jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Optimistic on December 22, 2013, 06:05:01 AM
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I've searched the forum and outside of a .pdf posted by someone describing the Chin Wing in German there really isn't that much info out there.
If someone wants I can have a go at translating the more pertinent parts of it. For those who speak German it can be found here: http://www.pyramide.ch/Docs/file/a_triaca@pyramide_ch.pdf (http://www.pyramide.ch/Docs/file/a_triaca@pyramide_ch.pdf)
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If we could discuss this procedure a bit more would be beneficial for everyone here.
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But the operation isn't available anywhere except Germany, is it?
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I am guessing it's because the cut for the chin wing goes all the way to the back of the mandibular body. So in a way the ramus is being lengthened. Why this is stable but a BSSO in the ramus is not, I couldn't really say
BSSO + chin wing gives a good result but seems like a scary amount of cutting of the mandible. Or am I just being a p*ssy??! Seems a good option for those with steep angles or short ramuses (ramii??) (usually class 2s but in that pic it's a class 3)
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weakjawbrah, any idea how this guy got that drop down ramus look? It doesn't look like his lower jaw was touched aside from the chin wing osteotomy
(http://i.imgur.com/YF9AdlS.png)
perhaps the rotation of the lower jaw upward following the Lefort created a more natural ramus angle? at any rate, huge improvement
The caption below says "Class 3: LeFort 1 Osteotomy with concurrent Chin Wing Osteotomy".
I skim read over the .pdf I linked in my first post, and the impression I got is that these kind of results are possible due to the way the osteotomy is performed. This also makes it very good at fixing asymmetries. So if I understand correctly, they're taking the lower part of the mandible and moving it into a more aesthetic location.
Since the cut can go right to the back it SHOULD mean the following:
- Chin Wing can easily correct asymmetries as the entire bottom part of the jaw can be levelled out
- Mandibular Plane should be improved as it won't affect the actual occlusion, only the skeletal structure affecting soft tissue along the jawline
- Cut goes right back to posterior part of jaw, so CCW rotation of a Chin Wing could provided the appearance of lengthened rami
Additionally, the osteotomised part of the Chin Wing can be divided up into various segments. This gives me hope that it should at least be possible to improve jaw angles and rami length from the posterior part of the jaw only, and thus giving a more angular, V-shaped jawline, as opposed to a broad and rounded one.
I'll go through tonight and double-check what I'm saying is at least a bit accurate, and I've noted to discuss this with MM in more detail next we talk. If the thread garners enough interest I'm willing to translate the entire document as it wasn't -that- long in fact.
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(http://i.imgur.com/drI7uhJ.png)
This image here should give a good idea of the applications of a chin wing osteotomy. It can be used for asymmetry, and I believe jaw angles too. I think impaction would be an option too.
MM mentioned impacting my lower jaw in addition to 'improve jaw angles'. Now I look at it I believe he was referring to the chin wing. The posterior parts could be flared and rotated, whilst any impaction needed for improved facial thirds could be done simultaneously.
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Wow. That looks... hardcore.
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Wow. That looks... hardcore.
Of course it's hardcore. I'm hardcore. If I wasn't hardcore I'd be getting some basic orthodontic work and a chin implant. Alas, I'm not. I'm so hardcore I'm going to let a relative stranger hack the bone of my face apart with a bloody saw just to chew salads a little better, and possibly increase my already dismal chances with the opposite sex.
I am hardcore.
I am Weakjawbrah.
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;D ;D ;D
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Seems pretty risky and I suppose the long term effects on the mandible aren't known. Might be better just getting HA or implants. But then again, I suppose if you're thinking of getting a genioplasty, you're likely to think 'might as well go the whole hog'.
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Seems pretty risky and I suppose the long term effects on the mandible aren't known. Might be better just getting HA or implants. But then again, I suppose if you're thinking of getting a genioplasty, you're likely to think 'might as well go the whole hog'.
HA paste will never give you this much.
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HA paste will never give you this much.
I guess I want the definition of an implant, but without the implant. At the moment, I'm thinking chin wing + HA. Yesterday, it was genio + implant. There does seem to be a lot of bone cutting in the chin wing though.
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Also, it would be great if anyone knew of any surgeons (apart from Triaca) that do it.
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Apparently, it helps with lip incompetence as well.
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I'll be getting this before the summer if everything proceeds according to schedule. I'll be sure to post pictures here provided I don't die on the operating table!
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I don't think this is a risky procedure. A nerve runs along the mandible but it can be traced on plain film X-rays prior to surgery to see if there is any risk of hitting it. I am considering the procedure next year. The pictures I have seen are nothing short of impressive.
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I'll be getting this before the summer if everything proceeds according to schedule. I'll be sure to post pictures here provided I don't die on the operating table!
How many months would that be roughly? Will you be taking good before and afters?
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I don't think this is a risky procedure. A nerve runs along the mandible but it can be traced on plain film X-rays prior to surgery to see if there is any risk of hitting it. I am considering the procedure next year. The pictures I have seen are nothing short of impressive.
can you post these impressive results? i have only seen impressive results when chin wing was combined with jaw surgery, best results were obv. bimax and chin wing. chin wing alone never looked that great, to be honest.
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can you post these impressive results? i have only seen impressive results when chin wing was combined with jaw surgery, best results were obv. bimax and chin wing. chin wing alone never looked that great, to be honest.
Here are pictures of two chin wing operations performed by Zarrinbal. One also included a rhino. Very good outcomes in my opinion although I would like frontal photos and for them to be on men. http://imgur.com/a/n27vM (http://imgur.com/a/n27vM)
How many months would that be roughly? Will you be taking good before and afters?
Depends on my work situation. I currently have a job, but I am starting a new higher-paying job next week and will see how that works out. I hope around May-June. I will definitely post before and afters.
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Here are more pdfs with chin wing results:
http://pyramide.ch/docs/Dysgnathien.pdf (http://pyramide.ch/docs/Dysgnathien.pdf)
http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf (http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf)
http://pyramide.ch/docs/Brusco_Zahnkrone_6_13.pdf (http://pyramide.ch/docs/Brusco_Zahnkrone_6_13.pdf)
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Zarrinbal has shown me some results of Chin Wing osteotomy.
This is a powerful procedure and can transform your lower third extremely. There was a guy whose aesthetics were vastly improved. There was a women who did that combined with Bimax and she completely transformed herself from a plain 4.5-5/10 to a legit hottie.
I was at Zarrinbal's too and I think the guy you are referring to had two rounds of jaw surgery and also rhinoplasty. I didn't see a single case of a guy getting just chin wing where he improved dramatically (maybe he showed you different pictures).
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You guys cant expect chin wing osteotomy to be a substitute for jaw surgery. It can greaty enhance the jaw line and chin but cant correct malpositioned jaws!
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Of course it's hardcore. I'm hardcore. If I wasn't hardcore I'd be getting some basic orthodontic work and a chin implant. Alas, I'm not. I'm so hardcore I'm going to let a relative stranger hack the bone of my face apart with a bloody saw just to chew salads a little better, and possibly increase my already dismal chances with the opposite sex.
I am hardcore.
