Sliding Genioplasty... I got one.

[anonymouth]

Hello board.

I'm post op 3 weeks and 1 day since I got a sliding genioplasty. Before getting it, I consulted several different message boards, this one included. I found that they were useful for knowing what to expect, and how it can vary. I thought I would share my personal experience as well, in case there's any other people out there who are interested in getting the procedure done.

First of all, I've always had a receded chin and a gummy smile. If I'm smiling really widely it's very obvious. I have no issues with my bite, and not even any desperate need for braces. I have some slight crookedness in some lower teeth, but nothing major that would necessitate braces. Other than for some aesthetic concerns, I've been pretty lucky.

Back in 2007, a dentist made me aware that I could get orthognathic surgery in order to correct the protrusion that creates my gummy smile. I was mad about the suggestion, but looked into it anyways. I ended up consulting several oral surgeons, orthodontists and dentists. I asked if there were any health concerns that would necessitate going through maxillofacial surgery, but none were found. At some point, it was suggested that removing 4 premolars and wearing braces to retract my teeth, would be enough to correct the gummy smile. But even after some reviews from several orthodontists, they concluded that full maxillofacial surgery would be better. However, it would just be for aesthetic reasons and not medical ones. The procedure would entail removing premolars anyways, a Le Fort, and a BSSO. There was also the suggestion that I could camouflage the protrusion with a sliding genioplasty and gum recontouring. Being that that was cheaper and less traumatic, I decided go for it. My receded chin has been a concern for a very long time.

I consulted two oral surgeons in San Diego. Dr. Robert Gramins, who I was told is very talented. However, he was expensive just for a first time consult. I did end up paying for x-rays and the consult regardless. (If it had been easier and cheaper to go back to him, I think I would have done it.) I also went to Dr Joel Berger, who didn't charge for my first consult and x-rays (I think he does this for plastic surgery patients, but I'm not 100% sure). He had a lot of qualifications, so he seemed like a safe choice. Although I will say that he's very practical. Unless you know *exactly* what you want, I would recommend going to him. But be prepared with more opinions from several other surgeons.

The surgery itself was an easy enough experience. It took place in his office building, so I didn't have to worry about hospital fees. I woke up without any nausea or dizziness, just soreness and some dull pain in my chin area. Once at home, I basically went back to sleep, had a smoothie (with a protein boost) and slept. The next 3-5 days were like that. I took pain medication, ate liquid or soft foods, and slept. The pain wasn't really a big deal. It was uncomfortable, but not anything I couldn't deal with.

Right out from surgery, I did feel that my lower teeth were numb and tight. I had some swelling as well, but the doctor said it wasn't as bad as in most patients. It went down to almost "normal" in about a week. I slept with several pillows the entire first week, even though I usually don't sleep facing up. Once I felt I had no more need for pain meds, sleeping was a pain an a half. I still felt a tad sore at night, and I had to take some tylenol. I know I was "numb" in that general area, but I didn't realize how much. The only numbness left is still on my teeth, and on a spot right and center on my lower lip. It feels like it's getting better because it tingles, and it even "tugs" from time to time. The hardest thing I had to deal with was biting. Since my lower muscles are being stretched out, they were really tight. I've been doing some slow movements just to get them to "loosen up" and start feeling more normal. I've been using heat on the area just about everyday. It's feels good, and it relieves any stress and soreness.

I've read that some people freak out at their new appearance. I had that experience as well. Once the surgical tape that was covering my chin was removed, I felt that my chin was too long. It's just one of those anatomical things you don't expect out of your body. Because it was receded, my chin always felt smaller. Once it was brought forward, it made it's natural length more apparent. If I had known of this, I would have had it vertically shortened by 1-2 millimeters. The doctor seems really happy with the result though. I don't have a lot of swelling at this point, so it's more or less close to it's intended result. Or it just appears that way... While it bothers me to some degree, I'm waiting several months until I'm sure it's fully healed. Maybe it's also a matter of getting used to it. But I do very much prefer it to the way it was before. I used to look mopey and sad. It was *really* apparent when I was tired. And thankfully people who know me didn't really realize I had something drastic done. I have discussed it with some friends, simply because I like being open about myself. So far, no one has said anything negative. At least to my face!

