jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Sinsajo on December 28, 2015, 06:14:20 PM
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Hi!!!
I did a BSSO with genioplasty three years ago. Everything went well but my jaw is very thin ... I like to have it wider. I wonder if after I made a BSSO can get a wing ching (would only widen) thanks !!
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But implants are dangerous because they erode the bone ...
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not to hijack the thread, but can anyone link the before/after pictures for chin wing osteotomies? google only shows 2 results
http://www.pyramide.ch/de/Zentrum-fur-Kiefer-und-Gesichtschirurgie/Informationen/Medienberichte
IMO, proper double jaw surgery should always be preferred to chin wings. Steep jaw angles are often a symptom of a steep occlusal plane, which ought to be fixed with CCW. Chin wings can only camouflage that.
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Yes , that is my problem... my surgery was not performed with CCW, I do not know any surgeon who does CCW Does anyone know any?
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Yes , that is my problem... my surgery was not performed with CCW, I do not know any surgeon who does CCW Does anyone know any?
If money is no object, then Wolford because he invented it and most of his business is revision jaw surgery. Many people who need CCW, don't get it, or worse get CW instead. So he fixes quite a lot of those.
Also Arnett, Gunson, Sinn. Probably a few others. Few can do it well.
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Yes , that is my problem... my surgery was not performed with CCW, I do not know any surgeon who does CCW Does anyone know any?
Where do you live ?
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Spain , but I would not mind traveling abroad
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Spain , but I would not mind traveling abroad
Have you consulted with Alfaro? You may need CCW instead.
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He does not do it. I Had thought about the Dr Sinn.
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He does not do it. I Had thought about the Dr Sinn.
I am talking about CCW, not chin wings.
http://jawsurgeryforums.com/index.php?topic=4156.0
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I knew what you meant. Alfaro know, it is very famous in Spain, but does not perform that operation.
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This is about Pelo:
http://jawsurgeryforums.com/index.php?topic=4637.msg37140;topicseen#msg37140
Alfaro has operated to people I know and have been left jaw down. Below I leave a case of Alfaro.
Not a bad surgeon, just like everyone but is more expensive.
http://institutomaxilofacial.com/casos-clinicos/27-Evamaria
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This is about Pelo:
http://jawsurgeryforums.com/index.php?topic=4637.msg37140;topicseen#msg37140
Alfaro has operated to people I know and have been left jaw down. Below I leave a case of Alfaro.
Not a bad surgeon, just like everyone but is more expensive.
http://institutomaxilofacial.com/casos-clinicos/27-Evamaria
Can you elaborate on Alfaro?
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Well, that makes you the same operation as a local surgeon but twice as expensive. While it is true that times of operation are records.
Well, that makes you the same operation as a local surgeon but twice as expensive. While it is true that times of operation are records.
In my opinion it is not no big deal, this girl is still asymmetric jaw and very down and checked.
http://institutomaxilofacial.com/casos-clinicos/6-Sara
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There is also the case with this girl that did not have the asymmetrical face and now, if any. In my opinion the reputation it has not deserve.
http://institutomaxilofacial.com/casos-clinicos/10-Estela
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There is also the case with this girl that did not have the asymmetrical face and now, if any. In my opinion the reputation it has not deserve.
http://institutomaxilofacial.com/casos-clinicos/10-Estela
She had asymmetry before. The big advancement just accentuated it.
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i think she looks way better than before
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I agree she looks better than before, but assymetry aside, doesn't anyone think her profile looks a little odd??
For some reason her appearance strikes me as one that wouldn't be found in nature.. maybe something to do with the angle and slope of her forehead not matching up with the ante-face surgery gave her.
Anyone??
Or maybe her lower jaw is too far forward and mandibular plane too steep (or ramus too vertically short), in the after, causing this appearance. Alternatively, she's just looking up in the photo.
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@breakingbad - something looks slightly off. But I'd rather that the post off looks than pre op look. Also judging by the angle of her ear if she were to rotate her head or move her chin down she's look like she'd have a straighter profile. Because what most people with steep occlusion sort of tilt their head making it look like their oclussion or profile is straight. But once someone has a CCW rotation tilting the head post op it technically makes the profile look off since it's already compensated but the bodies fine motor muscles haven't. This is my theory and it makes sense lol.
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this is my favourite topic , it is also very frustrating. i have seen some of the top doctors for chin wing in europe , and NOT ONE could show me a case where there was a dramatic improvement in width of the patients jaw, i.e. the transformational kind we are looking for and that are possible with implants. anecdotally i have heard about an austrian doctor that has widened by 10mm though.
i think there is a combo of reasons for this, mostly that there are not that many cases done where this is a priority. secondly, even by slicing the jaw up and filling up the gaps with your hip graft, you are simply not getting the incremental volume of material that you would need.
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Hi all!!! Dr. Z has answered me the message I sent you.I would do me some tests but he told me no problem.
I do not know what to do, if I let me or not because I'm already operated bimaxilar forward and become the chin wing means moving more down (and I do not want to have the longest face as I do I do to make it look wider and so disguise ) but among you go down and you can just avanzarme because I'm ... I operated nose to do ...
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this is my favourite topic , it is also very frustrating. i have seen some of the top doctors for chin wing in europe , and NOT ONE could show me a case where there was a dramatic improvement in width of the patients jaw, i.e. the transformational kind we are looking for and that are possible with implants. anecdotally i have heard about an austrian doctor that has widened by 10mm though.
i think there is a combo of reasons for this, mostly that there are not that many cases done where this is a priority. secondly, even by slicing the jaw up and filling up the gaps with your hip graft, you are simply not getting the incremental volume of material that you would need.
