Side Wing - is Z still the 'best'? has anyone had this?

[beautyislife]

I had jaw surgery a little over a year ago. I'm exploring (and am well aware that already having had jaw surgery may preclude getting a chin/side wing) getting a side wing. I am afraid of the chin wing because it seems like it could blunt the jaw angles due to having to move the chin forward as well - at least this is the concensus I've found when reading other posts on here regarding the chin wing.

My goal would be to lengthen my ramus and get my jaw angle closer to 90deg and it seems like a side wing would help achieve this. I'm wondering is Z still the best for this? I also need a septo-rhinoplasty and I know he does this as well so combining both surgeries vs having to go under 2x would be nice.

Open to hearing input on side wing if anyone has experience with Z or others on the procedure

[kavan]

For the side wing they still need to cut from front (chin) to back (posterior jaw angle) along the mandibular border. So, the prior BSSO cut very well could preclude the side wing. But you could always check with doctor to make sure.

Technically speaking, the side wing doesn't really elongate the ramus. But ya, it can give that appearance by prying downward (dropping down), at the mandibular border, the posterior jaw angle as to decrease its angle of inclination of the jaw line.

Have you considered just getting a posterior angle 'drop down' implant for the changes to the jaw line contour you seek?

[beautyislife]

Thanks Kavan.
I agree and do understand that the best course of action would be to ask one of the side wing docs as I've already had the BSSO which may prevent getting the side wing.

Also, thanks for correcting my misunderstanding. So to make sure I now understand, when reviewing the diagram here (https://www.sciencedirect.com/science/article/abs/pii/S0266435609005014) it shows the cut along the mandibular border and the entire section is 'dropped down' and gaps filled in. So the ramus itself is not actually vertically lengthened, instead by dropping the mandibular border and changing the angle of inclination, it gives the appearance of a longer ramus and a more squared angle? I am just trying to understand this a bit better.

I haven't done my due diligence researching implants, my initial thought was to go with a side wing as Z can do both that and a rhinoplasty at once to limit the number of times I have to have surgery/go under, but those may be a good option. Admittedly they (implants) may be the better option given the goal I have. I suppose I'm trying to better understand the degree to which a side wing can give me what I seek

[kavan]

Thanks Kavan.
I agree and do understand that the best course of action would be to ask one of the side wing docs as I've already had the BSSO which may prevent getting the side wing.

Also, thanks for correcting my misunderstanding. So to make sure I now understand, when reviewing the diagram here (https://www.sciencedirect.com/science/article/abs/pii/S0266435609005014) it shows the cut along the mandibular border and the entire section is 'dropped down' and gaps filled in. So the ramus itself is not actually vertically lengthened, instead by dropping the mandibular border and changing the angle of inclination, it gives the appearance of a longer ramus and a more squared angle? I am just trying to understand this a bit better.

I haven't done my due diligence researching implants, my initial thought was to go with a side wing as Z can do both that and a rhinoplasty at once to limit the number of times I have to have surgery/go under, but those may be a good option. Admittedly they (implants) may be the better option given the goal I have. I suppose I'm trying to better understand the degree to which a side wing can give me what I seek

Probably just a matter of semantics for me to express because it's hard to pin point describe where exactly the end/bottom of the ramus actually is because the (bottom of) ramus merges with the body of the mandible to form the angle. So since the cut along the border of the mandible actually cuts through the angle and can drop it down where the drop down is more towards the ramus 'side' or 'leg' of the angle, for all intents and purposes, it's basically the same effect as elongation of the ramus. It's JUST LIKE having a longer ramus and a more squared angle.