Do I need genio? [pics inside]

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#1 Post by **suetemi** » Sun Aug 31, 2008 11:05 am

delete

#2 Post by **Kerry** » Sun Aug 31, 2008 11:40 am

hiya

your never going to see the tru result but jutting your jaw forward because thats just going to move other parts of your face, we all try to do this to get an idea but you only really get a fraction of what your chin will look like along with the rest of your face.

have you seen your ortho ? he be the best person to tell you what surgery you need. x

#3 Post by **chipmunkcheeks** » Sun Aug 31, 2008 12:03 pm

for me it was apparent that i would need a genio. i looked like you in pic 1. not only did i need a genio, i had the excess bone from my upper jaw and donor bone used to bring my chin out where it needed to go. i would tell the surgeon that if they are in there and you need it to give yourself the proper profile (lip-lip-chin in a straight line to give the right aesthetic) then they should do it. it doesnt increase your recovery time or anything, as you are having so much other done. i had upper, lower, and genio and the chin didnt affect my recovery besides having to be more careful with the chin area than any other area on my face. its been almost 8 weeks and i am very glad that they did a bone graft with the genio- i wouldnt have been happy otherwise.

#4 Post by **Emaciated** » Sun Aug 31, 2008 2:13 pm

I paid for the genio ahead of time out-of-pocket and told the surgeon and a friend of mine (also doing the surgery) to judge on the spot whether they thought I needed the genio once they moved my jaws into place. I ended up needing one in their opinion and I'm glad they did it, but you could ask about the possibility of them deciding after they move your jaws and get a look at your profile. In my case I would've been out of the $2500 either way but it was worth it to me. I didn't want them to do one if I looked good without it just because I had paid for it.

#5 Post by **suetemi** » Sun Aug 31, 2008 5:18 pm

Thanks for the replies. Suddenly I'm not so scared or overwhelmed at the prospect of possibly having genio. Don't ask me why I was before..I guess it seemed like bimax was already complicated enough and to add another procedure to that felt like too much to deal with.

chipmunk cheeks, I can't wait to join you in the Former Chinless Wonders club. I do trust my surgeon's judgement very much so I will tell him to make the best decision for me once he's in there.

Karl -- good idea. Maybe before surgery I'll put down some kind of deposit for a genio and tell my surgeon that if he decides on the spot that I need one, I'll pay the rest afterward.

Meryaten -- When I had records taken, my surgeon did show me some quick digital processing, with and without genio. The former looked funny to me because it gave me a Quintin Tarantino chin, which seems exaggerated for my face...I think they need to work on those programs when it comes to chins ! However, my surgeon pointed out that it was just a preliminary step to get an idea of what procedures to send to the insurance co. for approval, and that I'd be back in for another round of impressions/x-rays/digital pics, etc. after being braced for a while. Hopefully those will be more accurate next time around.
And thanks for the compliment! I have low self-esteem so it means a lot. I think I will look much better too. Notice how in the first pic I look angry or gloomy? Well, far from the truth! People mistake me as being down or angry even when I'm pretty happy, because my jaws make me look that way. Can't wait for the day I no longer have that problem.

#6 Post by **OzzysMom** » Sun Aug 31, 2008 5:25 pm

Suetemi,
I totally understand what you meant when you said people mistake you for looking gloomy or angry when in fact, you aren't.
That has happened to me all my life and I've even been accused of giving people dirty looks when nothing could have been farther from the truth!
As a result, I feel I have to smile all the time. Can't wait for the day when I can just have my mouth in a relaxed position and appear "normal."

I also agree you are going to have amazing results!
Best Wishes

#7 Post by **fromjersey** » Mon Sep 01, 2008 7:56 am

Suetemi and OzzysMom: Me too. I was always being accused of frowning or being angry. Or people would ask me "Are you OK"? When I was very young, my mother would admonish me to "Smile!". Then I would smile and it would be mostly gums. If only for this reason, to fix that horrible situation, surgery is worth it!
Helen

#8 Post by **fromjersey** » Mon Sep 01, 2008 8:24 am

Also, people - genioplasty is not simply cosmetic. Just because insurance companies say it is, that does not make it so. It can eliminate sleep apnea and is a known procedure for this. -- See Sleep and Breathing, Vol. 7, number 4, 2003--"Improvement of Facial Appearance and Nocturnal Breathing with Geniotomy(Sliding Genioplasty): Report of Two Cases" by Manolis J. Papagrigorakis, D.D.S., M.Sc and others. This is an 8-page journal article with a list of 15 references. My sleep apnea is gone.

