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POSTED UNDER Genioplasty REVIEWS

Botched- sliding genioplasty gone terribly wrong, ruined jawline

ORIGINAL POST

Terrible

Funny455780
Terrible in every way - risks downplayed, surgical plan botched, inaccurate records provided after significant delays, gaslit during post-op.
I went to consult because I was dissatisfied with my short, square face. I had been having botox injected into my masseter muscles for years but felt my face still looked very square and short, and I was looking for a more oval shaped face.
My doctor recommended a sliding genioplasty to lengthen my chin. He said we would be moving the chin down but would keep the projection as it was, which I was happy about. He said that the lengthening would also make my wide chin appear narrower.
He made the sliding genioplasty sound like an easy surgery with low risk of complications; I asked about the potential for my chin pad to sag (which he said I should not worry about), and he said it was very unlikely that I would develop additional submental fullness because we would not be moving my chin backwards. He portrayed the surgery as easy to reverse or revise.
During my consultation he provided a drawing of the surgical plan. I wish I had consulted with more surgeons because I found out later that most surgeons use medical modeling teams, custom molds, software etc to make their surgical plans. However, I didn't know that at the time, and the surgical plan looked good so I was happy.
My November surgery went fine, but I noticed after my swelling began to come down that I had very sharp bumps along my jawline. I found out later that those bumps are bony irregularities that arise from a setback sliding genioplasty, when the projection of the chin is reduced. He said that these would go away within six months; they are still visible on my jawline six months later.
After all the swelling came down (it took about a month for me to look somewhat normal), I noticed that my double chin looked worse than before surgery. I also noticed that my chin pad felt weird and unsupported, and was more mobile/droopy than before surgery. I also noticed that my chin was very flat, particularly when smiling; plastic surgeons I spoke to to address my submental fullness all suggested horizontal chin augmentation which confused me because they had never done so before.
I decided to ask how much movement was done, because I had read that revisions are easiest to do in the first six weeks before the bone has healed. It took them 9 days to respond to this question, and they said the change was "4mm down and 1mm back". I did not have an x ray at that time so I trusted what they said.
During a post-op the following month I raised my concerns that the 1mm (or so I thought) backwards movement had caused additional fullness, and he dismissed me completely, drawing the width of a millimeter on a piece of paper to illustrate why deprojection had not impacted my double chin.
I came in in January for another post-op appointment, at which time they finally did a lateral x ray showing what my chin looked like from the side (my surgery was done in November, so it was 2 months after my original surgery). After reviewing I realized that the measurements that were written in my clinical notes and that I was told via email were wrong.
The chin shape was completely changed and the chin was deprojected significantly (probably ~4mm according to some maxillofacial surgeons' estimates) in addition to being lengthened more than agreed upon. I set up consultations with almost 10 other well-respected oral and maxillofacial surgeons, all of whom confirmed that they thought my projection was changed by more than 1mm which was contributing to my submental fullness and soft tissue droop. They also confirmed that my chin bone shape now is not normal and that they would restore it to a more normal-looking shape.
After seeing the discrepancy between my x ray and what I had been told, I asked for my full medical record. After several weeks of waiting and multiple reminders, I finally was sent only my clinical notes (no before/afters, x rays, etc). I then had to push again for the rest of my file. I was finally sent everything about three weeks after I had originally asked for it, after multiple reminders.
I decided to request a revision in February. Again he tried to gaslight/dismiss me, saying "you want me to move it forward 1 millimeter?" after which I had to call him out and show him overlays of my before and after x rays. He then said it was "not an accident" that my chin ended up in a completely different shape than before surgery and that my chin was "too pointy" before surgery (despite the surgical plan keeping the shape very similar and despite him saying in the operating room the day of surgery that my "lines were good").
I decided to proceed with a revision with him because I thought since he knew what was done during my initial surgery he would be the best person to restore my chin shape. However, every time I met with him he would continue to gaslight me, say "your chin looks great!", or try to persuade me to go to a surgeon who was "more qualified than him" (his words) for the revision, deliberately making me feel like he would mess up my chin further.
I requested an updated surgical plan from him, and after several weeks he sent me over a drawing which seemed to illustrate that he still didn't fully understand what was done during the first surgery. At that point I decided to cancel and go with another surgeon who has better planning procedures in place.
I was also extremely concerned by his repeated statements that he "would not be able to make me happy" and suggestions that I go with another surgeon- I worried that this meant he wouldn't try, or worse. He had initially asked for exact measurements/instructions to follow for the revision, and it felt like he was going to use these as a "gotcha"; however, since I knew the initial measurements were wrong, I asked him to provide me with the exact measurements needed to recreate my pre-surgery profile, at which point he said he would just "aim to restore the projection" without providing me with the measurements.
As a side note, the hardware he used did not provide clear imaging; another surgeon I consulted had much clearer imaging and only after I saw his imaging did I fully understand what happened to my chin. I offered to give him the imaging done by the other surgeon but he refused to look at it which was part of why I cancelled the surgery (because the revision planning was impeded by the unclear imaging).
I am upset enough with how bad my chin looks now and wish I had left it as it was before surgery. The other oral/maxillofacial surgeons I've spoken with have indicated that my chin was actually not the problem with my facial proportions- meaning a genioplasty probably wasn't even the right procedure for me (which explains why my chin looks fine at rest now but massive when smiling). The submental fullness, chin pad drooping and flat chin makes me even more unhappy. But if he had recognized these issues and recognized that my chin is in an abnormal, unsupported shape now, I would be less upset; the ongoing gaslighting and deliberately making me afraid to have him perform my revision made dealing with him a nightmare.
If you have an "ok" chin, please be very careful about doing surgeries like this - the surgeons I have spoken to have indicated that it is not simple to revise a sliding genioplasty, despite what Dr. Jamali says. And if you do, please make sure your surgeon has adequate planning in place and doesn't just "wing it" during surgery which seems to have caused my issues. Finally, read the reviews - I had seen multiple reviews indicating a "god complex" but I disregarded them - and it came back to haunt me when he was unable to accept that there were issues, even when I was trying to be nice and understanding and give him another chance to fix it.

