Sidewing-Technique from DR.B

[kavan]

the following cw-patient "could" be comparable to my case. He had a minor advancement and very little drop off:

https://www.instagram.com/p/BkDw1OoBQvo/?hl=en

Do you guys think he would benefit from the discussed side-wing procedure, where the jaw-angles are set back? Would that alone restore angularity to his face?

I think you need to develop your ability to observe what's there to observe before asking questions that demonstrate lapses in that ability and trying to get answers here about how someone elses case relates to yours.

The ceph shows that he got a DROP DOWN to mandibular chin wing segment (which means entire segment including the chin). The posterior jaw angle is moved down VERTICALLY and not moved horizontally to blunt there. The chin is also dropped down vertically. If the segment were moved horizontally, you'd see blunting of the jaw angles which are not seen in the ceph X ray.

It's very OBVIOUS from the ceph X ray that he doesn't need to have his jaw angles 'set back' BECAUSE they were not brought forward in the chin wing procedure to blunt them. Your questions are based on not observing that.

Try to practice and hone better observations skills if you need to compare your case and what you specifically had to someone else. It's an important base to have.

[mediumdrinkofwater]

Okay fine, he got some drop-down as well.

The seph was made from a diagonal angle, which might distort visibility of the actual movement made.

The link again for reference: https://www.instagram.com/p/BkDw1OoBQvo/?igshid=YmMyMTA2M2Y=

I think it’s quite evident that there was horizontal movement from the second picture, which shows the b/a from side profile and front view. I’m not sure how you are concluding that the jaw angles were not moved forward and that there is no blunting, since the picture from the front clearly shows a more roundish and less angular face.

I see the following here: drop down + horizontal advancement of the whole segment.

So the question remains, would he benefit from setting back his jaw angles.

[Tomasjohn]

The referenced case has been discussed before. The outcome was not only a function of CW, he had more done. See this reply: https://jawsurgeryforums.com/index.php/topic,7780.msg78404.html#msg78404

Impossible to say if he would benefit from simple setback because more complications could occur like stepp-off etc.
It is clearly different for every case.

If you could benefit from such a set-back can only be judged after a concrete plan has been made by a surgeon. Then we could comment on this plan.

You would make most progress by doing this:
1) See surgeon (I would go back to original surgeon) and explain what you want any why
2) Get an answer how he would do it and why
3) Get feedback here and assess by yourself
4) Act or change plan

[kavan]

..The seph was made from a diagonal angle, which might distort visibility of the actual movement made.

Keeping in mind that your questions were relative to the ceph of oblique perspective,'which might distort visibility of the actual movement made'. When that's the case, it calls into question why you expected it to yield an answer to the question of 'would he benefit from moving his jaw angles back?'. It's a demonstration of seeking answers to distorted questions which might yield distorted answers.

The link again for reference: https://www.instagram.com/p/BkDw1OoBQvo/?igshid=YmMyMTA2M2Y=

I think it’s quite evident that there was horizontal movement from the second picture, which shows the b/a from side profile and front view. I’m not sure how you are concluding that the jaw angles were not moved forward and that there is no blunting, since the picture from the front clearly shows a more roundish and less angular face.

So, now your question seeks out an answer to front and side views that you fail to link in your response and you're 'not sure' how I didn't see blunting from an oblique ceph your questions were based on.

From the ceph you introduced, I saw no telltale signs of an extent of horizontal movement that would yield blunted angles. So a question of 'should he move them BACK' can't be answered when a ceph used to ask the question doesn't show the jaw angle segment was moved forward.

I see the following here: drop down + horizontal advancement of the whole segment.

So the question remains, would he benefit from setting back his jaw angles.

To me, your questions resolve to demonstrations of using a faulty foundation to ask them and it's like trying to build on a foundation of sand to answer them. So, I leave you to your OWN observations. IF your observations are correct on what ever you use to base them on, you can use them to answer your own questions.

[kavan]

The referenced case has been discussed before. The outcome was not only a function of CW, he had more done. See this reply: https://jawsurgeryforums.com/index.php/topic,7780.msg78404.html#msg78404

Impossible to say if he would benefit from simple setback because more complications could occur like stepp-off etc.
It is clearly different for every case.

If you could benefit from such a set-back can only be judged after a concrete plan has been made by a surgeon. Then we could comment on this plan.

You would make most progress by doing this:
1) See surgeon (I would go back to original surgeon) and explain what you want any why
2) Get an answer how he would do it and why
3) Get feedback here and assess by yourself
4) Act or change plan

I saw no 'set forward' in the ceph the OP introduced to pose a question about a set back. If a set forward could not be seen from that perspective, it would require a ceph of profile to contend that it was. So, the 'impossibility' of answering his question is found in the way he poses it.

Also, when a person asks a question based on whether AN ENTIRELY DIFFERENT PERSON would look better (with this or that) and seeks that kind or answer to apply to himself, it's a red flag for a distorted question in which the OP might distort the answer if he applies to himself. For example, an answer of: 'He would look great by doing that (what ever 'that' happens to be) might be a good answer about the OTHER PERSON. But if the OP asking it is using another person as a PROXY for answering what the OP should do, it's a red flag and best not to answer it. People wanting to know if THEY would look good based on a proposed CHANGE to what ANOTHER person had or could have are best prompted to show THEIR OWN photos.

Your response pointing out 'impossibility' was a GOOD ONE and so were your suggestions as to how he should proceed.

[mediumdrinkofwater]

Okay, I will consult with my surgeon first. Thanks for the advice!