I am Weakjawbrah.
you are weakjawclown
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Here are more pdfs with chin wing results:
http://pyramide.ch/docs/Dysgnathien.pdf (http://pyramide.ch/docs/Dysgnathien.pdf)
http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf (http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf)
http://pyramide.ch/docs/Brusco_Zahnkrone_6_13.pdf (http://pyramide.ch/docs/Brusco_Zahnkrone_6_13.pdf)
applejuice are these only ching wing osteotomies or are they combined with bsso or bimax?
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Added the procedures:
http://pyramide.ch/docs/Dysgnathien.pdf (http://pyramide.ch/docs/Dysgnathien.pdf)
girl: chin wing
boy: lefort1 + chinwing
http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf (http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf)
girl: chin visor + chin wing
boy: upper jaw advancement + chin visor + chin wing
http://pyramide.ch/docs/Brusco_Zahnkrone_6_13.pdf (http://pyramide.ch/docs/Brusco_Zahnkrone_6_13.pdf)
girl1: lefort 1 + chin wing
girl2: bimax + chin wing
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Here are more pdfs with chin wing results:
http://pyramide.ch/docs/Dysgnathien.pdf (http://pyramide.ch/docs/Dysgnathien.pdf)
http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf (http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf)
http://pyramide.ch/docs/Brusco_Zahnkrone_6_13.pdf (http://pyramide.ch/docs/Brusco_Zahnkrone_6_13.pdf)
Thank you so much for those articles!
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okay so these chin wing and chin visor osteotomies are f**king incredible --they totally change the angulation of the chin and jaw angle. Amazing. So who is the best doc to do them? And thanks applejuice for the info....
since you read german could you maybe summarize some more of the details/risks, advantages, important tidbits, thanks.
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so could you explain to me how they made the lower half of this guys face i.e. the distance between the mandible so much wider? That doesn't seem to have anything to do with genioplasty or chin, it looks like implants to the side of the mandible and chin --i guess that's the effect of the chin-wing osteotomy? Would love to know what percentage of numbness results from this, cause the results are incredible in terms of symmetry and increasing the lower jaw width and face.
http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf (http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf)
girl: chin visor + chin wing
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(http://upload.wikimedia.org/wikipedia/commons/thumb/3/32/Chinwing.svg/500px-Chinwing.svg.png)
Since they are cutting below the nerve, the numbness caused by this osteotomy is minimal.
The bone part is still attached to the blood supply and the softtissue and can me moved around to create a nice jaw line. Additional bone grafts from the hip might be necessary.
The wider look of the lower face is achieved by reattaching the bone pieces more laterally and decreasing the gonial angle.
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(http://upload.wikimedia.org/wikipedia/commons/thumb/3/32/Chinwing.svg/500px-Chinwing.svg.png)
Since they are cutting below the nerve, the numbness caused by this osteotomy is minimal.
The bone part is still attached to the blood supply and the softtissue and can me moved around to create a nice jaw line. Additional bone grafts from the hip might be necessary.
The wider look of the lower face is achieved by reattaching the bone pieces more laterally and decreasing the gonial angle.
Yes, to add to this. As I explained earlier the bone can be divided into sections, so they can take a section at the rear, and move it about to create a wider jaw and better gonial angles.
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Yes, to add to this. As I explained earlier the bone can be divided into sections, so they can take a section at the rear, and move it about to create a wider jaw and better gonial angles.
thanks to both applejuice and weakjawbrah for explaining this further --and sorry for calling you weakjawclown, i was feeling irritable...
hope you guys are at least having a good holiday merry x-mas, kwanza, hannukah or whatever.... : )
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thanks to both applejuice and weakjawbrah for explaining this further --and sorry for calling you weakjawclown, i was feeling irritable...
hope you guys are at least having a good holiday merry x-mas, kwanza, hannukah or whatever.... : )
lol that's fine bro, merry Christmas to you too.
The Chin Wing Osteotomy really is a game changer for my plan. It can do everything I wanted to do in my 'extreme jaw surgery plan' or whatever I called it, where it was an IVRO + BSSO + + + . I just can't believe I never properly looked into this before... probably because it's so obscure.
For what it's worth I might as well tell you that I've e-mailed my ortho and explicitly asked for a referral to see Profilo.
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This forum is killing my will to live. Previously I thought my lower jaw was alright, now I think that my mandible is too steep. So perhaps a mandible setback is not such a bad idea in the big scheme of things (would make the steepness less obvious)... Or I SHOULD GET THE CHIN WING OSTEOTOMY! Does Coceancig do these?
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http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf (http://pyramide.ch/docs/Journal_fuer_Aesthetische_Chirurgie_Januar_2013.pdf)
This guy had an amazing result. He went from looking weird to being pretty respectable. His jawline is almost ideal now.
With the facial appearance he had before surgery it would be surprising if he had been bullied at school, been ostracized by his peers all his life etc. Now he probably has a whole new life. This surgery is so powerful.
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WJB, can you ask MM
- how the chin wing is combined with a BSSO? (as in, how is it done? how do they cut it and pin it? Guess they do the BSSO and then make the chin wing cut)
- how this way of lengthening a ramus is stable given that other ways (such as ramus BSSO) are not?
- what the healing is like given that this is a lot of cutting!!??
This procedure would allow me to avoid upper surgery (provided that I can get enough decomp). From what I've seen, ONLY implants or this give good improvements in the jaw angle areas for those of us with either short ramus or steep angles. However...it looks like a pretty brutal surgery
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Anyone have a list of surgeons who offer chin wing? So far I only know of three: Triaca, Zarrinbal, and Mommaerts. Are there any others?
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There are many others in germany, but they dont advertise it aggressively and/or call it differently.
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There are many others in germany, but they dont advertise it aggressively and/or call it differently.
Any names you know by chance please? I am German/American and have spent my life between the two countries.
Also, why is there not a single UK or American surgeon offering it? It really does give me pause.
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WJB, can you ask MM
- how the chin wing is combined with a BSSO? (as in, how is it done? how do they cut it and pin it? Guess they do the BSSO and then make the chin wing cut)
- how this way of lengthening a ramus is stable given that other ways (such as ramus BSSO) are not?
- what the healing is like given that this is a lot of cutting!!??
This procedure would allow me to avoid upper surgery (provided that I can get enough decomp). From what I've seen, ONLY implants or this give good improvements in the jaw angle areas for those of us with either short ramus or steep angles. However...it looks like a pretty brutal surgery
A chin wing is basically a form of sliding genioplasty. It is inherently stable because you are not affecting the bite or playing around with the forces on the TMJ. That's my understanding of it anyways.
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- how the chin wing is combined with a BSSO? (as in, how is it done? how do they cut it and pin it? Guess they do the BSSO and then make the chin wing cut)
i asked the same question during my consult. they don't combine it. if you see something like "bsso + chin wing" in those pdf files, it means two separate procedures. they usually do the chin wing when they remove the metal from the bsso/bimax.
- how this way of lengthening a ramus is stable given that other ways (such as ramus BSSO) are not?
see what dantheman wrote. chin wing = genio deluxe with jaw angle design
- what the healing is like given that this is a lot of cutting!!??
it is fairly tame. 3-4 weeks soft food diet, not much numbness. if they take a bone graft from the hip, you shouldn't walk too much for a week.
