jawsurgeryforums.com
General Category => Aesthetics => Topic started by: Hopeless Incel on April 04, 2020, 02:16:03 AM
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Hello Members
I had Genioplasty in 2018 September.
Now I feel like my jaw is narrow. I'm more inclined to side wing osteotomy rather than wraparound jaw implant.
Can side wing be performed?(if I've a lower third like the one in the pic I've attached)
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The chin wing surgeon would need to determine if it was OK to cut through where you had the genio and if your nerve was too close to where they cut through.
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Thanks for responding
Is there any technical possibility to have jaw implant of required after side wing Osteotomy?
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Thanks for responding
Is there any technical possibility to have jaw implant of required after side wing Osteotomy?
Custom jaw implants can be fitted over osteotomies. But a custom implant can also PRECLUDE need for having that kind of osteo to widen because it can widen without the osteo side wing. So, choose one or the other.
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Thanks kavan
I had a conversation with the Russian surgeon Dr.Andreishchev. I have attached the screenshot of our conversation. Also one guy from other forums suggested me the same like you've suggested i.e, to have wraparound jaw implant which solves my issue.
But my mind had been filled with these things
1. Chances Of Infection from implants
2. Bloated/unnatural results from implants
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I don't like the convo with that doctor. Red flags of "if you want it we will do it" (never let a patient decide), and very short in describing what he'd do.
Your jaw could appear narrower due to the lower third being out further. We'd have to see photos to see if what you're perceiving is even true.
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Thank you GJ For the response. It's my bad that I haven't attached the whole conversation pics. Now I've attached the conversation screenshots,CT Scans, Before and after pics
Past Medical History
1.I had Genioplasty in 2018, September and my chin had beenn advanced diagonally (Horizontal and vertical advancement).
I thought I had weak chin and had Genioplasty later I found that I had recessed jaws. My Genioplasty went well. But the downtime is very long like bone remodeling soft tissue changes and adapting to the new face. But due to long Advancement of my chin (I feel 5-6mm is normal) by about 11-12mm, my chin didn't blend well with the back of the jawline. It looked like a new chin had been attrached to my face. After 7 months I thought of undergoing revision
2. I had revision in 2019, may. During the revision my Titanium plates have been removed and my surgeon grafted bone from illiac crest and mixed that with bone powder and pasted that to my Jawline. You can see that in my CT Scan. I'm happy with my revision surgery too but there's some irregularity left even After revision. Thought only implants will solve the issue and I saw an article from Dr Yaremchuk mentioning irregularities
from osteotomies and implants to suffice that.
https://www.dryaremchuk.com/correcting-post-orthognathic-surgery-contour-imbalances-and-irregularities
Later I joined the PSL Forums and came to know that I had recessed jaws. I'm not sure about that though. Was informed to have Bimax of I need more forward advancement like we see in the forward grown faces. And my jaws are narrow not that masculine. I came to know about side wing osteotomy too.
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Pics Before Genioplasty
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Pics After Genioplasty
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CT Scan After Revision
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Conversation with the surgeon
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Conversation with the surgeon
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Conversation with the surgeon
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Conversation with the surgeon
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Conversation with the surgeon
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Present Face
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I'm attaching two morphs. Is the morph achievable?
I like Gonial Angles at oral Commissures
You can correct me
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I didn't suggest one thing or the other to you. I suggested that although implants (custom) can be placed over osteotomies there would be no need to get the osteotomy if you were to later get an implant BECAUSE the implant would address the desired widening. Hence, you must choose one or the other.
I can't tell you the 'exact' risks to you specifically as to one over the other. But the doctor is telling you risks (unfavorable fracture) with the chin wing is higher than it would be in someone with a 'virgin' area. So, if you are OVERLY FOCUSED (which you are) on ANY risks with an implant and enough so you're only focusing on the potentially NEGATIVE things with an implant and not the potentially POSITIVE things that could mean you'd be willing to take the chance of a higher risk of an unfavorable fracture in order to avoid the risks you associate with implants. That's called 'risk aversion' when someone is MORE afraid of one thing than the other EVEN IF the risks with either would be equal.