You added me on Skype and then disappeared. I would've shown you my own transformation. It is indeed dramatic, but with chin wing starting point is everything. It won't take you from potato jaw to brad pitt. However if you're decent then 1-2 chin wings plus chewing falim will get you there.
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Who did your chin wing Optimistic (you got it done twice you said): Triaca or Brusco? Do you have asymmetry too or is it not a problem for you? Do you think asymmetry is a common problem with the chin wing? Four patients have been discussed that have asymmetry after the chin wing so I'm wondering how big of a problem this really is. Or whether it depends on the surgeon that does the chin wing.
Triaca both times. No, I don't have asymmetry. I mean, I have asymmetry as far as one side of the face is a little bit wider than the other (as it is for every single person), so naturally the jaw is not perfectly symmetrical. However it is completely proportional, no asymmetries in the sense you're talking.
Honestly, how is asymmetry a problem? I can't understand. The wing osteotomy can be segmented. Why wouldn't the operating surgeon simply segment one side and widen more to create proper symmetry?? I've had no major asymmetries prior and the operation went fine, I've also seen people with major asymmetries who had the same procedure who came out with massively improved symmetry.
The biggest issue with the chin wing in my opinion is the chin area. If you need serious advancement there isn't the skin laxity to allow for a nice construction of it. So you can get a pointy chin or deep labiomental fold. However this can be fixed by seeing surgeon again at a later date for bone graft or chin visor osteotomy.
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Your face is longer now ?? I say this because with two ching wings down...
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Triaca both times. No, I don't have asymmetry. I mean, I have asymmetry as far as one side of the face is a little bit wider than the other (as it is for every single person), so naturally the jaw is not perfectly symmetrical. However it is completely proportional, no asymmetries in the sense you're talking.
Honestly, how is asymmetry a problem? I can't understand. The wing osteotomy can be segmented. Why wouldn't the operating surgeon simply segment one side and widen more to create proper symmetry?? I've had no major asymmetries prior and the operation went fine, I've also seen people with major asymmetries who had the same procedure who came out with massively improved symmetry.
The biggest issue with the chin wing in my opinion is the chin area. If you need serious advancement there isn't the skin laxity to allow for a nice construction of it. So you can get a pointy chin or deep labiomental fold. However this can be fixed by seeing surgeon again at a later date for bone graft or chin visor osteotomy.
Might be a bit off topic but wiht the chin wing, is it the nerve being too low that's the issue? Also, would a chin visor be more suitable if jaw angle is low any way but mandible is just short? (class 1 dental, class 2 skeletal). Thanks
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Ah great information thanks. You must look great after two wings.
Asymmetry does seem to be an issue though: 4 patients of Zarrinbal here have been said to have it, some with pics.
Why can't they do a bone graft immediately in the labiomental fold during the first surgery?
I'm told there are limits, probably more so with being young and having nice skin. Try tugging at the skin on your chin and it's already taut, now imagine stretching that even one centimetre. My guess is the skin gets too tight where there simply isn't enough laxity to build the area up with a material that isn't immediately solid.
Your face is longer now ?? I say this because with two ching wings down...
Had rotation every single chin wing. My chin philtrum ratio remains effectively what it was before. Since my second one it does appear chin lengthened a little bit (talking mm or something), but the improvement is very positive. Little bit more masculine.
Might be a bit off topic but wiht the chin wing, is it the nerve being too low that's the issue? Also, would a chin visor be more suitable if jaw angle is low any way but mandible is just short? (class 1 dental, class 2 skeletal). Thanks
I think so. The surgeon can look at your DVT and tell if you are a candidate. over 90% of people are.
Don't understand the second question, you're asking if jaw is fine and it's only labiomental fold that is a problem? Yes sliding genio and chin visor would work, or plain old bone grafting.
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I think so. The surgeon can look at your DVT and tell if you are a candidate. over 90% of people are.
Don't understand the second question, you're asking if jaw is fine and it's only labiomental fold that is a problem? Yes sliding genio and chin visor would work, or plain old bone grafting.
Thanks Optimistic. Second question wasn't very clear sorry- was referring to if mandibular plane angle is fine (i.e. chin wing with downward rotation may not be necessary) but chin is still retruded and a regular genio would deepen labiomental fold too much.
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However this can be fixed by seeing surgeon again at a later date for bone graft or chin visor osteotomy.
Isn't these two things the same?
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bone graft or chin visor osteotomy??? what is this?
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How long would I have to wait after double jaw surgery to have a chin wing?
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How long would I have to wait after double jaw surgery to have a chin wing?
12 months
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Isn't these two things the same?
Bone grafting is taking bone graft from the hip and using it to add boney volume to the chin. I guess this solidifies and is replaced by bone over time. Seems stable after the one month period.
Chin visor is an osteotomy that takes a block of bone from the labiomental fold region and advances it forward - then probably has some bone grafting on top to smoothen things out.
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12 months
Thanks.
Do any surgeons other than Triaca perform the chin visor osteotomy? Zarrinbal maybe?
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the visor sur to fill up the gap to avoid the fold increasing is filled at the same time the wing is done, no need to wait, doctor already has you cut open and can use the hip graft.
optimist, i lost your skype contact and had to heal up from a breaking my leg in a motorcyle crash so was not focussing on my jaw, but am now back on it asap.
the chin wing trio, unfortunatly, will try to tell you that it has almost no limits, which to me is surprise at they all also do bi max surgeries..