This procedure would allow me to avoid upper surgery (provided that I can get enough decomp). From what I've seen, ONLY implants or this give good improvements in the jaw angle areas for those of us with either short ramus or steep angles. However...it looks like a pretty brutal surgery
why would it allow you to avoid upper jaw surgery? do you mean because you would need rotation? because the chin wing does nothing to advance the maxilla.... i am confused. also, the surgery is less brutal than bsso or lefort, i don't really understand what makes you think otherwise.
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i asked the same question during my consult. they don't combine it. if you see something like "bsso + chin wing" in those pdf files, it means two separate procedures. they usually do the chin wing when they remove the metal from the bsso/bimax.
Chin Wing and lower jaw surgery can be combined in one surgery if the surgeon doesnt use the usual Obwegeser / Dal Pont osteotomy but the Schloessmann osteotomy (aka Bad Homburg method).
The cut is higher and thus doesnt interfere with the chin wing surgery. Zarrinbal for example does it this way.
(http://www.dysgnathie.de/images/sag_sag_epker_160_120.gif)
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i didn't know that, that's interesting for sure!
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Chin Wing and lower jaw surgery can be combined in one surgery if the surgeon doesnt use the usual Obwegeser / Dal Pont osteotomy but the Schloessmann osteotomy (aka Bad Homburg method).
The cut is higher and thus doesnt interfere with the chin wing surgery. Zarrinbal for example does it this way.
(http://www.dysgnathie.de/images/sag_sag_epker_160_120.gif)
Wouldn't it make more sense then to just get DO to advance the mandible, and a chin wing at a later stage after that? Then you'd avoid some metal in youth mouth, and get natural advancement, with all the added benefits of a widened jawline.
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Do you even know what DO is? There is "more metal in your mouth". With an osteotomy you get a planned result instantly. And what the f**k is more natural? Were do you get this bulls**t from?
(https://www2.aofoundation.org/AOFileServerSurgery/MyPortalFiles?FilePath=/Surgery/en/_img/surgery/05-RedFix/95a/HFM/P185-DOMandAdv/95-P185_i140_540.gif)
(http://www.medicon.de/fileadmin/mediapool/medicon/bilder/02_Produkte/Produktbereiche/02_CMF/01_Implantate/02_Distraktion/02_Distraktor_Horizontal/Bildergalerie/03_horizontal1_large.jpg)
DO is only worth it in rare cases like micrognathia, teenager therapy etc.
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Do you even know what DO is? There is "more metal in your mouth". With an osteotomy you get a planned result instantly. And what the f**k is more natural? Were do you get this bulls**t from?
(https://www2.aofoundation.org/AOFileServerSurgery/MyPortalFiles?FilePath=/Surgery/en/_img/surgery/05-RedFix/95a/HFM/P185-DOMandAdv/95-P185_i140_540.gif)
(http://www.medicon.de/fileadmin/mediapool/medicon/bilder/02_Produkte/Produktbereiche/02_CMF/01_Implantate/02_Distraktion/02_Distraktor_Horizontal/Bildergalerie/03_horizontal1_large.jpg)
DO is only worth it in rare cases like micrognathia, teenager therapy etc.
Ok, perhaps I worded myself poorly.
'more metal in your mouth' meaning long term. My understanding is that DO doesn't require screws once the distractor as been removed.
'more natural' meaning that a mandible that has had DO to lengthen it is said to be indistinguishable from a normal jaw, in that no signs of surgery are visible.
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Is there any reason that you believe DO wouldn't be worth it in a case like mine? If all I needed were advancement of the mandible, sans rotation and all that, then surely a BSSO and DO would just be two different ways to skin a cat.
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Ok, perhaps I worded myself poorly.
'more metal in your mouth' meaning long term. My understanding is that DO doesn't require screws once the distractor as been removed.
'more natural' meaning that a mandible that has had DO to lengthen it is said to be indistinguishable from a normal jaw, in that no signs of surgery are visible.
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Is there any reason that you believe DO wouldn't be worth it in a case like mine? If all I needed were advancement of the mandible, sans rotation and all that, then surely a BSSO and DO would just be two different ways to skin a cat.
Many surgeons remove the screws after 6-12 months anyway.
Do people have x-ray vision and then call you out on your surgery?! The osteotomy gaps also fill in over time.
BSSO and DO have the same outcome for a standard mandibular advancement. But BSSO is so much easier, has better patient comfort, less risk of infection, delivers instant results. There is absolutely no reason to choose DO over BSSO for such a simple surgeries.
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Many surgeons remove the screws after 6-12 months anyway.
Do people have x-ray vision and then call you out on your surgery?! The osteotomy gaps also fill in over time.
BSSO and DO have the same outcome for a standard mandibular advancement. But BSSO is so much easier, has better patient comfort, less risk of infection, delivers instant results. There is absolutely no reason to choose DO over BSSO for such simple surgeries.
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Many surgeons remove the screws after 6-12 months anyway.
Do people have x-ray vision and then call you out on your surgery?! The osteotomy gaps also fill in over time.
BSSO and DO have the same outcome for a standard mandibular advancement. But BSSO is so much easier, has better patient comfort, less risk of infection, delivers instant results. There is absolutely no reason to choose DO over BSSO for such simple surgeries.
No DO has a lot of benefits. It's kinder to the nerves/soft tissue, and there is less chance of relapse. Because it allows for slow movement, it is possible to grow the bone over time. Therefore larger advancements are possible.
Most surgeons won't advance more than about 6-7mm when they are doing a BSSO. If you have a surgeon who can advance 2-3cm, then there may be no need to use DO. It is still harsher on the soft tissues though.
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Work on your reading comprehension. I explicitly wrote there is no point in doing a DO for a standard mandibular advancement!!!
It certaintly has it's place but not when the jaw movement isnt like 9-10 mm and there are other individual factors. 6-7 mm as a maximium for BSSO?! Where do you get this bulls**t from?!
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the surgeon i spoke to instantly said that he wanted to BSSO my mandible at least by 12mm, because any less would not be worth the effort, pain and recovery. i think DO plays more of a role if you are looking at advancements north of 2cm but unless you look into the mirror and a severly deformed person is staring back, don't bother looking into it.
DO is great for teens though, because you can dynamically advance along the natural growth of their maxilla. for adults, BSSO is the gold standard.
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Exactly. Overbiter has obviously not spoken to surgeons and/or done research. He is just talking out of his ass and making things up.
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Work on your reading comprehension. I explicitly wrote there is no point in doing a DO for a standard mandibular advancement!!!
It certaintly has it's place but not when the jaw movement isnt like 9-10 mm and there are other individual factors. 6-7 mm as a maximium for BSSO?! Where do you get this bulls**t from?!
So you're obviously a troll username for some other retard, but never mind. The point I am making is that just because BSSO advancements of 12-15mm get bandied about on this forum it does not mean that these are standard advancements. Most surgeons don't have the skill to achieve large movements in one surgery. The average jaw surgeon would consider an advancement of 1cm to be huge. That's why they often do big genioplastys at the same time. It's easier to move the chin than the jaw.
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Most surgeons won't advance more than about 6-7mm when they are doing a BSSO.
That's simply false. 6-7 mm is no problem for MOST surgeons.
If you have a surgeon who can advance 2-3cm, then there may be no need to use DO.
That's also false. 2-3 cm (=micrognathia like i told you) is an advancement that's not reasonable possible with osteotomy and a case were DO is necessary.
