Author Topic: chin setback after chinwing  (Read 1516 times)

hadmysurgery

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chin setback after chinwing
« on: August 01, 2017, 09:53:20 AM »
Did anyone get a chin setback? As I wrote I had a chinwing and the submental fold, and actually the wider area of the lower part of the lower lip, also at the sides, looks really recessed. There is no support here of the lower part of the lower lip, the lip seems to almost flip inwards also when smiling.
I've tried to explain it as moving the lowest 1-1.5 cm of the mandible forward horizontally, which is what happens with the chinwing. You will end up with a horizontal disk-like shape that is flat on the upper surface, with just empty space above it. See it as putting a disk-like implant with a flat upper surface on the lowest part of the chin: the space above it is entirely empty.

I contacted a few surgeons that advised a chin setback (not my own surgeon; I do not know what he advises). I would really regret this as I needed the forward movement in the chin but then again: this doesn't look natural to me either.

Has anyone gotten a chin setback. What did it entail exactly and what was the result like?




« Last Edit: August 01, 2017, 10:15:10 AM by hadmysurgery »

Freeways

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Re: chin setback after chinwing
« Reply #1 on: August 01, 2017, 10:29:25 AM »
If I were you I would get a chin visor, this will improve the mentolabial fold as well as lower lip support. In the chin wing+visor results I've seen the fold looks natural and good, so I think this is a better idea than a chin setback. The surgeons who perform chin wing can also perform a chin visor, and the visor is much cheaper.
« Last Edit: August 01, 2017, 10:38:58 AM by Freeways »

boyo

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Re: chin setback after chinwing
« Reply #2 on: August 01, 2017, 10:56:58 AM »
If I were you I would get a chin visor, this will improve the mentolabial fold as well as lower lip support. In the chin wing+visor results I've seen the fold looks natural and good, so I think this is a better idea than a chin setback. The surgeons who perform chin wing can also perform a chin visor, and the visor is much cheaper.
please explain what exactly a chin visor is.

hadmysurgery

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Re: chin setback after chinwing
« Reply #3 on: August 01, 2017, 11:12:42 AM »
If I were you I would get a chin visor, this will improve the mentolabial fold as well as lower lip support. In the chin wing+visor results I've seen the fold looks natural and good, so I think this is a better idea than a chin setback. The surgeons who perform chin wing can also perform a chin visor, and the visor is much cheaper.

What I should have explained is that not everyone is a candidate for the chin visor. I am not a candidate for it I was informed as I have not a lot of bone there to do a visor.
Everyone has different anatomy in addition. I have a vertically short chin with little bone there.
Surgeons should inform patients not everyone can get a visor before getting the chinwing, because ending up with what to me is an unnatural looking chin is disappointing.

Freeways

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Re: chin setback after chinwing
« Reply #4 on: August 01, 2017, 11:13:28 AM »
please explain what exactly a chin visor is.
https://www.researchgate.net/publication/282871365_Visor_Osteotomy_of_the_Anterior_Mandible

What I should have explained is that not everyone is a candidate for the chin visor. I am not a candidate for it I was informed as I have not a lot of bone there to do a visor.
Everyone has different anatomy in addition. I have a vertically short chin with little bone there.
Surgeons should inform patients not everyone can get a visor before getting the chinwing, because ending up with what to me is an unnatural looking chin is disappointing.

Oh I'm sorry. Your surgeon seems pretty irresponsible if he didn't warn you about the fold beforehand. You could look into radiesse filler for the fold, but this would obviously be temporary. As for a setback genioplasty, the soft tissue response is not as predictable as with a forward movement, but I think your issue can be corrected quite well (obviously hard to say without pictures).

http://www.sciencedirect.com/science/article/pii/026643569290076U - "The soft tissue response was equal to the bone movement in the anterior repositioning but less predictable in- the posterior direction or when combined with vertical reduction." Furthermore: " In some cases of posterior repositioning of the segment, the soft tissue in front of the bone surface became thicker several months postoperatively. This could minimise the effect of the surgery."
« Last Edit: August 01, 2017, 11:31:34 AM by Freeways »

hadmysurgery

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Re: chin setback after chinwing
« Reply #5 on: August 01, 2017, 11:16:24 AM »
I know the paper, I know the visor.

Not everyone is a candidate to get a visor, I was told. And so you can end up with what to me looks like an unnatural result without solution.

I have no idea what the reason was to get a thumbs-down for any post I made in this thread on another note. Is it since my result from chinwing is not optimal to me and since I have aesthetic concerns? That seems almost 'not done' here, and is mostly critisized by people who didn't get a chinwing in the first place and don't seem to comprehend there can be drawbacks to this procedure. I paid a lot of money and am experiencing those drawbacks and it doesn't look natural to me. Frankly that is a bit unfortunate to experience: others wouldn't want to be in that position either.
« Last Edit: August 01, 2017, 11:34:27 AM by hadmysurgery »

hadmysurgery

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Re: chin setback after chinwing
« Reply #6 on: August 01, 2017, 11:33:24 AM »
As for a setback genioplasty, the soft tissue response is not as predictable as with a forward movement, but I think your issue can be corrected quite well (obviously hard to say without pictures). http://www.sciencedirect.com/science/article/pii/026643569290076U - "The soft tissue response was equal to the bone movement in the anterior repositioning but less predictable in- the posterior direction or when combined with vertical reduction." Furthermore: " In some cases of posterior repositioning of the segment, the soft tissue in front of the bone surface became thicker several months postoperatively. This could minimise the effect of the surgery."

Thank you Freeway, some helpful info. The last part about the soft tissue becoming thicker is a bit discouraging.

Lefortitude

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Re: chin setback after chinwing
« Reply #7 on: August 01, 2017, 03:06:33 PM »
you could consider a sliding genioplasty with an aditional bone graft to add vertical height to the chin.  This ofcorse only makes sense if you have a vertically short chin.  If your chin is already vertically long you risk throwing off the balance further.  However, lengthening the chin vertically will reduce the fold.