Tall chin Genioplasty/ Examples

[Deleted member 5891]

Can genioplasty make the chin taller?

Also I would appreciate results
short vs. tall chin examples

 

[Deleted member 5891]

bumo

 

[Merlix]

Yes it can vertically lengthen it. But it I'll also narrow the chin the further it extends which is why you never see frontal photos of before/after because it look like shit for the most extreme examples (the ones that look amazing from profile view).

 

[wristcel]

 

[wristcel]

 

[wristcel]

 

[Deleted member 5891]

View attachment 693520

the face of the guy looks so fucking narrow
did he only get genio`?

 

[Deleted member 5891]

Yes it can vertically lengthen it. But it I'll also narrow the chin the further it extends which is why you never see frontal photos of before/after because it look like shit for the most extreme examples (the ones that look amazing from profile view).

hmm I actually need it to widen it very much

 

[wristcel]

the face of the guy looks so fucking narrow
did he only get genio`?

i think so.
But you're right - and it's actually one of my concerns.
I need more lower third height, BUT without having more width to my jaws natrually, I worry that i'd just end up with a weird long face without any kind of angle/step off lol

 

[RealSurgerymax]

Yes it easily can. It is called vertical genioplasty. Genioplasty vertical augmentation can be combined with forward movement too.

If adding more than a couple mm’s of height it good to use a bone graft during the genioplasty (Sandwiched between the gap). This is to help prevent contour irregularities as well as for stability.

 

[RealSurgerymax]

i think so.
But you're right - and it's actually one of my concerns.
I need more lower third height, BUT without having more width to my jaws natrually, I worry that i'd just end up with a weird long face without any kind of angle/step off lol

This is where predictive imaging comes in.

 

[Deleted member 5891]

Yes it easily can. It is called vertical genioplasty. Genioplasty vertical augmentation can be combined with forward movement too.

I need mostly forward projection, and chin width,
vertical height is only optional
can I get all 3 or only the first 2?

also what is the maximum I can get for chin width

 

[RealSurgerymax]

I need mostly forward projection, and chin width,
vertical height is only optional
can I get all 3 or only the first 2?

also what is the maximum I can get for chin width

You can have all 3. This would be considered a complex genioplasty (still not all that complex, but requires more surgical time and a bone graft harvest site - either from the hip or calvarial bone grafts from the skull OR if smaller gaps no harvest of autologous bone may be required and you could have allogenic cortical-cancellous bone chips, available commercially.)

The chin segment would be separated from the jaw as in normal genioplasty, then cut and separated down the middle. Depending how much chin width you desire the appropriate bone graft would be wedged between the two sides and fixated with plates and screws.

Then the vertical+forward movement would take place, preferably with bone grafts again.

As for the maximum you can get with chin width - you will likely reach the aesthetic limit well before the anatomic/physiologic limit.

The maximum aesthetic width of the Chin is usually well-guided by the distal surface of the lower canines. So In most people that will rarely require over a centimeter. A 10mm thick ileac crest (hip) bone graft could be prepared to widen the chin Or multiple layers of calvarial bone graft could be used in a similar manner.

So ultimately most people can achieve their desires. However - have you considered the alternative, a custom chin implant.? That would be more exact and not require bone harvest from the hip or skull.

After such large Width genioplasty, burring or further osteotomies of the lateral chin segment will probably be required to restore flush, aesthetic contour (refining the contour after segment is plated in the final position.)

 

[Deleted member 5891]

First of thanks for your thoughtful reply, you are very knowledgeable

So ultimately most people can achieve their desires.

Yes, all my flaws can be resolved with surgeries etc. which is nice but sometimes I think what is the point especially during post nut clarity lol

However - have you considered the alternative, a custom chin implant.? That would be more exact and not require bone harvest from the hip or skull.

I am actually quite recessed
So I would like to have need bimax + genio, could you tell me how much degrees my gonial angle can be decreased, please?
I have over 130°
I only have considered infraorbital implants after lower eyelid surgery

 

[RealSurgerymax]

I also want to add some information about bone grafts in genioplasty and how to think about them.

