Re: Please...I can really really use some advice!! Thanks for reading...

[Guest guest]

Poor girl. It sounds like you are having a heck of a time. Let me

say that in part I know how you feel. I am a 25 year old female who

had assymetry, and a long chin, and I have often felt like an ugly

freak. I however never thought of going to a plastic surgeon as I

had known after seeing an oral surgeon at a young age that I needed

jaw surgery because of a malformed lower jaw. I had lower jaw

surgery on July 22nd, and while the results so far are not all that

I expected, they are still amazing. One of the best comments I have

got so far is, " your chin is so cute! " I don't think any of us here

can tell you which direction you should go. But why not try getting

a third, or even fourth opinion? If you have two separate people

saying two different things, you need another opinion. Let me just

tell you, this surgery is expensive and intense. If you are having

no pain with eating and no problems speaking, it is more likely than

not that insurance will not approve it. Even with these problems it

is difficult to get approved. Also, this surgery has a long

recovery period, definitely worth it to those of us who look forward

to eating all the foods our jaws couldn't eat before, and look

forward to a headache and migraine free period of our lives. You

have a lot to consider, but time is on your side. If you aren't in

pain, do your research, get your opinions and think long and hard.

We'll all be hear to support you and answer any other questions.

Connie

> I am a 27 year old female that recently decided that I wanted to

have

> plastic surgery on my chin. Basically my chin is too long and

kind

> of crooked. I went to one plastic surgeon (Dr. Baker) and he said

he

> was going to do a sliding genioplasty which would remove some bone

to

> make my chin shorter. I then decided to see another surgeon (Dr.

> Posnick)just for a second opinion. He told me that I had a major

jaw

> malformation and this is what was causing the long chin and the

> assymetry. He told me about the surgery (which sounds scary as

hell)

> and that I would need at least a year to a year and a half of

> orthodontal work before I can have the surgery. I don't have any

of

> the major problems that other people have when getting this

surgery.

> I have no jaw/facial pain, no problems eating or chewing, and my

> speech is fine. I also wore braces from the ages of 12-16 so I

would

> hate to have to do this again. I know I don't have the nicest

> looking bite but its not one of my huge concerns, esp. since I am

so

> much more focused on my chin. Dr. Posnick also insisted that if I

get

> the genioplasty from Dr. Baker rather than orthogathnic surgery

that

> I would not be happy with the results. Oh, and all of this would

> cost about a lovely $20k which is money I absolutely don't have.

So

> I left his office hysterical crying and feeling like an ugly

freak

> (he told me that I have a long, flat face. Yes, my face is

somewhat

> long, which is due a lot in part to the chin, but I never thought

of

> my face as flat and I am told that I am pretty) So anyway I went

back

> to Dr. Baker shortly after seeing Dr. Posnick on the same day. I

> basically walked into his office crying and he said 'let me guess,

> you've seen Dr. Posnick'. Its kind of funny that all the plastic

> surgeons in my city know each other. So both of these men happen

to

> specialize in the same type of surgery, but they disagree with

what

> should be done. Dr. Baker thinks we can correct most of the

problem

> that I am concerned about with a sliding genioplasty (which will

only

> cost me $5000) and Dr. Posnick thinks it would be a bad idea and I

> would be unhappy. I trust both of these doctors as they are both

top

> top surgeons in my city, so I am having trouble making a

decision.

> Does it sounds like I would really need this orthognathic

surgery??

> I mean, it does sound like it would make everything look perfect,

but

> i don't feel that I need perfect teeth/bite. But I'm also

> thinking 'what if I get this chin reduction surgery (the sliding

> genioplasty) and it ends up looking terrible. Please, please,

> someone give me some advice. I am soooo confused!! thanks!

[Guest guest]

If I'm reading your post accurately:

1. You think, at this point anyhow, that you are concerned only with

the cosmetic part of the surgery, which is why you have consulted

plastic surgeons, primarily. (Is that Dr. Baker by any chance Dr.

Dan Baker? If so, yes indeedy, he is well known around the globe, if

he's the N.Y.C., Dr. Dan Baker. Or used to be, anyhow.)

2. Yes. The jaw surgery always sounds scary. And almost always, that

preliminary fear is the worst of it.

There are a few exceptions I can think of -- and generally those

folks are the ones who have major pain, dysfunction and troubles

with eating, and have waited long, long time to try to get the

finances and other circumstances in order to get some relief, or

know ahead of time that they have problems with anesthesia, during

or after the op.