Insulting me doesnt make your statements true. You seem to be a very angry and ignorant person.
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Insulting me doesnt make your statements true. You seem to be a very angry and ignorant person.
Lol, you're just hilarious.
That's also false. 2-3 cm (=micrognathia like i told you) is an advancement that's not reasonable possible with osteotomy and a case were DO is necessary.
You haven't even read the posts on this board, have you? Other people are having osteotomies of this magnitude, Snackan for example. It is possible to advance this much just using rigid fixation techniques, but it's at the extreme end of the scale. Like I said before most jaw surgeries are relatively small movements to fix bite problems. Most jaw surgeons have no experience of doing large movements for people just because they want a new face. You might not like this but it is the truth.
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Lol, you're just hilarious.
You haven't even read the posts on this board, have you? Other people are having osteotomies of this magnitude, Snackan for example. It is possible to advance this much just using rigid fixation techniques, but it's at the extreme end of the scale. Like I said before most jaw surgeries are relatively small movements to fix bite problems. Most jaw surgeons have no experience of doing large movements for people just because they want a new face. You might not like this but it is the truth.
Obviously you havent read Snackan's thread. He had a CONSULT not a surgery with Gunson. The 28mm movement of the pog doesnt equal to the same enlongation of the lower jaw, which is MUCH less.
BSSO Advancements of ~10 mm are rare since most people dont have such extreme jaw malpositions. But they are no problem for most maxfac surgeons.
But how should you know?
I don't have any x-rays/cephs, I'm not even sure what a ceph is really.
Well maybe start educating yourself before you spill bulls**t non stop.
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Can chin wing give the chin a squarer more masculine appearance? My chin is long, recessed, and round.
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But BSSO is so much easier, has better patient comfort, less risk of infection, delivers instant results. There is absolutely no reason to choose DO over BSSO for such a simple surgeries.
What? Can you please explain how BSSO is easier, has better patient comfort and less risk of infection??? I would say completely the reverse. Maybe DO has more infection risk from where the distractors exit, still, certainly DO is also less risky in terms of nerve damage.
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BSSO = surgery and you are done, doesnt get easier
DO = surgery to cut the mandible and place the distractor; distractor placed in mouth for weeks (=discomfort, risk of infection), removal of distractor
And now please stop the DO discussion or start another thread. This thread is about Chin Wing Osteotomy and not about DO pipe dreams.
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pipe dreams
"pipe dreams" huh?
BSSO is a much bigger operation, with more risk, you only get one shot at the result, and I suspect a lot more patient discomfort.
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Another surgeon that does the chin wing osteotomy can be found here:
http://www.klinikum.uni-heidelberg.de/Willkommen.118273.0.html (http://www.klinikum.uni-heidelberg.de/Willkommen.118273.0.html)
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Another surgeon that does the chin wing osteotomy can be found here:
http://www.klinikum.uni-heidelberg.de/Willkommen.118273.0.html (http://www.klinikum.uni-heidelberg.de/Willkommen.118273.0.html)
Where did you find that? I tried quickly looking around the website and found no mention of a Chin-Wing Osteotomie.
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Where did you find that? I tried quickly looking around the website and found no mention of a Chin-Wing Osteotomie.
email
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email
Do you know what experience he has with it? How technical the osteotomie is?
Lots of people can do a BSSO too, but not everyone has the technical and aesthetic ability to produce pleasing results.
And did he give any indication of price?
Sorry for all the questions. I might e-mail him myself soon.
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I don't know the answer to any of those questions, but if you speak to him about his experience/price etc, please let me know what he said. Thanks.
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Here is a reply from one of the main surgeons performing the procedure. I thought it might be of interest to some of you here who may look like I do. I asked if double jaw surgery was necessary along with the chin wing in order to achieve optimal aesthetic improvement:
"thank you again for your request. Looking at your pictures we still recommend a Wing-Osteotomy alone since a repositioning of the upper jaw without wearing braces is not advisable and not necessary to improve just your looks."
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Here is a reply from one of the main surgeons performing the procedure. I thought it might be of interest to some of you here who may look like I do. I asked if double jaw surgery was necessary along with the chin wing in order to achieve optimal aesthetic improvement:
"thank you again for your request. Looking at your pictures we still recommend a Wing-Osteotomy alone since a repositioning of the upper jaw without wearing braces is not advisable and not necessary to improve just your looks."
Which surgeon was that?
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Which surgeon was that?
Dr. Brusco who works with Triaca.
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Did you ask for a quote?
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Did you ask for a quote?
Here is the quote, very expensive:
"The price is 10000.- CHF for the surgeon and about 2500.- for the Anesthesia if the operation is performed on a outpatient base. If you prefer to stay 1 or 2 nights in the hospital, wich is not mandatory, you would have to calculate about 8000.- CHF more.
"
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Thanks. That's really pretty expensive :(
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It doesn't sound that much to me (12500 CHF is only around $14k). Am I missing something?
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It doesn't sound that much to me (12500 CHF is only around $14k). Am I missing something?
That's pretty expensive considering Mommaerts charges 4000 Euros and another doctor 6000 Euros. Also, the stay in the hospital isn't really optional if you are a foreign patient so you have to add on the other 8000CHF hospital stay bringing the total to around $22000. When you factor in flight and hotel costs, you're going to wind up paying around $25000 to have chin wing at Pyramide am See.
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Chin Wing and lower jaw surgery can be combined in one surgery if the surgeon doesnt use the usual Obwegeser / Dal Pont osteotomy but the Schloessmann osteotomy (aka Bad Homburg method).
The cut is higher and thus doesnt interfere with the chin wing surgery. Zarrinbal for example does it this way.
(http://www.dysgnathie.de/images/sag_sag_epker_160_120.gif)
Yes but but but but but...one of the reasons that elongating the ramus or doing this type of ramus BSSO is supposedly unstable is because it's stretching the masseter (?sp) muscle - which is really strong and therefore doesn't like to be stretched. Which would also be the case in the chin wing. Are we saying that because the bite doesn't change, the stretching doesn't affect the result?
This type of BSSO is, in theory, quite a good option for many class 2s (can elongate ramus and improve mandibular plane) yet very surgeons chose to do it and their must be a reason for that.... :-\
Notrain, I guess I think that chinwing seems more brutal than BSSO because it's a full thickness ostetotomy around the entire mandible, guess I'm wrong
Chinwing would allow me to elongate the posterior face and improve the chin angle/plane without doing upper with CCW. However I might need upper with CCW to get the right amount of advancement so it's kindof a moot point I guess
Here is a reply from one of the main surgeons performing the procedure. I thought it might be of interest to some of you here who may look like I do. I asked if double jaw surgery was necessary along with the chin wing in order to achieve optimal aesthetic improvement:
"thank you again for your request. Looking at your pictures we still recommend a Wing-Osteotomy alone since a repositioning of the upper jaw without wearing braces is not advisable and not necessary to improve just your looks."
What do you look like? Class 2? Short Ramus? Steep plane? All of the above?
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That's pretty expensive considering Mommaerts charges 4000 Euros and another doctor 6000 Euros. Also, the stay in the hospital isn't really optional if you are a foreign patient so you have to add on the other 8000CHF hospital stay bringing the total to around $22000. When you factor in flight and hotel costs, you're going to wind up paying around $25000 to have chin wing at Pyramide am See.
