HA paste on cheeks + ZSO/chin wing

[beautyislife]

I will reach out to the Drs that do this, but I imagine the answer is no or would have to wait until post - op.
For my aesthetic goals, I think I'll need a zso and chin wing after jaw surgery, however, if I get HA paste on my cheeks, is a ZSO possible? HA is supposed to be permanent, but I'm wondering if because of the way it's placed, if that makes a ZSO impossible? or more difficult?

[Dogmatix]

I don't know the answer to you specific situation or plan. But in general, don't put something on, or modify a part, if you're going to move it later. Don't put in a chin implant if you're going to do a bsso later, and don't put HA paste on something that you're planning to move the underlying part from later. A doctor will probably not put on HA paste if they themself don't think it's the final procedure.

[Lazlo]

I will reach out to the Drs that do this, but I imagine the answer is no or would have to wait until post - op.
For my aesthetic goals, I think I'll need a zso and chin wing after jaw surgery, however, if I get HA paste on my cheeks, is a ZSO possible? HA is supposed to be permanent, but I'm wondering if because of the way it's placed, if that makes a ZSO impossible? or more difficult?

I also want to know if a chinwing is possible after double jaw surgery where ha paste might be used to create symmetry and widen the jaw angles. If I have surgery with gunson and he uses HA paste to widen my chin or whatnot, can I still have a chinwing with triaca afterward?

[kavan]

I will reach out to the Drs that do this, but I imagine the answer is no or would have to wait until post - op.
For my aesthetic goals, I think I'll need a zso and chin wing after jaw surgery, however, if I get HA paste on my cheeks, is a ZSO possible? HA is supposed to be permanent, but I'm wondering if because of the way it's placed, if that makes a ZSO impossible? or more difficult?

Sounds like you want to go to Gunson for bimax and HA paste to cheeks (as that was offered to you by him) and THEN go to Dr. Z to do a chin wing and ZSO.

So, correct, the answer is NO. If you want bimax and ZSO and chin wing than just get all of the above with Z. If you want bimax with Gunson (with standard BSSO) and the HA paste to the cheeks, then FORGO the chin wing and ZSO with Z.

Chinwing docs don't want to do them if you have a standard BSSO as they don't want to cut through the cut made for it. So, if you want a chin wing, you will need the type of BSSO (high bsso) the CW docs do if you also want bimax.   As to the HA paste, gotta wonder why it isn't intuitively obvious WHY one would NOT put that stuff over the bone and THEN plan on a ZSO afterwards. Think about it more.

You don't need more beauty. You need BRAINS.

[Lazlo]

Sounds like you want to go to Gunson for bimax and HA paste to cheeks (as that was offered to you by him) and THEN go to Dr. Z to do a chin wing and ZSO.

So, correct, the answer is NO. If you want bimax and ZSO and chin wing than just get all of the above with Z. If you want bimax with Gunson (with standard BSSO) and the HA paste to the cheeks, then FORGO the chin wing and ZSO with Z.

Chinwing docs don't want to do them if you have a standard BSSO as they don't want to cut through the cut made for it. So, if you want a chin wing, you will need the type of BSSO (high bsso) the CW docs do if you also want bimax.   As to the HA paste, gotta wonder why it isn't intuitively obvious WHY one would NOT put that stuff over the bone and THEN plan on a ZSO afterwards. Think about it more.

You don't need more beauty. You need BRAINS.

Kavan, with respect, I understand what you're saying about the the different bsso cut, though do we really know triaca or brusco wouldn't attempt a chinwing after someone has had a regular BSSO. I know Dr. Z refused a patient recently for this reason, but will all the other docs?

Also, do you think the reason you can't have an osteotomy if HA is applied to the area because the HA will crack up or dissipate once it's cut into? I clearly lack the brains to forsee what would happen. I mean if the HA is integrated and solidly on the bone,  couldn't it just be cut through as normal bone would and moved? I'm thinking about how Gunson applies the HA to the bone and it integrates. Are you saying cutting and moving segments with HA would be problematic? And why?

[kavan]

I don't know the answer to you specific situation or plan. But in general, don't put something on, or modify a part, if you're going to move it later. Don't put in a chin implant if you're going to do a bsso later, and don't put HA paste on something that you're planning to move the underlying part from later. A doctor will probably not put on HA paste if they themself don't think it's the final procedure.

BINGO! Don't do something ass backwards.

[kavan]

Kavan, with respect, I understand what you're saying about the the different bsso cut, though do we really know triaca or brusco wouldn't attempt a chinwing after someone has had a regular BSSO. I know Dr. Z refused a patient recently for this reason, but will all the other docs?

Also, do you think the reason you can't have an osteotomy if HA is applied to the area because the HA will crack up or dissipate once it's cut into? I clearly lack the brains to forsee what would happen. I mean if the HA is integrated and solidly on the bone,  couldn't it just be cut through as normal bone would and moved? I'm thinking about how Gunson applies the HA to the bone and it integrates. Are you saying cutting and moving segments with HA would be problematic? And why?

I can't really predict what the other CW docs will or won't do. I just understand the reasoning behind WHY they prefer the mandibular border (that they need to cut through to do the chin wing) NOT be compromised by a prior (standard) BSSO cut.

If you want HA paste, get it as the LAST thing you do.

Other than that, all I can suggest is to consult with the doctors you will be needing to cut through your HA paste and standard BSSO AHEAD OF TIME and tell us what they tell you.

ETA:
For all intents and purposes, HA over an area to augment it, is pretty much an IMPLANT. It's an implant made with bone paste. So, if you are going to have it, have it as the LAST thing you do and not something you want the next doctor to cut through. So, this question resolves to; 'Why can't he cut through my HA IMPLANT?'

Ass backwards. Get your HA IMPLANTS after your bone cuts. Not before them.

[Lazlo]

I can't really predict what the other CW docs will or won't do. I just understand the reasoning behind WHY they prefer the mandibular border (that they need to cut through to do the chin wing) NOT be compromised by a prior (standard) BSSO cut.

If you want HA paste, get it as the LAST thing you do.

Other than that, all I can suggest is to consult with the doctors you will be needing to cut through your HA paste and standard BSSO AHEAD OF TIME and tell us what they tell you.

ETA:
For all intents and purposes, HA over an area to augment it, is pretty much an IMPLANT. It's an implant made with bone paste. So, if you are going to have it, have it as the LAST thing you do and not something you want the next doctor to cut through. So, this question resolves to; 'Why can't he cut through my HA IMPLANT?'

Ass backwards. Get your HA IMPLANTS after your bone cuts. Not before them.

sensible advice, thanks.