jawsurgeryforums.com
General Category => Aesthetics => Topic started by: ODog on May 16, 2020, 07:00:12 AM
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There’s been a lot of talk that zygomatic osteotomies give rounded feminine cheekbones. I’ve heard this over and over but haven’t seen the results to confirm this.
This result is on a woman so that kind of effect would be welcome and yet I still don’t see rounded feminine cheekbones. Where are the apple cheeks? I just see a wider jaw and wider zygo arches - that’s it. Probably got a chin wing too.
Very subtle, Nothing special, but this result on a male wouldn’t be a bad thing IMO.
https://imgur.com/a/IjVJ5wV (https://imgur.com/a/IjVJ5wV)
Thoughts ?
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I think she got a bimax too.. her bite/tooth show is different. Her nose also looks wider/shorter which is characteristic of LF1 advancement. I think the only reason the zyg result would be acceptable for a male is because her mandible looks significantly broader too.
My guess is she got a zyg osteomy with a bimax; maybe with ccw because her mpa looks less steep and ccw also tends to make the mandible appear wider in cases of steep mpa.
IMO the main aesthetic improvement is coming from the lip/chin area and the bite. That's the part that looked 'off' in the before photo. It's a shame about the nose though. You would think they'd be able to control that better. I have a very similar nose-type to her.
I could be way off base here because i don't know much about zyg osteotomy.
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Can you confirm where those pics come from (like link the web site where there might be a description of her surgery) so we can cross reference what she actually had.
I'm not seeing any zyg osteo or chin wings. What I'm seeing is bimax surgery that balanced her jaw imbalance where that allowed her unaltered cheek bones to be better visually appreciated.
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She had more than only zygos. Look at her chin post and pre op.
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Maybe I will have a surgery soon with ZSO. I talked with my surgeon and asked him directly, if zso would give me round, apple shaped cheeks. He said no, it would give´me more a "sharp, pointed" cheek shape. I will also see some results soon and maybe go for this kind of surgery, if I could live with the cheek results. My main goal is to give me a more broader look like this woman in the link.
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Can you confirm where those pics come from (like link the web site where there might be a description of her surgery) so we can cross reference what she actually had.
I'm not seeing any zyg osteo or chin wings. What I'm seeing is bimax surgery that balanced her jaw imbalance where that allowed her unaltered cheek bones to be better visually appreciated.
This is what I'm seeing as well. The change to her mandible is characteristic of BSSO, especially with CCW-r. There's also no other way to explain the changes to her nose.
I think she looks better in the after but the nose really throws things off. It's like a +3 for fixing the chin, jaw and lips and then -2 for creating a problem with the nose.
I think the problem would be difficult to fix because the skin on her nasal tip looks thick to my untrained eye.
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This is what I'm seeing as well. The change to her mandible is characteristic of BSSO, especially with CCW-r. There's also no other way to explain the changes to her nose.
I think she looks better in the after but the nose really throws things off. It's like a +3 for fixing the chin, jaw and lips and then -2 for creating a problem with the nose.
I think the problem would be difficult to fix because the skin on her nasal tip looks thick to my untrained eye.
Pre-surgery with BRACES would be in preparation for maxfax surgery and not for a chin wing or zyg osteo. OP will need to list link where this came from and back up information as to what was done because the photo does NOT look like a zyg osteo or chin wing was done. Looks like she may have had maxillary advancement given the nose outcome and also reduction of the maxilla.
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She had bi-max with impaction/ CCW-r, genioplasty, and malar osteotomy.
Here’s a post-op where you can see the swollen cheeks.
https://imgur.com/a/qfxYRrp (https://imgur.com/a/qfxYRrp)
I agree the main comes from the impaction and chin shortening alleviating her lip strain.
She didn’t have chin wing after all. I’m surprised about this. Her jaw clearly looks wider. CCW-r only creates the perception of a wider back jaw but it’s so subtle as to be basically unnoticeable. Maybe fat loss too.
I guess I’m just wondering about this whole “zygomatic osteotomies only give feminine cheekbones” mantra... I’m not so sure it’s necessarily true. Maybe techniques have changed or surgeons are learning from past mistakes.
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Maybe I will have a surgery soon with ZSO. I talked with my surgeon and asked him directly, if zso would give me round, apple shaped cheeks. He said no, it would give´me more a "sharp, pointed" cheek shape. I will also see some results soon and maybe go for this kind of surgery, if I could live with the cheek results. My main goal is to give me a more broader look like this woman in the link.
That’s what I want too, this gives the ogee curve and broadens the face.
The results are VERY subtle though to be fair, but for me it’s sufficient because I can’t over-do it anyway due to my small IPD.
