Author Topic: Regret double jaw surgery and genie for open bite and retrognathia  (Read 19152 times)

jusken

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #30 on: March 12, 2018, 08:24:15 PM »
Are you implying your tissue loss came from the jaw surgery, jusken?

Nope 100% genetic for me.  I've always had a hyper metabolism and became very gaunt in my early 20's onward.  But I did get some bone loss after all the surgery/adult braces if that's what you're referring to.  Seems very common.

ditterbo

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #31 on: March 13, 2018, 07:44:02 AM »
Nope 100% genetic for me.  I've always had a hyper metabolism and became very gaunt in my early 20's onward.  But I did get some bone loss after all the surgery/adult braces if that's what you're referring to.  Seems very common.

Just curious, though I was referring to the tissue loss since I haven't heard of that post op.  Neither have I heard about bone loss post op - I've heard of adult braces hurting the teeth roots and interdental papilla. What bone loss is this you've experienced or that you say is common?  Thanks.

jusken

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #32 on: March 13, 2018, 07:53:00 PM »
Just curious, though I was referring to the tissue loss since I haven't heard of that post op.  Neither have I heard about bone loss post op - I've heard of adult braces hurting the teeth roots and interdental papilla. What bone loss is this you've experienced or that you say is common?  Thanks.

Different people definitely have different outcomes with adult braces.  Some don't experience much if any bone loss.

My black triangles are certainly related to tooth bone loss due to trauma/movement, which leads to alveolar crest bone loss, which leads to black triangles - gum recession.  There have been enough reports of this on here and online that I find it conclusive.

april

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #33 on: March 13, 2018, 08:33:30 PM »
Nope 100% genetic for me.  I've always had a hyper metabolism and became very gaunt in my early 20's onward.  But I did get some bone loss after all the surgery/adult braces if that's what you're referring to.  Seems very common.


I noticed gauntness on one side of my face after braces as a late teen. Not sure how to explain it as I have an identical twin who didn't experience this after the same orthodontics.
 

jusken

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #34 on: March 13, 2018, 10:21:17 PM »

I noticed gauntness on one side of my face after braces as a late teen. Not sure how to explain it as I have an identical twin who didn't experience this after the same orthodontics.

I'm not sure the why that would happen for you, but I too have an identical twin and we had completely different orthodontic cases in our teens.  He had a very wide arch with only a couple years of braces.  I had 8+ years of braces, very open bite, extractions, and a narrow arch.

Anyway, hopefully we haven't gotten too off track in this thread.

some1afterall

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #35 on: March 14, 2018, 09:42:52 PM »
Wow-that’s very interesting. So you softened facial lines and basically gave me a virtual eyelid surgery: the result is I look much younger, more youthful.

I’m weary of undergoing more major surgery. I have a large, prominent nose and post-djs wider base + more nostril show but rhinoplasties have such varied satisfaction rates I just don’t think it’s worth it.

I consult with Jamali tomorrow and Gunson I’m April, but mostly for information. I have come out if djs with a closed bite, no numbness and intermittent, pain in my left tmj that I feel is bearable. I don’t want to have more regrets and possible disability.

Thank you everyone for your input.

Puts things in perspective to hear that other people had less than perfect outcomes and maybe things didn’t turn out all that badly.



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jusken

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #36 on: March 15, 2018, 12:03:12 PM »
That's smart that you're wary of additional surgeries.  I want to reiterate that I'm NOT recommending any additional surgeries to you.  I'm just trying to show you the problem.

The paintover shows a 'simulation' of what it'd look like if you had more soft tissue all over your face in all the right areas.  Your facial gauntness is very similar to mine.  The current solutions out there for correcting this are risky procedures that won't fully address this and cost you a small fortune.  You're likely to get a lumpy or distorted look, especially since (like me) you have a thin face and any irregularities would be more obvious.

