Michael B. Barbick, DMD, MD

Have your orthodontist or surgeon trace the ceph and they can tell you the answer. It looks like a combo

It is good that your going to someone with a lot of experience doing these surgeries that for sure helps. However even in the most experienced hands all patients need to understand there are risks. Even if low they are present. Lower lip/chin numbness is almost a guarantee immediately after the surgery but as long as the nerve is intact and not injured, you should regain the sensation. Maybe there is a very tiny area that still stays numb but that would be a tiny area. But again your going in knowing that there is risk of nerve injury and it could be permanent but this is a low risk. Relapse is another thing to consider but again low. I as a surgeon am more worried about nerve injury then relapse. As long as the ortho set up is good and the surgical moves are not to extensive the relapse rate is very low and I don't see it often. If it is it can be corrected with some minor ortho.

Upper jaw surgery the main risks increase when you start doing segmental surgeries. Meaning you split the upper jaw into 2 or 3 pieces. That can decrease the vasculature in certain segments and you risk necrosis of that segment. You rarely see this with a single piece upper jaw surgery. Also the risk to damaging teeth is greater when doing segmental surgery of the upper jaw.

All the rest of the complications like infection, bad fractures, sinus issues, ear problems and visual problems are all very very rare. I know sometimes you just read the bad on forums because most people that are very happy don't take the time to go one and publish how happy they are. Its the ones that go wrong or complications occur that people tend to be frustrated and vent them on forums.

Its a safe procedure that has been done for many many years. Hope this helps   

To be honest I don't see your discrepancy that the photo is trying to capture. If your bite is normal I would not advocate getting jaw surgery for your desired results. You photo looks fine but if you are still certain you have a discreapcny then start with an orthodontist.

likely both. Don't work the lower setback will be a small move. It wont change much of your profile.

Your case needs surgery combined with ortho. I would first seek out an orthodontist for a consult that has experience with surgery cases. I think it's not wise to treat you only with ortho. You will likely have relapse post ortho. I'm going by just your pics and not X-rays. Then have them refer you to a oral surgeon for a consult before you start ortho to make sure this procedure is a covered benefit. If so that good news then start ortho. If not then you need the surgeon to tell you what the fees would be before you get started with ortho to make sure you can afford it. Self pay will be several thousands of dollars for upper jaw and same for lower jaw. Plus you will need to pay for the hospital fees and anesthesia fees which would be a couple of thousand if not a covered surgical benefit.