The second one involves quite a lot because I have a bad overbite AND crooked teeth AND no chin. So that would involve multiple surgeries. The nose thing is pretty self explanatory. My question is: based on the picture, what would be the best choice for my first surgery? O'ing have limited funds., so I would have to slowly save for each one, maybe with years in between. I'd like to know what would bring the most dramatic increase in aesthetic appearance
The two main things I feel that I need to do is get a nose job and fix my jaw/chin? (photo)
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Profileplasty is the answer
First of all, it is important to consider orthodontics and to determine whether formal orthognathic jaw surgery is what would be optimal for you. Hopefully, you would only need orthodontics and cosmetic dentistry to help with your dental problems. If the latter is the case, then you would be a good candidate for chin augmentation or bony genioplasty, but I would probably recommend an implant in your case. Your nose is quite prominent with a very high bridge at the junction with your forehead, so make sure that you are managed by an experienced rhinoplasty surgeon as well as one who has a good handle on evaluation and treatment of jaw deformities. Finally, chin augmentation is going to be the least expensive of the procedures that you are looking into, so if this is the route that is recommended, you hopefully can do this at the same time as the rhinoplasty. This combination, or "profileplasty", should provide a very nice change in your appearance.
Rhinoplasty and chin implant
A rhinoplasty can de-project the nose, while a chin implant can increase the projection of the mandible. The combination of both procedures will help with facial balance. Crooked teeth are best addressed with orthodontics. For many examples, please see the link below to our rhinoplasty/ chin implant photo gallery
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Rhinoplasty or jaw or chin surgery?
If you are not having any functional problems with your bite I would have the rhinoplasty first because you will achieve a more dramatic aesthetic result. Eventually your chin can be corrected at the same time as your bite.
The two main things I feel that I need to do is get a nose job and fix my jaw/chin?
I would target whatever aspect bothers you more.
Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD
Los Angeles, CA