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How much jaw bone can actually be removed?

Started by jayhey, June 16, 2015, 05:23:46 AM

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jayhey

Hi, everyone. I have been researching jaw reduction surgery for over a year now. I had my first in-person consult with Dr. Z and he agreed to do the surgery along with a neck lift. He did not think any other work would be needed (like cheek implants or brow lift).

My biggest concern (other than losing the feeling in my face or dying..) is how much mandible they can actually shave off.
I think I have only seen MY desired amount of bone removed on patients in Asia, but who knows if they Photoshop or not. Otherwise, it has been subtle for American patients, no? Any photos of that would be appreciated.

I am deciding between Dr. Z and Dr. Spiegal. I worry Dr. S would be too subtle, but I feel more comfortable with him due to the fact he demands x-rays for safety and does the surgery in a hospital (Dr. Z does not provide either). Dr. Z is local to me though. Dr. Z said Dr. S is unable to shave the chin vertically due to the "inside the mouth" technique, but who knows if it is true. I can't find pictures where Dr. S actually shaved the chin.

I should add, I am a genetic woman, but my jaw is large and masculine.

http://i.imgur.com/zILSqbJ.png

http://i.imgur.com/6SEVtWu.png

The shadow actually shaves off some of my jaw..
http://i.imgur.com/ZyhAPeS.png

http://i.imgur.com/9RloyuK.png
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Ever

I get the impression that some chin+jaw tapering can be done, but it will not be a humongous difference, but it will be a noticeable difference
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jayhey

Quote from: Ever on June 16, 2015, 06:17:30 AM
I get the impression that some chin+jaw tapering can be done, but it will not be a humongous difference, but it will be a noticeable difference

I need to find a doctor who does work like this then...

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sh1982

I would suggest Dr Park from ID Hospital in Seoul but if you want to stay in the USA i would suggest you contact Dr Harrison Lee in Beverly hills he is very talented in jawn an chin work.
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kittenpower

Quote from: jayhey on June 16, 2015, 11:55:19 AM
I need to find a doctor who does work like this then...



I've seen results from Dr. Z that are equivalent to the first set of pictures. It is my understanding that Dr. Z is very aggressive. Best wishes :)
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jayhey

Quote from: sh1982 on June 16, 2015, 04:19:58 PM
I would suggest Dr Park from ID Hospital in Seoul but if you want to stay in the USA i would suggest you contact Dr Harrison Lee in Beverly hills he is very talented in jawn an chin work.

Thanks for the suggestions!
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jayhey

Quote from: kittenpower on June 16, 2015, 04:49:57 PM
I've seen results from Dr. Z that are equivalent to the first set of pictures. It is my understanding that Dr. Z is very aggressive. Best wishes :)

You think? I saw his slideshow with patients and was wary of his results because his after photos were always glam selfies and not taken in a medical setting. I talked to someone who went to him and she said she had saggy skin and unevenness. I know everyone is different though.
  •  

mmmmm

Quote from: jayhey on June 16, 2015, 05:23:46 AM
Dr. Z said Dr. S is unable to shave the chin vertically due to the "inside the mouth" technique, but who knows if it is true.

I know!  :)

It not true... with "inside the mouth" incision it's possible to do both lateral and vertical osteotomies and shaving. How efficient, is largely dependent on surgeons skills. And how much can be removed depends on bone thickness, shape, etc...

Most FFS surgeons use "inside the mouth" incisions and avoid any unnecessary scars out outside.


I don't really have an opinion on which one out of those two surgeons would be "better" or more aggressive, as I didn't need to research and compare lower face for my surgery. 
  •  

kelly_aus

All the women in those before and after pics had clearly lost weight in the after shots, especially the top/1st one.. Reduced amounts of fat will also make a visible difference.

Also, removing too much bone makes the likelihood of breaking your jaw much higher.
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kittenpower

Dr. Z also removes some of the masseter muscle which helps to refine the jawline. 
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jayhey

Quote from: kittenpower on June 16, 2015, 07:01:13 PM
Dr. Z also removes some of the masseter muscle which helps to refine the jawline.

He mentioned that which actually scares me. I don't want that to affect my chewing strength. Maybe I am ignorant on the subject, but I just don't see that as a problem for me. I am all bone issues.
  •  

myfairlady49

Quote from: jayhey on June 16, 2015, 05:23:46 AM
Hi, everyone. I have been researching jaw reduction surgery for over a year now. I had my first in-person consult with Dr. Z and he agreed to do the surgery along with a neck lift. He did not think any other work would be needed (like cheek implants or brow lift).

My biggest concern (other than losing the feeling in my face or dying..) is how much mandible they can actually shave off.
I think I have only seen MY desired amount of bone removed on patients in Asia, but who knows if they Photoshop or not. Otherwise, it has been subtle for American patients, no? Any photos of that would be appreciated.

