Author Topic: Getting a Chin Wing for my weak jaw - can I get some input?  (Read 1235 times)

crosshold

  • Newbie
  • *
  • Posts: 10
  • Karma: 0
Getting a Chin Wing for my weak jaw - can I get some input?
« on: February 20, 2022, 06:50:31 PM »
Hi, I plan on having a chin wing within the year and I need some help with planning it.

https://imgur.com/a/CSsCBkm

I guess my main questions are how much wider should I go. I'm thinking I should line my gonions up with my temples. Would that be good? I don't want a HUGE jaw or anything, just a solid one. I would like to have my ratios close to the "ideal" if possible.

Another question I have is if I should change my gonial angle or not. Currently, I kind of like what I have now. I look pretty angular from the front and would really dislike it if that went away or I looked too blocky. Judging by my ct scan, would you recommend some rotation?

This is the "type" of chin wing I plan on getting (rear ends are flared outwards by stretching the bones slightly). I am also going to have slight forward movement. There is a method to reducing the mentolabial fold, correct? I would also do that.

https://gyazo.com/d1b4c721276b11d3eca6cacd062f493e

kavan

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4029
  • Karma: 426
Re: Getting a Chin Wing for my weak jaw - can I get some input?
« Reply #1 on: February 20, 2022, 08:01:59 PM »
No one here can 'plan' your chin wing for you and what ever you plan for yourself might not be totally in sync with some of the realities of chin wings. Here are some realities of chin wings:

1: People with very high 'sloped' mandibles and also very narrow mandible bodies, (you have a very high sloped mandible and also a narrow mandibular body) aren't ideal candidates for the chin wing. That's because it's hard for them (CW doctors) to angle up the cut on a high sloped mandible and there can be little space between where the NERVE is and where the cut needs to be. So, FIRST your candidacy for the CW needs to be established by the doctor as to how close the NERVE is to the cutting device to perform the osteotomy of the mandibular border.

2: In candidates where they can and do cut all the way through to the back angle of the jaw, they can move the segment down and also forward. But when they move the segment forward, part of the back angle also comes forward with that. So, you can't expect to have your back jaw angle look exactly like it does now. It can get a little 'blunted' with the forward movement of the mandibular border segment.

3: As to PRYING out laterally the segment as is shown in your link (to someone else's bone structure), how much they can pry outward like that would depend on the thickness of the segment and also the ELASTICITY of it. So, if the segment is just a thin sliver, (for example in a person who has narrow mandibular body and a high sloped mandible), there's only so much they can PRY the segment outward before it SNAPS/breaks.

That said, I'm not trying to dissuade you or scare you about a chin wing. But I do think you should CROSS REFERENCE your expectations with a chin wing doctor as to all these things you want to get out of it.

Have you actually CONSULTED with a chin wing doctor? It doesn't sound like you have. If you haven't, get back to us when you get an assessment of your candidacy for it and also what movements/displacements they said can be done for you.
Please. No PMs for private advice. Board issues only.

crosshold

  • Newbie
  • *
  • Posts: 10
  • Karma: 0
Re: Getting a Chin Wing for my weak jaw - can I get some input?
« Reply #2 on: February 20, 2022, 09:00:40 PM »
No one here can 'plan' your chin wing for you and what ever you plan for yourself might not be totally in sync with some of the realities of chin wings. Here are some realities of chin wings:

1: People with very high 'sloped' mandibles and also very narrow mandible bodies, (you have a very high sloped mandible and also a narrow mandibular body) aren't ideal candidates for the chin wing. That's because it's hard for them (CW doctors) to angle up the cut on a high sloped mandible and there can be little space between where the NERVE is and where the cut needs to be. So, FIRST your candidacy for the CW needs to be established by the doctor as to how close the NERVE is to the cutting device to perform the osteotomy of the mandibular border.