DECISION MAKING UNDER UNCERTAINTY.
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In decision making analysis, it is something where one needs to make a decision in the absence of CERTAINTY where the exact outcome can't be predicted and the risks inherent in one choice over the other can't be removed in order for the decision maker to decide between 2 choices yet wants NEITHER to have ANY risk at all. So, this is not something where there is CERTAINTY of neither having any risk at all before you decide. Inherently, it's a decision made under UNCERTAINTY.
Decisions made under uncertainty often involve something called RISK AVERSION on the part of the risk taker. Now, risk aversion is NOT a scientific measure of the degree of risk. But rather, it's a matter of what could be considered 'irrational' or 'emotional' fears; what someone is more afraid of or AVERSE to.
For example, someone who's very risk averse to implants would choose bone cut procedures to avoid all the risks of implants and it wouldn't matter to them if the risks of the implant infection were low and the pay-off of better aesthetic result were high. That's what risk aversion is.
Conversely, someone who's very risk averse to bone cutting procedures for fear of unfavorable fractures would choose implants over bone cuts and it wouldn't matter to them that the bone cuts could give a better outcome over implants. That's what risk aversion is.
You seem to be MORE risk averse to implants than bone cut procedures. But it's not something where I can predict the 'exact' risk of possible later down the line infection with implants FOR you. What I can tell you as to implants is that infection with MEDPORE would be harder to remove if infection, which is one of the reasons, silicone is chosen because it's easier to remove. Conversely, you seem to be LESS risk averse to an unfavorable fracture via the bone cutting chin wing procedure. Like you kind of know that risk is there but your FOCUS is implant infections and bloated results. Hence you are more RISK AVERSE to implants than the bone cuts.
Again, the doctor told you your risks with the chin wing are higher (assumption being higher than someone with a 'virgin'/ no prior bone cut to work through). BUT he can't remove that risk FOR you to decide totally in favor of the chin wing. IF you were MORE risk averse to unfavorable fractures, you would be expressing worry over that and want to avoid that risk by getting implants which usually don't come with the risks of unfavorable fractures.
That said, given that the risks of EITHER can't be removed FOR you, the question becomes one of WHICH risk would you like to avoid MORE; the risk of an unfavorable fracture with a bone cut or the risks you associated with implants.
Basically, the doctor doesn't have a definite CERTAINTY to convey to you as which choice would be better (because BOTH have inherent risks). He's telling you your risk for unfavorable bone fracture is higher and letting you choose the one you are LEAST risk averse to. Hence, he will do one or the other.
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By the way....when I address an INITIAL question, it's not meant to be an 'invitation' for me to evaluate all correspondence you have with doctors, whether or not this or that doctor can produce the results in your morph, eradicate all risks associated with one surgery over the other or otherwise provide you with ABSOLUTE CERTAINTY.
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Yes, it's not an invitation for you to evaluate all the correspondence. It's more like providing the complete information all I had and gathering opinions from the knowledgeable
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Yes, I'm more risk averse to implants now. But before joining any forums and listening to an infected implant experience, I was risk averse to Osteotomies because I already had one and experienced the irregularity which led me to a revision. And regarding my side profile my upper lip is kinda overlapping on my lower lip. From the front my upper lip looks upturned. Can that be corrected with upper jaw surgery?
Also are my jaws recessed? Do I need bimax?
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Yes, I'm more risk averse to implants now. But before joining any forums and listening to an infected implant experience, I was risk averse to Osteotomies because I already had one and experienced the irregularity which led me to a revision. And regarding my side profile my upper lip is kinda overlapping on my lower lip. From the front my upper lip looks upturned. Can that be corrected with upper jaw surgery?
Also are my jaws recessed? Do I need bimax?
I think you look good and you don't look recessed. Male models have a combination of distance relationships which are rare to have and for the most part can't be bought which is why they are models. This isn't one of those 'PSL' sites where recession is based on not having what a male model has.
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Your face does look more narrow, but it actually looked overly wide before. Now it looks very balanced. You look pretty great. Not sure why you're messing around with more procedures unless I'm missing something.