Right now you look fine, and some day we'll hopefully have an ideal solution for solving these kinds of issues.  Doctors are very confident and you want a solution - but I'm warning you that it's currently VERY risky.

kavan

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #37 on: March 15, 2018, 02:30:02 PM »
Good for you for wanting to keep focus within the scope of this board which is basically bone cuts to the jaw area. Other cosmetic procedures can be entertained at a later time.


Now back to the focus on the CHIN. Your present photo seems to show some dimpling to the chin which often is an indicator of some strain to the chin muscles when closing the mouth. I would attribute that to the same thing you state as your ISSUE which is a poorly done genioplasty.

In your case, from what you said prior, the genio was NOT done DURING the maxfax surgery but rather at a later time. Since genios are part and parcel of the whole 'balance' of a maxfax surgery (when they are needed), SOMEONE (no pun intended about your screen name) made a poor choice not to plan it into the surgery but rather to have it at a later time. That's because they are part of the balance of the bi-max and need to be planned in DURING the same surgery.

A properly planned genio, especially for someone with Vertical Maxillary Excess (VME) or what can be called 'horsey' or 'long face' involves sliding the chin forward along a DIAGONAL cut.

A 'Forward' slide along a diagonal cut yields both a horizontal advancement and a vertical shortening. The vertical shortening is due to the chin segment being slid in UPWARD direction.

I think your dissatisfaction CAN be isolated to the CHIN and you should be seeking out someone who can do an ISOLATED REVISION genio. The rest of your bimax surgery is acceptable and THAT part doesn't need a do-over.

Any other cosmetic issues are not ones maxfax/bimax, chin genios correct and can be entertained and/or pursued later down the line.


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girl

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #38 on: March 15, 2018, 03:33:50 PM »
That's smart that you're wary of additional surgeries.  I want to reiterate that I'm NOT recommending any additional surgeries to you.  I'm just trying to show you the problem.

The paintover shows a 'simulation' of what it'd look like if you had more soft tissue all over your face in all the right areas.  Your facial gauntness is very similar to mine.  The current solutions out there for correcting this are risky procedures that won't fully address this and cost you a small fortune.  You're likely to get a lumpy or distorted look, especially since (like me) you have a thin face and any irregularities would be more obvious.

Right now you look fine, and some day we'll hopefully have an ideal solution for solving these kinds of issues.  Doctors are very confident and you want a solution - but I'm warning you that it's currently VERY risky.

Nope. She looks perfectly normal and does not need more all over her face. Very minor amounts in selected areas, I would say, which makes her no different to most people. And that can effectively be achieved with temp fillers. IMO, it's not very helpful to put forward that view before saying "nothing to be done about it".

As for the genio. I can't see your x-rays - did you have the diagonally cut genio mentioned by Kavan, or was a different type of cut used?

If it was the latter, I suspect revision options might be limited, unless it can be re-cut diagonally?

some1afterall

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #39 on: March 15, 2018, 04:42:52 PM »
I believe it was a straight forward horizontal movement, 4mm plate... maybe slightly diagonal?

The proposal I’ve received for a revision would be a T-shape osteotomy which both shortens vertically and tapers the chin, these surgical methods were developed in Asian countries and are now employed often in female feminization surgeries...I’ve read some studies that show high levels of patient satisfaction and low levels of complications.

jusken

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #40 on: March 15, 2018, 04:49:15 PM »
Nope. She looks perfectly normal and does not need more all over her face. Very minor amounts in selected areas, I would say, which makes her no different to most people. And that can effectively be achieved with temp fillers. IMO, it's not very helpful to put forward that view before saying "nothing to be done about it".

As for the genio. I can't see your x-rays - did you have the diagonally cut genio mentioned by Kavan, or was a different type of cut used?

If it was the latter, I suspect revision options might be limited, unless it can be re-cut diagonally?

Well sounds like I'm digging a deeper hole with my opinions on this board.  I think she looks good, perfectly normal, and doesn't need anything tbh.  I made this clear I felt like.  Still, 'good' is a relative sentiment. Many will still look for problems or be more critical of themselves, especially after a change like jaw surgery.

