hansmoleman
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Hi, I have consulted two orthofacial surgeons, and they gave contradictory advice. For context, this is my starting situation:
- Perfect bite.
- Small chin.
- Small jaw.
- Bad gonial angle, bad jawline.
- Technically not exactly recessed, although could definitely benefit from advancement (jaw aligned with lips, but recessed wrt nose tip).
- No sleep apnea.
Surgeon 1:
- Offers two options: bimax and genio + custom jaw implants (peek).
- Says he doesn't do chin implants because the probability of re-absorption is not negligible (as opposed to in the case of jaw implants, he says in that case it's virtually impossible).
- Bimax it's more expensive, more invasive, would require 6 months of orthodontics after the surgery (not before because my bite is already fine).
- He advises bimax because he believes it's better in the very long term.
- He also offers genio + custom jaw implants (peek) because he believes it's also a good option. He refuses doing chin implants due to re-absorption risk.
Surgeon 2:
- Offers two options: genio + custom jaw implants (peek) and custom chin and jaw implants (peek).
- Says bimax is not advisable at all in my case and refuses doing it, because:
* Perfect bite.
* Not recessed.
* Functionally not needed (no sleep apnea).
* Aesthetically would worsen by aspect: he says a bimax would give me a monkey-like aspect, with both upper and lower bites being too advanced (while aligned). He even sketched a toy simulation modifying my picture with some program (for a better simulation he says he would need scan etc) and the result was quite bad indeed.
- Says chin implant reabsorption is not possible because the chin implant would also be attached to the jaw implants. He showed me one case of reabsortion, and he showed how in that case there were no jaw implants attached to the chin implant.
- Thus, he advises custom chin and jaw implants. He would also do genio + custom jaw implants because he believes it's also a good option. However, he advises chin implant instead of genioplasty because my chin is small, and thus a genioplasty would improve my side profile but not the front one.
I'm quite shocked to see the massive discrepancy:
- Bimax being the best option vs not being a sensible option at all! And not because of price or the surgery being invasive, but because the aesthetic results would be bad!
- Chin implants being a dangerous option vs chin implants being perfectly safe and preferred over genioplasty.
The only consensus seems to be that genio + custom jaw implants (peek) would be the second best option for both doctors, so currently I'm more inclined to this one (idk with which of the two doctors, price would be similar).
In a few months I'n seeing a third surgeon. For the moment, I'd prefer not to upload photos and not to give surgeon names. Might do at some point in the future. I'll be updating this thread with more info whenever I have it.
- Perfect bite.
- Small chin.
- Small jaw.
- Bad gonial angle, bad jawline.
- Technically not exactly recessed, although could definitely benefit from advancement (jaw aligned with lips, but recessed wrt nose tip).
- No sleep apnea.
Surgeon 1:
- Offers two options: bimax and genio + custom jaw implants (peek).
- Says he doesn't do chin implants because the probability of re-absorption is not negligible (as opposed to in the case of jaw implants, he says in that case it's virtually impossible).
- Bimax it's more expensive, more invasive, would require 6 months of orthodontics after the surgery (not before because my bite is already fine).
- He advises bimax because he believes it's better in the very long term.
- He also offers genio + custom jaw implants (peek) because he believes it's also a good option. He refuses doing chin implants due to re-absorption risk.
Surgeon 2:
- Offers two options: genio + custom jaw implants (peek) and custom chin and jaw implants (peek).
- Says bimax is not advisable at all in my case and refuses doing it, because:
* Perfect bite.
* Not recessed.
* Functionally not needed (no sleep apnea).
* Aesthetically would worsen by aspect: he says a bimax would give me a monkey-like aspect, with both upper and lower bites being too advanced (while aligned). He even sketched a toy simulation modifying my picture with some program (for a better simulation he says he would need scan etc) and the result was quite bad indeed.
- Says chin implant reabsorption is not possible because the chin implant would also be attached to the jaw implants. He showed me one case of reabsortion, and he showed how in that case there were no jaw implants attached to the chin implant.
- Thus, he advises custom chin and jaw implants. He would also do genio + custom jaw implants because he believes it's also a good option. However, he advises chin implant instead of genioplasty because my chin is small, and thus a genioplasty would improve my side profile but not the front one.
I'm quite shocked to see the massive discrepancy:
- Bimax being the best option vs not being a sensible option at all! And not because of price or the surgery being invasive, but because the aesthetic results would be bad!
- Chin implants being a dangerous option vs chin implants being perfectly safe and preferred over genioplasty.
The only consensus seems to be that genio + custom jaw implants (peek) would be the second best option for both doctors, so currently I'm more inclined to this one (idk with which of the two doctors, price would be similar).
In a few months I'n seeing a third surgeon. For the moment, I'd prefer not to upload photos and not to give surgeon names. Might do at some point in the future. I'll be updating this thread with more info whenever I have it.
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