Advanced X-Rays of my face - can someone tell me my problems?

[MrRochester]

My history is that I got braces when I was around 13. The orthodontist recommended jaw surgery plus chin surgery, but my parents declined and instead two upper teeth were removed and I endured a very lengthy braces treatment.

I am 26 and just had these x-rays done because I am contemplating either jaw surgery with sliding genioplasty or just a sliding genioplasty.

Here are my x-rays









This is my profile IRL (Image is too big to post in thread)

http://i.imgur.com/PvQXviL.jpg

Any advice would be appreciated. I'm especially wondering if it's worth it to endure the extra pain and braces to get full-fledged jaw surgery or to just get a chin wing osteotomy. The doctor I saw here in Germany seems to think that a sliding genioplasty won't be sufficient because my maxilla is recessed (but he hadn't seen any x-rays yet and based this opinion on how I bite). Thank you.

[MrRochester]

I don't know why they chose to remove just two upper teeth. I wish they hadn't removed any because then maybe my maxilla wouldn't so recessed.

I've always been confused about my bite. My orthodontist was absolutely obsessed with it, but I never cared. No matter where I bite it feels unnatural. Whether I bite on my molars or further up front, it feels awkward. They usually tell you to bring your back teeth together and that's what they told me for this x-ray. It felt like I was pushing my lower jaw backwards and isn't how I'd normally bite.

[ExtractionsRuinFaces]

I don't know why they chose to remove just two upper teeth. I wish they hadn't removed any because then maybe my maxilla wouldn't so recessed.

I've always been confused about my bite. My orthodontist was absolutely obsessed with it, but I never cared. No matter where I bite it feels unnatural. Whether I bite on my molars or further up front, it feels awkward. They usually tell you to bring your back teeth together and that's what they told me for this x-ray. It felt like I was pushing my lower jaw backwards and isn't how I'd normally bite.

Totally natural. Your jaws arent actually aligned so biting together wont feel natural.

Your maxilla is indeed recessed so your lower jaw is sitting back, it isnt in its "natural" position. Some people that have this (myself included) grind their lower incisors at night. Basically their jaw is trying to push itself forward into the natural position. Do you grind your teeth at all?

[Kristen]

I noticed your wisdom teeth came in on your maxilla.   Do you have your lower wisdom teeth taken out?

[MrRochester]

I noticed your wisdom teeth came in on your maxilla.   Do you have your lower wisdom teeth taken out?

Actually I still have my upper wisdom teeth so they weren't removed from my maxilla. I think I had my bicuspids removed from my upper jaw before braces when I was quite young.

I had my bottom wisdom teeth removed.

I do not grind my teeth at all except when working out. I have chipped the bonding on my front tooth like three times because I invariably grind my teeth/push my lower jaw forward when exerting myself at all. I have seen videos of myself and even when I am just sitting up or sitting down, I will momentarily jut my lower jaw out. I have no clue why I jut my lower jaw out if my upper jaw is recessed, but I have observed it so I know it's true.

[MrRochester]

Here is my actual face in case it is helpful for giving me suggestions as to whether you think jaw surgery + sliding genioplasty or just sliding genioplasty alone is better.

http://imgur.com/a/Z0ri1

I took all three of these just right now. I took the first two without flash and the last one was from a distance, but I had to take with flash because it doesn't show up well when you don't use flash from a distance. Anyway, they should give you some idea how I look in the flesh.

I know I'm not handsome, but I am just seeking more expert opinions on what level of cosmetic improvement you think I can have from my various options. I'm very eager to look better, but at the same time, I don't want to undergo a very invasive, expensive, and risky procedure if I am likely to only enjoy minimal improvement.

[Kristen]

I don't see any reason that you need to take out upper wisdoms.   Amazing how you had room for them to come in.   Shows that upper bicuspids had room as they take up even less space than wisdoms.
Anyway,  agreed you do look good.  If you step into any surgeons office though they will recommend jaw surgery to rotate jaws and move forward.
Do you have any pics of your bite from front and side?
In the hands of an expert a genio would probably aesthetically balance out your lower face.
How are you functionally as far as breathing , etc.?

[MrRochester]

I don't see any reason that you need to take out upper wisdoms.   Amazing how you had room for them to come in.   Shows that upper bicuspids had room as they take up even less space than wisdoms.
Anyway,  agreed you do look good.  If you step into any surgeons office though they will recommend jaw surgery to rotate jaws and move forward.
Do you have any pics of your bite from front and side?
In the hands of an expert a genio would probably aesthetically balance out your lower face.
How are you functionally as far as breathing , etc.?

I saw a doctor here in Berlin and yes, he advised that I have full jaw surgery plus genioplasty (he performs chin wing osteotomy so it's a special type of sliding genioplasty). He said that if I want to "really look good" this is what  should do and will offer maximal improvement.

Functionally I don't think I have many issues, certainly nothing that impairs my quality of life to a degree that jaw surgery would make any sense whatsoever. I might be a mouthbreather, but I try to pay attention to this and keep my mouth shut. If I were to have surgery, though, it would be solely for aesthetic reasons.

[Kristen]

Are you happy for the most part?    If so, leave everything alone.   Jaw surgery is a long road.
Definitely wouldn't do it in your case if no real functional issues.  Just my opinion.

[MrRochester]

I am unhappy with my appearance. I don't really have any functional issues so this is purely cosmetic. I think you are right that jaw surgery is too extreme for my situation.

What is your opinion on sliding genioplasty?

[Kristen]

What exactly don't you like about your appearance?

[MrRochester]

What exactly don't you like about your appearance?

I personally have no problems with my appearance except some minor skin ones. I personally don't care about my chin position, but I posted on another messageboard and they told me that I have "no lower third" and that my chin is seriously deficient.

I won't do jaw surgery I don't think. I was only really considering it because the surgeon himself said that this would offer the greatest cosmetic improvement.

I think I will stick to just getting a chin wing osteotomy, a type of sliding genioplasty performed in Europe. I just want to be better looking and I don't want to limit my romantic and professional options in life (looks are hugely important in both these realms) when I have the possibility to correct them.

Does anyone here have an opinion on whether I would stand to benefit from a chin wing osteotomy? I'm thinking I would, but I am very afraid of looking worse afterwards and having a chin like Jay Leno.

[Sharptoys]

http://puahate.com/showthread.php?p=2186172

[MrRochester]

http://puahate.com/showthread.php?p=2186172

Yes, this is the other forum I was referencing.

[x]

http://puahate.com/showthread.php?p=2186172

LanzaIsMyHero

lmao seems like a valuable addition to this place