undecided regarding genioplasty - please advise!

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undecided regarding genioplasty - please advise!

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Started 6 months ago by bracedblogger
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bracedblogger
Member

Hi all, I'm new to the jawsurgeryblog.com site. I'm having double jaw surgery on 12/17 and I am undecided whether to go through with the genioplasty (chin augmentation) at the same time. My surgeon is great and I trust him. He says he thinks I would be happy without it but that having it would be "icing on the cake."

My dilemma is twofold: (1) increased risk factors of permanent numbness and (2) aesthetics. My surgeon says three factors are working against me and the chances of permanent numbness increases (although I have no statistics but do plan to ask): (a) my age - 33 yrs old; (b) the degree of movement of the mandibular advancement (10 mm/1 cm!); and the genioplasty (5-7 mm). He said that the genio is the biggest factor here, although I didn't think to ask why. I have read from others here that doing the genio at the same time as jaw surgery can put extra strain on the nerve and perhaps that's why the risk increases, not really sure. I plan to ask about that as well at my final pre-surgical apt.

I'm very petite and have a small face/head. I worry about it looking too big for my face, so I'm leaning towards not doing the genio with the jaw surgery. With such significant jaw movement, I wonder if it would be best to wait to see how the muscle settles down. However, if I feel like I need it later, I probably won't go through another surgery though because my experience with this surgery is that one is enough. So there is a part of me that wonders if I should just stop being a baby and do what the surgeon suggests.

But to reiterate, he does think I would be happy even without it. My chin will essentially look "flat" and would go down in a straight line vs having any curve to it. What do you guys think? Feel free to check out my blog at: tara-jaws.blogspot.com as I have lots of pics there.

Thanks so much for any advice or feedback you have!

Double jaw surgery on 12/17/11. BSSO mandibular advancement of 10 mm; two-piece le fort 1 with 3 mm impaction and maxilla brought forward 1 mm.

http://www.tara-jaws.blogspot.com

Posted 6 months ago #
April
Member

I had the same concerns before my surgery and took all the time I needed to decide on the genioplasty. What I actually decided to do, though, was let my surgeon decide after the jaws had been moved during surgery. We talked about a sliding genioplasty vs. a silicone implant beforehand. I chose the implant for a couple reasons, the most importnat to me being, an implant can be easily removed (in the clininc, not the OR) if you decide later it's not right for you. Or if I didnt have it done and later decided i would look better with a chin implant, they can do the procedure later in the clinic too. I wasn't keen on the idea if changing my face drastically and I also didn't want to come out looking weird, but my surgeon and the residents agreed I would be happier with the aesthetic results if I went ahead with the genioplasty. In the end, I decided that since they do this surgery twice a week and are experts at achieving harmony in the measurements of a face, that I would let them use their best judgement. They explained that the chin is dealt with last during the procedure, so they could judge everything after my jaw was in its permanent position. They had my implant ordered and ready to go, and after all that they decided during surgery that my profile looked right-on without it. They said that all three if them (surgeon and her 2 residents) discussed it at length, measured and measured again, and then resolved to leave it be. I'm so glad. I totally agree that my chin looks great. I knew that either way, I could reverse my decision later if I was at all unhappy, but now I know I don't need to.
So that's just my experience...like everything else concerning this surgery, everyone's situation is different :) good luck to you!

Posted 6 months ago #
coffeecups
Member

I had a look at your pictures;
From what I can see, you actually have a pretty nice chin. I think after your jaws have been moved around, your chin will come out on it's own and you'll probably be nicely surprised by the results. What your surgeon says is also correct, the added genio may be that extra little 'oomph' for a nicer profile... but there is no way to see until you correct your jaws first. Only your surgeon would be able to make that judgement on the day.

If I were you, I probably wouldn't do genio. The way I see it is, would you rather have surgery after to reverse genio (worst case scenario), or add genio (where you can have a clearer idea of what it'll look like)?

