Plastic surgeon vs Maxillofacial Surgeon

[peskywabbit]

About 12 years ago, I had lower jaw surgery. I should have had the double jaw surgery, to correct the maxillary cant, but it wasn't done. The doctor, Dr Felice O'Ryan, also moved my chin forward about 3 mm, which looks masculine and crooked and I hate it. I am a girl. This genioplasty also accentuated the maxillary cant which is small but now more noticeable.

To have the maxillary cant fixed I'd either have to have upper jaw surgery, which seems excessive, or try some experimental orthodontics with TAD anchors which will take about a year and a half and cost about $8,000. I would also elect to have the genioplasty reduced for a cost of about $5000 after the cant was corrected. This might make my face look more symmetrical for a total cost of $13,000 and a year and a half commitment.

OR: I could just recede my chin 3mm and level it accordingly to my cant so it looks like it goes with the natural curve flow of my face at a cost of only $5000 and have it done within a matter of weeks.

I'm thinking I would just get my chin reduced without addressing the cant. The orthodontics are experimental, time consuming and expensive. So my main question to the archwired community is now this:

Should I seek a maxillofacial surgeon or a plastic surgeon to perform this chin reduction? At this point I'm more concerned about aesthetics, but I also want someone who's skilled with function as well.

Dr Joel Berger in San Diego said he could perform the chin reduction and not to worry about the cant. He said he's performed many chin reductions. Dr Robert Relle in Los Angeles, said my suggestion of correcting the cant first might be a good idea, but he's only done one chin reduction to correct a genioplasty before. They are both excellent maxillofacial surgeons.

I hear Dr Gunson is great but he's all the way up in San Luis Obispo and my life is too crazy with little kids and responsibilities to be going too far out of my way and to spend at least $500 just for a consultation.

Does anyone know any good plastic surgeons in the So Cal area. I know there's a lot here, but finding a great one is still difficult.

Would love your opinions.

[Marisama]

Dr. Gunson is in Santa Barbara, not San Louis Obispo

[Summertimeolive]

I would recommend skimping on a corrective jaw/genioplasty surgery. Trust me on this.

Id recommend you consult with a few surgeons and then select one that you feel understands your case best and deliver the results you want.
Plastic surgery really isnt in the same domain as jaw surgery which is focused on bone and jaw alignment/health.

I have heard good things about Dr.Schendel, Dr.Relle, Dr. Gunson & Arnett and Im sure there are more but look into it!

Good luck

[bracedfaced]

Hmmmm....

Okay so I had surgery a year ago. I was very symmetric pre-op. Plan was to impact my upper jaw, advance my lower. I woke up and my entire jaw, top and bottom, where tilted on an angle. WTF, right!?

In any case, that left me with a cant I never had pre-op, and a tilted jaw/chin. I assume quite similar to what you are dealing with...

My ortho is using TADs on me right now to fix the cant... I have to say that they work QUICK! My top teeth levelled out in a week. We'll probably wait a full month though.

That being said, I am not completely optimistic. We tried TADs before and they fell out before we could raise my lower arch to meet with the top (close the open bite caused by the lifting of the upper teeth). We'll see how this plays out.

Of course even if the TADs work, my jaw/chin is still crooked. I will likely wait a while post-braces to see how much this concerns me before seeking a fix.

Good luck to you. Sounds like our situations are very similar.