Metal Mouth Message Board

Hi all! I'm pretty new here.. 26 y.o. female, have had my braces for just over 2 months now. I have an open bite and mild overjet due to a long mandible, and my lower jaw is retrusive. After a few months of deliberation I have finally accepted that I am going to have double jaw surgery (probably in early 2012)... I wanted to avoid it, but I think that I am a good candidate, and that it has the best chance of giving the functional/aesthetic results I want (other option involved extractions and greater chance of relapse).

My surgeon prepared 2 predictions for me, and placed them each beside my current profile- so cool! Both are with a maxillary impaction of 4mm and a lower advancement of 2mm. In the 2nd one there is also a genio (rotation 6 mm). I can see why he proposed the genio... in the 1st one my jaw is still retrusive... 2mm advancement isn't very much, but I'm guessing it's all they can do for my bite to meet. I'm leaning towards no genio (still a huge improvement), because it just looks more like "me," and it also looks more feminine (not that strong jaws can't look great on women, they often do!). It will be a much more subtle change which I think will be easier to cope with psychologically. It's also one less incision, one less bone cut, and less nerves cut. I know it is the least invasive of the 3 procedures but it still feels smart to minimize these things!

However, I just wanted to get some unbiased opinions- what do you think?

That's great that your surgeon gave you two options and predictions that you can look over and assess away from the office! We have similar cases: I'm due for maxillary impaction of 3-5mm, lower advancement (don't know how much) and probably genio. I say probably because I had to transfer my treatment to a different hospital when I moved house. My original surgeon never mentioned genio, but the new one said that people often opt just to have the jaw surgery, get a 'good' result, then come back later for a genio to get a 'great' result. Is his opinion the genio is so minor compared with the jaw surgery you may as well get the whole lot done at once and know your surgeries are all behind you and you're going to get the best possible result. Like you though I'm worried that altogether it'll be too much of a change in my appearance and won't match the rest of my face.

Are you paying for your treatment? I'm being treated on the NHS so another concern I have is that if I don't get the genio at the same time I'll probably have to go private to have it done later and that'll be a lot of money, which according to some other threads I may need to keep aside for a facelift!! (I'm 33 and apparently skin can go a bit saggy after this op and the older you are the less chance there is that it'll tighten up again.)

Sorry - I've deliberately not answered your question. I think it's for you to decide but personally I think I'll go for the genio because I don't want to go through something this major and in the back of my head be thinking that the result won't be the very best it could be. Either way you're sure to be pleased with the result and you have plenty of time to get lots more opinions.

It does appear on the bottom picture that you are still somewhat deficient in the lower jaw, the one on the top looks a bit unfeminine however (maybe it's the lack of long hair). Maybe these predictions aren't all that accurate tho. I would probably go with the genio, it usually provides a nice balanced finish to a jaw surgery.

I like the look with the genio.

Hi, thanks all for your opinions! I know this is a decision I have to make myself, but it's interesting to hear what others think.

Keeponsmiling, I'm in Canada so most of my surgery is covered, but I do have to pay the surgeon's fees for the work he does outside the hospital. So I hear what you're saying about getting it all done in one shot- it won't cost me any more if I do it now, but it would if I were to do it later. However, I doubt that I would get it done at a later date, I'm doing this mainly to correct functional problems- the change in my appearance should be an added perk, but I'm not the type to get surgery for solely cosmetic reasons. So which ever I choose, I will live with it unless it's absolutely awful.

I don't know how accurate the predictions are, it's probably more of a general idea. They can't really tell how the soft tissue will change and they can't give me a front prediction, so it's a loose prediction of bone movement and how that will change the proportions of my face. I hope the real life result will look better, since my lips will look more natural. I also know the angle of my nose may change, which they did not change in the prediction (too hard to predict). I find the predictions look kind of angry because of the angle of the mouth, which is probably not accurate because of the way my parted lips were just kind of digitally pasted together. In my before photo they told me to clench my teeth but leave my lips loose, so it's kind of an extreme "before."

My chin looks similar to yours and im having genioplasty with my double jaw surgery. From the results I have seen people end up looking really look when they get genioplasty for a recessive chin

I would go with the genio if your surgeon is recommending it. I've heard of others who didn't do it and then later had to deal with additional expenses to do it post-op. I think, right now, you are probably looking at the pictures thinking the after without the genio is still such a drastic change. But I think once you are post-op you will realize it isn't that big of a difference and you will wish you had included the genio. FYI, I went with a genio so perhaps I am biased! Your bite will be perfect either way!

I didn't mention this in my reply, but as you age, you will be glad you have a bit more definition to your jawline.

Update, y'all. I've decided not to go for a genio. Well, 99% sure. I realized that the computer prediction of what I'll look like without the genio doesn't account for the chin bone that I have buried in there somewhere (it comes out when I smile- photo attached as proof!). I feel like the maxillary impaction will allow that to rotate forward some, which the computer doesn't know, because you wouldn't even know that it's there in my unsmiling profile shot. If it falls short, I'm ok with that too- it'll still be an improvement. I'm actually really excited to see what my chin "should" have looked like all along had my jaws grown properly.

Thank you all for your input. I'll definitely be back to post about my results- don't have a date yet but I should soon, it'll be January or February.

goodluck on your journey

Olive, I am in the exact same boat as you. I was on the fence about the genio as my surgeon said if I get it, it would make my profile ideal and would be like "icing on the cake," but he said I would be fine without it and would not have a recessed chin (although probably a bit "flat"). I've decided to hold off for now and if I feel I need it later, I'll get it. You can check out my blog pics at tara-jaws dot blogspot dot com. I cannot view your pics yet because I'm a new member. Do you have a blog?

Best of luck!

Tara
ps. my surgery is 12/17. My pre-op final apt is Monday 12/14 only 3 days prior to surgery. I look forward to following you!

Olive, I can view your photo now - I think you made the right decision to hold off on the genio - you have a cute, feminine chin!

Good luck with surgery!

I look forward to following you!
www.tara-jaws.blogspot.com

Thanks for your input! I actually already saw your blog, on jawsurgeryblog.com. I don't have a blog of my own. Good luck with your surgery and I will definitely be thinking of you and following your recovery.