There are two nerves that run down either side of your jaw, parallel to your teeth (but lower down, 'beneath' them.) In lower jaw advancement, the nerve has to be moved to avoid being cut. Then, it is essentially 'stretched' as they advance your jaw. This temporarily 'traumatises' the nerve but since it is not cut, it usually recovers 100% or close to. A sliding genio is basically the same thing, but it is harder to see the nerve as it gets smaller towards the chin.

Good luck and I'm sure you'll make the right choice! You know your jaw best :)

Posted 6 months ago #
Colleen
Member

Sorry, lady! I meant to mention on your site that this was where I first saw your story! I'll be going in for surgery on 12/19 and will keep an eye out for your updates...so excited for you!
My surgery is significantly different...I'll be having upper jaw moved forward and split in the back to widen my bite. I'll also be having genioplasty to reduce my lower chin. Haven't posted any pics or blogged much yet, but have been so informed and encouraged on this site that I have to give back in some way!
~C

Double jaw surgery 12/19/2011: 4mm forward upper with lefort 2piece split, lower back 3mm; possible genioplasty

Posted 6 months ago #
xdianao
Member

I had the same issues as you are having with the genioplasty. I wanted it done, but my surgeon was on the fence about it. So I went into surgery not really knowing if I was going to have one done or not. He ended up not doing it and I'm thankful. After my jaws got moved around, my chin now looks great. I think that if he did a genioplasty, my jawline would have been too strong and less feminine looking.
I think it's best to leave it in your surgeons hands and let him/her decide when they move your jaws.

Posted 6 months ago #
Olive
Member

I am actually faced with the same dilemma... the surgeon offered it because he thinks my chin will still be a bit too "far back" without it. But I think I am actually into keeping a somewhat delicate chin and feeling like I'll still look more like myself, and more feminine, too. I'm also convinced that I have a chin in there somewhere (it shows when I smile, but the bone is pointing "down" rather than out... but like you, it will rotate forward after my double jaw surgery).

I agree with the other posters that you should err on the side of caution ... I feel like so many people just get a genio automatically along with their other jaw surgery procedures, when it's maybe not always necessary. And you're right to realize that there ARE additional risk factors, sure less than the other procedures, but it's not something to be taken lightly. Don't get me wrong, they often look really great, especially in profile, but I just don't think it's the look for me.

Posted 6 months ago #
bracedblogger
Member

To all - thank you for your feedback. I've had time to think about the genioplasty some more and at this point I think I'm going to hold off on it. The main reason being is that I am comfortable going back for a second surgery if I feel like I need it. My surgeon emailed me and said that if I chose to do it later, it would only take 45 minutes, in his office. I know it would be more time off work and slightly more expensive (same base cost but with the added cost of sedation); however, I would rather do that than wake up with a strong chin that I don't like. I've also had the chance browse around at some photos of others on the Before and After forum and I have found a few women who have the "flat" chin after surgery but I think they look beautiful. My surgeon assures me it will not be receded, just more of a straight line down from my lip as opposed to having the soft "S" curve that is ideal in a profile. I'm ok with that for now. I also don't really want to drastically change my appearance so this was also part of my decision process. I look forward to seeing what some of you decide with your own upcoming surgeries! If you want to follow my progress after surgery, check out my blog at tara-jaws.blogspot.com.

Thanks again for your feedback!

Posted 5 months ago #
Olive
Member

That's great that you've come to a decision that you feel comfortable with- that's really the most important thing.

I checked out your blog- you're really pretty and I think you would look great either way.

Like you, I am getting my upper impacted and my lower advanced (5 mm and 2 mm, respectively), and opting out of genio. My surgery's not until late Jan/early Feb (don't even have a date yet but will soon). I will definitely be following your blog. Best of luck!

Posted 5 months ago #
bracedblogger
Member

Hi everyone - I know I wrote that I had come to a decision not to do the genioplasty along with double jaw surgery but now I am second guessing that decision. Ugh...surgery is in 11 days and I just can't make up my mind. I see the Oral Surgeon on Monday and will likely not be able to make the decision until I see him again.

Anyone else out there this undecided??

Posted 5 months ago #
HANKYPANKY
Member

if ur unsure about chin wait after jaw surgery. and why would u want to back out now....

Posted 5 months ago #

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