Hi I’ve lurked the forums for a few years now. I’m an early 30s male who’s still trying to figure out his options. I’d like to know what the knowledgeable amateurs here see in my pics (link at bottom)
A bit of background: I’ve had serious oral health problems since early childhood until my early teens. I suffered from serious periodontal disease and had several teeth extracted. My first attempts at self-improvement of my face and smile was at 17, when I requested braces in my desperation.
Nov 2009 – dental braces
April 2012—consulted dental surgeon for crown lengthening
May 2012—braces come off
July 2012—interest in chin augmentation
early 2013—first consultation for chin augmentation w implants with plastic surgeon
early 2014—crown lengthening done
mid 2014—tried injectible fillers to augment chin
2013—2017 tried injectible fillers to “even up” crooked smile
2016—consulted Barry Eppley for sliding genioplasty
I don't have more authoritative records with me at the moment. My orthodontist said I had a significant overbite. I don't believe there was ever any mention of orthognathic surgery. The two plastic surgeons I've met remarked on my very small facial bones. I've contacted real maxfacs in my area and so far nobody willing to operate on a healthy patient.
Since 2019 I’ve realized that much of my face is recessed and this is not limited to my chin. That brought me here. Though I’m of East Asian descent, our average regional phenotypes involve stronger facial features than the stereotypical Manchu-Korean type look. My parents and grandparents on both sides had relatively strong features and forward facial growth. Remarkably none of my siblings have as strong features, and I’m the weakest of the bunch.
I've been paying more attention to the upper half of my face, which I believe is the most important for aesthetics, but as I understand it, surgical work in this area comes with the most risks. I think in an ideally safe world, I'd go for a modified LF3 under an experienced surgeon (I suppose we all would).
IMGUR:
https://imgur.com/a/h0nBYqG I've been leaning towards maxillomandibular advancement for years now, but two major concerns of mine are the feasibility of this movement given my tooth position relative to the tip of my chin (seems most people who get jaw advancement done have a relatively normal chin; it's just retruded). The other concern is what my malar/infraorbital area would end up looking like. As you can see, my eyes are almost bulging, especially when I squint [pic 2]. There's such a serious lack of support and I'm wondering whether my orbits, like the rest of my face, are smaller than they should be to hold my eye in, if that makes sense. This article (
https://www.joms.org/article/S0278-2391(17)31419-2/pdf)I read a few years ago seems to suggest there can be some subjective improvement in malar appearance after just a LF1, but I have a feeling that I'm not in the camp that can get away with this. There is the frequent suggestion of implants to correct this, but I've been against them for years now.
There is also a curious little asymmetry going on with my nasolabial folds [5] and eyebrows and I'm wondering whether it's a cheekbone asymmetry causing this or the orbits, or some interaction I'm not understanding. Left side of my face is noticeably better looking than the right, where my soft tissues seem to uniformly balloon across that whole side [4].