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The main reasons for the Surgeries I'm opting are
1. Wraparound jaw implant to cover up my osteotomy irregularity because after my Genioplasty, my chin didn't blend well with the Jawline behind. It looked like a new chin had been attached.
2.Bimax because my upper lip is turned upward and protruding/overlapping on my lower lip which I believe needs rotation of my upper jaw
As far as lower jaw is concerned I need my jaw to be advanced so that my chin should be exactly equal to or inline with the nose and not behind the nose when observed from a profile view
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Do you really want an lip which hangs down vertically? Yes upper jaw surgery can make it happen. It’s called chimp lip.
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Hangs down vertically?? Sorry I didn't get you. Can you post some pics like that. I don't want a chimp lip
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You are a really good looking guy now, definitely better than average. The morphs you posted here do not look any better than your current looks, in fact they look weird and unnatural. You will never look like those male models simply because you have a different kind of face - any doctor that tells you he will make you look like that is lying and just wants your money. You don't look worse than them, you look different. No doctor with any medical ethics that cares about anything else than money is going to break your jaw bones the third time just to make you look more like a male model.
You should stop reading weird plastic surgery forums, stop looking at yourself in the mirror quite so much and focus on something else in life.
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Models have a type of structure that can't be bought/constructed via surgery. Attempts to do so will just result in looking in the mirror afterwards and asking; 'Why don't I still look like a model after all this surgery?'
Why? Because models have overly large HEADS/skulls for their body giving them a wider EAR TO EAR distance that is NOT going to be re-created via any surgeries and they have horizontally 'long' eyes as in a 'larger than life' inner to outer canthal distance with one of those long eye widths between them. Those things GO WITH their forward faces and excellent bone structure to the jaws. So, the entire GESTALT of a model is contingent on the very things that can't be reproduced via surgery.
Wanting to look like a model or 'have what the model has' is actually not too different from buying all the clothes that the model is hired to 'sell' by the designers where the act of BUYING the things they are modelling doesn't make one look like the model either. It's like that.
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I dont know why people always think the aim should be to look like a male model.
The aim should be to look better!
And thats surely possible!
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Firstly I welcome all the suggestions,Opinions & criticisms.i believe they should be backed my some basic theories, experiences or proofs.i have never mentioned (in the whole thread) that I want to look like a male model which even I believe is not possible. I have never posted a model pic that I want to look like. I just posted a morphed pic that too done by me which is nothing but widening my jaw (I'm not that great when it comes to morphing).I really don't understand till now WHY
1.Fixing my post osteotomy irregularity
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2. Widening of Gonial Angles (that too not dramatic) equal to my bizygomatic width
LOOK LIKE A COSMETIC SURGERY AIMING TO ACHIEVE MODEL LOOK
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Firstly I welcome all the suggestions,Opinions & criticisms.i believe they should be backed my some basic theories, experiences or proofs.i have never mentioned (in the whole thread) that I want to look like a male model which even I believe is not possible. I have never posted a model pic that I want to look like. I just posted a morphed pic that too done by me which is nothing but widening my jaw (I'm not that great when it comes to morphing).I really don't understand till now WHY
1.Fixing my post osteotomy irregularity
&
2. Widening of Gonial Angles (that too not dramatic) equal to my bizygomatic width
LOOK LIKE A COSMETIC SURGERY AIMING TO ACHIEVE MODEL LOOK
The implication was there in your correspondence with doctor by showing a modelesque face. Add being member on one of those 'PSL' lookism type sites where the standard of advancement is what a model has.
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That's completely a reference for forward jaws. How a side profile would look like. When you Google out forward grown faces those are the one that most pop out.And it definitely doesn't come under"MALE MODEL ASPIRING LOOK". Had that been the case,I would be wishing to alter every single part of my face close to the model which looks like the morph I've attached
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That's completely a reference for forward jaws. How a side profile would look like. When you Google out forward grown faces those are the one that most pop out.And it definitely doesn't come under"MALE MODEL ASPIRING LOOK". Had that been the case,I would be wishing to alter every single part of my face close to the model which looks like the morph I've attached
The reference is a MALE MODEL which infers the implication of male model aspiring look which is how it comes off whether you admit it or not. No 'crime' in wanting to look like a model. Not many people who wouldn't want to look like one. It's just that not many people will no matter how many surgeries they get.
