surgeon for revision jaw and nose, help needed! photos added

[Raya]

dear members,

Here are some photos of the situation. I would like to hear what you think about the situation.
https://imgur.com/a/d5tAaXq
this is the situation before the v line and rhinoplasty.
https://imgur.com/a/rotDWTJ
This is after. I don't understand how it is possible that my chin is so crooked and the one on the scan is not. I have a feeling that the scan isn't mine. the doctor doesn't want to give me another scan either.

https://imgur.com/a/VRCiN7D

as you can see my lip position is out of balance.

https://imgur.com/a/FlaNK4l

this is Dr Defranq's simulation.
Thank you for thinking along. I've fallen into a deep depression and hate the day I ever got into it.

[GJ]

When you say your lip position is out of balance, what exactly do you mean?

I do think it's your scan. I can see the step off in the chin, and it's showing in the flesh.

I would think a revision genio could maybe (a) reattach the mentalis higher to show less lower tooth at rest and (b) fix the step off by better centering the chin and/or using graphing material like bone or HA.

This would probably be the least invasive way to deal with the issues, if I'm understanding your issues correctly. I'm not sure I am.

[Tomasjohn]

I am confused. The pictures in this link https://imgur.com/a/rotDWTJ show the before AND after scan with the bottom picture being the after v-line??

If this is the case: In the bottom picture you can clearly see that volume is missing on the left side of the chin (compared to the other side), which in turn causes the slant.

Personally I don't think the lip lineup is the problem. Temporarily you could try to balance out the volume deficiency on the left chin side with filler.

I uploaded a pic for clarification: https://imgur.com/a/okIIoFO

[kavan]

Sorry to say but your presentation; how you organize information is a poor one and would require excess time just to unravel the haphazard presentation.

I suggest the following as it applies to a better presentation:

1: Make CLEAR which image is the before and after.

2: Don't expect any advice on your NOSE based on a scull scan that does NOT show the nose.

All I can determine here is that you don't like what you see in the MIRROR subsequent to 2 bone cutting surgeries. However no one here can see what you see (and don't like) in the mirror based on bone scans. (Because no full face frontals or profiles are given).


On a side note IMGUR, at least for me, CUTS off visibility to some of the links.

[Tomasjohn]

How to upload pictures in french:

https://fr.wikihow.com/t%C3%A9l%C3%A9charger-des-images-sur-Imgur

As kavan said

[kavan]

How to upload pictures in french:

https://fr.wikihow.com/t%C3%A9l%C3%A9charger-des-images-sur-Imgur

As kavan said

IMGUR actually doesn't work for me anymore. For some reason, it makes the photos disappear (for me) and/or just shows a grey screen void of photos. Sometimes, it will let me see one photo link. Other photo links not. So, when people elect to put their photos on multiple imgur links instead of all photos on one imgur link, chances get LOWER for my seeing all their photos.

[Raya]

This is before any surgery
https://imgur.com/a/07elQHS

This is after with genioplasty
https://imgur.com/a/g0ivBg3

This is after v line, rhinoplasty
https://imgur.com/a/N0ZT8xO

I hope it's okay this way. I WoW like to know if a downgraft of the upper jaw and a cw setback will improve.

[Tomasjohn]

I still stand with my original statement, especially if we consider the scan in the previous post. It seems that more bone was shaved on one side and that's why the chin looks crooked. The chin is actually fine, it is the side of the chin that is the problem.

[Tomasjohn]

IMGUR actually doesn't work for me anymore. For some reason, it makes the photos disappear (for me) and/or just shows a grey screen void of photos. Sometimes, it will let me see one photo link. Other photo links not. So, when people elect to put their photos on multiple imgur links instead of all photos on one imgur link, chances get LOWER for my seeing all their photos.

Hmm, maybe you could try a different browser?

[kavan]

Hmm, maybe you could try a different browser?

TBH, I stick to the browser I'm using and easier to look at photos uploaded on this site.

[GJ]

I still stand with my original statement, especially if we consider the scan in the previous post. It seems that more bone was shaved on one side and that's why the chin looks crooked. The chin is actually fine, it is the side of the chin that is the problem.

