jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Lestat on October 29, 2016, 03:01:14 PM
-
I am looking only for more jaw width from the front and an improved jaw shape.
My chin is fine!
What I want is a SQUARE FACE.
Is it possible to do a chin wing without moving the chin forward?
And will the result even be better, if you dont move the chin forward?
What are your thoughts?
-
IMO a square face is the most beautiful type of face shape.
(https://m2hair.files.wordpress.com/2014/07/long-square-face.jpg)
-
The user "Vic" asked dr.Z for me. Thank you very much Vic you are great!! :D
Dr. Z told him that it is possible to do a chin wing without movement of the chin. It is called a side wing.
I need more information about this side wing.
Does it give a better result for jaw widening and jaw angles than a traditional chin wing?
How many mm are possible?
Maybe Vic can ask Dr. Z and is willing to share his knowledge with us.
I would really appreciate it.
-
A so called side wing is a variation of the chin wing.
I found this in an older thread:
I just had a phone consultation with Dr Z. He was telling me about a variation of the chin wing he does called the side wing. Anyone else heard about it?
He said its way of making the ramus longer without touching the chin
-
Yes, the side wing is the augmentation of the width and length of the jawline without touching the chin
-
Dr Z's gone for the day now, but if you let me know what you want to know about it, then I'll ask him tomorrow?
-
I guess the side wing would augment the most at the ramus and taper down to nothing to conform to the chin bone area, right? I wonder if that would look natural? Anyways I defer to Lestat for questions to ask Z, he's been researching all these things way harder than me. ;)
-
Thank you guys my questions are: how many mm are possible for each side and does it give better results for widening the jaw than a traditional chin wing? Is it also possible to lenghten the jawline? And could he describe the procedure a little bit maybe? Thanks.
-
Thank you guys my questions are: how many mm are possible for each side and does it give better results for widening the jaw than a traditional chin wing? Is it also possible to lenghten the jawline? And could he describe the procedure a little bit maybe? Thanks.
Dr, Sinn does some sort of wing only procedure --I didn't have it done but he does it I know.
-
Thank you guys my questions are: how many mm are possible for each side and does it give better results for widening the jaw than a traditional chin wing? Is it also possible to lenghten the jawline? And could he describe the procedure a little bit maybe? Thanks.
He said that how many mm's depends on the individual and how close the nerve is towards the edge of the jawline. He's sending me off to this X-ray place to tomorrow, which takes a cone beam CT, so he can see where the nerve is, but he said with his software he can plan the actual side wing by doing the cuts using the software and can see exactly what position and how far down towards the chin he will move the bone and how far he can move the bone outwards and downwards and also how the soft tissue will move and look after the surgery. So I'm hoping to have a plan all set for when I come back in 5 months for the next surgery and will pretty much know what the end result should look like
-
Hi Vic thank you for your answer. It is really very interesting. The best would be to make an appointment with Dr. Z. and speak with him personally, because each patient is different.
Wish you the best for your further surgeries with Dr. Z. Vic.
-
Hi Vic thank you for your answer. It is really very interesting. The best would be to make an appointment with Dr. Z. and speak with him personally, because each patient is different.
Wish you the best for your further surgeries with Dr. Z. Vic.
No worries mate. Yes, it's best to have a phone consultation then a face to face consultation
-
^
that's exactly why you never use a CW to bring out your chin. Forward movement is really bad on your gonials and will reduce angularity. What that patient should have done was getting the gonials flexed vertically and bone shaved the whole mandible in a more straight line and lower angle. Would have looked far better.
-
^
that's exactly why you never use a CW to bring out your chin. Forward movement is really bad on your gonials and will reduce angularity. What that patient should have done was getting the gonials flexed vertically and bone shaved the whole mandible in a more straight line and lower angle. Would have looked far better.
can you explain this in better detail
i hear the bone shaving thing bandied here a lot and it just sounds like trying to cosmetically contour the manidble into looking like its angular without actually addressing the problem that is causing a lack of definition (projection), sort of like removing the fat pad in the cheek to create an effect that is actually due to high and wide cheekbones.
-
True, but it is not just the forward movement of the chin wing that ruins the angularity. I've seen multiple chin wings in which either the chin was not brought forward, or even brought backwards and the jaw angle was still ruined. Because even if there is no forward movement, the wing still moves downwards which of course causes a gap between the ramus and the lower mandible.