The tongue is pulled forward along with the bone and this opens up the airway. Also it can reduce or eliminate lip incompetence. And an open mouth is more than a cosmetic problem. Our gums and throat are affected, irritated by an open mouth. Dried out tissues, even dental decay is implicated. Those are not merely cosmetic. I think our surgeons need to hit these insurance companies with some medical facts.
Helen

#9 Post by **fromjersey** » Mon Sep 01, 2008 1:57 pm

Meryaten: Is there any way to get to these insurance companies to educate them? Does some new group need to be formed, in this world of ten million groups, to attempt this?
Helen

#10 Post by **Andantae** » Mon Sep 01, 2008 8:17 pm

suetemi~

Having a more defined jawline was one of the things I was most looking forward to post op. Can't wait for you to see yours!

My OS's standard practice for patients who may need genio in addition to orthognathic surgery is to have the patient bring in a check for the full amount at the last records appointment. The check is held and not deposited until post op if the genio was done. If not, they send the check back.

They did not, in fact, do a genio on me and I'm glad they didn't as it would have been too much. I think it is great that they can move your jaws into their new positions first and then decide what looks best. I'm with Meryaten; if I were to take a guess, I would say that last bit of movement via a genioplasty will end up giving you a little better profile.

#11 Post by **suetemi** » Mon Sep 01, 2008 8:35 pm

Andantae wrote:I think it is great that they can move your jaws into their new positions first and then decide what looks best. I'm with Meryaten; if I were to take a guess, I would say that last bit of movement via a genioplasty will end up giving you a little better profile.

Thanks for the advice. I'm curious how the surgeon can tell whether or not someone needs genio after moving the jaws, especially if it's a fine line between needing one and not needing one. Isn't there some swelling that occurs after those hours of surgery that might make it harder to make a judgment? Is it really just a matter of "eyeballing" it? That's kind of worrisome to me, despite trusting my surgeon, because what if his idea of ideal facials proportions is a little different than mine? Ack, I'm just worrying too much.

Well so far the scale is tipping more toward genio. Hey, whatever it takes to get the face I was meant to have, right?

#12 Post by **Andantae** » Mon Sep 01, 2008 9:26 pm

I had some of those very same thoughts! I think the steroids they give you keep most of the swelling at bay during surgery, so they can get a pretty good idea of what they are looking at.

Is it really just a matter of "eyeballing" it? That's kind of worrisome to me, despite trusting my surgeon, because what if his idea of ideal facials proportions is a little different than mine?

On the other hand, what if your surgeon stuck strictly to his pre-determined measurements instead of 'eyeballing' it in the operating room? I would rather have a surgeon with a trained eye and well versed in facial balance and aesthectics willing to 'eyeball' the last mm to decide what looks best rather one who just stuck to his pre-op formula!

Do ask him about it at your next appointment, though, suetemi and have him explain to you how he will make the determination. My OS said that if it was close enough that it could go either way that he would err on the side of caution and not do another procedure for a minimal benefit.

Hey, whatever it takes to get the face I was meant to have, right?

I have always looked at it that way, too!

#13 Post by **Graceful58** » Wed Sep 03, 2008 1:20 pm

My OS also is suggesting a genio for me but it would be to reduce my chin because he said that typically people like myself who need a lower jaw advancement don't have a chin...but I do and once they move my jaw foward he feels it would be too much of a chin.

So, I like my chin and my plan is to keep my chin looking the way it is by reshaping it to that look once they move my jaw foward. Those are my plans...LOL...let's see what they're plans are though.

#14 Post by **jmrut22** » Thu Sep 04, 2008 9:47 am

Your profile is alot like mine (well before my BSSO) I had an open bite and retrognathic mandible.

He decided against the genioplasty during surgery. It was just too close to call. So he told me beforehand while he was doing the lower jaw if he liked the chin where it was he would keep it. If not he would do genio. I totally trusted him. He decided against it and told me when I woke up it would have been too strong a chin. I was in shock. I was so sure he would have done it. Im glad he didnt. At first I couldnt really tell but now that all the swelling went down he was right.

I have posted some pics here lately do a search under my name.

#15 Post by **cersepn** » Fri Sep 05, 2008 5:49 am

Haha, i'm so glad someone else thought of the same thing - how does the surgeon see what's the ideal facial profile when there's all the swelling. It's kinda strange cos i don't see many people here worrying about that.

Regarding the surgeon's opinion of the ideal facial profile, it's all measured. There's a golden ratio, a facial profile to say what profile's ideal, so when people look at your face, they feel it looks good. Of course you read of cases in archwired where people are not happy with their post op results.. sometimes it's the surgeon, but a good many of these cases are due to the patient not liking their new, 'ideal' face.
To be honest, a huge % of gd looking people have excellent profiles and facial proportion.. i know i see so many people on the streets with a receding chin and think to myself 'hey that girl could look so good if she didn't have all that lip strain and a good balanced chin'