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Deleted.
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I think she looks better in the after but the nose really throws things off. It's like a +3 for fixing the chin, jaw and lips and then -2 for creating a problem with the nose.
I think the problem would be difficult to fix because the skin on her nasal tip looks thick to my untrained eye.
True. The changes to the nose are unfortunate. In some sense it almost negates the other improvements. Like why get jaw surgery if your nose looks puggish afterward.
Males can handle a wider nose fine as it’s a masculine trait... therefore Post bi-max I still believe you’re being too hard on yourself. I saw a picture of your beard from an old post and your convex lip is not even noticeable. Masculine even.
It might be possible that some kind of VY plasty could up turn your upper lip and give it more support/ that upwards curl... because a big component of chimp lip is not just the convexity of the philthrum but the downwards hanging vermillion.
I have a bit of a chimp lip too and I’m considering this. PM and I can tell you what a surgeon told me could help.
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That nose is definitely fixable. Overall a big win.
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She had bi-max with impaction/ CCW-r, genioplasty, and malar osteotomy.
Here’s a post-op where you can see the swollen cheeks.
https://imgur.com/a/qfxYRrp (https://imgur.com/a/qfxYRrp)
I agree the main comes from the impaction and chin shortening alleviating her lip strain.
She didn’t have chin wing after all. I’m surprised about this. Her jaw clearly looks wider. CCW-r only creates the perception of a wider back jaw but it’s so subtle as to be basically unnoticeable. Maybe fat loss too.
I guess I’m just wondering about this whole “zygomatic osteotomies only give feminine cheekbones” mantra... I’m not so sure it’s necessarily true. Maybe techniques have changed or surgeons are learning from past mistakes.
There was actually a study shared on a thread here that showed BSSO itself actually does physically increase bi-gonial width in a large majority of cases. The effect was greatest immediately post-op and attenuated over the following year, but the 'stable' width was still greater than baseline. The increase in BGW was not associated with the size of the movement.
Here's an example from Movahed (amazing result IMO) where real/perceived width increased in a similar way as the case you posted:
https://movahedoms.com/services/osa/case-study-4/
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You are wanting to discuss malar osteo based on photos where there is NO LINK to the SOURCE of the photos where a malar osteo can be cross referenced where the cheek area looks to be the LEAST changed thing in the photos. That leaves you as the ONLY one on here privy to what ever procedure she may have or may have not had to her cheeks and the rest of us guessing whether or not she had that.
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There was actually a study shared on a thread here that showed BSSO itself actually does physically increase bi-gonial width in a large majority of cases. The effect was greatest immediately post-op and attenuated over the following year, but the 'stable' width was still greater than baseline. The increase in BGW was not associated with the size of the movement.
Here's an example from Movahed (amazing result IMO) where real/perceived width increased in a similar way as the case you posted:
https://movahedoms.com/services/osa/case-study-4/
Maybe it’s a little objectively wider from the BSSO alone. I didn’t know it objectively widened the jaw. So that does play a role.
However in the case you posted I think it’s mostly is the perceptional change from the reduced mandibular plane angle. It’s less steep and downwards at the sides and more forward, giving an improved GA and the illusion of a wider jaw... but it’s more like a well-balanced or harmonious jaw.
For example someone with a long and pointy chin is going to appear to have a narrower jaw than someone with a shorter chin, even if the GW is identical in both cases.
When I look JUST at the goinals of the Before and after I’m hard-pressed to notice widening. I’m sure it’s there, it’s just not too obvious.
When you step back and perceive the face as a whole and how the parts relate, the improved goinal angle seems to account more for the perceived facial width increase.
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You are wanting to discuss malar osteo based on photos where there is NO LINK to the SOURCE of the photos where a malar osteo can be cross referenced where the cheek area looks to be the LEAST changed thing in the photos. That leaves you as the ONLY one on here privy to what ever procedure she may have or may have not had to her cheeks and the rest of us guessing whether or not she had that.
https://www.instagram.com/p/Bb07vP5BwvL/?igshid=8gb5algu6b9b (https://www.instagram.com/p/Bb07vP5BwvL/?igshid=8gb5algu6b9b)
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https://www.instagram.com/p/Bb07vP5BwvL/?igshid=8gb5algu6b9b (https://www.instagram.com/p/Bb07vP5BwvL/?igshid=8gb5algu6b9b)
Thanx. Wow. Her nose really took a beating from the profile perspective. Photos taken the day after surgery. As to the cheek osteo, there would be SWELLING. But still, if the swelling does not show much of a difference to cheek area even with swelling, it will do LESS after the swelling goes down.
