Chin shortening - revision genio? Arnett/ Gunson Oct 2012

[Antbee]

Some of you might remember I used to post on here a lot - surgery with Arnett in Oct 2012. Double jaw, 3-piece le fort, loads of HA paste to orbital rims, cheek bones and outer mandible angles. Impaction 5.8mm plus both jaws brought forward 2.4mm and genio.

I'm really happy with Arnett's work, but have been in denial a bit about the issue of my lower lip hanging too low - showing loads of my bottom teeth. I tried the stretching exercises, but they haven't really helped. When I'm tired, talking is a real drag and I'm self-conscious. I have chin dimpling (tried botox, it works but still doesn't solve the too-low lip issue) I can't exactly show this in pictures, as it's more something I feel and you can see when I speak.
I've been seeing Dr Gunson about this problem as Dr Arnett is away lecturing so much. 8 months ago Gunson removed my chin hardware to try and free up the chin muscle as sometimes it gets 'tangled' in the hardware. It was indeed tangled up, he said, but the metal removal hasn't helped to bring my lip up or improved the dimpling. Since the hardware removal, my chin is flatter and my lower lip turned in a bit. (I used to always have really full lips). I don't hate that effect as it's subtle, but I'd like to not be self-conscious after all this surgery! I talk with my hand over my mouth (again). I think this issue was caused mostly by my large impaction.
Anyway, Gunson is keen to ensure I feel confident and happy with my results, so we've been discussing a revision genio to shorten my chin. Apparently this is the last option for people whose lower lip hangs low post-op. He says it will be complex as he has to both shorten and narrow my chin to make it work visually and to rotate it and reduce it underneath (he said this, but I didn't fully get what he has in mind).
1. My worries are, with even more shortening to my face, will I look older? Gunson says soft tissue can't be predicted (which I knew), but has anyone had this experience? Can you give me advice? I've already had so much bone chopped out of the length of my face...which leads to aging...
2. ALSO how likely am I to lose more sensation with a revision genio?  I still have numbness in my chin, but I have full feeling in my lower lip - I'm scared of losing that if I do another genio.
----If anyone has had their chin shortened, knows anything concrete about it, has before and afters they can share, I'd be extremely grateful. Thanks

[molestrip]

Anytime anyone asks about the risks of further procedures I tend to wonder whether their case is really that bad. Most people don't understand and appreciate risk well. If you're within the bounds of the normal population at this point, then count your blessings and move on with your life. The risks to your nerves, new aesthetic problems, etc are very real. Long term risks are especially hard to appreciate. Dr Gunson wants a happy customer, let him know that you'll be happy either way and ask him for honest advice about how he thinks you should proceed. He certainly knows.

[funnybones]

Molestrip, I get what you mean after seeing some perfectly fine folks agonizing over their looks. Sometimes it just seems crazy. But I would expect a reasonable person to mull over the cost/benefit situation before jumping into surgery - risk being a major wild card.

Auntbee, I sent you a PM.

[sean89]

Yeah, seems obvious but there's definitely a heightened chance of numbness with a revision.

Will it make you look older? Who knows but you're not happy with it now, so I wouldn't dwell on that aspect too much.

When I had my chin shortened, my lower lip turned in more and didn't hang as low. When you said that you're lower lip felt heavy, this is what happened to me POST surgery, so it may be the effect of trauma or changes to the muscle rather than where the chin is actually positioned. 

[ForeverDet]

Yeah, seems obvious but there's definitely a heightened chance of numbness with a revision.

Will it make you look older? Who knows but you're not happy with it now, so I wouldn't dwell on that aspect too much.

When I had my chin shortened, my lower lip turned in more and didn't hang as low. When you said that you're lower lip felt heavy, this is what happened to me POST surgery, so it may be the effect of trauma or changes to the muscle rather than where the chin is actually positioned.

Hi Sean,

Could you describe how your chin was shortened? Because I have a similar issue to Antbee although I don't plan on getting anything done about it. When I think of chin shortening, I imagine vertical reduction where a segmented portion of the chin is removed so the height is shorter. In that scenario I can't see how it would change the lower lip length/posture relative to the upper tip of the lower teeth. Or by shortening, did the doc segment your chin and slide it forward and/or tilt it upward? Now that I can see would put the lower lip closer to the upper lip as well as cover more lower teeth.

[ForeverDet]

I found this passage in a book about facial feminization surgery for trans women. It popped up when I searched about lengthening the lower lip to cover more bottom teeth.

Obviously this book is not directed at this forum's audience (unless there are trans people here? Welcome! If you're reading this). But I found this quote interesting.

http://tinyurl.com/pct6nku

"I know of no aesthetically pleasing way to vertically lengthen the lower lip."

I also have yet to come across a surgeon who's accomplished this other than it being a by-product of jaw surgery i.e. normalizing the skeletal positions causing the soft tissue to follow. Well I had that done and so did Antbee. The other thing I've seen is when someone's chin pad was not properly re-attached during a genioplasty so it hangs really low but after correction, their lower lip has good posture. This doesn't apply here.

Which is why I'm very interested in knowing what exactly Dr. G has in mind to make the lower lip cover more lower teeth at rest. Perhaps I should contact his office.

[trojans101]

Hi OP,

Do you have images of before and after of your lips?