Thoughts on HA paste for square chin

[needadvancement]

ha paste seems to have a bad rep on here. If it is true about the downsides then I understand the risks if it's used between cuts of bones. But what about adding it on top of the chin bone to make a square shape. What is the worst that can happen, that eventually your chin goes back to its original shape?

[SJay]

Not sure about the square chin, but I know Dr Gunson often uses it to sharpen the whole jawline. We considered it when I got my genio with him but didn't do it in the end. When I asked, he said worse case is asymmetry, and he would simply revise it, adding a little more to the lower side if needed. He noted I had very slight asymmetry to begin with, so said that'd be taken into account else the asymmetry could be amplified. It's actually extremely light stuff, he showed me some of it. It's almost like polystyrene but in fine granuals which are squashed together. Depending on where you want it, you may need additional incisions towards the back of the mouth.

[needadvancement]

Not sure about the square chin, but I know Dr Gunson often uses it to sharpen the whole jawline. We considered it when I got my genio with him but didn't do it in the end. When I asked, he said worse case is asymmetry, and he would simply revise it, adding a little more to the lower side if needed. He noted I had very slight asymmetry to begin with, so said that'd be taken into account else the asymmetry could be amplified. It's actually extremely light stuff, he showed me some of it. It's almost like polystyrene but in fine granuals which are squashed together. Depending on where you want it, you may need additional incisions towards the back of the mouth.

Very light? How about the toughness of this stuff.

[SJay]

It's tough, just surprisingly light, and you can see all the fine grains it's comprised of. They preheat it before the surgery, mix a little of your own bone in for good measure, mould it into place and let it set.

[needadvancement]

Okay. I would hope it can withstand a hard impact. If my chin was wide enough I would just get it shaved down into a square shape but I don't, and ha paste looks like a much better option than an implant.

[asphyxia]

I'm looking for the same thing, that square shape, because even after my genio, my chin is still pointy. It's not exactly a side effect, it was even more so before, just my thin bones, again.
Since we were talking about it, needadvancement, maybe this could be an alternative to a repeated genio,  because wide chins need less projection to look good.
But, would A&G be willing to perform this without further jaw surgery?  How about foreign body reactions down the line?

[needadvancement]

I'm looking for the same thing, that square shape, because even after my genio, my chin is still pointy. It's not exactly a side effect, it was even more so before, just my thin bones, again.
Since we were talking about it, needadvancement, maybe this could be an alternative to a repeated genio,  because wide chins need less projection to look good.
But, would A&G be willing to perform this without further jaw surgery?  How about foreign body reactions down the line?

If you can go to them you'll probably be in good hands, unfortunately that's too far away for me so I'd need to look around in North Europe.

Also there is another osteotomy where they cut the chin bone like a sliding genio and then cut it down the middle as well so they can spread it and make it wider. However there's the issue of notches forming afterwards but if the chin is wide enough later, they could easily shave it down and also make it square. This could work I think?

[asphyxia]

Yes, it would, it's called T shape osteotomy, but I don't know of a surgeon who performs it, although it's technically logical, it's very rarely used for widening.

But an "onlay" seems more straightforward to me, injecting radiesse for instance could provide aesthetically satisfying results, but, as for me, I won't. I want something permanent, and I don't want to mess up with that area with injectables again.
Also,I'm in Europe too, an I know how difficult it is down here to find a middle way between purely functional and cosmetic surgery.

I'm glad you're looking for the same thing as I do, but I still don't get why there aren't more maxillo facial procedures to change the shape of the chin aside from those silicone things, because a deficient chin is often a narrow one as well, and you need to correct defects in 3 dimensions.

[needadvancement]

Yes, it would, it's called T shape osteotomy, but I don't know of a surgeon who performs it, although it's technically logical, it's very rarely used for widening.

But an "onlay" seems more straightforward to me, injecting radiesse for instance could provide aesthetically satisfying results, but, as for me, I won't. I want something permanent, and I don't want to mess up with that area with injectables again.
Also,I'm in Europe too, an I know how difficult it is down here to find a middle way between purely functional and cosmetic surgery.

I'm glad you're looking for the same thing as I do, but I still don't get why there aren't more maxillo facial procedures to change the shape of the chin aside from those silicone things, because a deficient chin is often a narrow one as well, and you need to correct defects in 3 dimensions.

Exactly right. I'm booked for sliding genio end of next month and it will be both vertical and forward movement so it will be a big step forward. But if I can get some squareness somehow later on it would be the cherry on top.

[asphyxia]

I wish you well , it's not a tough procedure, I would do it all over again tomorrow if I had to
 

[Bobbit]

ha paste seems to have a bad rep on here. If it is true about the downsides then I understand the risks if it's used between cuts of bones. But what about adding it on top of the chin bone to make a square shape. What is the worst that can happen, that eventually your chin goes back to its original shape?

I think you are wanting to end up with one of those impressive masculine squared off frontal jaw profiles.  ( Many of us would like to have the same ! )

I don't think hydroxyapatite (alone) can do what I think you are wanting.    I wonder if it is even possible to do it that way.

However, the procedure I suspect that would actually accomplish what I *think* you are really wanting (make the chin more masculine) to have done is something that I recall as being described somewhere in the literature,  but I can't find a copy on line.   Authors were maybe either Ousterhout or Ousterhout and Tessier. 

I think it is described as something like a segmental osteotomy of the chin with expansion in both the vertical and horizontal directions, and a bone graft to fill in the space opened up by the segmental movement and then some hydroxyapatite to fill in some of the intervals or on some of the corners (really guessing on that part).  Depending on how much vertical height you have, you might not want the vertical expansion,  but to get a squared off jaw shape - - you would still probably want to get the horizontal expansion portion of that procedure, but maybe without part or most of the vertical expansion. (Have not seen any pictures to be able to guess at that.)

Pretty sure all of that is a significantly different procedure than a simple sliding genioplasty.

[needadvancement]

Thanks for the input guys. Hopefully I'll be so satisfied with my SG next month that I might not even care about this at all afterwards. Bobbit yes I want that masculine square chin. I also have a bit of a cleft in the middle too btw, I once heard that that's considered masculine looking as well but not sure.

[Schrödingers Jaw]

But can fillers really provide angularity?

It's soft tissue augment at the end of the day isn't it, I get that it will add projection but wouldn't it make the jawline "soft"?

[SJay]

I don't think so. I tried a little in the chin a couple of years ago, it didn't look good.