Funny455780's provider

Majid Jamali, DMD

Majid Jamali, DMD

Board Certified Oral & Maxillofacial Surgeon

Funny455780 rating for Dr. Jamali:

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Replies (14)

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May 19, 2021
When I see your before pics, I agree that maybe it wasn't the best thing to do or start with. Fortunately for you, you're still beautiful and I hope you can find a solution to your dilemma. Keep us posted on what happens? :)
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May 19, 2021
Oh sh*t... Sorry you're in this situation, but I'm sure you can get it fixed to your liking. I consulted with Dr. Jamali and was considering doing a genioplasty with him .hmmm... maybe I will keep on researching
May 19, 2021
Yes definitely keep researching. I am so upset. And not only does my chin look terrible but it still feels weird months after surgery. This surgery is not one to be undertaken lightly as I ended up with pretty much every aesthetic complication in the book despite having no prior chin surgery (and despite him saying he had never had an instance of ptosis on a "virgin" chin during my consultation as he reassured me that I wouldn't have it). I do hope I will find someone else to fix this- other surgeons have indicated that sliding genioplasty revisions can be risky, and in particular the way he cut my bone (cut segment too small) makes revision even more challenging according to these doctors. Furthermore it's unclear if my chin soft tissue is permanently thickened because he moved it backwards (one surgeon said that backwards movement results in permanent thickening). My case is not an easy one. Part of what I was upset by is obviously the surgical incompetence and misdiagnosis, but I am also horrified by the way he treated me after he botched me- the gaslighting, lying, and manipulating was something so far outside the realm of anything I've ever experienced from a medical professional. It got to the point where to legitimately felt like he was subtly threatening me (given how every five seconds he would say how he wouldn't be able to make me happy and wasn't "smart enough" to fix this) and I was afraid to be under general anesthesia around him for a revision for fear he would again "go rogue" or teach me a lesson. It was almost surreal the level of unprofessionalism I had to deal with.
May 19, 2021
One other thing to note is he says that recovery is quick and pain free. That was not the case at all for me. I had severe pain that interfered with my sleep for over a week (and was provided nothing more than extra strength ibuprofen- no Percocet or anything to help me sleep). And while he says most swelling is gone after a week it was definitely at least three weeks until I looked like I hadn't just had surgery. He seems to over-recommend jaw surgery and genioplasty and minimize the risks just to pump up his sales.
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May 20, 2021
OMG that's crazy! I even followed up to ask about lingering numbness, and was told that it never happens permanently, and resolves always after a few weeks. I was concerned because it seems every time I have a surgery I get some kind of lasting numbness in some area. Ugh, I am sooo sorry you are having to deal with this. You are right he makes it seem like it is a super no-big deal easy peasy surgery, but it is pretty major. I was literally this close to going with him, so thank you so much for writing your review. I read all his reviews and couldn't find really any negative ones. So, I really appreciate yours. I started this journey thinking I wanted a chin implant...which I don't love the idea of silicone in my face, but it's easier to correct if needed later. Dr. Jamali instantly poo-pooed implants as soon as I said I had been considering it. If it makes you feel any better at all, I would love to have your "after" chin. I have barely one at all. But, I don't mean to discount your frustration and suffering. I know what it's like to be unhappy with certain features and especially after when procedures don't come out as hoped/expected. I am confident you will find a skilled surgeon that can correct your chin and jawline. It might take a combo with one to correct the genioplasty and then another that does intricate neck work that can pull and tighten to get the chin pad flat again. I would love to know your list of others you consulted with. I heard Dr. Amato in NJ is good, but have had a hard time finding many other oral/maxillofacial surgeons in the NY area. I guess they're not on RealSelf, anyway. Good luck, and please keep us posted! xx
May 21, 2021