I am deciding between Dr. Z and Dr. Spiegal. I worry Dr. S would be too subtle, but I feel more comfortable with him due to the fact he demands x-rays for safety and does the surgery in a hospital (Dr. Z does not provide either). Dr. Z is local to me though. Dr. Z said Dr. S is unable to shave the chin vertically due to the "inside the mouth" technique, but who knows if it is true. I can't find pictures where Dr. S actually shaved the chin.

I should add, I am a genetic woman, but my jaw is large and masculine.


Before you make any final decisions,  maybe you should consider seeing  a board certified plastic surgeon - -  who is also formally trained in orthognathic surgery.  I am pretty sure that is the "right" set of surgical skills  that one would want in order to properly address the concerns you have described.

   
  •  

myfairlady49

Quote from: jayhey on June 16, 2015, 05:23:46 AM
Hi, everyone. I have been researching jaw reduction surgery for over a year now. I had my first in-person consult with Dr. Z and he agreed to do the surgery along with a neck lift. He did not think any other work would be needed (like cheek implants or brow lift).

My biggest concern (other than losing the feeling in my face or dying..) is how much mandible they can actually shave off.
I think I have only seen MY desired amount of bone removed on patients in Asia, but who knows if they Photoshop or not. Otherwise, it has been subtle for American patients, no? Any photos of that would be appreciated.

I am deciding between Dr. Z and Dr. Spiegal. I worry Dr. S would be too subtle, but I feel more comfortable with him due to the fact he demands x-rays for safety and does the surgery in a hospital (Dr. Z does not provide either). Dr. Z is local to me though. Dr. Z said Dr. S is unable to shave the chin vertically due to the "inside the mouth" technique, but who knows if it is true. I can't find pictures where Dr. S actually shaved the chin.

I should add, I am a genetic woman, but my jaw is large and masculine.

http://i.imgur.com/zILSqbJ.png

http://i.imgur.com/6SEVtWu.png

The shadow actually shaves off some of my jaw..
http://i.imgur.com/ZyhAPeS.png

http://i.imgur.com/9RloyuK.png

BTW - - I went back and looked at your pictures.  Sorry I should have looked before the last post. 

You are an incredibly beautiful woman.   Please be careful in your research and "get this right" - -  the first time.  You really do not want any "re-do's".   One of the reasons you want to see an orthognathic surgeon is because there are some recently developed methods to use digital modeling of the bone structure in order for the jaw surgeon to better predict the final result.  That is pretty new technology - -  but it is being done by at least a few orthognathic surgeons, and some of them are also fully certified ABMS / ABPS board certified plastic surgeons.       

  •  

kittenpower

Also, from the pictures you have shared, you look as though you could be a professional model, therefore your current jaw and chin shape could give you a unique look, and if you decide to alter them, it could change your look so much, that it could affect your ability to find jobs, or on the other hand it could help you. I'm just making an assumption based on what I could see in your pictures, so please forgive me if I am overstepping any boundaries. 
  •  

jayhey

Quote from: myfairlady49 on June 16, 2015, 11:25:42 PM
BTW - - I went back and looked at your pictures.  Sorry I should have looked before the last post. 

You are an incredibly beautiful woman.   Please be careful in your research and "get this right" - -  the first time.  You really do not want any "re-do's".   One of the reasons you want to see an orthognathic surgeon is because there are some recently developed methods to use digital modeling of the bone structure in order for the jaw surgeon to better predict the final result.  That is pretty new technology - -  but it is being done by at least a few orthognathic surgeons, and some of them are also fully certified ABMS / ABPS board certified plastic surgeons.     

Thank you for that suggestion! It did not cross my mind and have only looked into plastic surgeons for FFS. I will reach out to a local orthognathic/maxillofacial surgeon and ask if they do jaw reductions. I mean, they cut the jaw already for overbites.. can't they shave mine down? Maybe they can at least give referrals. Great idea.

Thank you for the compliments.  ;D
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jayhey

Quote from: kittenpower on June 16, 2015, 11:30:33 PM
Also, from the pictures you have shared, you look as though you could be a professional model, therefore your current jaw and chin shape could give you a unique look, and if you decide to alter them, it could change your look so much, that it could affect your ability to find jobs, or on the other hand it could help you. I'm just making an assumption based on what I could see in your pictures, so please forgive me if I am overstepping any boundaries.

One of the photos was for a (free) photo shoot to try and boost my self-esteem and get me out of my shell. I am not a professional, but thank you! You are not overstepping. Honestly, after getting that photo shoot done, it only showed me how large my jaw actually was. I was being deceived by the shadow in my bathroom mirror I'd look at every morning.
  •  

Ever

One thing I'm skeptical about with those before and after shots, not only for the reasons mentioned above, but also because every single one of the before's head is tilted back, while all the after's are tilted forward.



