What surgeries do I need?

[goneion]

 

[rya222]

wait i will go to medical school then i will comeback and tell you what you need

 

[vermicel]

What surgeries do I need ?

> bimax + vertical genioplasty (downgraft)
> filler (Radiesse) in the gonions
> radix graft
> minoxidil + microneedling to grow taller and longer eyebrows (lateral part, not medial)

As illustrated in the morphs above, this won't turn you into a gigachad, just a more harmonious and more dimorphic version of your current self. Which would already be a nice upgrade.

Other soft tissue procedures might benefit you, but this front profile pic doesn't allow a more accurate assessment.

 

[chrishell]

You're a DJS candidate

 

[vermicel]

@goneion as a complement to my previous post : I think your progress will be hardcapped by 4 aspects.

[1] from the side, your brow ridge and supra-orbital bone are too recessed. Fixing the radix (see morph in the previous post) won't suffice to make projection ideal in that area. While brow ridge implants and supra-orbital implants do exist, I'm not convinced they would deliver good results. But you can do your own research on those procedures.
[2] from both the side and the front, your midface is too long. It cannot be fixed by current surgical techniques (it would require to lift your nose upwards and to shorten it in the process ; the mouth — and everything behind it — would have to be moved upwards too). At best, you can augment the upper lip with either HA fillers or a lip lift, although I don't think there would be a high ROI for you there.
[3] there seems to be some sort of vertical orbital dystopia (left eye — right in the pic — seems to be set quite higher @Hardmaxx.aze ). Other pics would be needed for a better assessment.
[4] from the front, your mouth seems too narrow, and the lips lack some height/fullness. Mouth width cannot be fixed in a significant and aesthetically-pleasing way (commissuroplasty is a meme) ; you could augment both lips with HA fillers, but it would have to be done in a tasteful and conservative way, or else it would queer you out.

Just for the sake of illustration, if we were not bound by current surgical limitations, here's what an above average side profile would look like :

The front profile may remain average/ordinary, but with all significant flaws removed, it would look harmonious and quite attractive in a relatable way (not overly masculine or "striking") :

While we're at it : I guess one could argue that a BSSO + vertical genioplasty (downgraft) would be enough and yield most of the aesthetic benefits of a bimax + vertical genio. It would spare you the risk of getting "dogmaxxed" and would make recovery easier/faster. The only trade-off would be a bit less forward growth. Of course, we're assuming that you wouldn't need a Lefort 1 for functional reasons.
Here's the same morph as in my previous post, with a BSSO instead of a bimax :

 

[key]

@goneion as a complement to my previous post : I think your progress will be hardcapped by 4 aspects.

[1] from the side, your brow ridge and supra-orbital bone are too recessed. Fixing the radix (see morph in the previous post) won't suffice to make projection ideal in that area. While brow ridge implants and supra-orbital implants do exist, I'm not convinced they would deliver good results. But you can do your own research on those procedures.
[2] from both the side and the front, your midface is too long. It cannot be fixed by current surgical techniques (it would require to lift your nose upwards and to shorten it in the process ; the mouth — and everything behind it — would have to be moved upwards too). At best, you can augment the upper lip with either HA fillers or a lip lift, although I don't think there would be a high ROI for you there.
[3] there seems to be a pronounced ocular vertical asymmetry (left eye — right in the pic — seems to be set quite higher @Hardmaxx.aze ). Other pics would be needed for a better assessment.
[4] from the front, your mouth seems too narrow, and the lips lack some height/fullness. Mouth width cannot be fixed in a significant and aesthetically-pleasing way (commissuroplasty is a meme) ; you could augment both lips with HA fillers, but it would have to be done in a tasteful and conservative way, or else it would queer you out.

Just for the sake of illustration, if we were not bound by current surgical limitations, here's what an above average side profile would look like :

View attachment 5741750

The front profile may remain average/ordinary, but with all significant flaws removed, it would look harmonious and quite attractive in a relatable way (not overly masculine or "striking") :

View attachment 5741763

While we're at it : I guess one could argue that a BSSO + vertical genioplasty (downgraft) would be enough and yield most of the aesthetic benefits of a bimax + vertical genio. It would spare you the risk of getting "dogmaxxed" and would make recovery easier/faster. The only trade-off would be a bit less forward growth. Of course, we're assuming that you wouldn't need a Lefort 1 for functional reasons.
Here's the same morph as in my previous post, with a BSSO instead of a bimax :

View attachment 5741811

Some of the best advice I've seen on this site in a long time, mirin. op say thank you

 

[key]

Here's the same morph as in my previous post, with a BSSO instead of a bimax :

However I will say that I don't think his occlusion allows for a meaningful BSSO even if he undergoes a year long decomp phase, how many mm would he get? Genio would do most of the heavy lifting here

 

[vermicel]

However I will say that I don't think his occlusion allows for a meaningful BSSO even if he undergoes a year long decomp phase, how many mm would he get? Genio would do most of the heavy lifting here

You're possibly right. I'm quickly out of my depth when it comes to orthognathics.

 

[goneion]

@goneion as a complement to my previous post : I think your progress will be hardcapped by 4 aspects.

[1] from the side, your brow ridge and supra-orbital bone are too recessed. Fixing the radix (see morph in the previous post) won't suffice to make projection ideal in that area. While brow ridge implants and supra-orbital implants do exist, I'm not convinced they would deliver good results. But you can do your own research on those procedures.
[2] from both the side and the front, your midface is too long. It cannot be fixed by current surgical techniques (it would require to lift your nose upwards and to shorten it in the process ; the mouth — and everything behind it — would have to be moved upwards too). At best, you can augment the upper lip with either HA fillers or a lip lift, although I don't think there would be a high ROI for you there.
[3] there seems to be some sort of vertical orbital dystopia (left eye — right in the pic — seems to be set quite higher @Hardmaxx.aze ). Other pics would be needed for a better assessment.
[4] from the front, your mouth seems too narrow, and the lips lack some height/fullness. Mouth width cannot be fixed in a significant and aesthetically-pleasing way (commissuroplasty is a meme) ; you could augment both lips with HA fillers, but it would have to be done in a tasteful and conservative way, or else it would queer you out.