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The thread is completely going off the topic which I don't want to. However I want to clarify this once for all. The conversation with the surgeon is because of the opinions I've gathered from PSL sites.i.e,
1.Implants look s**t on recessed jaws and they go well in case of forward grown faces.
That's how bimax got into picture. Like I said I've very limited knowledge because of which I've joined these forums
when a surgeon asks for a reference on how you wish the results to look like, and if you've very limited knowledge on facial aesthetics, then you'll end showing pictures which means that you wish to have that part of the face (be it jaw, nose, eyes, cheekbones, chin) to look like the ones projected on the pictures. And That definitely doesn't mean altering your face to look like a MODEL. Had That been the case, like I said I would have asked the surgeon that I want to look exactly like that MODEL And would've asked him all the surgeries required to alter my face and clearly that hasn't happened. And I concur with you that it's not A CRIME.
I don't know why a pic that has been sent to the Doc is more bothering than the real issues I've been claiming again and again (osteotomy irregularity & an angular jaw)
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...... then you'll end showing pictures which means that you wish to have that part of the face (be it jaw, nose, eyes, cheekbones, chin) to look like the ones projected on the pictures. And That definitely doesn't mean altering your face to look like a MODEL. Had That been the case, like I said I would have asked the surgeon that I want to look exactly like that MODEL And would've asked him all the surgeries required to alter my face and clearly that hasn't happened. And I concur with you that it's not A CRIME.
I don't know why a pic that has been sent to the Doc is more bothering than the real issues I've been claiming again and again (osteotomy irregularity & an angular jaw)
Of course it doesn't because that's not going to happen.
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It happened in some cases and I've seen those. But in the end they didn't look like a model just by altering one part of the face. Even if they alter every part of the face, they won't coz it's completely the proportions of each and every part which can't be altered.
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I think your lip is totally fine and messing around could give you some results which you won't like. It is really really slight issue which you criticize about your lip (just looking at your picture). Maybe it looks different without beard, but with beard it is totally fine. About your jaw angle: I think it is possible to work with botox (depends how extreme you want your result). Of course you have to refresh it by sometime, but it is less risky than messing around with implants.
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Is there anything that needs to be done with lip reduction? My lip looks okay when seen from front and not the same when send from a profile view.
But fillers don't last long, right? And there are no good injectors in my place.
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Is there anything that needs to be done with lip reduction? My lip looks okay when seen from front and not the same when send from a profile view.
But fillers don't last long, right? And there are no good injectors in my place.
Dude your lip is fine
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I'm attaching two morphs. Is the morph achievable?
I like Gonial Angles at oral Commissures
You can correct me
This morph is probably not achievable with osteotomy nor implants (anyone can correct me if I'm wrong). From what I have seen, I only saw this kind of angularity with fillers. Implants go high up the face to fix them, so there'll always be a certain level of expansion of the soft tissue above the jaw boarder. Probably, in the ideal case, implants only target the lower boarder of the jaw. But there won't be way
to fix them. That's why sometimes you see bloated faces after implants (I think), while fillers only target the spots that should be targeted.
Could also be that angularity isn't only the bone structure but also masseter + soft tissue. I see your facial structure/bone structure on other people who do have more angular jawangles.
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I think you look good and you don't look recessed. Male models have a combination of distance relationships which are rare to have and for the most part can't be bought which is why they are models. This isn't one of those 'PSL' sites where recession is based on not having what a male model has.
Can you please expand on what this "combination of distance relationships" is / means?
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Can you please expand on what this "combination of distance relationships" is / means?