Plus in this case that you see in the X-Ray the chin is even vertically shortened, so the gap is still far less obvious than in most chin wings where the chin is often vertically lengthened a bit or keeps the same vertical length.
This doesn't make any sense to me. The "gap" you speak of is filled with bone graft, both in between the cut and on top of the gonial angle. The wing is not only vertically dropped, but is flexed horizontally as much as possible, increasing width and projection. Are you claiming Zarrinbal told you he doesn't do segments? Because he told me just recently the opposite, he even could split the wing in pieces and fill them with grafts which will actually push the gonials backwards, lengthening them posterior. He didn't recommend it though because he isn't sure if the area will get sufficient with nutrition and not relapse.
-
It seems to me that chin wings are like rhinoplasty - budget for 2.
-
take a look at the procedure in this pdf http://dr-brusco.ch/wp-content/uploads/2014/12/Artikel-April2014.pdf
that was done to treat asymmetry obviously, but there is no reason this couldnt be performed to widen the mandible AFAIK. And the split is so close it would almost certainly fill in with bone rather rapidly.
moon im not sure why you think bony regrowth doesn't happen, its pretty well documented, and is infact the thing that allows limb lengthening to work.
-
I feel the chin wing is sometimes seen as the fantastic solution to get a great jawline here at the forum, and any suggestion that it may not be is met with criticism. I'm not sold on implants either but the chin wing has a lot of downsides that I'd like to discuss and contemplate rather than to get surgery and end up with ruined gonial angles or visible asymmetry. When someone posts about implants and gets the reply 'implants LOL' this doesn't seem like a discussion anymore about what gives the best result and about risk-benefit rewards. Rather it implies that implants are discussed with disdain, and with that some have started to automatically conclude that thus osteotomies such as the chin wing offer the ideal aesthetic solution. If you then question that, people don't want to hear it since it is the only surgical option they want to consider to improve their appearance and I've met a fair amount of criticism if I do discuss the downsides of the chin wing.
This is another chin wing result: for me I'd cringe if I would end up with this jaw angle. And I'm just not willing to take that risk without first knowing what I'm getting myself in for and discuss it.
Now this is even with a more ideal starting point for the chin wing since the chin is not moved forward. Still the gonial angle imho is ruined.
I wasn't criticizing you btw, the way you had written it sounded like you were saying the ostetomies leave permanently gaps that never fill in, which would seem impossible given it would be necessary for multiple procedures to be possible.
I agree the chin wing might be overrated. When i look at a basic diagram of the chin wing, i cant help but think "thats just a big genioplasty", its why i struggle to understand members here who say the chin wing can enhance the jaw in all planes. This just does not seem technically possible with the cut as described. Some other cut? perhaps, but then thats not a chin wing, its something else.
I'm not anti-implants but i can see why some members here are. 99% of the results that are publicly available look like s**t (there are obvious reasons for this of course that are more due to patient incompetence than they are due to implants being preternaturally bad), while at least some of the CW results bring about better looking faces. I can count on one hand the amount of good jaw implant results ive seen, and they are really good, but if there are many young men getting these surgeries and have great results, they are sure as f**k keeping it a tombstone secret.
This forum has a fair few american posters, some of you guys should really consult with eppley or yaremchuk (or even terino) and see whats what and report back here. Ive read the results in office that they cant publish online are much better, but i dont know what to believe at this point.
-
MOON!
Thank you for sharing your knowledge with us!
True, but it is not just the forward movement of the chin wing that ruins the angularity. I've seen multiple chin wings in which either the chin was not brought forward, or even brought backwards and the jaw angle was still ruined. Because even if there is no forward movement, the wing still moves downwards which of course causes a gap between the ramus and the lower mandible.
Question: and what if you move the wing ONLY SIDEWARDS? Is this even possible? Would it not improve the angularity of the jaw angle? What do you think?
This is why I don't understand that Triaca doesn't segment. Zarrinbal doesn't do it, but he seems to have quite a few results with asymmetry so perhaps asking to segment is asking for more problems. But that aside: he doesn't do it.
One member here said Triaca does segment, but Triaca said he hardly does it. So why not? Zarrinbal said because of bone absorption he does not segment. No idea what Triaca's reason is.
Do you mean bone absorption of the native bone or of the graft (f.e. hip bone)?
Thanks.
-
MOON!
Thank you for sharing your knowledge with us!