This I *was* wondering though... I asked my doctor if we could shorten my chin by burring the bone. But he said that, "That doesn't work." He would instead "go in there" and have the sliding genioplasty redone. Not really something I want to consider right now. I've tried looking for more information online regarding bone burring/shaving, but there's not a lot published that doesn't require paying for a medical journal.

Anyhoo, I'll update this thread if any news or questions arise. Or forgot to mention something.

[ReoSity]

Re-doing a genio will increase your chances of numbness and possibly other complications so keep that in mind. That said having a vertical reduction genioplasty isn't usually a problem, the doctor just removes the section of your chin bone. There's no need for bone shaving I don't think.

[anonymouth]

I've heard about someone getting chin ptosis after an SG reversal.

I thought about bone burring because I've heard that asian plastic surgeons do it, to create more delicate-looking faces. It sounds "simpler" to me than a re-do of a sliding genioplasty. That is, resecting the bone, taking a bit off of the top of the section, and reattaching in to the original spot with the plates. Having the bone heal in place again. Instead, I wondered if just burring the tip a millimeter off or so would do the job. I really don't know if the risks are the same or what other issues that entails. That, or I'm getting the details entirely wrong. Please educate me, if that is the case.

I was also wondering about this... Since I have a gummy smile, I did feel that it "climbed" slightly. Me smile seems like it kinda tightened. I've heard other people complain about this after their SG. It *was* a risk I decided to take. My doctor says that the SG has no connection to my smiling muscles, and that I'm just more aware of it. It might be all in my head? I'm giving it time to heal and see if it looks and feels the same as before. Not any better, but just the same. Down the road I am planning having my gum line contoured. I'm still going to show some gum, but that's okay for me.

[anonymouth]

It's now the 1 month mark from the surgery, and my chin is healing nicely. I've noticed small amounts of swelling go away in pictures I've taken of myself. It's still feels tight (although obviously less than after the surgery) and my lower lip and teeth are still numb. I few days ago I felt an instance of small shooting pain in between my lower teeth. I don't know what that means, I just hope it's about regaining sensation. I've had very little patience for it these past few days.

As for how happy I am with the results of the surgery, I am about 60-70% happy, if that makes any sense. I am *thrilled* that the feature (or "pocket") that was caused by the mentalis strain on my chin is gone. I do still wish I would've worked towards a more rounded face and less longer chin. If anyone has ever seen Charlotte Gainsbourg, I feel I approximate her "look." While I think she's really lovely, it's not exactly what I had in mind. But I can still live with it, if everything looks and feels great at the end of my healing. I was a bit disappointed that family members found it "noticeable." I was really looking for a subtle change.

This did lead me to think that it's really important to communicate fully with your surgeon about what you want. I think my surgeon did a wonderful job, but I could have been more verbal, brought more pictures and been more straightforward instead of deferring to his plan. If anyone is interested in getting a sliding genioplasty, and are looking for a specific aesthetic look, don't assume the doctor knows what you want!!! Or that he *knows* what will look better on you! This is not a haircut! Bring pictures of people (family members, friends, models, etc). Bring good and bad pictures of yourself and so you can point out what you like and don't like. Also use photoshop to approximate what results you want on yourself and bring to your surgeon. While I read somewhere that digital simulations are mostly "caricature", having the simulation helps to approximate what you want in your head, and helps the doctor see what you want and tell you if it's achievable. If the surgeon is willing to work with you and do the best to give you the results you want, you'll probably know you're with the right person.

Also remember that just because they fix your profile, it doesn't mean it'll look good at every angle. I look good from the front and profile, but at the 3/4 angle my chin looks really prominent. If I look down, my lower cheeks sink a bit and my chin looks sorta u-shaped. This might change with the coming months, but it's just to illustrate the fact that just because the profile is great doesn't mean the rest of your face will look fine as well.

[angelstrings]

I consulted with Dr. Relle recently for sliding genioplasty. I didn't bring in any pictures but hearing you say that makes me wish I did! I just didn't think there was anything that could be done to alter the shape of the chin. I did ask him if it would make my chin look wider and he said no. He said to do that you'd have to split the chin and insert a wedge (or something like that). Anyway, I can't conceptualize what the frontal view is going to be like after surgery. I saw that the profile is going to look great, but I just can't picture the front.