But most of us find that the surgery, even on two jaws and a chin,

and maybe some work on the nose and turbinates, helps so much that

we're willing, even yearning, to get through it and past the

discomfort of healing.

Most often, there is not a lot of actual post-op pain. Sometimes

discomfort, swelling, congestion, etc., if you have work on the

upper jaw and nose structures. But there are ways to help yourself,

if you'll undertake to do them.

3. You say:

it does sound like it would make everything look perfect, but

> i don't feel that I need perfect teeth/bite. But I'm also

> thinking 'what if I get this chin reduction surgery (the sliding

> genioplasty) and it ends up looking terrible.

I doubt seriously that it wold end up " looking terrible. " What would

worry me is that you won't have had the fixes it sounds as though

you need in the matching of your jaws, and the fixes might not hold

up. In other words, ask about the possibilities/probabilities of

relapse, after you've had whatever surgery/surgeries you choose.

4. Honey, I've never heard anyone speak or write of being thrilled

about the prospect of fixed braces with wires and brackets. Except

for those who've fought to get them and been turned down by

insurance companies. They are not so bad as they once were;

techniques are much better now. And generally, in this day of

Mohawks, tattoos, pink and purple hair, studded doggie collars and

piercings, nobody cares. But that's for you, and not me, to choose.

Most particularly, ask about the risks of long-term numbness, and

see what effect that might have on your life. (E.g.: if you play a

musical instrument that involves an embouchure.)

Ask Dr. Posnick why he (or she) thinks it's important. Ask Dr. Baker

why he (or she) thinks it's not. And then you figure it out.

If you get out of this with a bill for $5,000, you have hit a home

run -- but only if your results give you long-term satisfaction, and

that's an important question to ask of everyone.

My major medical insurance covered the surgery for lower jaw

advancement. Most cover upper jaw work, as well. Very few cover

genioplasty, as it is indeed usually judged cosmetic, unless maybe

you have issues about sleep apnea.

As for the braces, my insurance paid somewhere between $1,000 and

$1,500 (US) and the balance was up to me. But I could not have had

the surgery that saved my teeth from my " very destructive bite " (per

my periodontist) without doing the ortho, as well.

Sorry if this is discouraging. It's not meant to be. But do try as

best you can, to inform yourself completely. If you have a trusted

general dentist, talk with him/her, as well. (I asked five dentists

of varying specialties before I even agreed to the braces. Five out

of five agreed about the braces; one was worried about the changes

in jaw pressure which could have increased the pain from the TMJ.

That did not happen. Mercifully.)

Good wishes. Weigh carefully, and try to figure out what will give

you the results you want.

You also need to know that it's up to you to figure out the

risk/benefit ratio. I have never heard a physician guarantee a

result, and would be terrified of one who did.

Best,

Cammie

> I am a 27 year old female that recently decided that I wanted to

have

> plastic surgery on my chin. Basically my chin is too long and

kind

> of crooked. I went to one plastic surgeon (Dr. Baker) and he said

he

> was going to do a sliding genioplasty which would remove some bone

to

> make my chin shorter. I then decided to see another surgeon (Dr.

> Posnick)just for a second opinion. He told me that I had a major

jaw

> malformation and this is what was causing the long chin and the

> assymetry. He told me about the surgery (which sounds scary as

hell)

> and that I would need at least a year to a year and a half of

> orthodontal work before I can have the surgery. I don't have any

of

> the major problems that other people have when getting this

surgery.

> I have no jaw/facial pain, no problems eating or chewing, and my

> speech is fine. I also wore braces from the ages of 12-16 so I

would

> hate to have to do this again. I know I don't have the nicest

> looking bite but its not one of my huge concerns, esp. since I am

so

> much more focused on my chin. Dr. Posnick also insisted that if I

get

> the genioplasty from Dr. Baker rather than orthogathnic surgery

that

> I would not be happy with the results. Oh, and all of this would

> cost about a lovely $20k which is money I absolutely don't have.

