Hello I'm a 24 year old female. I have receded chin (weak chin) I don't have over or underbites, but i do have a gummy smile which I also want to get rid of. I can't keep my mouth shut unless I remember to and I breathe with open mouth all night. Am I a candidate for Corrective jaw surgery? What exactly will be done and what other options do I have?
Corrective Jaw Surgery for Receded Chin?
Doctor Answers 4
Gummy smile, weak chin
You might not need something as major as mandibular and maxillary bony surgery.
Although the pictures do not show the gummy smile you describe, it appears that you are strain to get closure of the lips. The receding chin is well illustrated. A simple Silastic chin augmentation can correct the chin and is reversible if it does not work out. The surgery for the gummy smile involves resecting a strip of tissue inside the mouth where the gum meets the upper lip thereby bringing down the upper lip complex to a better level.
Gummy smile with a weak chin
When you have have a gummy smile, it usually indicates that you may have a condition called vertical maxillary excess. With a weak chin, this may indicate that you may require double jaw surgery. This kind of surgery requires a lot of preparatory work, including wearing braces for 9 to 12 months if indicated.
It is best that you consult a craniomaxillary surgeon in your local area for further advice.
Conservative chin augmentation with chin implant, and Botox for a gummy smile
Yes, you can consider conservative chin augmentation with chin implant. I really feel that if your bite is correct, this provides the best possible option with limited risk. As far as your gummy smile, conservative Botox can help reduce its activity. You should also get evaluated for nasal breathing issues if you are a major mouth breather.
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Corrective Jaw Surgery Can Correct most of those concerns but the surgery is pretty extensive
Corrective Jaw Surgery Can Correct most of those concerns but the surgery is pretty extensive. The procedure involves cutting through the upper jaw and lower jaw and moving the complete segment of your jaws and many times you need your jaws wired shut for awhile, sometimes as long as a month or more. You can determine if you need some chin augmentation through this discussion:
Chin implants (Dr Young specializes in plastic surgery in the Face and Neck in Bellevue Washington) come in many shapes and sizes. Sometimes, even with the many variations there might not be one that fits all of your needs. This is when a custom implant may be the perfect choice for you. One of the first questions you should ask is whether or not a chin implant would work for you. There are multiple ways of assessing whether you could benefit from enhancing your chin. The first thing to do is to understand the various landmarks. In the first picture, the Glabella, labelled “G” is the most projecting point on the lower parto f the forehead and is usually right between the eyebrows. The nasion, labeled “N”, is the most depressed point below G and is usually at the root of the nose. The Subnasale, labeled “SN”, is the point of transition from the nose to the upper lip. It is where the nose, columnella, intersects the upper lip. The upper vermillion is the point of transition from the white part of the upper lip to the red portion of the lip (Called the Vermillion) and is labeled “VU”. The same point coinciding with the lower lip is labeled “VL”. The Pogonion, labeled “PG”, is the point of the chin that is the most projecting anteriorly. The mentum, labeled “MN”, is the most inferior portion of the chin. One thing to be careful of is when the patient has a double chin. The mentum is the part of the chin that is associated with the chin and not the inferior part of the sagging that can occur under the chin and posterior to the chin. One rule was developed by Gonzalez-Ulloa shown in the second picture. The horizontal line you see will be refered to a lot by surgeons. It is called the frankfort horizontal. It travels from the top of the ear canal and through the top of the inferior orbital rim. The vertical line you see is part of there interpretation of where the chin should be. The vertical line should travel through the Nasion and the the Pogonion should approximate this line. Some think that the augmentation based on this rule would lead to too much projection. A similar rule places the vertical line of the Gonzalez-Ulloa line more posteriorly at the subnasale, although sometimes it is very close as in this picture, called the Epker and Fish Rule. Based on this rule or law, the vertical line should travel from the subnasale and through the upper vermillion “VU” and the lower vermillion should be 2mm behind this point, and the pogonion should be 4mm behind. The third really common rule is based on the Nasal Chin Lip Line. It is based on the ideal nasal length measure from the root of the nose at the level between the upper eyelid crease and the upper eyelid margin to the nasal tip. From the half point distance, a line is drawn through the upper lip vermillion. From this location, the pogonion should be be 3mm behind this line. The last two rules are my most preferred ways to assess how much chin augmentation to do. In another blog, I will address the vertical dimensional analysis.
To get a full description you can look up my blog and there are pictures there to explain the above.
If you look up my theory on facial aesthetics you can get an understanding of how your face should be proportioned. The theory is called the Circles of Prominence.
Hope that helps!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.