I didn't suggest one thing or the other to you. I suggested that although implants (custom) can be placed over osteotomies there would be no need to get the osteotomy if you were to later get an implant BECAUSE the implant would address the desired widening. Hence, you must choose one or the other.
I can't tell you the 'exact' risks to you specifically as to one over the other. But the doctor is telling you risks (unfavorable fracture) with the chin wing is higher than it would be in someone with a 'virgin' area. So, if you are OVERLY FOCUSED (which you are) on ANY risks with an implant and enough so you're only focusing on the potentially NEGATIVE things with an implant and not the potentially POSITIVE things that could mean you'd be willing to take the chance of a higher risk of an unfavorable fracture in order to avoid the risks you associate with implants. That's called 'risk aversion' when someone is MORE afraid of one thing than the other EVEN IF the risks with either would be equal.
DECISION MAKING UNDER UNCERTAINTY.
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In decision making analysis, it is something where one needs to make a decision in the absence of CERTAINTY where the exact outcome can't be predicted and the risks inherent in one choice over the other can't be removed in order for the decision maker to decide between 2 choices yet wants NEITHER to have ANY risk at all. So, this is not something where there is CERTAINTY of neither having any risk at all before you decide. Inherently, it's a decision made under UNCERTAINTY.
Decisions made under uncertainty often involve something called RISK AVERSION on the part of the risk taker. Now, risk aversion is NOT a scientific measure of the degree of risk. But rather, it's a matter of what could be considered 'irrational' or 'emotional' fears; what someone is more afraid of or AVERSE to.
For example, someone who's very risk averse to implants would choose bone cut procedures to avoid all the risks of implants and it wouldn't matter to them if the risks of the implant infection were low and the pay-off of better aesthetic result were high. That's what risk aversion is.
Conversely, someone who's very risk averse to bone cutting procedures for fear of unfavorable fractures would choose implants over bone cuts and it wouldn't matter to them that the bone cuts could give a better outcome over implants. That's what risk aversion is.
You seem to be MORE risk averse to implants than bone cut procedures. But it's not something where I can predict the 'exact' risk of possible later down the line infection with implants FOR you. What I can tell you as to implants is that infection with MEDPORE would be harder to remove if infection, which is one of the reasons, silicone is chosen because it's easier to remove. Conversely, you seem to be LESS risk averse to an unfavorable fracture via the bone cutting chin wing procedure. Like you kind of know that risk is there but your FOCUS is implant infections and bloated results. Hence you are more RISK AVERSE to implants than the bone cuts.
Again, the doctor told you your risks with the chin wing are higher (assumption being higher than someone with a 'virgin'/ no prior bone cut to work through). BUT he can't remove that risk FOR you to decide totally in favor of the chin wing. IF you were MORE risk averse to unfavorable fractures, you would be expressing worry over that and want to avoid that risk by getting implants which usually don't come with the risks of unfavorable fractures.
That said, given that the risks of EITHER can't be removed FOR you, the question becomes one of WHICH risk would you like to avoid MORE; the risk of an unfavorable fracture with a bone cut or the risks you associated with implants.
Basically, the doctor doesn't have a definite CERTAINTY to convey to you as which choice would be better (because BOTH have inherent risks). He's telling you your risk for unfavorable bone fracture is higher and letting you choose the one you are LEAST risk averse to. Hence, he will do one or the other.
