27M — Lost weight but still have underchin fat. Dentist says mandibular excess, suggests genio (+ rhino if I want). Thoughts?

R4id3nn

R4id3nn

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27 years old. Recently lost a good amount of weight, expected the submental area to tighten up along with the rest but the underchin fat/skin is still there. Started looking into why.

Went to see a dentist for an unrelated reason and she flagged that I have a longer lower jaw relative to the upper jaw (mandibular excess vs maxilla). Bite is functionally fine, no occlusion issues. She said the profile is currently "compensated" by my nose — meaning the nose projection is visually balancing out the jaw discrepancy so it doesn't look like a severe class III from the side.

Her take: the underchin fullness might partly be a soft-tissue consequence of the skeletal setup — a longer/more forward lower jaw stretches the skin envelope differently, so fat and skin pool under the chin instead of sitting tight against a sharper jaw-neck angle, even at lower body fat.

She suggested genioplasty to correct the proportions, and mentioned rhinoplasty as an option too if I want to fully rebalance the profile once the chin is repositioned (since the nose is currently "doing work" to compensate).

Questions for the more experienced guys here:

1. Does this skeletal explanation for underchin fat track with what you've seen — i.e. jaw position affecting submental fullness independent of BF%?
2. If genio alone won't fully clear the fat/skin, has anyone paired it with submental lipo or a neck lift in the same session with good results?
3. For anyone who's done geniorhino together — worth doing simultaneously or staging them?

Attaching profile and front photos. Appreciate any input before I go further into surgical consults.
Thank you in advance
 
Last edited:
Yeah also have 10 degrees strabismus im seeing an orthoptist to fix that and also a ptosis on one eye (will make the procedure).
Have shitty eye area i believe with sunken eyes i might do the fat graft in the future and why not canthoplasty.


I think i need to do something for the lips but idk why will wait genio if you can give advice thank you very much
 
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Not a genio case, your jaw not being wide can definitely be one of the factors why the soft tissue is not being held up.
Might be a stupid question, but your tongue does fit onto your palate right?

I'd say jaw angles or filler and submental lipo.
 
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You are biretruded, genio and Rhino won't suffice, get bimax. You can add genio on top which could help even more but you have to fix the base first
 
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Not a genio case, your jaw not being wide can definitely be one of the factors why the soft tissue is not being held up.
Might be a stupid question, but your tongue does fit onto your palate right?

I'd say jaw angles or filler and submental lipo.
Yes it fits
Anyway i have an appointment with a specialized surgeon
I saw orthodentist with knowledge of this but not expertise
 
You are biretruded, genio and Rhino won't suffice, get bimax. You can add genio on top which could help even more but you have to fix the base first
Orthodentist said only lower jaw was protruding
 
Thanks for all ill ask at next appointment.
But ive been told also to fix my mouth like what exactly should be done ?
Thank you in advance
 
Orthodontist is bluepilled, consult with any decent orthognathic surgeon
Yeah true she was trying at first to make me accept cope
I have appointments with 2 different orthognathic surgeon and ill ask them
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Diagnosis
Orthodentist said my lower jaw is longer/protruding, but that the occlusion compensates for this, and that genioplasty and rhinoplasty are sufficient for aesthetic purposes. Do you confirm this diagnosis, or do you see something else (biretrusion, etc.)?
What are you basing your assessment on—cephalometric radiographs, cephalometry (SNA/SNB/ANB)?
Is the lack of soft tissue support under the chin/neck structural (bone base, jaw width) or is it a soft tissue/fat issue that would respond to submental liposuction or a neck lift?

Options
If the protruding lower jaw and occlusal compensation are confirmed as Éché stated, are genioplasty and rhinoplasty truly sufficient, or should the bone base be addressed first (bimaxillary reshaping)?
If I only perform liposuction and a neck lift without altering the bone, will this be sustainable, or will the structural problem cause the loosening to recur? Actual gain from bimaxillary vs. genioplasty + rhinoplasty in my case — noticeable or marginal difference?

Consistency
Does your opinion differ from orthodentist regarding jaw length/position? If so, why?

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