As an update on the herbst, it's really uncomfortable. My teeth don't touch and chewing is hard. Speaking is very difficult too, and I have a big lisp. My jaw hurts and feels like it's too far forward. Eating has been very hard. I've been going to speech therapy to adjust to speaking and eating with the appliances, and it's helped some.
I had a consult with an oral surgeon yesterday about getting a chin implant. He took photos like at an orthodontist consultation. He said the herbst is improving my jawline, giving me a more distinct jawline and facial profile. That should improve more as the herbst is activated. He said I still have basically no chin and while the herbst is giving me a lower jawline, it would take an implant to give me a chin. He recommended it in order to balance my face and improve my facial profile. He said the procedure shouldn't be too hard to recover from. He will consult with my orthodontist, but recommended doing the implant while I still an in braces, just so more adjustments can be made to the treatment if needed. He may want to do it as soon as in several months. I'll talk to my orthodontist more about it at my next appointment.
One final question about getting dental work while in orthodontic treatment. On Monday, I had to have several fillings. My dentists knows I'm in orthodontic treatment, as he's the one who's been suggesting I do it for a while. It still felt odd to show up with the appliances and I wasn't sure if they could do the fillings. He had to undo the herbst and was able to get the fillings, though the tongue crib was a bit in the way. It was just an unusual experience.