Ah okay I didn't know what other surgeons are charging. Do you know how much a bimax or similar costs?
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Notrain, I guess I think that chinwing seems more brutal than BSSO because it's a full thickness ostetotomy around the entire mandible, guess I'm wrong
Yes, but chin wing leaves the teeth alone entirely and you technically don't sever the mandible bone entirely. I have to admit that I didn't look into this yet this much, because my posterior face height is fine (my ramus is long enough imo and plane is flat). I am just f**ked sagitally.
If you are considering adding a chin wing to your surgery, then I'd get bimax without genio first and once you are healed get the chin wing a year later if you think you still need it.
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Got a response from Dr. Kater at www.dysgnathie.de (http://www.dysgnathie.de). He performs a modified chin wing osteotomy.
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Wouldn't an IVRO be a good alternative to a BSSO in this case? Then one could get IVRO + Chinwing simultaneously.
My problem with the Bad Homburger method is it looks like it would create a very slanted ramus angle, which I don't find aesthetic. Some slant is ideal, as that 90? box look is awful, but the slant would surely get worse depending on how much advancement is required.
And does anyone if it truly is necessary to wait a while year to get a chinwing after a BSSO? My understanding is that the chinwing does not have to be done using the entire lower jaw. It should be possible to simply make the standard BSSO cut, advance the mandible and rotate, whatever for the proper bite. Then behind that osteotomy perform the chinwing for jaw angles, mandibular plane, ramus length, and smoothen it all out with HA paste.
Am I dreaming here? I know a BSSO will provide a great aesthetic improvement to my profile, it's just I want to get the improvements to my frontal view ASAP too. Put the whole thing behind me, you know?
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New chin wing result posted to Triaca's website. This result is just chin wing with no other concurrent surgeries.
(http://i.imgur.com/52ZEAyr.png)
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rochester, that result is over 1 year old and it doesn't change the fact that chin wing is just another camouflage technique for class 2 patients who had class 2 orthodontics. look at that girl, you can see her lower lip is overeverted from her proclined incisors (although less after the chinwing) and her upper lip is still rolled inward.
you will never ever achieve the same result with this procedure as with a properly aligned jaw. from what i have read you are looking into this procedure as a means to get girls. do you honestly think a centimetre of bone on your chin will make you go from not getting a girl to getting her? because those triaca results are pre-selected to only showcase the very very very best outcome.
don't get me wrong, it is a great procedure, but surgeons are pushing chin wing surgeries because they can charge significantly more than for a bsso. basically they are adding the sum that you would pay an ortho for braces to the cost of a BSSO and that's what they are charging for a chin wing. they are simply pocketing way more cash that way, because they are cutting the ortho out of the loop.
a chin wing can never achieve the same aesthetic improvement of bimax + genio, not even by a mile. any surgeon who says that if you just want to look better a chin wing will give the same results is lying. you can still spot the class 2 skeleton on that girl.
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She still looks great now. The outcome with perfect jaw surgery and chin wing would maybe be 10% better. Definitely not worth it if her bite is fine.
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well i didn't have jaw surgery yet and you did, so you can judge this better. but triaca has results where he did bsso and chin wing and they look significantly better than chin wing alone. the other thing is, your bite will always be "off". the best you can achieve by camouflaging the skeletal issue is a class 1 molar relationship and a class 2 relationship as you move forward. yes, all your teeth will occlude fully but your lower incisors are severely proclined, upper incisors retroclined and the lower arch is displaced anteriorly which oftentimes results in gum recession at the lower front teeth. check the educational section of the board, there is a thread discussing this.
i agree though, chin wing is a quicker and easier fix if that is what you are after.
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If you get a result like her, then just thank god on your knees.
The published results mean s**t. It's a scam. The results posted by patients are seldom impressive. Look at the patient results Rochester posted.
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If you get a result like her, then just thank god on your knees.
The published results mean s**t. It's a scam. The results posted by patients are seldom impressive. Look at the patient results Rochester posted.
I think the other girls are pretty impressive too and both of them said they were highly satisfied with the results.
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They got a better chin but paid for it with a deep labiomental fold and a recessed lower lip.
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They got a better chin but paid for it with a deep labiomental fold and a recessed lower lip.
I think the labiomental fold looks natural and wouldn't quite qualify as deep http://imgur.com/a/n27vM, (http://imgur.com/a/n27vM,) but I guess you disagree.
My main personal concern about the surgery is the changes to lip position although to be honest, I can't really detect them in the photographs (which unfortunately aren't too good). Of people who've had the surgery done, the lip alterations seems to be the most frequently voiced complaint.
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chin wing on class 2 patients needs to be coupled with chin visor osteotomy.
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I've emailed a few surgeons and they seem to be advocating (if you don't want to change bite):
1. jaw implants as best option
2. Chin wing/'border expansion' as second best
There are surgeons who are saying, from experience, that they have given up the use of hydroxyapatite, not that it would be particularly effective in creating any sort of considerable width to the face.
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There are surgeons who are saying, from experience, that they have given up the use of hydroxyapatite, not that it would be particularly effective in creating any sort of considerable width to the face.
Who are these surgeons you're talking about? It seems that very few surgeons have any experience with HA at all so I'm surprised to learn that surgeons are using it, let alone abandoning it. Did they say why exactly they've given up on HA?
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Who are these surgeons you're talking about? It seems that very few surgeons have any experience with HA at all so I'm surprised to learn that surgeons are using it, let alone abandoning it. Did they say why exactly they've given up on HA?
Are they giving up on using it everywhere, or just the extremities? Lower jaw, chin outline?
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To be honest, the responses are pretty vague and I should put them into context. I emailed about 20 surgeons asking them what they did for wider jaw...do they use such materials as medpor, peek, titanium, silicon, hydroxy...most just said we use medpor/silicon, 2 of the surgeons who responded said they don't use ha paste from experience but without providing a reason.
From what I've heard, it has the propensity to crumble and cannot be accurately applied by many surgeons so maybe that's the reason...
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I've had the same feedback about HA for the jaw, waste of time basically.
Anyone familiar with peek implants? There's a fair chance I'm spelling it wrong btw ;D
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I've had the same feedback about HA for the jaw, waste of time basically.
Anyone familiar with peek implants? There's a fair chance I'm spelling it wrong btw ;D
I appreciate that a lot on here parrot that, but every study (that I've read to date) on HA paste disproves this.
Where is the evidence?
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Interesting response I received from a surgeon on the need for a hip graft to reduce sublabial fold.
Hip graft: I share the opinion of Prof. X that there is no hip graft needed. Why: bone transplantations (bone grafts) are principally a good idea when it comes to further stabilizing osteotomized bones. We do so in downgrafting a maxilla. But the bone cut in chin wing osteotomy offers a perfect surface for a good bony healing and a bone graft is prone to infection. What about the sublabial fold: the soft tissue layer is thick enough that this will not happen. When we fear a palpable step we use hydroxyappatite cement to fill up the gap.
Lower lip: no, it will not be smaller after ching wing osteotomy. Your idea is right in theory but from studies we know that this will not happen.
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What about the sublabial fold: the soft tissue layer is thick enough that this will not happen. When we fear a palpable step we use hydroxyappatite cement to fill up the gap.