Yes, I've had cosmetic surgery in a few areas and this one was definitely by far the hardest recovery (others I feel pretty good by day 3 even if still swollen, this had severe pain up until about a week, along with no strong painkiller). I'm not looking forward to going through it again but feel like I don't have a choice since my chin keeps getting worse as the swelling softens and the soft tissue droops more. On the numbness, I will say I don't have complete numbness anywhere as far as I can tell, but sensation is definitely significantly dulled. I can feel when I touch my chin, but I can't feel when food is on my chin, etc. And while he may say that a chin implant is bad because it's "foreign", metal plates aren't natural either. Even though I don't have anything "foreign" in my chin beyond the plates and screws it definitely feels weird still (probably because they have to cut the mentalis muscle to access the bone), and has pockets of dimpling from my mentalis straining because I don't have any bone support anymore. There was one girl who got jaw surgery that was botched, and her post op experience seems pretty similar to mine in terms of gaslighting, denial etc. I thought that was an exception so I didn't pay as much attention but it aligns pretty closely with my experience even though I only had genioplasty. Thanks for the rec! I reached out to Dr. Amato as a result. I've also been speaking with Dr. Sachs from NYCOMS and Dr Steinbacher from Yale (so CT but close enough). Any experience with either of them?
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May 23, 2021
I haven't consulted yet with any other than Jamali, but I'll look into those other two you mentioned, thanks! :) You're totally right-- ain't nothing "natural" about a metal plate and screws either...LOL. The 2 other realllly great ones that have done plenty of revisions are Dr. David Alfi (Texas) and Dr Keojampa (SF I think). They're far, but impressive from what I've seen. I think I saw a good one in Massachusetts too, but can't remember his name at the moment. I know it's a pain to do a revision, but you'll pull through it and I'm sure be much happier. ;)
July 10, 2021
Just FYI I posted a new update on my review.
June 6, 2021
Hi, I am sorry you are going through this. My first genio was a total mistake in that I should have never done it at all. Bone was cut and chin lengthened. It was supposed to only be 3mm adjustment but turned into 5. It seemed ok the first year in that I didn’t have any complications other than numbness in a specific area of my chin. I knew that was a possibility so shrugged it off. After that first year though, my face “collapsed” and my chin Pad dropped or wasn’t attached properly and my smile changed. The length seemed to get even longer, felt like I grew an additional 3mm. I lived with it for a solid 8 years before I went back For a consult. The original Maxillofacial surgeon Had a poor revision plan so I saw two others: Dr. Eppley in Indianapolis and Dr. Harrison Lee in Beverly Hills. I went with Dr. Lee for the revision mostly because I’m already in CA. He also has a New York location if you’re on the East Coast. Between the two locations he has a long “waitlist” so book something ASAP while you’re still doing research. He was able to address the length of my chin and I can tell his technique was better than the first surgeon. The inside scar looks a lot cleaner. My profile and chin pad look better. And the numbing I had is barely there, it’s 95% gone! I’m 5 months post-op and am being patient with the swelling since I think I need to wait a full year for the full result. Don’t get me wrong, I look normal and only had the post-op swelling for about 4 weeks. I have an abundance of patience and I can tell my current look is already much better. When I get the chance, I will try to create my “journey” post. I’m glad you got your money back. Since you’re having a revision much sooner ask the surgeons if there is any excess skin/tissue due to the lengthening that will need to be addressed. In my case, both surgeons recommended lipo under the chin. Cosmetic surgery feels similar to home Improvement because we change one thing But then have to Do other work in order for it To all blend together. Wishing you well and better outcome whoever you choose.
June 24, 2021
Thank you for sharing. Who did your original surgery? And did Dr Lee do anything in particular to address the drooping in your chin pad? Finally, what movements did you have during the revision, and how different does your chin look vs your original chin? At this point I would be so happy just to get my old chin back...
July 11, 2021