I asked him if he thought it'd make my face appear more narrow, and he said because we are advancing it only 4-6mm, it should not have any impact on the frontal view. He also adds in grafting material and makes the cut in the bone so as to avoid hourglass deformity.

So, is there any way to even come close to "seeing" what the front of my face is going to look like after SG?

[anonymouth]

I would like to know if you can get a frontal view for a genioplasty as well! I never asked, and I wish I had. And I had that nagging question in my head, but I didn't think I needed to bother. Heck, it'd be awesome if you could rotate your head and see what slight changes would look like. But maybe this is technology that hasn't been developed.

It's hard to say if the appearance of your face would change a lot since everyone's anatomy is unique. You would have to look at your own bone structure and imagine what bringing that forward would do. Before my SG, my face had an "apparent" round look to it. Once the SG was done, it was really obvious that the isolated shape of my chin is like a very wide "U". And because my chin was receded, my chin appeared vertically shorter in most angles. It has also changed my facial expressions. When you smile, your mouth climbs up and the chin sticks out. And at least on me, a 7mm advance appears more substantial! So that's several things to keep in mind... I just don't think that looking at a profile modification is enough to predict a good overall outcome.

As for changing the shape of the chin, etc... There are different chin bone cuts a surgeon can do depending on the effect the patient wants. The cut on my chin was horizontal and brought forward, but I've seen genioplasties where the cut is an angle and moved slightly upwards. I think it's pretty cool that there are all sorts of possibilities. But I don't know if it's all within the realm of an oral surgeon or a plastic surgeon.

http://www.ijps.org/article.asp?issn=09 ... =Deshpande

I've also seen that in Asia they do a genioplasty for pointier chins. The surgeon cuts the chin horizontally, takes a section off the middle, then puts it back together with plates and screws.

http://nangmui.vn/news/331d/v-line-facial-surgery.html

While vertically shortening the chin, my understanding is that they take the desired millimeters off the top of the bone section, which doesn't change the shape of the tip. Asian plastic surgeons, burr and shave the jaw bone to create "softer" looking faces, which is much more popular there. Male-to-female feminization surgery also involves some interesting plastic surgery procedures.

[CaliforniaKid]

So that's several things to keep in mind... I just don't think that looking at a profile modification is enough to predict a good overall outcome.

qft

[Love2enhance]

I came across your post bc I was googling SG recovery. I had mine done 5 days ago. Your post was very informative & helpful. However, I had to join this forum to post a comment on the passage you wrote. I feel the urge to comment because I really want you to feel better about yourself. First of all, I disagree with you about redoing your chin..site unseen. I think if you have it shortened you'll really regret it. You should really give it more time to heal and get used to the new you. Have you thought about getting a rhinoplasty? It's probably your nose that's causing your chin to look disproportionate to the rest of your face. I had a rhinoplasty for the first time 20 years ago & it made my chin look weaker. I had issues w the silicone implant in my nose so I had to get it removed. I have always considered a chin augmentation after my first Rhinoplasty bc I knew I needed just a little more definition to my jawline. I only wanted 2 cm longer in the tip of my chin. Anyway, I had a revision rhinoplasty done 5 days ago & I had my chin moved forward & refined w a little rib cartilage. I had my bandages removed yesterday (5 days post op) and I'm extremely happy with the results but I have to admit that I had the opposite reaction to my new chin as compared to to your reaction to your new chin. I wished for my chin to be a little longer...like 2 cm longer. I had my chin enlongated by 4cm & it protrudes a little more than before...the chin is supposed to be aligned w how far your mouth & lips protrudes pass the middle face to achieve perfect balance & harmony on the face. If I didn't augment my nose I would've have noticed a bigger change in my chin. That said, I think my chin was so small to begin with and my new nose is bigger I should've gone w 1-2cm longer. The change in my chin is sooo subtle it's almost not worth doing. All that pain, time & money for such a little change...Anyway, I really think you're just over whelmed w the new change in your chin so you're fixated on it every time you look at yourself. I will bet that if you do a survey by showing random strangers your before & after photos they would say that the person in the after photo looks better. A strong chin is considered more beautiful & assertive nowadays. A weak chin makes a person seem timid. You gotta give yourself a break and don't pick yourself apart too much. I bet Charlotte Gainsburge got a chin augmentation & she wasn't as attractive before her chin augmentation. Anyway, I would say that your new long chin gives you more character than a less pronounced chin. I recommend braces too. I'm getting braces after I fully recover. Teeth makes a huge difference in your smile. Braces will help line up everything in your lower face perfectly. I also recommend lip augmentation for a perfect balance to your new chin. Once your lips get bigger the chin will automatically look much smaller. I naturally have huge lips but my upper lip is much bigger than my lower lip. The lower lip is suppose to be much bigger than the upper lip to achieve harmony on the face. So 2 weeks before I got my SG & Rhinoplasty revision...I had Restalyn injected into my lower lip. This made my weak chin almost disappear and I noticed the unattractive extra skin under my chin. So that was when I knew I had to get a SG. I really believe that you'll look super sexy w a rhinoplasty (just to fine tune things) and lip augmentation you'll then be very happy with your new look.