The Bone Graft Conundrum, and why they are ultimately good.
​

Complex genioplasty with bone grafts do have higher risk of complications like bone resorption, infection, and complications of the second surgical site (ileac crest or scalp

This is because a free graft is not vascularized, unlike the osteotomized Genioplasty chin segment which is vascularized by a soft tissue pedicle. Incase you did not know, the chin segment in genioplasty may be completely cut off from the bone but it is still connected by muscles behind it which provide a blood supply - so loss or infection of this is highly unlikely.

The free graft however requires speedy vascularization by the recipient site. Until then is cannot fight off infection if it is contaminated by even the smallest amount of bacteria. Craniofacial free bone graft has nearly the same infection rate as alloplastic implants (1-4%). The body will not vascularize or incorporate infected tissue - it would require removal (second surgery) and replacement (probably third surgery.)

But here is the concept I need to make -
Do not take this to mean using bone grafts increase complication rate. Using bone grafts still decrease complication rate in osteotomies that require them - without bone graft in very large moves the osteotomy is not stable (meaning expect more relapse) and visible and palpable contour irregularities are more likely (being able to feel a gap or step-off through the skin, or even worse, the casual observer able to SEE it at a conversational distance.)

So a complex genioplasty with bone graft has more complications than a simple genioplasty, yes. But in a genioplasty with large gaps, filling those with bone graft still far outweigh the risks and improve the result.

This is why it is so important to be a healthy person in general but especially not smoking.

In healthy, lean, non-smoker the risks are still low. But this is why I recommend you at least give consideration to the alternative - a custom implant in place of a complex genioplasty.

While a custom implant can also become infected, it’s removal and replacement would pose a much smaller bump in the road because it is providing no stability to a “floating” osteotomy. It’s removal, should it come to that, would simply return you to a pre-surgical state while the several-month management of bone graft infection would have you in a sort of limbo where you now have a defect awaiting re-operation.

 

[RealSurgerymax]

First of thanks for your thoughtful reply, you are very knowledgeable


Yes, all my flaws can be resolved with surgeries etc. which is nice but sometimes I think what is the point especially during post nut clarity lol

I am actually quite recessed
So I would like to have need bimax + genio, could you tell me how much degrees my gonial angle can be decreased, please?
I have over 130°
I only have considered infraorbital implants after lower eyelid surgery

Yes just send static (no facial expression) TRUE side profiles (standing up, looking forward with head in natural feeling everyday position, NOT head turned against body.), frontals, quarter shots, and ceph tracing and or x rayif you have them.

 

[Deleted member 5891]

OT head turned against body

you mean not chin tucking? even if I have a bad neck posture?

 

[RealSurgerymax]

you mean not chin tucking? even if I have a bad neck posture?

I mean looking straight forward. If I ask for side profile and do not clarify this I have found that 100% of the time people turn their head looking sideways toward their shoulder, instead of looking forward, standing up.

 

[wristcel]

i think so.
But you're right - and it's actually one of my concerns.
I need more lower third height, BUT without having more width to my jaws natrually, I worry that i'd just end up with a weird long face without any kind of angle/step off lol

bit like this?

 

[wristcel]

This is where predictive imaging comes in.

true.
Are you an expert at this shit?
My main concern at the moment is rhino and hair transplant, but I defo want to fix my chin down the line. Bit confused about it though.
Could I maybe get your thoughts in PM?

 

[CursedOne]

Doenst sliding genio increase it too?

 

[Deleted member 5818]

Doenst sliding genio increase it too?

sliding genio = genio

 

[RealSurgerymax]

true.
Are you an expert at this shit?
My main concern at the moment is rhino and hair transplant, but I defo want to fix my chin down the line. Bit confused about it though.
Could I maybe get your thoughts in PM?

yes

 

[JustBeCurry]

yes

your smart ,ive seen a segmental chin osteotemy thing floating around for chin width is it good? and also can widening be done in conjuction with something like a chin shield osteotemy

 

[RealSurgerymax]

your smart ,ive seen a segmental chin osteotemy thing floating around for chin width is it good? and also can widening be done in conjuction with something like a chin shield osteotemy

No because that cut doesn’t give room to allow lateral expansion

 

[Deleted member 5891]

@RealSurgerymax what do I need for hollow cheeks?
I mean what should the surgeon during my jaw surgery to achieve them?
Would widen the gonion be sufficient assumining my zygos are okay?