For context, I originally had a rounder face and a protruding chin. In my first genio, the surgeon cut bone horizontally to bring it down and back (a setback). The movement was 5mm instead of the agreed upon 3mm. Bone filler was placed into the area of cut bone. In retrospect, a bone shave would have been the better route. Dr.Lee removed the bone growth and did a T-genioplasty to reduce length and width producing a smaller, more feminine chin. Overall the plan was to bring the chin back up and slightly forward. I retained my original chin length And will wait until the 1 year mark to see if the length is satisfactory. I felt the same way just wanting to go back to my original look but realistically couldn’t expect that. I think Dr. Lee got pretty close and am happy overall. I’m glad your fees were returned to you. If you’re open to suggestions, I do not recommend going back to the surgeon who gave you results you weren’t pleased with. Focus your energy on finding a surgeon who will listen to your concerns and in turn be open to their recommendations. You may need additional work you weren’t expecting like lipo. When you can release the pain from the first surgery, you will have room to accept what is presented and move forward. Lastly, know which plating system your surgeon used. My first surgeon didn’t document it and Dr.Lee ended up using a universal kit for me. He mentioned that I had bone growth in one screw and it was a pain in the butt to finally undo the screw, so thank goodness he was able to do it! The After photo you shared from the physician website shows a nice chin shape and I can see how the profile is not ideal. It was really tough to find surgeons doing genioplasty and I wish you luck. Get as many consultations as you can before deciding.
July 11, 2021
P.S I’m not sure exactly what was done with my chin pad. Each of the surgeons “reattached” it. I do wonder if maybe the initial sutures dissolved before I fully healed and maybe that’s why it appeared flat in that area after the first genio. Things are looking good and Dr.Lee is pretty booked so my next follow up is in November.
July 28, 2021
Thanks a6gel for this additional detail. So just to clarify, was the setback 5mm of horizontal movement? Or was that the amount of vertical movement? Was a t-genioplasty done the first time as well as the second? And do you have any overbite or deep bite/was your original chin/face short? It seems like the thing that may have caused both of our problems is the setback- apparently they have a high rate of aesthetic complications (according to all the literature I've found online) which is why im so annoyed I had one done to me without warning or consent. I think also part of the issue is that I have a slight overbite so when I have my teeth clenched together (as he was making me do when we were taking my before and afters) my face looks worse, but when I'm at rest or smiling I have my teeth apart so my before chin didn't look so short and my after chin looks huge when I'm holding my face naturally. Yes, knowing all I know now I have some serious questions about this doctors skills and aesthetics.
July 31, 2021
The initial genio was horizontal only and not a T-genio. I had to lookup my records which say, “ lower border and chin were down-fractured 5mm and moved posteriorly 3mm.” So it was a mixture of both horizontal and vertical movement - my initial concern was for projection and the vertical movement was supposed to only be 3mm during our in-office consultation. My pre-op diagnosis was microgenia, short lower facial height.
My facial height seemed fine to me and a 3mm vertical movement didn’t seem like it would be a big deal. Before any of this, I corrected an overbite with braces which resulted in the protruding chin. after braces my chin did seem slightly big/wide which then gave the impression of that short lower facial height. In retrospect, I should have trusted what God gave me naturally. I didn’t look bad and I should not have let a few bullies’ taunting make me feel insecure. I went down a similar rabbit hole like you researching what went wrong with the first genio and yes, performing a setback has its complications. I can’t undo what’s already been done so I’m just focused on what’s ahead of me. I told myself that maybe I just wasn’t used to the new look so I gave it some years before deciding that I would never like it and needed to change it once more. You’re doing the right thing by having other consultations. Trust your gut in selecting your next surgeon. If you can, schedule an appointment with Dr.Lee. In your most recent post you mentioned that other surgeons say you don’t have any fat to remove and so I would be curious about Dr.Lee’s feedback for you. His schedule fills up fast- my next 3month follow up is in November due to limited availability so try to get on his books anyway. Keep me posted :)
UPDATED FROM Funny455780
6 months post

Before photos

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UPDATED FROM Funny455780
6 months post

After photos

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These are my after photos

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