Author Topic: Genioplasty revision - things to know?  (Read 1320 times)

Vincent999

  • Newbie
  • *
  • Posts: 27
  • Karma: 2
Genioplasty revision - things to know?
« on: November 03, 2020, 03:10:22 AM »
Had my double jaw a little over 7 weeks ago. Escaped somewhat unscathed from upper and lower jaw, lip doesn't protrude unnaturally too much, likely should have been impacted 1-2mm but not worth a full revision. My genio was done poorly from an aesthetic (the only?) point of view. It is clear at this stage my chin is far too long for my face, particularly one side as there is asymmetry from the poor planning too. Measures nearly 50mm. 

I'm looking for general advice on the best way to approach a revision. Will need a new surgeon of course. I know in my head the movements that should be performed.

GJ

  • Administrator
  • Hero Member
  • *****
  • Posts: 1493
  • Karma: 215
Re: Genioplasty revision - things to know?
« Reply #1 on: November 03, 2020, 07:44:45 AM »
If you're revising the chin only this should be easy. Just consult with surgeons about the chin...?
Millimeters are miles on the face.

Sergio-OMS

  • Oral and Maxillofacial Surgeon
  • Newbie
  • *
  • Posts: 37
  • Karma: 22
  • Gender: Male
  • I am just trying to help
    • Clinica Gonzalez y Campos
Re: Genioplasty revision - things to know?
« Reply #2 on: November 03, 2020, 12:32:01 PM »
Had my double jaw a little over 7 weeks ago. Escaped somewhat unscathed from upper and lower jaw, lip doesn't protrude unnaturally too much, likely should have been impacted 1-2mm but not worth a full revision. My genio was done poorly from an aesthetic (the only?) point of view. It is clear at this stage my chin is far too long for my face, particularly one side as there is asymmetry from the poor planning too. Measures nearly 50mm. 

I'm looking for general advice on the best way to approach a revision. Will need a new surgeon of course. I know in my head the movements that should be performed.


Best way, in my opinion: guided surgery (operate the CT and get titanium custom cutting guides and custom osteosynthesis plates)

Lani

  • Private
  • Newbie
  • *****
  • Posts: 9
  • Karma: 4
Re: Genioplasty revision - things to know?
« Reply #3 on: November 16, 2020, 01:05:29 AM »
I'm gonna chime in as I'm going through the same thing, only I am going from genio to another genio+double jaw.

It sounds like you might be unsure, as the first surgery wasn't up to par, and want a way to "vet" a surgeon to ensure a better outcome the 2nd time around?

At 7 weeks, there is still alot of swelling. I thought my genio was more "botched" than it really was due to the swelling. The good news is that your bone won't have grown over the plates and screws and a surgeon won't have to dig through them/cut the screws out, which many won't do. You can start to look for surgeons now, and set up appointments in a few months time so that by then, your swelling will have abated more but the bone has not yet grew over the plates/screws.

things to ask: (how I would approach it)
--ask how they "re-drape" the muscle during the revision after the chin has been moved for the 2nd time. There is a technique to this and many won't do it correctly. Sense it out if they feel confident in their techniques to do so or if they have fake charisma/confidence or hesitate. This will show experience and confidence in genio revisions. After the first genio, your muscle will be re draped and after a revision, it will have to be done again as well. It gets harder to do each time due to various factors like scar tissue, etc.
--Ask hypothetically if you were to come to them with a double jaw/genio from five years ago and bone had grown over the plates/screws, how they would approach it. The ones with experience will say they will cut through the bone and dig the plate out. The more conservative docs will say they would hold back in that case.
--don't tell them what movement you want, first tell them generally it's too long, etc and see what they say and what rough measurements they might use. see how much it aligns with your thoughts to see their asesthetics and see how much rationale is behind those movements.

I recommend a doctor that has alot of personal experience and can tell aesthetics and asymmetry from feel, or somebody that uses extensive computer guided pre planning (not just the super simple software). Since most docs don't use the latter, your best bet with somebody with the former.

Also, This is a personal preference of mine, but I try to go for surgeons that are not extremely big boned as I fear they won't be as gentle/smooth. I also have small bones, so take it for what it's worth.

In a revision genio, the skin and muscles will already be stretched. If the genio were to be moved back, then there may be sagging. This area of soft tissue is independent of the area that is stretched during a double jaw. Ask them about your concern for this and see what their reaction is.


Vincent999

  • Newbie
  • *
  • Posts: 27
  • Karma: 2
Re: Genioplasty revision - things to know?
« Reply #4 on: November 16, 2020, 06:11:20 AM »
Well I won't be proceeding with a revision after waiting a while longer for swelling to dissipate. It appears substantial swelling has been resolved (seemingly overnight) after lingering for well over 2 months. The swelling made my chin look too long for my face but that is not the case anymore and I was foolish to think residual swelling wasn't responsible. The slight asymmetry I do have is not worth a revision.