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strange, here she looks completly different https://www.instagram.com/p/BvCel7lgw4u/
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Here is the original message, where the screenshot was taken in the first post: https://www.instagram.com/p/BilsAINhv78/
@kavan: In this post the surgeon says, he did the follow things:
- shortening and advancement of upper jaw
- advancement of lower jaw
- shortening and advancement of chin
- widening of skull (whatever this means, here he does not say, that a ZSO was performed)
By the way, her nose looks almost like the same before. She had already before a flat nose bridge and the nose is really slightly upturned now, should be easy fixable, if she wants it. The surgeon seems to be aware of the negative nose changes, but many patient just does not want to change it.
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Here is the original message, where the screenshot was taken in the first post: https://www.instagram.com/p/BilsAINhv78/
@kavan: In this post the surgeon says, he did the follow things:
- shortening and advancement of upper jaw
- advancement of lower jaw
- shortening and advancement of chin
- widening of skull (whatever this means, here he does not say, that a ZSO was performed)
By the way, her nose looks almost like the same before. She had already before a flat nose bridge and the nose is really slightly upturned now, should be easy fixable, if she wants it. The surgeon seems to be aware of the negative nose changes, but many patient just does not want to change it.
Firstly, NOW that we have the LINK where all this came from, with a little bit of brain power, we can cross reference what he did.
Я не понимаю почему, 'ОП' изначально держал ссылку в секрете.
To the best of my knowledge the info conveys surgeon did 4 things:
A Lefort 1, impaction (shortening) and advancement of the maxilla
A BSSO, forward advancement of mandible
A sliding genio (forward advancement along a diagonal cut; horizontal advancement with vertical shortening)
'expansion of the cheek bones'.
Now the first 3 things constituted the BIMAX surgery, which to me, were very visually clear she had those things for the more noticible facial changes.
Although he did not use terms such as 'Lefort 1', impaction, advancement, BSSO, sliding genioplasty...a literal translation of the words he used as to how he moved things would resolve to those procedures. However, he did list; 'expansion of cheek bones' for some kind of zyg osteo.
As to your statement of: 'By the way, her nose looks almost like the same as before.' I think you need to SHARPEN your observational powers because the surgery has clearly EXAGGERATED the problems with her nose as to turn a bad nose much WORSE. The BASE of nose with it's bulbous tip has come more forward in frontal view as seen via the Nostril widening. Profile view shows a very exaggerated SCOOP as in making the scoop she started with all the more WORSE.
Of course, the surgeon is aware of the very negative outcome to the nose. (Who wouldn't be by looking at it?) What we don't know is whether or not the surgeon informed her initially that her nose would become WORSE from the surgery. You can say; 'Many patients would not want to change something like that'. But I say; Many doctors would not want to PRE-INFORM the patient of negative changes like that. Such a negative change would be PREDICTABLE given the initial shape of her nose and how it would change with the displacements she got. (Usually not to the patients. But the doctor would be able to anticipate that in advance.)
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I think it is clear, that she had something like a ZSO. Not really on the front view, but more on the halfprofile 3/4 view. If she didn't had any cheek osteotomy, then she would look like this: https://www.reynoldsoralfacial.com/files/2015/06/case2_01.jpg
Unfortunately her left cheek looks really round, what was the concern of OP. If you scroll to the third photo in the series and look at the bottom right photo, it is clearly seen: https://www.instagram.com/p/BvCel7lgw4u/
The surgeon said, this photo is 1 1/2 year old. So this shouldn't be any swelling.
@kavan: I take notice of your answer and I agree with your observation, but I won't discuss if her nose was "bad" or it did worsen her situation.
edit: I asked the dr. what kind of cheek osteotomy she had: It was a L-shape sandwich osteotomy of cheek-bones.
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I think it is clear, that she had something like a ZSO. Not really on the front view, but more on the halfprofile 3/4 view. If she didn't had any cheek osteotomy, then she would look like this: https://www.reynoldsoralfacial.com/files/2015/06/case2_01.jpg
Unfortunately her left cheek looks really round, what was the concern of OP. If you scroll to the third photo in the series and look at the bottom right photo, it is clearly seen: https://www.instagram.com/p/BvCel7lgw4u/
The surgeon said, this photo is 1 1/2 year old. So this shouldn't be any swelling.
@kavan: I take notice of your answer and I agree with your observation, but I won't discuss if her nose was "bad" or it did worsen her situation.
edit: I asked the dr. what kind of cheek osteotomy she had: It was a L-shape sandwich osteotomy of cheek-bones.
I've acknowledged she had cheek work AFTER it was confirmed with the link source.
