Metal Mouth Message Board

Hi everyone,

I had a small chin implant years ago. 3 weeks ago, I had Lefort 1 and BSSO (8.4mm advancement) to correct my overbit and overjet. Now I'm still abit swelling, mainly protruding upper lip.

Attached are photos of my 3 week post-op profile, which I still feel like a "before" photo of other patients. My chin is still weak, short and recessed. The chin implant looks very weird especially when I smile. I know I should wait for more days to get a more clear picture of how I look because I'm still swelling. However, I'm not satisfied with my result and feel very concerned. I just can't take this off my mind!

My surgeron did not offer sliding-genioplasty as an option to go together with my double jaw surgery, because he said my chin impant looks good and the advancement of the lower jaw would be sufficient. The simulated post-op photo looks good. So I chose to only go with double jaw surgery without genio.

Right after the surgery, I looked at the mirror and felt the advancement was not enough. My bite is perfect after the surgery. Functiona wise, the problem is corrected. However, aesthetically I feel it's not enough. Now, I'm thinking taking out the chin implant and get sliding-genioplasty to get a stronger and longer chin with a more natural look.

Here are some of my questions:

1. Do I need to AND is that possible to take out an implant and get a sliding-genioplasty? (I saw other people've done this)
2. How long should I wait to get genio after double jaw surgery?
3. How's the recovery feel of genio comparing with the double jaw surgery?

Thank you guys for any opinions on this!

Image: https://imgur.com/a/uSXHD

I can't really answer your questions at the end but I do want to say that 1) at 3 weeks, you are still a lot more swollen than you and think, which often makes the chin look smaller than it is; and 2) I looked at your photos and I think your chin looks really nice. It looks balanced with your face and also feminine. Maybe in your mind you were expecting more and so the reality doesn't quit fit your expectations, but I think it looks great.

As far as recovery from sliding genio vs jaw surgery, there aren't many people on the board who had sliding genio without jaw surgery. As someone who had sliding genio, I can tell you that it often leads to some nerve damage. Personally, my chin area has felt tight ever since the surgery, but I almost never think about it anymore. Also, the front of my chin (below my lips) never quite went back to normal, the sensation there is reduced.

Hi Guys, I have some updates here:

I visited my surgeron this morning. He said I can get SG for a better profile and more natural look. I asked him why we did not have the SG and bimax done together. He said he might not have a good eye, because for the bimax we had so many things need to be done. It's better to do it now because he can have a better image when the jaw bones are settled.

He said he took the impant out when doing the bimax, and the implant was actually quite big. It covers all the chin area and even bigger than that. He is not sure whether the SG would give me a better look (probably yes), because he usually only does no more than 6 mm advancement for SG. He mentioned anything more than 6mm might cause some depressions on the jaw line (anywhere between the chin and jaw). Is this common?

My surgeon(Dr. Relle) is highly rated. The bimax went very well, which made my recovery quite smooth. So I think I'd trust him on this, but still wondering should I get a second opinion? He is very experienced but as read here, he is a bit conservative. He does as less as possible to gurantee the function but does not put too much attench on the aesthetics.

As to the timeline, he said we will decide when to have SG after 2 weeks (maybe 2 months from there). We'll also decide the SG plan by then. The main concern is how much my mouth can open to get the breathing stuff go through for the general anesthesia. He asked me to practice more mouth opening from now on.

He also mentioned the recovery of SG should be much easier and less painful than the bimax.

[quote="jaime"]I can't really answer your questions at the end but I do want to say that 1) at 3 weeks, you are still a lot more swollen than you and think, which often makes the chin look smaller than it is; and 2) I looked at your photos and I think your chin looks really nice. It looks balanced with your face and also feminine. Maybe in your mind you were expecting more and so the reality doesn't quit fit your expectations, but I think it looks great.

As far as recovery from sliding genio vs jaw surgery, there aren't many people on the board who had sliding genio without jaw surgery. As someone who had sliding genio, I can tell you that it often leads to some nerve damage. Personally, my chin area has felt tight ever since the surgery, but I almost never think about it anymore. Also, the front of my chin (below my lips) never quite went back to normal, the sensation there is reduced.[/quote]

Thank you Jaime! I do understand the recoevry isn't over. I might look better after the swelling goes away. I'll wait to see how it will turn out after 2 months.

My chin is still short and recessed comparing to the other parts of my face. Also, the implant does not look very natural. These are the main reasons I want to get SG.

Could you share more details about your SG recovery? My surgeon mentioned that there might be 2 depressions on each side of the jaw line (near the chin part). He said the biggest movement he can go for SG is 6mm. For my case, it would be even smaller. Does this sound normal?

Thanks!

overbiteme wrote:Could you share more details about your SG recovery? My surgeon mentioned that there might be 2 depressions on each side of the jaw line (near the chin part). He said the biggest movement he can go for SG is 6mm. For my case, it would be even smaller. Does this sound normal?

Thanks!

Yes, a max of 6mm sounds pretty normal to me. I know they combined my BSSO and SG for a total 1cm forward movement of my chin. However, I agree with Jaime. It looks pretty good already, but it appears that your midface and upper lip are very swollen. I suspect that when that swelling finally goes down it will look even better. Note that you will not notice the swelling disappearing because it takes many months, perhaps up to a year. Your profile appears to be pretty closely aligned to what's considered ideal for females, save for the midface swelling. Your chin appears to be in the right place. Honestly, I wouldn't do the SG if I were you. I think an SG would give you too prominent of a chin, which is generally considered a masculine feature.