help so far!

[needadvancement]

This week I will have my first visit to an orthodontist. I've been using photoshop lately and when I block out my upperlip/philtrum my chin does not even look recessed, only vertically deficient but I can live with that.

But I've been worrying, is it possible that the upperlip and entire moustache area could be protusive due to excess skin/muscle tissue and not just an issue with teeth and bite? Well, we'll see soon enough I hope.