2: In candidates where they can and do cut all the way through to the back angle of the jaw, they can move the segment down and also forward. But when they move the segment forward, part of the back angle also comes forward with that. So, you can't expect to have your back jaw angle look exactly like it does now. It can get a little 'blunted' with the forward movement of the mandibular border segment.

3: As to PRYING out laterally the segment as is shown in your link (to someone else's bone structure), how much they can pry outward like that would depend on the thickness of the segment and also the ELASTICITY of it. So, if the segment is just a thin sliver, (for example in a person who has narrow mandibular body and a high sloped mandible), there's only so much they can PRY the segment outward before it SNAPS/breaks.

That said, I'm not trying to dissuade you or scare you about a chin wing. But I do think you should CROSS REFERENCE your expectations with a chin wing doctor as to all these things you want to get out of it.

Have you actually CONSULTED with a chin wing doctor? It doesn't sound like you have. If you haven't, get back to us when you get an assessment of your candidacy for it and also what movements/displacements they said can be done for you.

Thank you for responding.


1. According to 2/3 surgeons I contacted, I am a candidate. Zarrinbal denied me due to the nerve position but Brusco and Andrescheiv said it was okay enough to proceed.

2. I have a "recessed" posterior of the mandible. When my head is in neutral position, I don't have any definition of the jaw angles but when I jut, I do. Wouldn't that simulate a chin wing to a degree since my gonions would have a similar position after the chin wing?

3. Yes, I am aware of this. I'm hoping it won't be a big deal for me though since I don't want THAT much augmentation.

I had a video consultation with Brusco. He was great and confirmed I could achieve my goals with a chin wing. He did indeed mention it depends on my bone elasticity, how much expansion, etc. I'm mainly making this thread to just get some extra input. Mainly from you and GJ since you two are the most knowledgeable on this forum.

kavan

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4029
  • Karma: 426
Re: Getting a Chin Wing for my weak jaw - can I get some input?
« Reply #3 on: February 20, 2022, 10:23:11 PM »
Thank you for responding.


1. According to 2/3 surgeons I contacted, I am a candidate. Zarrinbal denied me due to the nerve position but Brusco and Andrescheiv said it was okay enough to proceed.

2. I have a "recessed" posterior of the mandible. When my head is in neutral position, I don't have any definition of the jaw angles but when I jut, I do. Wouldn't that simulate a chin wing to a degree since my gonions would have a similar position after the chin wing?

3. Yes, I am aware of this. I'm hoping it won't be a big deal for me though since I don't want THAT much augmentation.

I had a video consultation with Brusco. He was great and confirmed I could achieve my goals with a chin wing. He did indeed mention it depends on my bone elasticity, how much expansion, etc. I'm mainly making this thread to just get some extra input. Mainly from you and GJ since you two are the most knowledgeable on this forum.

Z. confirmed with what it looked like as to the nerve proximity to the cut. Jutting is not a good simulation of chin wing. I suspect you will get less prying out laterally than the photo you showed. But if they can pry it out modestly (less than the photo you showed), that might be ok with you.
Please. No PMs for private advice. Board issues only.

crosshold

  • Newbie
  • *
  • Posts: 10
  • Karma: 0
Re: Getting a Chin Wing for my weak jaw - can I get some input?
« Reply #4 on: February 21, 2022, 06:46:14 AM »
Z. confirmed with what it looked like as to the nerve proximity to the cut. Jutting is not a good simulation of chin wing. I suspect you will get less prying out laterally than the photo you showed. But if they can pry it out modestly (less than the photo you showed), that might be ok with you.

For reference, this is a gif comparing the before and after for aforementioned chin wing:

https://gyazo.com/a189dc5ef2174360bd2d7229376f5c73

Yes, my nerve position was said to be not ideal but still possible to operate on. I guess it just depends on how comfortable the surgeon is with it and how risk averse they are. I think chin wing will be a solid choice for me; at least over implants or any other sort of augmentation. Thank you for the input.