Another point I wanted to make is I think bringing in photos of celebrities or people you want to look like is a huge mistake. First of all you can't look like other people and why would you want to look like someone other than yourself? Almost any plastic surgeon would agree that it's creepy & crazy to bring in photos of other people you want to look like. Plastic surgeons aren't Gods they can only work with your natural anatomy so what can be achieved is limited. It's unrealistic to creat a chin for you that looks like someone else's chin because the rest of your face is different. It's like putting BMW wheels on a Mercedies. I can't come up with a better analogy. Maybe I can explain it better this way..I'm an Asian woman so naturally my nostrils flare out a little. That's not really considered beautiful in our modern society but I can only reduce the size of my nostrils so much until it looks likes Caucasian nose. The Caucasian nose is very narrow & very beautiful and very cute BUT I don't want a Caucasian nose because it wouldn't look right on me. A Caucasian nose would look too pinched on me. The face has to be looked at as a whole. Megan fox had a cute nose..she had a rhinoplasty. Angelina Jolie has a perfect nose..she had a rhinoplasty & a chin augmentation. Every person is beautiful in their own unique way and everyone can use a little fine tuning especially with aging. It's life...nobody is perfect. A pretty woman can go from looking pretty to looking gorgeous with plastic surgery. Ugly can't go to gorgeous it's not realistic. Average can be made to gorgeous though. Look at Reese Witherspoon's chin. You have to admit she has a huge chin BUT she is beautiful & super cute w that chin! It's natural too but it looks fake bc it's huge but she wears it well! Lol. That chin gives her character & made her career. She wouldn't be as distinguished without that chin...so please...love your new chin. You'll get used to it after a year when the final results are really there. I think once all the swelling goes down especially in my nose and face then my chin will look my pronounced so I'll be happier with it.

What I'm trying to say is you gotta love the features you were born with first, and then it's ok to enhance it. Cosmetic surgery is to enhance not to completely change. If you want a complete change then your face will look too over worked and fake. I do think plastic surgeons do know what looks best because they're well experienced and they understand how to achieve perfect harmony in the face because that's what they were trained to do. I know your picky & critical so it all boils down to simple mathematics to achieve perfect harmony & balance in the face and every plastic surgeon has been trained in this. You can google it & really find out how to do the calculations on your own face. I'm telling you this because I really think it's not your new chin that's causing you to be dissatisfied with your new look. It's like painting a house. The house looks better with new windows, a new garage door & fnew front door at the same time. A house ages & needs a facelift too. The result of aging is what causes the face to be off balance & unattractive. SG or chin implant helps restore youth to the face. Therefore, don't have regretsabout you SG. Think about what I wrote. You'll be more at peace & in a happier place if you understand my perspective. You're too critical of yourself. Charlotte Gainsburge is a lovely woman and I'm sure you're not of equal looks compared to her bc no two people on earth looks the same unless they're same gender identical twins. Anyway, it's not healthy to want to look like someone else other than yourself and it's self destructive to try to look like someone else. That's a brutal way to go through life. Stop worrying about your chin. It's going to be fine. Be Youtiful!

[chevyblack0171]

Why would an orthodontic assistant grind the biting edges of front teeth before orthodontic treatment started. I feel like I lost a substantial amount of tooth length from this and also dental arch width from the braces treatment. Here is a before photo


And here is the after