Just for the sake of illustration, if we were not bound by current surgical limitations, here's what an above average side profile would look like :

View attachment 5741750

The front profile may remain average/ordinary, but with all significant flaws removed, it would look harmonious and quite attractive in a relatable way (not overly masculine or "striking") :

View attachment 5741763

While we're at it : I guess one could argue that a BSSO + vertical genioplasty (downgraft) would be enough and yield most of the aesthetic benefits of a bimax + vertical genio. It would spare you the risk of getting "dogmaxxed" and would make recovery easier/faster. The only trade-off would be a bit less forward growth. Of course, we're assuming that you wouldn't need a Lefort 1 for functional reasons.
Here's the same morph as in my previous post, with a BSSO instead of a bimax :

View attachment 5741811

Really appreciate the effort and morphs, thank you. I have no functional issues and had braces to fix/camouflage my bite which puts me off the idea of bimax though I do think it would give the best aesthetic result. Do you think I could cope with just a horizontal+ vertical genio and gonial fillers for the lower third or would I be leaving too much on the table by not going for trimax? If you dm me I can send more pics if you need.

 

[vermicel]

I have no functional issues and had braces to fix/camouflage my bite which puts me off the idea of bimax though I do think it would give the best aesthetic result. Do you think I could cope with just a horizontal+ vertical genio and gonial fillers for the lower third or would I be leaving too much on the table by not going for trimax?

If you have no functional issues and if you are part of the "side profile is cope" school of thought, then, yeah, you could probably get away with just the genio and fillers.
Note that you may have to fine-tune the results of the vertical genio with a custom implant or fillers, to achieve the right height and/or shape ; it's not a mandatory step, but a possibility if you really want to nail the chin.

 

[vermicel]

@goneion I forgot to say that you could fix your radix for cheap with Radiesse instead of a regular cartilage/bone graft. Some call it a "liquid rhino", and I usually don't like the idea too much when it's about the dorsum and tip, but Radiesse is the firmest and most stable temporary filler, which makes it a good alternative to augment a bony part like the radix. One syringe would most likely be enough, and it would set you back $400-600 in Western Europe (price varies depending on countries, cities, and surgeons). Immediate results, no downtime. I think it's really worth considering if your nose requires no other alteration.

 

[cannibaloid]

View attachment 5740195View attachment 5740197

Bimax

 

[Hardmaxx.aze]

@goneion as a complement to my previous post : I think your progress will be hardcapped by 4 aspects.

[1] from the side, your brow ridge and supra-orbital bone are too recessed. Fixing the radix (see morph in the previous post) won't suffice to make projection ideal in that area. While brow ridge implants and supra-orbital implants do exist, I'm not convinced they would deliver good results. But you can do your own research on those procedures.
[2] from both the side and the front, your midface is too long. It cannot be fixed by current surgical techniques (it would require to lift your nose upwards and to shorten it in the process ; the mouth — and everything behind it — would have to be moved upwards too). At best, you can augment the upper lip with either HA fillers or a lip lift, although I don't think there would be a high ROI for you there.
[3] there seems to be some sort of vertical orbital dystopia (left eye — right in the pic — seems to be set quite higher @Hardmaxx.aze ). Other pics would be needed for a better assessment.
[4] from the front, your mouth seems too narrow, and the lips lack some height/fullness. Mouth width cannot be fixed in a significant and aesthetically-pleasing way (commissuroplasty is a meme) ; you could augment both lips with HA fillers, but it would have to be done in a tasteful and conservative way, or else it would queer you out.

Just for the sake of illustration, if we were not bound by current surgical limitations, here's what an above average side profile would look like :

View attachment 5741750

The front profile may remain average/ordinary, but with all significant flaws removed, it would look harmonious and quite attractive in a relatable way (not overly masculine or "striking") :

View attachment 5741763

While we're at it : I guess one could argue that a BSSO + vertical genioplasty (downgraft) would be enough and yield most of the aesthetic benefits of a bimax + vertical genio. It would spare you the risk of getting "dogmaxxed" and would make recovery easier/faster. The only trade-off would be a bit less forward growth. Of course, we're assuming that you wouldn't need a Lefort 1 for functional reasons.
Here's the same morph as in my previous post, with a BSSO instead of a bimax :

View attachment 5741811

His vertical orbital dystopia is very minor, if present at all. IMO, not worth doing anything for it. The rest of the procedures/assessments are spot on. I think trimax will improve his looks a lot, since he is a textbook candidate.

 

[goneion]

@goneion I forgot to say that you could fix your radix for cheap with Radiesse instead of a regular cartilage/bone graft. Some call it a "liquid rhino", and I usually don't like the idea too much when it's about the dorsum and tip, but Radiesse is the firmest and most stable temporary filler, which makes it a good alternative to augment a bony part like the radix. One syringe would most likely be enough, and it would set you back $400-600 in Western Europe (price varies depending on countries, cities, and surgeons). Immediate results, no downtime. I think it's really worth considering if your nose requires no other alteration.

Is there any risk of migration with radix filler? I’ve heard the jaw is low risk but not sure about the nose. Though non surgical rhinoplasty is a popular procedure so probably fine