This is kindof contradictory. In some patients (depending on bite and current bone structure) there will be a significant increase sublabial fold. Hence why some people will need HA to fill it; in fact I think most people would benefit.
I've got an implant with wings which at the front, is not a totally dissimilar result (at the front at least) to a chin wing. My sublabial fold is pretty bad. I need filler but my doc said that radiesse might show under the skin so I left it.
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This is kindof contradictory. In some patients (depending on bite and current bone structure) there will be a significant increase sublabial fold. Hence why some people will need HA to fill it; in fact I think most people would benefit.
I've got an implant with wings which at the front, is not a totally dissimilar result (at the front at least) to a chin wing. My sublabial fold is pretty bad. I need filler but my doc said that radiesse might show under the skin so I left it.
At first I thought it was contradictory too, but I think he meant that for me personally, I will not suffer from a deeply increased sublabial fold since based on my x-rays and pictures, the soft tissue is thick enough. These are my x-rays and face http://imgur.com/a/b2zmH (http://imgur.com/a/b2zmH)
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Hope so, but I had more soft tissue than you and I got a significant increase. However I already had quite a lot of fold prior to the implant
My ceph (featuring my super short ramus) -
(http://i14.photobucket.com/albums/a337/izzification/latcephcrop.jpg) (http://s14.photobucket.com/user/izzification/media/latcephcrop.jpg.html)
You can see the implant there on the bottom of the chin. I think I actually had more soft tissue than you at the chin point.
But anyway, I think a chin wing will give you a great result! You've got a nice flat occlusional plane and your lips are well lined up
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The pyramide PDF links all went down. Can someone please reupload a copy? Especially this one: http://www.pyramide.ch/Docs/file/a_triaca@pyramide_ch.pdf (http://www.pyramide.ch/Docs/file/a_triaca@pyramide_ch.pdf)
Thank you!
Zarrinbal has shown me some results of Chin Wing osteotomy.
This is a powerful procedure and can transform your lower third extremely. There was a guy whose aesthetics were vastly improved. There was a women who did that combined with Bimax and she completely transformed herself from a plain 4.5-5/10 to a legit hottie.
kizarq, would you happen to have those before/afters? I wanted to get a sliding genioplasty, but I might change my mind.
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does anyone know how the recovery for a chin wing would compare to say a BSSO? Food wise and feeling awful wise?
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Was told I wouldn't need to stay in hospital and nobody would known I even had surgery when i went back to work. So I assume really quick.
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Was told I wouldn't need to stay in hospital and nobody would known I even had surgery when i went back to work. So I assume really quick.
Thanks Dan! That's super good to know. Are you going ahead with it?
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I think I have a bigger issue (airway) that I wouldn't want to mask with this procedure. Cosmetically, I think for many people it can provide a great improvement to their appearance. How about you?
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I think I have a bigger issue (airway) that I wouldn't want to mask with this procedure. Cosmetically, I think for many people it can provide a great improvement to their appearance. How about you?
Airway is my only functional problem, but being female Has helped that not translate into major sleep apnea. Surgery is off the cards because functional issues are minor and my bite is good. I'm seriously considering chin wing but I'm a long way from Switzerland.
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Airway is my only functional problem, but being female Has helped that not translate into major sleep apnea. Surgery is off the cards because functional issues are minor and my bite is good. I'm seriously considering chin wing but I'm a long way from Switzerland.
cost is a huge factor too. Doesn't help that the Swiss Franc is strong right now.
Do you have a ceph?
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cost is a huge factor too. Doesn't help that the Swiss Franc is strong right now.
Do you have a ceph?
I think all up including flights etc its cheaper or on par with bimax so I'm ok with that considering its probably a better option all round for me. I'm probably going to wait a year or so and make aure its what i really want. I don't have a copy of my ceph sorry
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Is the chin wing generally considered a safe procedure? In terms of blood supply to the osteotomized segment and healing etc?
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Is the chin wing generally considered a safe procedure? In terms of blood supply to the osteotomized segment and healing etc?
I would say so.
My main concern is how all this stuff actually heals. Whether it'll have a natural feel to the touch, or if it'll be an odd step-off.
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I would say so.
My main concern is how all this stuff actually heals. Whether it'll have a natural feel to the touch, or if it'll be an odd step-off.
kinda what I was wondering too, like if there's a downward movement with the segment, do they need to graft or idoes it just kind of bridge together. Are you going ahead with it disillusioned?
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My main concern is how all this stuff actually heals. Whether it'll have a natural feel to the touch, or if it'll be an odd step-off.
Someone should ask this and post here what the surgeon said. This interests me as well.
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are there no real before and after pics of this procedure!!?? i.e. chin-wing osteotomy. would like to see some of zygomatic advancement as well!
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are there no real before and after pics of this procedure!!?? i.e. chin-wing osteotomy. would like to see some of zygomatic advancement as well!
I think there were papers full of chin wings on Dr Z's site at some point.
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I think there were papers full of chin wings on Dr Z's site at some point.
Plus some on various German sites. Triaca also has papers showing results.
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Do you need to have a good sized rams to have a chin wing?
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Stop asking these questions here since OBVIOUSLY no one has had one yet. We need someone who has had one oterwise kill this thread.
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Stop asking these questions here since OBVIOUSLY no one has had one yet. We need someone who has had one oterwise kill this thread.
3 people here have had it.
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3 people here have had it.
Then please encourage them to post here. Surely they can at least post their jawlines without giving away their identity!
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I wonder why chin wing isn't more common. It seems that only two or three surgeons do these on a weekly basis. I read that Gunson dislikes this procedure. Why do think that is? The risk of relapse might be high.
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I wonder why chin wing isn't more common. It seems that only two or three surgeons do these on a weekly basis. I read that Gunson dislikes this procedure. Why do think that is? The risk of relapse might be high.
Where did you read this?
Another American surgeon told me that dropping the ramus in a chin wing is not very stable due to the very strong masseter muscles pulling things back.
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Where did you read this?
Another American surgeon told me that dropping the ramus in a chin wing is not very stable due to the very strong masseter muscles pulling things back.
Unfortunately I don't remember which forum it was.
Chin wing is like the first real alternative to jaw implants and seems technically easy to do. There must be reasons why so few surgeons do it. It was introduced in 2009 and that is a long time ago.
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While it might be technically easy I think it needs a lot of experience to get it right.
I've been told that more and more surgeons in Europe are using it. I'm seeing Dr. T again next month so I could ask him.
(Yes, I've had a chin wing a few weeks ago and no, you won't get any pictures. Pretty happy with the result and recovery was a breeze.)
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Unfortunately I don't remember which forum it was.
Chin wing is like the first real alternative to jaw implants and seems technically easy to do. There must be reasons why so few surgeons do it. It was introduced in 2009 and that is a long time ago.
6 years is nothing in medical terms.
FWIW, CCW is decades old, yet many surgeons don't do it. Ditto for high level mid face osteotomies. Ditto for BSSO advancements over 10 mm.
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While it might be technically easy I think it needs a lot of experience to get it right.
I've been told that more and more surgeons in Europe are using it. I'm seeing Dr. T again next month so I could ask him.
(Yes, I've had a chin wing a few weeks ago and no, you won't get any pictures. Pretty happy with the result and recovery was a breeze.)
Do you have any numbness? Was a bone graft from your hip used? How long till the swelling became unnoticeable to others?