Yes, this is what I said in the first post: I can see the step off in the chin, and it's showing in the flesh.

It's very clear on the side of the chin.

It looks like either the face/chin was elongated or the mentalis wasn't attached correctly because there's excess lower tooth show in the after photos. Though, the prior photo is a smile, which is totally different, making comparisons impossible.

[kavan]

I am confused. The pictures in this link https://imgur.com/a/rotDWTJ show the before AND after scan with the bottom picture being the after v-line??

If this is the case: In the bottom picture you can clearly see that volume is missing on the left side of the chin (compared to the other side), which in turn causes the slant.

Personally I don't think the lip lineup is the problem. Temporarily you could try to balance out the volume deficiency on the left chin side with filler.

I uploaded a pic for clarification: https://imgur.com/a/okIIoFO

Your observation of soft tissue having somewhat of a dip where there is a dip to the bone is a CORRECT one.

What I can offer so far to this thread is what a 'V line' procedure is and what it really isn't. It looks to to me that the OP may have had somewhat of a V line to begin with and may have requested the chin to be made shorter. Although there are no bone scans of before any surgery, the 'before' presentation where you see the step offs flanking the chin, is consistent with the chin being made shorter (via a horizontal segment cut from the central chin). So, the 'V line' stated here that the OP ostensibly had was most likely a restoration of the chin that was prior shortened (setting it down lower). That's consistent with the step offs flanking the 'before' scan being blended in more with the after. (Refer to the illustrations to see what happens with different types of cuts.)

Since the presentation/communication from the OP is hard to follow, when that is the case, it is not uncommon for miscommunication to transpire during requests for changes.

I will also add that the OP didn't relay anything about a zygomatic osteo which is seen in the after and although I could not 'capture' the before soft tissue photos (presented later), I'm a loss to explain why the skin color was DARK in one of the soft tissue shots (could not 'capture' it on IMGUR) but very LIGHT in the close up of the chin.

Included here is an illustration, with some explanations of what I observed based on the illustrations and photos. That's all that can be offered given the OP's presentation.

[Tomasjohn]

What I can offer so far to this thread is what a 'V line' procedure is and what it really isn't. It looks to to me that the OP may have had somewhat of a V line to begin with and may have requested the chin to be made shorter. Although there are no bone scans of before any surgery, the 'before' presentation where you see the step offs flanking the chin, is consistent with the chin being made shorter (via a horizontal segment cut from the central chin). So, the 'V line' stated here that the OP ostensibly had was most likely a restoration of the chin that was prior shortened (setting it down lower). That's consistent with the step offs flanking the 'before' scan being blended in more with the after. (Refer to the illustrations to see what happens with different types of cuts.)

Ok very useful presentation of how bone cutting and shaving can be used together in these v-line procedures. Thanks! Again, learned something new.

Also I think for OP the blue statement at the end is important!

Raya, check the statement in blue by kavan in the picture.
.... It would not call for another bone cutting surgery.

[Raya]

thank you for thinking along. sorry for the bad presentation. I'm not very good at it.
it's also chaos in my head because so much has happened. I don't have the last scan yet because the doctor claims that everything went well. She won't explain to me what happened.

I did indeed have a djs with a genioplasty. they had placed the chin back crookedly and  hadn't taken the sides of the jaw which made me feel this. as seen in this scan and Photo.

https://imgur.com/a/d5tAaXq

https://imgur.com/a/g0ivBg3

I then went to Dr defranq for a consultation. He wanted a downgraft upper jaw and a cw setback lower jaw to return to my old face as best as possible. I had then visited a doctor in the Netherlands. she could do the same, she said with a v line (that's what she called it). so apparently she has removed too much of the side of the jaw, so that why my chin is crooked.

as you van see in the picture my lower jaw is too far forward, like a male lower jaw. now I am looking for a doctor who can do the downgraft upper jaw and setback lower jaw for me as Dr Defranq said.If you look at my scan you think it is feasible.



Thanks!

[Raya]

https://imgur.com/a/XesRfaN

The simulation from Dr Defranq