 

[RealSurgerymax]

@RealSurgerymax what do I need for hollow cheeks?
I mean what should the surgeon during my jaw surgery to achieve them?
Would widen the gonion be sufficient assumining my zygos are okay?

I would need to look at your pictures and xrays of available.

Gonial angles can only be noticeably widened in an aesthetic manner with custom implants. I am well aware of extended chin wing, IMDO, and minuscule widening caused by mandibular advancement. None of these will give the sharp jaw angle enhancement that most people are looking for period.

 

[Deleted member 5891]

I would need to look at your pictures and xrays of available.

Gonial angles can only be noticeably widened in an aesthetic manner with custom implants. I am well aware of extended chin wing, IMDO, and minuscule widening caused by mandibular advancement. None of these will give the sharp jaw angle enhancement that most people are looking for period.

I don't know if I understand you

I meant for hollow cheeks one need wide zygos and a wide jaw

So I widen the jaw I should get hollow cheeks

 

[RealSurgerymax]

I don't know if I understand you

I meant for hollow cheeks one need wide zygos and a wide jaw

So I widen the jaw I should get hollow cheeks

How do you plane on widening jaw?

 

[Deleted member 5891]

How do you plane on widening jaw?

Like in the picture in the DM
Maybe I did not express myself correctly

 

[RealSurgerymax]

Like in the picture in the DM
Maybe I did not express myself correctly
View attachment 695379

Will make no noticeable difference in width.

I just remembered I did not show you the picture from the textbook I will post it itt.

 

[Deleted member 5891]

I noticed when I clench my jaw + good lighting I get a bit of hollow cheeks

So when I would widen the actual bone the skin would stretch??
Like this

 

[TRNA]

this result looks pretty good, will get in the future

 

[Deleted member 3020]

you can move it anywhere u’d like habibi

 

[RealSurgerymax]

I noticed when I clench my jaw + good lighting I get a bit of hollow cheeks

So when I would widen the actual bone the skin would stretch??
Like this
View attachment 695390

You need to understand that a BSSO is an advancement, rotation, and (can be) a setback procedure. It is not for widening the jaw. What minuscule jaw widening effects it has has to do with the condylar segment torquing from the posterior (and in most people wider) osteotomized jaw segment sliding underneath of it.

This is not going to give you a noticeable jaw angle improvement, and depending on 1.) the arc of your mandible (if it actually gets much wider as you go back or is more U shaped) and 2.) the angle of the saggital cut that is allowed by your existing anatomy - may give you little if any condylar & gonial widening at all.

If you want aesthetically wider jaws you need custom implants.

 

[Deleted member 5891]

Thank you for your informative response.

I know this sounds ridiculous but Is there a surgery that could stretch my skin and give me hollow cheeks like when I doing "duck face" beside jaw implants and buccal fat removal?


Did you have or are planning to do any surgery or why did you study about this so much

 

[RealSurgerymax]

Thank you for your informative response.

I know this sounds ridiculous but Is there a surgery that could stretch my skin and give me hollow cheeks like when I doing "duck face" beside jaw implants and buccal fat removal?


Did you have or are planning to do any surgery or why did you study about this so much

The advancement which MMA provides will stretch the soft tissue out some.

Buccal fat pad removal of you are already low bodyfat% or injection lipolysis if you have resistant subcutaneous facial fat. I wrote about it on lookism “Addressing Facial Fat” and I believe someone copy and pasted it to this website too.

Then zygomatic and jaw angle augmentation.

I have not seen your pictures and don’t see why you are against these surgeries looking for an alternative.