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I've had a BSSO+LeFort I before with another surgeon that didn't went well so my chin was still a bit numb from that. I feel like the additional numbness from the chin wing is already gone. Also, a bit of numbness is really not a big deal - nothing you ever notice in your daily life.
Yes, I had a bone graft, but in most cases it's not needed anymore today. I had a big gap in my bone on one side from the last surgery that made it impossible to do a continuous cut without damaging the nerve, so he had to cut around it and took the bone graft to try to fill it up. So far that seems to work, but there's a danger of bone resorption. But this is not something normal cases need.
Like any lower jaw surgery, swelling is biggest after 3-6 days, then goes down. I was back at work after 8 days and I don't think the swelling was noticeable anymore... but I also didn't care too much.
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I've had a BSSO+LeFort I before with another surgeon that didn't went well so my chin was still a bit numb from that. I feel like the additional numbness from the chin wing is already gone. Also, a bit of numbness is really not a big deal - nothing you ever notice in your daily life.
Yes, I had a bone graft, but in most cases it's not needed anymore today. I had a big gap in my bone on one side from the last surgery that made it impossible to do a continuous cut without damaging the nerve, so he had to cut around it and took the bone graft to try to fill it up. So far that seems to work, but there's a danger of bone resorption. But this is not something normal cases need.
Like any lower jaw surgery, swelling is biggest after 3-6 days, then goes down. I was back at work after 8 days and I don't think the swelling was noticeable anymore... but I also didn't care too much.
Good to hear that things went well with your chin wing surgery. Was it really just to camouflage the bad BSSO? Did Triaca give you options regarding grafting other than your own bone?
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While it might be technically easy I think it needs a lot of experience to get it right.
I've been told that more and more surgeons in Europe are using it. I'm seeing Dr. T again next month so I could ask him.
(Yes, I've had a chin wing a few weeks ago and no, you won't get any pictures. Pretty happy with the result and recovery was a breeze.)
Great to hear your comments! Triaca could be able to tell you how many of his patients have experienced relapses i.e. how common it is.
How impressed you were by the before/after pics of the chin wings Triaca showed you? How much the patients improved on average? Were the aesthetic improvements usually better on the front or on the profile?
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While it might be technically easy I think it needs a lot of experience to get it right.
I've been told that more and more surgeons in Europe are using it. I'm seeing Dr. T again next month so I could ask him.
(Yes, I've had a chin wing a few weeks ago and no, you won't get any pictures. Pretty happy with the result and recovery was a breeze.)
hi swisser, could you tell us how much you paid for chin wing ?
thanks
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How much width and angularity can a chin wing give you? From what I've seen a frontal view doesn't change much which is a disappointment.
(http://www.progenica.de/forum/uploads/monthly_03_2011/post-4936-130132862773.jpg)
(http://sluthate.com/uploads/imgur/4oMNVN8.png)
Those results are bad in comparison to Sailer's jaw line augmentation. What material does Sailer use?
(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_32l.jpg)(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_33l.jpg)
Custom made jaw implants seem to be aesthetically superior to chin wing that's almost always a compromise.
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How much width and angularity can a chin wing give you? From what I've seen a frontal view doesn't change much which is a disappointment.
(http://www.progenica.de/forum/uploads/monthly_03_2011/post-4936-130132862773.jpg)
(http://sluthate.com/uploads/imgur/4oMNVN8.png)
Those results are bad in comparison to Sailer's jaw line augmentation. What material does Sailer use?
(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_32l.jpg)(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_33l.jpg)
Custom made jaw implants seem to be aesthetically superior to chin wing that's almost always a compromise.
are those implants on the guy with glasses or Sailer's lypholized cartiledge?
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I dunno those after pics look kind of airbrushed.
I mean I will give Sailer this, he definitely knows how to transform people. Someone said his "implants" i.e. cadaver bone turn into "real" bone or something which sounds I dunno not possible but who knows what happens if blood vessels and stuff grow into that stuff. Also, how strong is it? Like could you still participate in sports and get a blow to your chin or would the cadaver bone just shatter and come apart or would it heal like regular bone if you were hurt. I just don't like the idea of these implants in the sense that it's not living tissue.
That said, if they don't produce erosion that's good. The blonde woman looks transformed. I know people who are happy with their sailer results. I'm just not gonna go down that path I don't think. But he does produce the results people want.
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The after pictures are also taken from a different angle.
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That's a nice result. His jaw work seems to be very solid from what I've seen but I think he's out of his element when it comes to the midface.
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I'm talking about the upper midface. Malar implants and stuff. It's not relevant in this case but it seems to be what gives some of his other patients that unfortunate tranny look.
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This guy had an impressive result. Le Fort III?
(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_46p.jpg)
(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_47p.jpg)
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Where are the frontal pics? He looks very similar to me before my first surgery except he doesn't have as much of an underbite as I had/have.
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what are you guys talking about that guy looks amazing now, he looks like Cillian Murphy. His palette isn't too narrow.
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what are you guys talking about that guy looks amazing now, he looks like Cillian Murphy. His palette isn't too narrow.
Yeah I think he looks really good too even if he might still technically have some aesthetical issues. It looks like he has makeup on though so the after pictures feel a bit dishonest.
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god I love that i spelled palate, palette, hahahahah what is he f**king Matisse?
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Someone said his "implants" i.e. cadaver bone turn into "real" bone or something which sounds I dunno not possible but who knows what happens if blood vessels and stuff grow into that stuff. Also, how strong is it? Like could you still participate in sports and get a blow to your chin or would the cadaver bone just shatter and come apart or would it heal like regular bone if you were hurt. I just don't like the idea of these implants in the sense that it's not living tissue.
That said, if they don't produce erosion that's good. The blonde woman looks transformed. I know people who are happy with their sailer results. I'm just not gonna go down that path I don't think. But he does produce the results people want.
Do other surgeons use cadaver bone to augment jawline? Sailer is out of reach because of sky high fees. If the risk of infection and bone erosion is smaller in comparison to regular implants, it sounds like a good option to me.
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(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_48p.jpg)(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_49p.jpg)
(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_44p.jpg)(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_45p.jpg)
This guy looks amazing! That's the face of someone who can now pull the hottest girls.
Not sure what he's actually had done, though. Lower jaw looks wider. Jaw angle seems to have changed loads,too!
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Mommaerts used homologous lyophilized cartilage too in a case of morphing to Michael Jackson.
https://www.academia.edu/6713047/2001_Mandibular_angle_augmentation_with_the_use_of_distraction_and_homologous_lyophilized_cartilage_in_a_case_of_morphing_to_Michael_Jackson._ACPE
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Mommaerts used homologous lyophilized cartilage too in a case of morphing to Michael Jackson.
https://www.academia.edu/6713047/2001_Mandibular_angle_augmentation_with_the_use_of_distraction_and_homologous_lyophilized_cartilage_in_a_case_of_morphing_to_Michael_Jackson._ACPE
I wonder why it's not used more if it's so good? Too expensive perhaps?
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The impaction of his maxilla, chin shortening and bringing the jaws foward made his palate look wider.
Definitely don't think it's too narrow now.
Lol how does he look like a tranny... I don't see that??
The guy on the previous page had cheekbone onlays as well.
