Genioplasty or Bimax? Need a brutal assessment (Please Help)

[intothenight]

I’m trying to figure out whether my situation fits better with sliding genioplasty or full double jaw surgery. I don’t want to jump into anything without getting opinions from people who understand facial structure.

Based on my side profile (photo included), I feel like my chin might be slightly recessed, but I’m not sure how much of my issue is lower third vs actual maxilla/mandible position. I don’t know if my bite or jaw alignment is severe enough to justify bimaxillary surgery, or if a genioplasty alone would fix the aesthetic part.

I’m not looking for reassurance — I want honest feedback.

Do you guys think this looks like a case for genioplasty, double jaw surgery, or neither?

Any input or breakdown would help a lot.

 

[vermicel]

4th pic is the most reliable to assess your side profile, and based on that, I think you are not recessed and therefore you don't need any jaw surgery. Sure, you could project the chin a bit further forward, but the overall improvement would be minimal, and you already have a good chin from the front profile. So my advice would be to leave it as it is.

That said, the absolute priority for you right now should be your hair. You are a Norwood 3 at 19 yo, with a visibly thinning forelock, which exposes you soon to a Norwood 4 ... at that point, you might as well say it's over (hair-wise).

As your hair loss must be pretty fresh, you are likely to stop it and revert it (part of it, if not all) with the following tried and tested treatments : finasteride, minoxidil, and microneedling. Some will tell you to jump on dutasteride, which is more potent on paper, but reality is not as simple. I would keep duta for a later point, if you don't respond to finasteride.
You have basically three therapeutic approaches : either both oral fina & minox ; or both topical fina & minox ; or oral fina & topical minox. Regardless of your pick, add weekly microneedling (dermastamp 0.75mm) to your routine. If you have dermatitis or an oily scalp, you can also add Nizoral (ketoconazole shampoo) to the mix.

Don't waste time, hop on a treatment asap.
According to conservative medicine, 19yo may be a tad early for a DHT-inhibitor (fina/duta), but you seem to have developed your adult features already (full beard, chest hair, mature features). You can go first for a topical fina+minox lotion, as topical fina has a much lower impact on DHT serum, while staying almost on par with oral fina when it comes to reducing DHT in the scalp.

Alright. NEXT THING TO ADDRESS : your hollow temples. Most likely with fat grafting.

 

[intothenight]

A few questions

1. Is hallow temples a bad thing? And what is fat grafting?

2. I have minoxidil how much do I apply? Do I leave it on over night and how often do I apply (assuming everyday) and where do I apply? Meaning do I apply to the places my hair is receding (just over my temple where the W shape is) or only the places I do have hair (my scalp) also is the one in the picture shown good enough?

3. Do I only use microneedling one per week and where are the areas I should apply

4. What brand do you suggest for finasteride I would like to take pills but I’m open to any

I will add some more picture of my scalp to help you determine the answers

 

[vermicel]

1. make a research here and on Google

2. a small amount twice a day on a clean and dry scalp ; apply it where there is thinning hair and also on recent bald spots (i.e. hairline and temple peaks) ; leave it in, don't wash your scalp for hours after application (be it in the morning or at night)

3. yes, once per week, e.g. on Sunday mornings. Do not apply minoxidil on the same spots for the next 12-24 hours (to let the skin heal). Dermastamp the same spots as with minoxidil (thinning & bald).

4. you can go with Propecia, Proscar (5mg tablets to cut into 5 parts), or any generic you want. If you want to source it from a local pharmacy, you'll need a medical prescription (through your MD or a dermatologist). But you can probably source a safe generic from Indiamart without any administrative constraint.


Based on your latest pics, the forelock is in better condition than I initially thought. But you gotta be proactive and at the very least preserve what you are currently left with. If you respond well to the treatments, you will redensify your hairline and temple peaks, and maybe fill in your temples down to the blue line below ( = +/- Norwood 2).