Another Sliding Genioplasty with Dr Gunson

[SJay]

Okay, so I'm in desperate need of a shave now, but I'm worried I might displace my chin. To those of you who've had a genioplasty or jaw surgery, how long did you have to wait before shaving? Also, if you have any tips or work arounds, I'd be glad to hear them. Thanks!

[needadvancement]

If anything you should have grown a beard to hide the swelling(That's what I'm planning) or does your work require you to be clean shaven? Also how's the pain at this point? I would imagine that's a bigger issue for shaving than displacing your chin.

[SJay]

The pain is absolutely fine. I was in pain when I first woke up from the surgery, but they gave me a little morphine and that seemed to do the trick. I've also been taking tremadol since leaving the hospital and haven't been in any pain since, my chin is just really fat and puffy from the swelling. The swelling seems to keep getting a little worse each day, but they did warn me that it would peak on day 3 or 4, so hopefully things will improve from here on in. I won't be returning to work for another week or so, so that's not a worry, it's just that I'm not a massive fan of beards, at least not on my face. Stubble is fine, but it's way beyond that now.

[SJay]

Okay, so I seriously need a shave and a hair cut (just got off the plane from Santa Barbara), but here are the 2 week post op photos. I know I'm still slightly recessed as I was 9mm off and only opted for a 7mm advancement, but I'm happy enough with it. My lip has also thinned out a bit and I kind of wish I'd also had the paste to smooth out the back of the jaw and remove the genial notches. But Dr Gunson said we can do it at a later date if needed.

[ditterbo]

I see the step-off, I think, but that looks like one of those things no one would notice but yourself (or maybe an SO).  I haven't seen your before but looks like a great result.  Hopefully your lower lip will return in time. Any numbness or tightness? 

Off topic, but is that bridge height more in line with what you thought I should have had?  Personally I feel like my face is so recessed that a 'strong' nose with a dorsum and radix like that would almost leave me where I started.  Your lower face half allows that nose to 'fit in'.   But anyway, don't mean to derail your thread here..

[kjohnt]

Your result looks good and I wouldn't worry about paste for any notches.  I don't see anything.

I will say though that I was thinking another 2-3 mm would have been perfect, and reading that Gunson recommended 9mm and you did 7mm, I would advise anybody else to trust him 100% if having surgery with ihim.  I'd like to have seen 9mm to 10mm in your case.

[SJay]

@ditterbo: I've not really had any numbness, but I know some people can't feel their lower teeth for a short time after... perhaps I got lucky! My lower face still feels a little tight and I have trouble saying 'thanks' (so I'm going with 'thank you' for now), the 's' at the end just comes out at as a 'sh'. Dr Gunson said this will return to normal soon. Regarding the nose, I prefer higher bridges, especially on men, and I wanted a nose which would suit my face as I aged. I think a lower bridge can look good on some younger guys, if they've got other pretty features, but I'm not so sure the look works as we age. Hey, that's just my opinion and I guess we all have different preferences.

[SJay]

@kjohnt: I think another few mm would have improved the profile, but I was scared of ending up with a pointy chin when viewed from the front and a deep mento-labial fold. I just didn't want to chance it, I had a really bad rhino a couple of years ago (which I've had revised now) and I tread a lot more carefully as a result. But sure, Dr Gunson certainly knows what he's doing, he gave me the option and did warn about the possible consequences of a more significant advancement. I can genuinely recommend him to anyone considering a similar surgery.

[Vic]

Did the genio make your chin wider from the front view?

[SJay]

I don't think there's been too much change from the front. Here are some images for comparison.

[Tezcatli]

I don't think there's been too much change from the front. Here are some images for comparison.

You are looking good, but to be honest you already had a good jawline to begin with excluding the chin.

[Vic]

I don't think there's been too much change from the front. Here are some images for comparison.

The genio has given you such a quality result. Nice sharp defined chin and jawline. You said you reduced the height by a couple mm's, but at the moment it looks longer than the before pic, I presume thats the swelling though.

[SJay]

Thanks. In the end, we just did a straight forward 7mm advancement, and yeah I do think my chin now looks a little longer from the front... they usually do if the chin isn't also moved up. Moving the chin up would have apparently caused issues with my lips though.

[needadvancement]

Was this done without having to add bone grafts between the chin bone and empty space?

[SJay]

We didn't use any bone grafts. It was a straight forward horizontal advancement with HA paste to smooth out the step off, and also a little paste to prevent the creation of a deep mento-labial fold. This is something which I was quite concerned about, in fact I even went as far as asking Dr Gunson to give me a flat chin, but he explained it would look unnatural and that the chin should have a subtle S curve to it.