Yes, you do look like a gorgeous creature!


But I also understand the desire to change something that others may hastily dismiss you as being too self-deprecating.

I'm sorry this has bothered you so much... and hopefully you get what you need, and have it done well...

I don't say this in any paternalistic sense, but I think it may be good to find a therapist to just talk to about how you feel.  To reflect on my own case: there's all these annoying hoops I had to jump through in order to start hormones, but in retrospect, I see that I made some fantastic bonds and helped myself in ways I wouldn't have otherwise sought... (however, I find that I don't fit well with 19 out of 20 therapists I try out, so it takes some shopping sometimes, or sometimes you get lucky on the first try)

In any case, it hasn't changed the fact that I'm going to get FFS in August, but it has helped me to talk about it, and has inclusively helped me with making the decision of surgeon.
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myfairlady49

Quote from: jayhey on June 16, 2015, 11:41:40 PM
Thank you for that suggestion! It did not cross my mind and have only looked into plastic surgeons for FFS. I will reach out to a local orthognathic/maxillofacial surgeon and ask if they do jaw reductions. I mean, they cut the jaw already for overbites.. can't they shave mine down? Maybe they can at least give referrals. Great idea.

Thank you for the compliments.  ;D

Jayhey,

Sorry - -  maybe I was more confusing than clear.   
I would suggest that what you really should find for your surgeon is:

First,  a  plastic surgeon.  A board certified plastic surgeon and one who is board certified by the Am Brd of Plastic Surgery (an ABMS approved "real" board, rather than one of the pseudo boards).

Second,  that board certified plastic surgeon should ALSO be trained in orthognathic (or oral maxillo facial) surgery. 

One without the other - -  is not what I suspect that you really want.  You will probably have to travel to find one.  Some of the surgeons trained this way also do FFS and a couple of them are also trained in craniofacial surgery.

There are not very many in the U.S. that are both.  There are some.   But be careful ! Be thorough.   The internet makes this confusing.   There are some maxillo-facial surgeons  who claim to also be plastic surgeons,  but they are not actually trained as plastic surgeons (full five or six year plastic surgery training program ) and they are not board certified by the ABPS.   Some advertise some of the pseudo boards which have confusingly similar names (example: ABFPS - - Am Brd of Facial Plastic Surgery). If you are unsure,  you can go to  the  www.abms.org (american board of medial specialties web site) and find a list of the 24 boards that are the "real deal".   The ABFPS is not one of those 24 recognized boards.

And given what is evident from your pictures - -  a decision to have nothing done may have some merit.   But do your homework.

  •  

sh1982

Quote from: jayhey on June 16, 2015, 11:45:01 PM
One of the photos was for a (free) photo shoot to try and boost my self-esteem and get me out of my shell. I am not a professional, but thank you! You are not overstepping. Honestly, after getting that photo shoot done, it only showed me how large my jaw actually was. I was being deceived by the shadow in my bathroom mirror I'd look at every morning.

If you want to achieve a result close to what the asian girls got in the photos you shared you will need more then just shaving, you would need a genioplasty for your chin and most likly what is called 2 jaw surgery korea wherby they move your lower and/or upper jaw forward or backward depending on that is needed you would also need to a wear braces after that kind of surgery/
  •  

jayhey

Quote from: myfairlady49 on June 17, 2015, 05:32:29 PM
Jayhey,

Sorry - -  maybe I was more confusing than clear.   
I would suggest that what you really should find for your surgeon is:

First,  a  plastic surgeon.  A board certified plastic surgeon and one who is board certified by the Am Brd of Plastic Surgery (an ABMS approved "real" board, rather than one of the pseudo boards).

Second,  that board certified plastic surgeon should ALSO be trained in orthognathic (or oral maxillo facial) surgery. 

One without the other - -  is not what I suspect that you really want.  You will probably have to travel to find one.  Some of the surgeons trained this way also do FFS and a couple of them are also trained in craniofacial surgery.

There are not very many in the U.S. that are both.  There are some.   But be careful ! Be thorough.   The internet makes this confusing.   There are some maxillo-facial surgeons  who claim to also be plastic surgeons,  but they are not actually trained as plastic surgeons (full five or six year plastic surgery training program ) and they are not board certified by the ABPS.   Some advertise some of the pseudo boards which have confusingly similar names (example: ABFPS - - Am Brd of Facial Plastic Surgery). If you are unsure,  you can go to  the  www.abms.org (american board of medial specialties web site) and find a list of the 24 boards that are the "real deal".   The ABFPS is not one of those 24 recognized boards.

And given what is evident from your pictures - -  a decision to have nothing done may have some merit.   But do your homework.

I found someone with better credentials. Dr. Barry Eppley (has he ever been talked about on here for jaw work?)
"He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery."
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