Had sliding gdnioplasty and mandible contouring feel botched

[mindwitch]

I had vline surgery done. the surgeon did a combination of sliding genioplasty and mandible contouring and now i have a double chin. Im highly upset. Surgeon is offering to reverse the sliding genioplasty after 6 months but im unsure if that will fix things. I have attached my after pic which has me in a purple shirt and the before is the white. Would it be wise for him to reverse it? What could solve this issue any reccomendations?

[Sergio-OMS]

Oh I see why you are upset.I don't think reversing the genioplasty will correct things, honestly.

You should consult in person with the surgeon/s you choose, provide your previous records, medical reports and probably get a spiral CT done (your surgeons will tell you what radiology tests they want).

Maybe you don't need additional bone surgery but other procedures (even non surgical), maybe you do.

[kavan]

It's not clear if you even had a 'sliding genioplasty' done as part of a V line surgery. What's clear about V line surgery in general is that it involves bone removal from the chin and also the rest of the mandible. I don't know what your specific surgery involved.

A sliding genio usually refers to ONE cut to the chin in order to move it in the desired direction. Usually the desired movement is 'forward' advancement to improve the profile and give MORE bone SUPPORT to the SOFT TISSUE.

Sliding genios usually DON'T involve removing bone. Just directional movement isolated to the chin.  V-line contouring surgeries DO involve REMOVING bone. Not only to the chin but also to the rest of the mandible. A a cut is made to the chin, then a middle segment removed from the chin, then the freed chin segments moved inward to close the space left by removing a middle segment. That is followed by removal of segments to the mandible, all of which is what forms the 'V' line to the BONE.

Basically, V line contouring for the chin and mandible to take on the contour of a 'V' involves BONE REMOVAL and subsequent LOSS of soft tissue support. What you are seeing now to loss of soft tissue support.

 I included a DIAGRAM to illustrate. The red arrows indicate the bone segments lost and tossed. The green arrows indicate the remaining bone segments to be moved inward to form the overall V contour. Now once the remaining bone segments are moved inward to close the gap of the segment of chin removed, the new chin formed from that can be moved forward or backwards but that alone doesn't 'reverse' what was done to the chin because it doesn't involve putting back the part of it removed.

It sounds like your surgeon is offering you the option of moving WHAT'S LEFT OF the chin more forward for what ever more bone support would arise from that. Whether or not all your soft tissue would follow the V line made by all the bone reduction to form it would depend on the extent of the bone removal. If the bone reduction was to a LARGE extent, you would probably need a FACE LIFT for the soft tissue to cling along with the contour of the V formation made to the bone structure.

Included with this post is an illustration.

[mindwitch]

It's not clear if you even had a 'sliding genioplasty' done as part of a V line surgery. What's clear about V line surgery in general is that it involves bone removal from the chin and also the rest of the mandible. I don't know what your specific surgery involved.

A sliding genio usually refers to ONE cut to the chin in order to move it in the desired direction. Usually the desired movement is 'forward' advancement to improve the profile and give MORE bone SUPPORT to the SOFT TISSUE.

Sliding genios usually DON'T involve removing bone. Just directional movement isolated to the chin.  V-line contouring surgeries DO involve REMOVING bone. Not only to the chin but also to the rest of the mandible. A a cut is made to the chin, then a middle segment removed from the chin, then the freed chin segments moved inward to close the space left by removing a middle segment. That is followed by removal of segments to the mandible, all of which is what forms the 'V' line to the BONE.

Basically, V line contouring for the chin and mandible to take on the contour of a 'V' involves BONE REMOVAL and subsequent LOSS of soft tissue support. What you are seeing now to loss of soft tissue support.

 I included a DIAGRAM to illustrate. The red arrows indicate the bone segments lost and tossed. The green arrows indicate the remaining bone segments to be moved inward to form the overall V contour. Now once the remaining bone segments are moved inward to close the gap of the segment of chin removed, the new chin formed from that can be moved forward or backwards but that alone doesn't 'reverse' what was done to the chin because it doesn't involve putting back the part of it removed.

It sounds like your surgeon is offering you the option of moving WHAT'S LEFT OF the chin more forward for what ever more bone support would arise from that. Whether or not all your soft tissue would follow the V line made by all the bone reduction to form it would depend on the extent of the bone removal. If the bone reduction was to a LARGE extent, you would probably need a FACE LIFT for the soft tissue to cling along with the contour of the V formation made to the bone structure.