To have the mentality that there HAS to be a solution now I think is a mistake many people on this board are prone to.  I have done a massive amount of research on soft tissue fillers of all kinds, and I wouldn't recommend them to anyone who is very critical of themselves.  It is risky regardless of the permanence of the procedure.  If you study aging and volume loss, you will understand that a targeted approach to fillers is flawed.  Many people end up looking slightly unnatural and regret it over time.

I do think an ideal solution to soft tissue regeneration is on the horizon - so to say that my stance is: 'nothing to be done about it' also isn't totally accurate.  Anyway, not trying to be overly aggressive, I honestly just want to get the information I've learned out there so people don't do things they'd regret!

some1afterall

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kavan

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #42 on: March 15, 2018, 05:36:59 PM »
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236372/

1: The X ray does not show the type of genio with an UPWARD slide to the chin; the type that would make it look shorter in frontal but still give 'horizontal' profile projection.

2: The type of 'V' line genio proposed to you is for ASIAN with WIDE chins. Your lower face is already very NARROW. So narrow the chin more and it's going to look more narrow to you.

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kavan

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #43 on: March 15, 2018, 05:48:00 PM »
Well sounds like I'm digging a deeper hole with my opinions on this board.  I think she looks good, perfectly normal, and doesn't need anything tbh.  I made this clear I felt like.  Still, 'good' is a relative sentiment. Many will still look for problems or be more critical of themselves, especially after a change like jaw surgery.

To have the mentality that there HAS to be a solution now I think is a mistake many people on this board are prone to.  I have done a massive amount of research on soft tissue fillers of all kinds, and I wouldn't recommend them to anyone who is very critical of themselves.  It is risky regardless of the permanence of the procedure.  If you study aging and volume loss, you will understand that a targeted approach to fillers is flawed.  Many people end up looking slightly unnatural and regret it over time.

I do think an ideal solution to soft tissue regeneration is on the horizon - so to say that my stance is: 'nothing to be done about it' also isn't totally accurate.  Anyway, not trying to be overly aggressive, I honestly just want to get the information I've learned out there so people don't do things they'd regret!

I fail to see the reason to morph soft tissue filling on her face when:

1: This is a JAW SURGERY board.
2: It's pretty clear she is bothered mostly by her CHIN.
3: You're very much against soft tissue fillers.

It's like saying: 'Here, I've found all your flaws and fixed them in the morph by filling in the gauntness but there really isn't any reliable solution of even trying to fix those  areas with soft tissue fillers because they distort and leave the face lumpy.'
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jusken

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Re: Regret double jaw surgery and genie for open bite and retrognathia
« Reply #44 on: March 15, 2018, 05:58:01 PM »
I fail to see the reason to morph soft tissue filling on her face when:

1: This is a JAW SURGERY board.
2: It's pretty clear she is bothered mostly by her CHIN.
3: You're very much against soft tissue fillers.

It's like saying: 'Here, I've found all your flaws and fixed them in the morph but filling in the gauntness but there really isn't any reliable solution of even trying to fix those  areas.'

I see your points, and I did consider this a risk before doing the morph.  To show someone an 'ideal' outcome that isn't currently attainable is frustrating.  But, look at the flip side:  to understand the problem is also to not make the mistake of looking for problems where there aren't any (or are minimal).  This was my goal here and I can see why there'd be a bit of backlash.  I am disheartened by people who undergo surgeries that were unnecessary.

This is a jaw surgery forum, and I have gotten jaw surgery and been through all that.  I am noticing a pattern between the OP's case and my own, where I started looking into additional procedures that would help - and almost went through with it.  In retrospect, I think I made the right choice.  I am trying to pass on that knowledge.

I think, despite the frustration, it's worth it to communicate this...  I do apologize if you don't see it this way.