Yes the cartilage is very expensive and then there is the whole process of carving out your desired shape.
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"What is Lyophilized Cartilage ( lyophilized cartilage )?
Lyophilized cartilage also called freeze-dried cartilage comes from the rib bones of organ donors and is an ideal bone substitute material."
More: http://www.sailerclinic.com/en/aesthetische_chirurgie/lyoknorpel.html
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Does anyone have an idea of how much the material costs?
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He's two steps behind Madonna with those round, chipmunk cheeks. I don't find them masculine nor attractive- at all. They should be sitting higher up and not so full. His 3/4 view and profile look odd too.
Well then blame his mother because he didn't have cheekbone work... his natural ones are high set actually you can see.
Sailer gave me high set angular ones
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IDK whenever I see those Sailer results I am torn between thinking it's good because his patients never look underdone but at the same time I can't help but feel that Sailer somehow goes by a checklist (an attractive face should have x,y,z) and adds those features to his patients when their original face was never meant to have them and afterwards their faces "don't fit".
FWIW that underbite kid would have looked so much better if he wasn't unshaven with s**tty skin and an equally s**tty haircut. Put his before pics with the same haircut, skin quality and clean shaven and I think he would actually look better than his own after. His after reminds me of that "human ken doll" idiot, just my 2 cents of course.
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You've got 'Sailer cheeks'? How long has it been? Do you like them/do they look 'good'? Tell me they don't look like that guy above...
It's been 7 months and 1 week, no they look really good
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IDK whenever I see those Sailer results I am torn between thinking it's good because his patients never look underdone but at the same time I can't help but feel that Sailer somehow goes by a checklist (an attractive face should have x,y,z) and adds those features to his patients when their original face was never meant to have them and afterwards their faces "don't fit".
FWIW that underbite kid would have looked so much better if he wasn't unshaven with s**tty skin and an equally s**tty haircut. Put his before pics with the same haircut, skin quality and clean shaven and I think he would actually look better than his own after. His after reminds me of that "human ken doll" idiot, just my 2 cents of course.
I agree and that's why I think the after pictures are dishonest. Still, the result looks like the kind a puahater would love to have because it does attract the attention of females.
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It's been 7 months and 1 week, no they look really good
Did you have a weakness under the eyes before your surgery or did you just have the surgery to give you more angularity? I would love to see some pics.
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^^How much did it cost?
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The guy looks like a model after. It's an amazingly good result.
He looks like a male model that you see in chewing gum adverts and stuff!
I think it's his nose which might make him look slightly feminine. I'm not sure whether it's a side-effect of jaw surgery or whether he's had work on it, but it seems to have whittled away to nothing.
He actually looks quite handsome in the before pic from this angle
(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_46p.jpg)
(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_47p.jpg)
Still, overall I bet he's extremely please and is probably getting used to having girls throwing themselves at him! lol
DO we know what he actually had done? Can't work out why his jaw angle looks so different
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What type of females though? LOL...
Those with penises under their skirts...
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(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_46p.jpg)
(http://www.sailerclinic.com/media/content/bilder_neu/KPS-aesthetische-chirurgie_47p.jpg)
DO we know what he actually had done? Can't work out why his jaw angle looks so different
Wow, are we certain that this is really a chin wing result and not implants? If the former, chin wings are potentially at least twice as amazing as I could ever have imagined! His jaw went from more obtuse than mine to near square.
I do note that the head tilt is quite different in the after, but his gonial angle is still impressive.
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While chin wings are indeed pretty amazing, I'm almost certain that Sailer does not do them and does implants instead.
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While chin wings are indeed pretty amazing, I'm almost certain that Sailer does not do them and does implants instead.
Do you know how much ramus/chin height and overall chin/jaw width a chin wing osteotomy could potentially add? I've heard conflicting reports from various (rather unreliable) sources, everything from 5-14 mm of total width.
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Wow, are we certain that this is really a chin wing result and not implants? If the former, chin wings are potentially at least twice as amazing as I could ever have imagined! His jaw went from more obtuse than mine to near square.
I do note that the head tilt is quite different in the after, but his gonial angle is still impressive.
NO, THAT IS NOT A CHIN WING RESULT. Sailer doesn't perform them but uses rib cartilage. I linked the first pics to demonstrate how inferior the chin wing is in comparison to what Sailer uses.
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There is also the issue of Sailer's pics being heavily photoshopped. Look at the underbite kid's before and take note of the background. It has a texture everywhere, it probably is a wall that's painted blue.
Now look at the after. The texture is still there in the upper left corner, but once you come closer to the patients face it is gone. Someone obviously made the patients skin look smoother and smoothed the wall texture as well by accident.
Then there are alterations to: contrast, brightness, hue and saturation compared to the before. This is all subtly done to make the patient look younger and more full of life in addition to the illusion of smoother skin and darker hair - if you increase contrast you tend to "clip" artifacts/blemishes. Just try it on your TV, if you crank up the contrast to full any bright area will lose all detail within it.
In the afters his patients also never are depicted with a full profile shot but rather at a slight angle - not 3/4 but something between that and full profile. They are also all looking slightly upwards to give more chin and neck definition whereas in the before they are all instructed to tuck their chins and look down.
Unless I could see unaltered photos of his patients I personally would not agree to a surgery with him.
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Terribly sorry but what can a chin wing surgery actually achieve in terms of jaw angularity?
The way I understand it the lower mandible is cut horizontally but how could that possibly make the jaw wider or the gonials more flared?
It should provide more vertical length but I don't see how it could mimick jaw implants.
On another note Sailer has some great results and his use of cadaver bone is really interesting. Allegedly they turn into your own bone with time but surely there must be some long term risks- as with other implants, what about infection, sliding out of place" and erosion?
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Terribly sorry but what can a chin wing surgery actually achieve in terms of jaw angularity?
The way I understand it the lower mandible is cut horizontally but how could that possibly make the jaw wider or the gonials more flared?
It should provide more vertical length but I don't see how it could mimick jaw implants.
On another note Sailer has some great results and his use of cadaver bone is really interesting. Allegedly they turn into your own bone with time but surely there must be some long term risks- as with other implants, what about infection, sliding out of place" and erosion?
It can provide that horizontal projection by cutting the mandible border on the midline and separating them apart a few milimeters laterally
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It can provide that horizontal projection by cutting the mandible border on the midline and separating them apart a few milimeters laterally
Thank you, seems to lack the precision of implants though. I feel like it often gives a sort of "boxy" appearance, at least from what I've seen.
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Thank you, seems to lack the precision of implants though. I feel like it often gives a sort of "boxy" appearance, at least from what I've seen.
I wonder if one might simply increase by a few mms every dimension of the jaw/chin complex (height as well as width width) and retain the original shape, enlarging the whole package.
I am sufficiently content with the shape of my jaw, so I wouldn't really need any alterations in that department.
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I wonder if one might simply increase by a few mms every dimension of the jaw/chin complex (height as well as width width) and retain the original shape, enlarging the whole package.
I am sufficiently content with the shape of my jaw, so I wouldn't really need any alterations in that department.
Personally I am looking for width rather than height, an augmentation of my existing shape would make me conent as well.
The more one changes and deviates from ones natural "look" the more risk of creating an unbalanced, unnatural looking face. The jaw doesn't exist in a vacuum after all, one template does not fit all.