Included with this post is an illustration.

No i had a sliding genioplasty for a fact. My cat scan shows this. He also shaved my jawline aka mandible contoured it.

[kavan]

No i had a sliding genioplasty for a fact. My cat scan shows this. He also shaved my jawline aka mandible contoured it.

Which direction was your sliding genio; forwards or backwards? As I said prior, removal of bone from the rest of the mandible would contribute to loss of soft tissue support.

[InvisalignOnly]

I think you look nice (both before and after, probably even more in the after), I would not worry about the double chin. I am underweight, had double jaw surgery and genioplasty that involved my mandible / chin being moved forward 1cm in total and I still have a double chin even now. Some people just have soft tissue like that. Nobody has ever commented on my double chin, I don't think anybody notices it apart from me. If you are happy with other aspects of the surgery, I don't think you should get it reversed.

[mindwitch]

Which direction was your sliding genio; forwards or backwards? As I said prior, removal of bone from the rest of the mandible would contribute to loss of soft tissue support.

it was forwards. he also removed bone from my jaw which im pretty sure has contributed to my sagging? do you think chin lipo would solve this or is a face lift the only thing?

[kavan]

it was forwards. he also removed bone from my jaw which im pretty sure has contributed to my sagging? do you think chin lipo would solve this or is a face lift the only thing?

Yes. That's what I said prior: Removal of bone from jaw would contribute to sagging.


If ALL he did to the chin itself was advance forwards, then I would not suggest reversing it with genio in opposite direction (backwards). Risk is loss of more soft tissue support.

Also, review the illustration I posted about what they can do in V line surgery to the chin and check your records and scan to see IF he also removed a segment from the chin.

As to lipo 'solving' the under chin problem, fat would not be the only soft tissue that lost support from removal of bone. Lipo would only work for subcutaneous fat (fat directly under the skin). It would not work for loss of muscle support nor for any other types of various tissue found deep below the surface muscles of the under chin area.

Face lift procedures redistribute tissue so they 'cling' better to the bone structure and are sometimes done after these 'V line' surgeries when too much soft tissue support is lost. If on what ever SCAN you have, like if it shows the new bone structure and you like the bone structure from the surgery, a face lift surgeon would be the type to consult with if you wanted your soft tissue to be redistributed to better confirm to the shape of the new bone structure.

[mindwitch]

Yes. That's what I said prior: Removal of bone from jaw would contribute to sagging.


If ALL he did to the chin itself was advance forwards, then I would not suggest reversing it with genio in opposite direction (backwards). Risk is loss of more soft tissue support.

Also, review the illustration I posted about what they can do in V line surgery to the chin and check your records and scan to see IF he also removed a segment from the chin.

As to lipo 'solving' the under chin problem, fat would not be the only soft tissue that lost support from removal of bone. Lipo would only work for subcutaneous fat (fat directly under the skin). It would not work for loss of muscle support nor for any other types of various tissue found deep below the surface muscles of the under chin area.

Face lift procedures redistribute tissue so they 'cling' better to the bone structure and are sometimes done after these 'V line' surgeries when too much soft tissue support is lost. If on what ever SCAN you have, like if it shows the new bone structure and you like the bone structure from the surgery, a face lift surgeon would be the type to consult with if you wanted your soft tissue to be redistributed to better confirm to the shape of the new bone structure.

I have requested medical records a dozen times and been given the run around. My ct scan does not show the sides of my jaw have been removed like in the picture u showed but they definitely were filed down i believe otherwise i wouldn't have lost so much definition. Is it impossible for jaw lipo to do any improvement?

[kavan]

I have requested medical records a dozen times and been given the run around. My ct scan does not show the sides of my jaw have been removed like in the picture u showed but they definitely were filed down i believe otherwise i wouldn't have lost so much definition. Is it impossible for jaw lipo to do any improvement?

As to lipo 'solving' the under chin problem, fat would not be the only soft tissue that lost support from removal of bone. Lipo would only work for subcutaneous fat (fat directly under the skin). It would not work for loss of muscle support nor for any other types of various tissue found deep below the surface muscles of the under chin area.

[mindwitch]

THANKS everyone