Keep in mind that WITHOUT the initial link source multiple perspectives and descriptions could not be viewed, which is why I requested the OP list the link source so all could take a closer look. No need to discuss if her nose was bad and got worse. One just needs to SEE it. Good thing to establish the term for the type of zyg osteo she had.
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Jeez how the lip lengthened in profile. Yet surgeons
keep lying insist LF1 can't do this.
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Jeez how the lip lengthened in profile. Yet surgeons keep lying insist LF1 can't do this.
Her philtrum was already long pre-op. The upturning of the nose and the pronounced convexivity make it worse independent of any actual lengthening.
Gunson showed me the same thing on some of my pre-op pics. Long philtrum is characteristic of AOB because the upper lip is being pulled down to make the seal. Maybe something similar is going on in a class 3 bite.
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I think it is clear, that she had something like a ZSO. Not really on the front view, but more on the halfprofile 3/4 view. If she didn't had any cheek osteotomy, then she would look like this: https://www.reynoldsoralfacial.com/files/2015/06/case2_01.jpg
Unfortunately her left cheek looks really round, what was the concern of OP. If you scroll to the third photo in the series and look at the bottom right photo, it is clearly seen: https://www.instagram.com/p/BvCel7lgw4u/
The surgeon said, this photo is 1 1/2 year old. So this shouldn't be any swelling.
@kavan: I take notice of your answer and I agree with your observation, but I won't discuss if her nose was "bad" or it did worsen her situation.
edit: I asked the dr. what kind of cheek osteotomy she had: It was a L-shape sandwich osteotomy of cheek-bones.
Hey man I think you’re confusing things the link you posted mentions “plastic cheekbones.” Are you sure these are the results of her *zygomatoc osteotomy*? Lol. Or did she get further work done down the line with cheek implants ?
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Jeez how the lip lengthened in profile. Yet surgeons keep lying insist LF1 can't do this.
I agree man my philthrum looks clearly longer post-op. It was actually quite short and stunted looking before surgery. Weird. If it’s only a perceptional change, it *might as well* be an actual change because it sure looks like it. And the only thing that matters in aesthetics is how something appears to be, not how it actually is.
So when a surgeon says “your lip actually doesn’t get longer” it’s irrelevant from an aesthetic perspective if it LOOKS longer.
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Hey man I think you’re confusing things the link you posted mentions “plastic cheekbones.” Are you sure these are the results of her *zygomatoc osteotomy*? Lol. Or did she get further work done down the line with cheek implants ?
I asked him about this photo series: https://www.instagram.com/p/BilsAINhv78/ There he answered it was a L-shape sandwich ostetomy of cheek-bone. Also in this photo series you can see her left 3/4 profile, what seems to be really round. But I think the cause for that is not the cheek osteotomy, but the impaction of her upper jaw.
I would go even further and put a theory: If your face is short and you get cheek advancement, then your face get rounder.
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I asked him about this photo series: https://www.instagram.com/p/BilsAINhv78/ There he answered it was a L-shape sandwich ostetomy of cheek-bone. Also in this photo series you can see her left 3/4 profile, what seems to be really round. But I think the cause for that is not the cheek osteotomy, but the impaction of her upper jaw.
I would go even further and put a theory: If your face is short and you get cheek advancement, then your face get rounder.
Ok you can clearly see the rounded cheeks in the 3/4th view. Perhaps this result isn’t ideal for a man. Doesn’t it seem like she got anterior projection? Her midface is very much improved. I personally think it’s an impressive result.
I’m likely going for this surgery along with chin wing mid June.
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If her face would be a bit longer, this rounded effect wouldn't be so strong. Also I don't know if a ZSO would produce another effect, than a L-shape sandwich osteotomy. That should be considered.
It is also interesting to notice, that the upper right picture would be acceptable for man.
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I agree man my philthrum looks clearly longer post-op. It was actually quite short and stunted looking before surgery. Weird. If it’s only a perceptional change, it *might as well* be an actual change because it sure looks like it. And the only thing that matters in aesthetics is how something appears to be, not how it actually is.
So when a surgeon says “your lip actually doesn’t get longer” it’s irrelevant from an aesthetic perspective if it LOOKS longer.
Yes. That is correct. To the best of my knowledge the absolute distance of the philtral/upper lip area remains constant. It will look shorter if it's aligned on on a diagonal plane (reference profile facing right, reference x-y graph with negative slope as to 'diagonal'). Same distance will look longer if aligned on vertical plane. In a situation where maxilla is advanced A LOT, philtrum/upper lip area can take on a conVEX curve and this will also look longer.