bimax + chinwing + genio?

[ppsk]

So we know its possible for the bimax and chin wing (or "side wing" as some prefer to call it) can be done at the same time, but is there any reason a genio could not also be done at the same time?

Seems like this would be ideal to do it all in one shot, and would provide the most transformative effect: advancing the maxillomandibular complex, projecting the chin, and widening the posterior/jaw angles.

I realize its a big surgery, but does anyone know if it has been done, or if there is any reason it cannot be done?

[Milli_Meters]

Bimax and genio are routinely performed together.

Sometimes a chin wing focuses more on the jaw angles and to distinguish this type of procedure from the one that emphasises  on the chin it is called a "side wing".

Bimax + chinwing + genio... the genio sounds a bit redundant because the traditional chin wing(which is less concerned with the lateral augmentation of jaw) is kind of an exaggerated genio.

Those are my 2 cents. Maybe others can shed some insight. You might also wanna ask the surgeons who are doing the chin wing.

[swsee]

I had asked Dr Z about doing a bsso, side wing, and genio, since my goal was to not blunt my jaw angles. He said he doesn't do it due to lack of blood flow to the segments, which didn't make much sense since he does all of these as standalones, but that was his reasoning. Anyway, I think that would be the best approach if you can find someone to do it.

[Vic]

That's way too much surgery in the same area's at once. If you ever wanted a reversal, there would be no way to do it and the risk of having permanent nerve damage after will be very high. Surgeries are best to be done in stages, give your body the ability to heal and repair itself then see what needs to be done, that way you know that each movement is exactly how it should be and you don't have all different movements effecting each other

[ppsk]

That's way too much surgery in the same area's at once. If you ever wanted a reversal, there would be no way to do it and the risk of having permanent nerve damage after will be very high. Surgeries are best to be done in stages, give your body the ability to heal and repair itself then see what needs to be done, that way you know that each movement is exactly how it should be and you don't have all different movements effecting each other

see Dr Z told me he can do bimax + chin wing in same surgery, and if progenica is anything to go by this actually seems to be a very common combination.

I'm just wondering why its a bridge too far to add genio in as well. Segments too small or something?

[boyo]

see Dr Z told me he can do bimax + chin wing in same surgery, and if progenica is anything to go by this actually seems to be a very common combination.

I'm just wondering why its a bridge too far to add genio in as well. Segments too small or something?

Segmenting is really not recommended. With more segments is the increased risk of relapse and i'm not only talking about the grafted bone disappearing, but whole parts of your own. Triaca and Z highly discourage it with the exception of the chin area which picks up nutrients more easily then other parts of the lower jaw and can be done. 

[johnnyg12]

Wouldn't this be overkill unless someone has a very recessed chin? Chin wing is just a more invasive genioplasty. I wouldn't see the need to add a genio at all? How far are you trying to make your chin stick out? Just my two cents. All the results I see for bimax + genio look great.

[Milli_Meters]

Wouldn't this be overkill unless someone has a very recessed chin? Chin wing is just a more invasive genioplasty. I wouldn't see the need to add a genio at all? How far are you trying to make your chin stick out? Just my two cents. All the results I see for bimax + genio look great.

Exactly what I was thinking. Why would anyone get a genio when the chin is already being advanced with the wing. Generally folks who have genio after wing its to correct  asymmetry etc rather than further advancement.

I intend on getting bi max  and chin wing. Unless the surgeon is super confident about doing both at the same time I would prefer to get them separately.

[ppsk]

Exactly what I was thinking. Why would anyone get a genio when the chin is already being advanced with the wing. Generally folks who have genio after wing its to correct  asymmetry etc rather than further advancement.

I intend on getting bi max  and chin wing. Unless the surgeon is super confident about doing both at the same time I would prefer to get them separately.

the chin wing in this case is being used for lateral movement, not sliding forward.

[Milli_Meters]

Gotcha

imho its better to get 2 separate wings with separate focal points.  It has been suggested its a compromise between lateral projection of jaws in the back and chin projection in the front. 

[johnnyg12]

Is there any other procedure that widens the jaw besides chin wing or implants? SARPE doesn't seem to do that much, if that's even the purpose.

[ppsk]

Is there any other procedure that widens the jaw besides chin wing or implants? SARPE doesn't seem to do that much, if that's even the purpose.

supposedly greyandblue knows of some procedure, but he's not telling

I can't even imagine what else could be possible.

There is distraction osteogenesis in its many different iterations - but doesn't seem to be widely performed for whatever reason despite the obvious advantages. I'm guessing the growth is unpredictable, takes a lot of patient compliance over a long period of time and the gear is expensive.

[johnnyg12]

supposedly greyandblue knows of some procedure, but he's not telling

I can't even imagine what else could be possible.

There is distraction osteogenesis in its many different iterations - but doesn't seem to be widely performed for whatever reason despite the obvious advantages. I'm guessing the growth is unpredictable, takes a lot of patient compliance over a long period of time and the gear is expensive.

It looks like it wouldn't even be worth it, seems to me a lot could go wrong because of the anatomy. Could result in asymmetry that would require for more surgeries or implants just to cover it up.

[ppsk]

It looks like it wouldn't even be worth it, seems to me a lot could go wrong because of the anatomy. Could result in asymmetry that would require for more surgeries or implants just to cover it up.

probably isn't.

Of the few public DO results I've seen, three were completely underwhelming and the results from a BSSO by the same doctor were significantly better, and the one good DO result Ive seen also had a genio and other stuff performed.