Should I get genioplasty? Age 20, female, self-conscious about chin and jaw. (photo)

Question

I’m a 20 year old female who has always been self conscious about my chin and jaw. I’ve been wanting to do something about it but I was unsure on what type of specialist to see and the type of procedures I might need. I was wondering if a genioplasty would work or if I need something else.

Mats Hagstrom, MD (license on probation) · Answer

When it comes to candidacy for chin augmentation, it’s very important that we assess the actual shape of the mentalis region of the mandible a.k.a. the chin.
In your case, your chin is recessed or it’s lacking in projection.
There can be other parts of the demandable that can be insufficient and it’s important to differentiate which region of the mandible has the problem. 
To me, you’re an exceptional candidate for chin augmentation.
This can be done in three ways.
As you mentioned, you can have a sliding genioplasty.
You can also opt to Fore an implant.
The third option is to use temporary fillers.
Each one of these Three options can give very high-quality results.
One is not better than the other.
Each option has advantages and disadvantages.
Oral surgeons seem to lean more towards a sliding genioplasty while plastic surgeons sometimes have a preference for using implants.
That is not to say there aren’t oral surgeons who use implants and plastic surgeons who do sliding genioplasty.
These are just Things I’ve noticed.
Fillers have many great advantages.
Fillers are highly predictable, versatile and unlike surgery what you see is what you get and you can even watch while they’re doing the injections and give input to how much volume you want in what area.
If you’re unhappy with the outcome, you simply wait and the filler dissipates, or you can reverse the fillers.
 This can give the patient a sneak preview and for those who don’t want surgery and are willing to have repeat treatments fillers can be optimal.
Of course, as with any procedure provider selection is paramount in getting quality outcomes.
Simply getting chin fillers doesn’t mean the results will be good if you’re not in the hands of a sufficiently experienced provider.
Finding the right provider is probably the most important variable, potentially even more important than what treatment option you choose.
Finding the right provider is not at all easy and can be frustrating.
My experience has been that patients are not particularly good at choosing plastic surgeons.
Recognize that oral surgeons do much of this work and may offer certain levels of expertise.
To find the right provider, I suggest first making a list of both oral surgeons and plastic surgeons who seem to have a lot of experience with this procedure in your community.
Please bring a set of facial pictures of yourself to use as a reference during the consultation.
The pictures you’ve posted here will do fine.
At least make sure you have access to them on your telephone or better yet on a iPad or laptop.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar facial structures.
Study your own pictures and compare them to other people who’ve had these procedures to see if you can learn to recognize other individuals who have the same anatomic composition.
Look carefully at the relationship between the lips, the lips and the chin, etc., etc.
An experienced provider should have an ample supply of pictures and should be able to find the pictures of previous patients more or less look just like you.
An experienced provider who has done several hundred of these procedures should not have difficulty finding good matching examples.
Having pictures of yourself is really helpful.
It’s not helpful to see exceptional results impatient who had a different level of candidacy for the procedure than yourself.
Each person has their own level of candidacy for an excellent outcome and some patients inherently have much greater potential than others.
Seeing the very best results out of a providers career isn’t helpful.
What you’re looking for is what average results look like on previous patients who have your facial characteristics.
I would say at a minimum a provider should be able to show you at least 10 and preferably 20 previous patients who had the procedure they are recommending.
 Excuses like the pictures are on their computer at home or patients don’t want me to show their pictures, etc. etc. can simply be excuses.
If a provider doesn’t have a good collection of before and after pictures as described above, then you should probably continue your search and go onto the next consultation.
I do not recommend having only one consultation and then scheduling surgery.
Do not schedule surgery during the consultation.
 Avoid a virtual consultations at all cost.
You want to meet the surgeon who’s going to do your procedure in person.
This is the best way to vet the provider and push them to open up their portfolio and show you more pictures or to see if their collection of pictures is limited.
 I recognize there’s convenience with virtual consultations, but from firsthand experience, I can tell you that the chance of dissatisfaction from misunderstandings is substantially higher when patients do not have a proper in person consultation.
There’s no correct number of consultations needed to find the right provider.
The more consultations you scheduled the more likely you are to find the better provider for your needs.
 Most people do not have a lot of experience consulting with plastic surgeons.
Knowing what questions to ask and understanding that you’re responsible for vetting the provider just like you’re hiring a contractor to work on your house. 
If you can narrow down the list to people who clearly have expertise or experience in the procedure, then you can start by having three in person consultations.
Unless you feel very confident, one of those three is truly exceptional continue scheduling a few more consultations.
Finding the right plastic surgeon with multiple consultations is going to be a bit time-consuming and may involve financial cost.
This is not a waste of money.
This is a really good investment in yourself to maximize a chance of having a high-quality outcome and minimizing the chance of having a regretful procedure that requires multiple revision surgeries.
Average plastic surgeons do average work.
Only exceptional plastic surgeons deliver exceptional outcomes on a regular basis.
You need to find an exceptional provider and this is difficult because no one is going to post that they do average work.
It’s your job and responsibility to find the one who is truly exceptional.
 Having someone with good bedside manners who is charming considerately be nice but bedside manners does not correlate to operating room skills.
Look for providers were very thorough and spend enough time to explain all the variables during the consultation.
Providers to do fast consultations are most likely going to be fast in the operating room and are usually going to be cutting corners. 
When in doubt, slow down and schedule more consultations.
While computer morphing programs may be helpful I think seeing actual before and after pictures, especially of people who look just like you it’s the most accurate way to understand what your potential outcome is in the hands of a particular provider.
There really is no one best procedure.
Have each provider explain why they preferred the procedure they do and in the end, make a decision based on having done Good research first.
Patients often tell me they’ve done their homework by spending hours on their computer or cell phone.
In my opinion, you cannot access providers accurately, without an in person consultation.
Sorry for the rambling nature of my response.
All the very best,
Mats Hagstrom MD

Should I get genioplasty? Age 20, female, self-conscious about chin and jaw. (photo)

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Should I get genioplasty? Age 20, female, self-conscious about chin and jaw. (photo)

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