Chin Wing after Bi-Max ??

[kavan]

I’m not coming in through SJ in the slightest. In fact his isolated experience turns me off from it. I am interested in CW because of what it can theoretically do. I only commented on SJ because it’s relevant that he had prior jaw surgery. His relevance to this thread stops there.

If SJ's stuff is what let you know about CW's and Z, than you would be coming in with SJ's stuff. Either way, people who want Z's chin wing look like they will also either need to have 'virgin' jaws OR have Z do the L1 and BSSO work/cuts.

[Lazlo]

If SJ's stuff is what let you know about CW's and Z, than you would be coming in with SJ's stuff. Either way, people who want Z's chin wing look like they will also either need to have 'virgin' jaws OR have Z do the L1 and BSSO work/cuts.

Yeah I have a feeling you're right that his recent experiences have not been satisfactory on patients who have already had bi-max. Jeesh, another thing that just sucks in the world. I think I should just become a Buddhist monk and accept all is suffering.

[ODog]

I know it sucks I really didn’t want to go the implant route. Really disapointed.

[PloskoPlus]

If SJ's stuff is what let you know about CW's and Z, than you would be coming in with SJ's stuff. Either way, people who want Z's chin wing look like they will also either need to have 'virgin' jaws OR have Z do the L1 and BSSO work/cuts.

Strange. Part of Triaca's sales pitch is that chin wings allow to camouflage dodgy bssos. A few people here had them done for this very reason.

[ODog]

I am going to email Triaca then and some others.

[GJ]

SJ is still extremely recessed, after bi-max and at least one chin wing, though I do think he had two.

He's been doing crazy plastic surgery procedures to try to mask everything, and now he just looks flat out odd.

[beautyislife]

fwiw, I have spoke to dr. brusco and he mentioned that a chin wing is possible after bi-max, but like others have said, they would need to see the end result of your bimax to see if a chin wing was doable. I think Z is pretty much indicating the same, but prefers to do it all together himself so he has control over movements.

[kavan]

Strange. Part of Triaca's sales pitch is that chin wings allow to camouflage dodgy bssos. A few people here had them done for this very reason.

Could be. But as far as sales pitches or claims go, it all boils down to candidacy. What kind of BSSO someone had would relate to candidacy for chin wing.

3 basic variations; The Trauner-Obwegeser (TO), Obwegeser (Ob), and Obwegeser-Dal Pont (OD).

First one, 'TO' is basically the type they call 'high BSSO' and prefer to use when they are also going to add a chin wing to the surgery or maybe do one later down the line. Last one; 'OD' is the more modern one and commonly used BSSO. Middle one, somewhere in-between.

Here's a clip of the 3 basic BSSO variations.

[ODog]

fwiw, I have spoke to dr. brusco and he mentioned that a chin wing is possible after bi-max, but like others have said, they would need to see the end result of your bimax to see if a chin wing was doable. I think Z is pretty much indicating the same, but prefers to do it all together himself so he has control over movements.

Thanks for sharing. Be careful with Dr. Brusco he totally screwed up BenFromUK... as far as I understand, instead of dropping down the back jaw angles he made the cut further down and dropped the front/ middle part of the mandible, elongating the wrong part of the face which was already long to begin with. He’s now getting implants put in to fix the mistake.

[PloskoPlus]

Could be. But as far as sales pitches or claims go, it all boils down to candidacy. What kind of BSSO someone had would relate to candidacy for chin wing.

3 basic variations; The Trauner-Obwegeser (TO), Obwegeser (Ob), and Obwegeser-Dal Pont (OD).

First one, 'TO' is basically the type they call 'high BSSO' and prefer to use when they are also going to add a chin wing to the surgery or maybe do one later down the line. Last one; 'OD' is the more modern one and commonly used BSSO. Middle one, somewhere in-between.

Here's a clip of the 3 basic BSSO variations.

Good post.

Looks like the popular cut maintains more bone contact and allows for larger advancement vs the chin wing optimised cut.

[PloskoPlus]

SJ is still extremely recessed, after bi-max and at least one chin wing, though I do think he had two.

He's been doing crazy plastic surgery procedures to try to mask everything, and now he just looks flat out odd.

Yep. Very disappointing that a big name like Pelo could not even give him a decent bite. That's the absolute minimum a surgeon should do.

[kavan]

Good post.

Looks like the popular cut maintains more bone contact and allows for larger advancement vs the chin wing optimised cut.

Yes indeed. The popular cut (3rd one) allows for the most advancement and the one that's usually combined with the CCW.

 According to one study (the one I found the diagrams on), the 3rd cut was found to be the most stable.

The first cut didn't start out as a chin wing optimized cut.  it was just an EARLIER version of the BSSO.

But as you can see by looking at the 1rst one, which is what the chin wing docs call 'High BSSO', you can see why they like that because it IS optimized to do a CW because where they cut to do a chin wing does not traverse the cut the do for the high BSSO.

[Lazlo]

I don't even know what BSSO cut I got.

I had an aggressive genioplasty so I don't think a chin wing is even appropriate for me, unless I guess to lower the ramus area. What kind of chin wing is that? Is that what's called a wing osteotomy or something?

[ODog]

I don't even know what BSSO cut I got.

I had an aggressive genioplasty so I don't think a chin wing is even appropriate for me, unless I guess to lower the ramus area. What kind of chin wing is that? Is that what's called a wing osteotomy or something?

That's a side wing and it doesn't matter; if your cut is the one Dr. Z and Kavan is saying disqualifies you, it would be for both chin wing and side wing.

He did give a follow-up response to me when I asked if this was a new approach he was taking, and he said "it's not always the case, but very often."

I guess the next thing to determine is why some BSSO cuts are preferred to others and why. Is it arbitrary? Does it depend on the surgeon?

I am getting 6-7 mm advancement, which I would say is a moderate movement, so maybe my surgeon won't make the cut Kavan is saying is for "larger movement." Who knows... but I'm not about to tell my surgeon where to cut my mandible lol.

[kavan]

Most BSSO's are the modern ones which is the 3rd one .