Chin Wing or Custom Jaw Implants for Jawline Contouring?

[IconVillage]

Currently in a bit of a dilemma deciding whether to get a chin wing (more of a side wing type) to add some horizontal width and contouring to the jawline, or to opt for custom jaw implants. My case is a bit unique in that I don't need forward advancement of my chin really, as I have previously had a sliding genioplasty with good results, rather I just need some angularity and width to my narrow jawline.

My concerns with the chin wing would be its unpredictability, possible nerve damage, and irreversibility, however, most results I have seen have a subtlety and naturalness that I really like that I can't find in most jaw implant results. However, I've also read concerns on here that a chin wing would blunt the jaw angles depending on the type of cut used. Not sure what cut would be used in my case (I have consulted with a chin wing doctor and was told that a "side wing" would be the more appropriate cut, saying that my case was one of facial framing rather than forward advancement).

Due to these concerns, I've considered custom jaw implants, which while I believe would be more precise in terms of movements, lack angularity and often leave the patient with a bloated look. Although the upside with implants would be that they are removable if I don't like the result. Any recommendations on which path would be most beneficial for me? I'm not looking for drastic results as seen with many jaw implant cases, rather something natural and subtle.

Additionally, would anyone know the recovery period for a chin wing vs jaw implants? With my genioplasty, it only took about a month for me to start seeing nearly the final result and look presentable, whereas with jaw implants I've read it can take up to 6 months before you even get a glimpse of the final result.

Here are some scans of my mandible for reference: https://imgur.com/a/k2zuhcW
Thanks!

[Lestat]

Hi! Haven't you already had surgery with Dr. P.?

What does he suggest you?

[IconVillage]

Hi! Haven't you already had surgery with Dr. P.?

What does he suggest you?

I had a zygomatic osteotomy with him, never talked about the jaw. I'm not sure if he does a chin wing, I know he does custom implants though.

[Tomasjohn]

If you have no forward movement, there are two directions left. Downwards and outwards. The blunting of the angles is mainly associated with a forward movement in which the cut goes all the way back through the angles.

If you only have a downward movement, you are not widening the jaw strictly speaking.

I have seen CT scans where you can see that the jawline has actually been moved outwards towards the back "lateral flare" (to make the jaw appear wider). As far as I know, one user in this forum had a very bad experience with such a surgery. Here is the quote:

I think cw might be a good option if you have severe recession of lower third, to balance things out. It just doesn't seem ideal to create angularity. SJ posted his jaw results as if it was only cw, but in the end it turned out to be alot of filler that created that angularity.

I had cw + outward flare of jawangle, but it turned out superunstable, jawangle bones all shattered after surgery, probably due to lack of bone elasticity. Too risky. Total disaster. That being said, it was with lateral flare, so only cw is less risky and it works, mostly for people with (very) recessed lower jaws, to bring back harmony.

To give more specific answers, it would be very good to know exactly what kind of incision and movements the surgeon wants to make (especially since you have already had a genioplasty).

[IconVillage]

If you have no forward movement, there are two directions left. Downwards and outwards. The blunting of the angles is mainly associated with a forward movement in which the cut goes all the way back through the angles.

If you only have a downward movement, you are not widening the jaw strictly speaking.

I have seen CT scans where you can see that the jawline has actually been moved outwards towards the back "lateral flare" (to make the jaw appear wider). As far as I know, one user in this forum had a very bad experience with such a surgery. Here is the quote:

To give more specific answers, it would be very good to know exactly what kind of incision and movements the surgeon wants to make (especially since you have already had a genioplasty).

Ah, that is concerning about the instability of a lateral movement. When jutting my mandible slightly forward it gives the illusion of a wider jaw, so perhaps some forward advancement of the mandibular border would be beneficial. I believe this is the cut that I'd be looking for , the doctor I consulted with did mention that we could advance forward and shave down the advancement on the chin previous done with the genioplasty so it would not be too pointy after a CW.

[dusselgurr]

I had a zygomatic osteotomy with him, never talked about the jaw. I'm not sure if he does a chin wing, I know he does custom implants though.

Do you recommend ZSO?

[IconVillage]

Do you recommend ZSO?

I had a modified zygomatic osteotomy so it was a bit different from a standard ZSO, but it is a relatively moderate result. I chose to go more conservative but there is a definite difference with the width of the cheekbones and arch. I chose to augment it later with 0.5 ml of filler and I've gotten a few compliments on my cheekbones. 

[Dopesaint]

I have a familiar antegonial notch and I am going with jaw implants.