POSTED UNDER Genioplasty REVIEWS
Botched- sliding genioplasty gone terribly wrong, ruined jawline
ORIGINAL POST
Terrible
Funny455780May 16, 2021
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.
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.
UPDATED FROM Funny455780
6 months post
Before photos
Funny455780May 18, 2021
These are my before photos.
Replies (14)
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 :)