So

> I left his office hysterical crying and feeling like an ugly

freak

> (he told me that I have a long, flat face. Yes, my face is

somewhat

> long, which is due a lot in part to the chin, but I never thought

of

> my face as flat and I am told that I am pretty) So anyway I went

back

> to Dr. Baker shortly after seeing Dr. Posnick on the same day. I

> basically walked into his office crying and he said 'let me guess,

> you've seen Dr. Posnick'. Its kind of funny that all the plastic

> surgeons in my city know each other. So both of these men happen

to

> specialize in the same type of surgery, but they disagree with

what

> should be done. Dr. Baker thinks we can correct most of the

problem

> that I am concerned about with a sliding genioplasty (which will

only

> cost me $5000) and Dr. Posnick thinks it would be a bad idea and I

> would be unhappy. I trust both of these doctors as they are both

top

> top surgeons in my city, so I am having trouble making a

decision.

> Does it sounds like I would really need this orthognathic

surgery??

> I mean, it does sound like it would make everything look perfect,

but

> i don't feel that I need perfect teeth/bite. But I'm also

> thinking 'what if I get this chin reduction surgery (the sliding

> genioplasty) and it ends up looking terrible. Please, please,

> someone give me some advice. I am soooo confused!! thanks!

[Guest guest]

Hi Connie-

Thanks so much for your kind words. I'm still having trouble

deciding what to do!! All of this is so overwhelming. I have the

genioplasty scheduled for the morning of August 24th, now I just have

to decide if I want to go through with it. If I opt for the jaw

surgery, there is just no way I can afford it, and I have Blue Cross

Blue Shield as my insurance and I've heard that its hard to get them

to approve these types of surgery. I guess I could take out a loan.

Have you heard of many people doing this, when they didn't have

enough money for the surgery. Also tihs doctor that I went to said I

needed to have my lower and upper jaw fixed and my chin as well. So

it came to about $20k and that didn't include the $8k I would need

for braces. I am just so completely overwhelmed with all of this...

Samara

> > I am a 27 year old female that recently decided that I wanted to

> have

> > plastic surgery on my chin. Basically my chin is too long and

> kind

> > of crooked. I went to one plastic surgeon (Dr. Baker) and he

said

> he

> > was going to do a sliding genioplasty which would remove some

bone

> to

> > make my chin shorter. I then decided to see another surgeon (Dr.

> > Posnick)just for a second opinion. He told me that I had a major

> jaw

> > malformation and this is what was causing the long chin and the

> > assymetry. He told me about the surgery (which sounds scary as

> hell)

> > and that I would need at least a year to a year and a half of

> > orthodontal work before I can have the surgery. I don't have any

> of

> > the major problems that other people have when getting this

> surgery.

> > I have no jaw/facial pain, no problems eating or chewing, and my

> > speech is fine. I also wore braces from the ages of 12-16 so I

> would

> > hate to have to do this again. I know I don't have the nicest

> > looking bite but its not one of my huge concerns, esp. since I am

> so

> > much more focused on my chin. Dr. Posnick also insisted that if I

> get

> > the genioplasty from Dr. Baker rather than orthogathnic surgery

> that

> > I would not be happy with the results. Oh, and all of this would

> > cost about a lovely $20k which is money I absolutely don't have.

> So

> > I left his office hysterical crying and feeling like an ugly

> freak

> > (he told me that I have a long, flat face. Yes, my face is

> somewhat

> > long, which is due a lot in part to the chin, but I never thought

> of

> > my face as flat and I am told that I am pretty) So anyway I went

> back

> > to Dr. Baker shortly after seeing Dr. Posnick on the same day. I

> > basically walked into his office crying and he said 'let me

guess,

> > you've seen Dr. Posnick'. Its kind of funny that all the plastic

> > surgeons in my city know each other. So both of these men happen

> to

> > specialize in the same type of surgery, but they disagree with

> what

> > should be done. Dr. Baker thinks we can correct most of the

> problem

> > that I am concerned about with a sliding genioplasty (which will

> only

> > cost me $5000) and Dr. Posnick thinks it would be a bad idea and

I

> > would be unhappy. I trust both of these doctors as they are both

> top

> > top surgeons in my city, so I am having trouble making a

> decision.

> > Does it sounds like I would really need this orthognathic

> surgery??

> > I mean, it does sound like it would make everything look perfect,

> but

> > i don't feel that I need perfect teeth/bite. But I'm also

> > thinking 'what if I get this chin reduction surgery (the sliding

> > genioplasty) and it ends up looking terrible. Please, please,

> > someone give me some advice. I am soooo confused!! thanks!