Yes I used to offer cosmetic work in SEA but now that I am studying to be licensed in a first world country don’t know if I will continue. I was going to have a 2 month surgery block in Phnom Penh this summer mostly liposuctions and some facial implants including customs etc. but then coronavirus put that to a stop. But I probably will slow that down for a while as I don’t want to get expelled from my program here. It would frowned upon to say the least.

 

[Donc0ck]

Yes it easily can. It is called vertical genioplasty. Genioplasty vertical augmentation can be combined with forward movement too.

If adding more than a couple mm’s of height it good to use a bone graft during the genioplasty (Sandwiched between the gap). This is to help prevent contour irregularities as well as for stability.

Could one simultaneously reduce the mentolabial fold while doing this?

 

[RealSurgerymax]

Could one simultaneously reduce the mentolabial fold while doing this?

It depends on your existing fold but usually, yes. The vertical movement alone opens the fold. Otherwise bone graft to the Mentolabial sulcus is an option.

 

[JustBeCurry]

You need to understand that a BSSO is an advancement, rotation, and (can be) a setback procedure. It is not for widening the jaw. What minuscule jaw widening effects it has has to do with the condylar segment torquing from the posterior (and in most people wider) osteotomized jaw segment sliding underneath of it.

This is not going to give you a noticeable jaw angle improvement, and depending on 1.) the arc of your mandible (if it actually gets much wider as you go back or is more U shaped) and 2.) the angle of the saggital cut that is allowed by your existing anatomy - may give you little if any condylar & gonial widening at all.

If you want aesthetically wider jaws you need custom implants.

View attachment 695409

are implants really the only way cant you get a side wing osteotemy or something

 

[RealSurgerymax]

are implants really the only way cant you get a side wing osteotemy or something

Does not give the sharp jaw angle widening most people desire or have the degree of control as a custom implant.

 

[DoctorLooksmax]

Yes it can vertically lengthen it. But it I'll also narrow the chin the further it extends which is why you never see frontal photos of before/after because it look like shit for the most extreme examples (the ones that look amazing from profile view).

You can just get fillers afterwards to broaden it though

 

[hope69]

I also want to add some information about bone grafts in genioplasty and how to think about them.

The Bone Graft Conundrum, and why they are ultimately good.
​

Complex genioplasty with bone grafts do have higher risk of complications like bone resorption, infection, and complications of the second surgical site (ileac crest or scalp

This is because a free graft is not vascularized, unlike the osteotomized Genioplasty chin segment which is vascularized by a soft tissue pedicle. Incase you did not know, the chin segment in genioplasty may be completely cut off from the bone but it is still connected by muscles behind it which provide a blood supply - so loss or infection of this is highly unlikely.

The free graft however requires speedy vascularization by the recipient site. Until then is cannot fight off infection if it is contaminated by even the smallest amount of bacteria. Craniofacial free bone graft has nearly the same infection rate as alloplastic implants (1-4%). The body will not vascularize or incorporate infected tissue - it would require removal (second surgery) and replacement (probably third surgery.)

But here is the concept I need to make -
Do not take this to mean using bone grafts increase complication rate. Using bone grafts still decrease complication rate in osteotomies that require them - without bone graft in very large moves the osteotomy is not stable (meaning expect more relapse) and visible and palpable contour irregularities are more likely (being able to feel a gap or step-off through the skin, or even worse, the casual observer able to SEE it at a conversational distance.)

So a complex genioplasty with bone graft has more complications than a simple genioplasty, yes. But in a genioplasty with large gaps, filling those with bone graft still far outweigh the risks and improve the result.

This is why it is so important to be a healthy person in general but especially not smoking.

In healthy, lean, non-smoker the risks are still low. But this is why I recommend you at least give consideration to the alternative - a custom implant in place of a complex genioplasty.

While a custom implant can also become infected, it’s removal and replacement would pose a much smaller bump in the road because it is providing no stability to a “floating” osteotomy. It’s removal, should it come to that, would simply return you to a pre-surgical state while the several-month management of bone graft infection would have you in a sort of limbo where you now have a defect awaiting re-operation.

I actually developed a palpable and visible step off in the posterior mandible after my wisdom tooth removal. How could this be explained and fixed?