It means aesthetics comprises more than one or two ratios between features. For example it's not enough to have a strong chin or brow or wide gonial angles, etc. These features can even look overdone or unnatural in isolation. The MM look involves several ratios working together to achieve a particular aesthetic that is superior to the aggregate of these features. In particular, Kavan often brings up the point that MM eyes are absolutely essential to the MM look. Incel types call these 'hunter eyes'. Without that crucial piece (which is genetic), you might end up looking like a failed Creature of Frankenstein
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It means aesthetics comprises more than one or two ratios between features. For example it's not enough to have a strong chin or brow or wide gonial angles, etc. These features can even look overdone or unnatural in isolation. The MM look involves several ratios working together to achieve a particular aesthetic that is superior to the aggregate of these features. In particular, Kavan often brings up the point that MM eyes are absolutely essential to the MM look. Incel types call these 'hunter eyes'. Without that crucial piece (which is genetic), you might end up looking like a failed Creature of Frankenstein
Absolutely agreed, the main component of 'hunter eyes' is a big palpebral fissure length (eye width --> wide eyes basically) with no or very little upper eyelid exposure, a positive canthal tilt, huge browridge and well-developed supraorbitals, afaik
My PFL is horrible and no plastic surgery can elongate my eyes to my knowledge, sadly.
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Absolutely agreed, the main component of 'hunter eyes' is a big palpebral fissure length (eye width --> wide eyes basically) with no or very little upper eyelid exposure, a positive canthal tilt, huge browridge and well-developed supraorbitals, afaik
My PFL is horrible and no plastic surgery can elongate my eyes to my knowledge, sadly.
Your PFL is not even bad. At least based on the picture from your most recent thread.
If that middle picture is what you actually look like then you have no business pursuing plastic surgery, much less JS. You're going mess up your face. If you're that worried about mild chin recession just get a genio.
Anyway, didn't mean to hijack this thread.
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Can you please expand on what this "combination of distance relationships" is / means?
It's a very complex and esoteric aesthetic geometry to explain and not something I would elect to explain here since too many people on here don't even seem to have fundamental grammar school geometry underbelt.
Besides, what's so hard to understand a simple qualitative statement that relays that models are not all or mainly surgical constructs but rather RARE and lucky flukes of nature. The model wannabees are the least likely to accept that and hence, the most futile group to be receptive of why they won't be looking like a model. Not to mention, I'd rather be spending time on people who are seeking improvement due to very unbalanced aesthetic relationships than those wanting to be indulged in how they can obtain their narcissistic goals. Besides, there's another board for model worship.
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It means aesthetics comprises more than one or two ratios between features. For example it's not enough to have a strong chin or brow or wide gonial angles, etc. These features can even look overdone or unnatural in isolation. The MM look involves several ratios working together to achieve a particular aesthetic that is superior to the aggregate of these features. In particular, Kavan often brings up the point that MM eyes are absolutely essential to the MM look. Incel types call these 'hunter eyes'. Without that crucial piece (which is genetic), you might end up looking like a failed Creature of Frankenstein
BINGO! + The eyes have it.
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You guys mean to say that option 1 often defeats option 2??
1. Hunter Eyes, Average Jaw, Average Cheekbones
2 Average Eyes, Good jaw & cheekbones
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You guys mean to say that option 1 often defeats option 2??
1. Hunter Eyes, Average Jaw, Average Cheekbones
2 Average Eyes, Good jaw & cheekbones
Yes. That's what it basically means.
When #1 gets the jaw and cheek bones improved, it FRAMES THE EYES and the whole picture is improved.
So, it's not just the frame but rather what is being framed.
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when a surgeon asks for a reference on how you wish the results to look like, and if you've very limited knowledge on facial aesthetics, then you'll end showing pictures (...) I don't know why a pic that has been sent to the Doc is more bothering than the real issues I've been claiming again and again (osteotomy irregularity & an angular jaw)
There are no real 'issues' with your jaws. If you had real issues, you would not need to go around with anybody else's pictures saying you want to look like that. For example, I have 'real issues' with my jaws and no doctor ever asked for a photo of what I wanted to look like because it is clear to them what the issue is and they understand I want to look like the best possible version of myself, not like another person. If a surgeon is asking for a 'reference' of what you want to look like, there is something already quite wrong with that picture (literally). But you can't see that so fine, keep paying doctors for breaking your jaws.