Question: and what if you move the wing ONLY SIDEWARDS? Is this even possible? Would it not improve the angularity of the jaw angle? What do you think?
Do you mean bone absorption of the native bone or of the graft (f.e. hip bone)?
Thanks.
This is what i want to know, as i could bring my face into nearly perfect balance just by WIDENING the mandible, i dont need forward projection, and any minor amount i could want could easily be achieved by a sliding genio at a later date I'm thinking.
-
It is clear that hip bone, used as an onlay will resorb and that is why it should be only used as a sandwich. But is it even possible that your native bone could absorb a little bit due to a failed chin wing?
-
ilovethemoon, i'm willing to share a video of myself in motion to show what results i obtained via chin wing. Please contact me via pm!
-
Moon!
Thank you for bringing light into the darkness!
But fact remains that if you look at the CAT scan of her results there is bone growth along the mandible (in between the wing and the lower part of the mandible) but not in the gap posteriorly at the gonial angle.
Can you please explain to me why it is not possible to fill the gap with bio oss or ha? I think this would solve the problem.
Another question: Have you seen Stupidjaws before and after photos? He had a pea-sized jaw at the beginning and look at his jaw now, after two chings (and other surgeries). Some users call him the Jawmaster! So please tell me: How do you explain his result?
-
moon et al -
great discussion, let me chime in as i have met with b, t, w and z, and have downloaded and reviewed all of the cases that are available on pubmed (granted only about 15 totoal but still).
gonial angle - dont follow you - you have to admit that the cw does REDUCE the gonial angle significantly. for example the guy on brusco's Website defenitly has a better ie flatter angle than before, we dont know if it could have been even flatter or if that was the max. in my case i am trying for an angle as flat as possible, and am seeing to Combine the flattening of the cw with some rotatoin in the bsso.
widening - wish we would discuss this more, ist actually much more important in Terms of attaction how you look from the front vs from the side, yet 80% of the pics we diccuss seem to be Profile shots. and this is where the cw has ist limitations, as admited by the doctors that perform it - and as you are 100% right to to focussed on. while we may gain some windth by bending the half circle open, we do loose length the back. You will never get a result as dramatic as that by which you insert an XL medpore implant, which can give you 14mm depending on how it is placed.
loss of length - agree fully, this is a Limitation, just read from a Girl in swiss that had a 10mm movement, and she said that now there is a gap in the back, which the doc said would Close over time.
https://www.progenica.de/forum/topic/15452-chin-wing-ohne-knochenentnahme/?#comment-178864
-
Some of them have a better jaw angle (and of course better jaw line) in the after.
http://dr-brusco.ch/wp-content/uploads/2014/12/Artikel-April-2011.pdf
Look at picture 3 and 4! Such a great result! Her jaw anlge and whole jaw line is a lot better now!
http://dr-brusco.ch/wp-content/uploads/2014/12/Artikel-Juni-2013.pdf
The guy here has lost his jaw angle completely!
http://dr-brusco.ch/wp-content/uploads/2014/12/Artikel-januar-2013.pdf
What do you guys think?
-
I think we're going in circles now
its clear some CW results are quite impressive, while others are mediocre at best.
stupidjaws has spoken about mandibular shaving being "crucial", i'm not clear on this, because if you try to research mandibular body shaving you will only come across feminization protocols where they want to make the jaw less heavy and more rounded, which i imagine is the complete OPPOSITE to what most people here want ;D
None the less SJ results are very good but he also uses fillers for that cherry on top touch. If one were to shave the mandibular body though.... could this removed bone material not be used to graft onto areas in need of augmentation, such as the gaps that would occur with a large movement?
-
My theory on why some get blunt gonials after only doing vertically movement (sidewing) is because of the technique used.
This is the cut we want to get (minus the anterior movement):
(http://i.imgur.com/drI7uhJ.png)
this is what some get instead which obviously is bad on the posterior ramus shape:
(https://www.researchgate.net/profile/Daniel_Brusco/publication/279313173/figure/fig1/AS:285853353689088@1445164158251/Fig-1-Former-design-of-the-chin-wing-osteotomy-In-patients-with-hyperdivergent.png)
-
Was lurking here again after a few months and checked if there was any new information discovered on this forum about surgery and my mind is actually blown how less information in this community exist about chin wing or implants in 2016. You are literally going in circles in a forum dedicated about jaw surgeries.
The pics of stupidjaws that are praised are not posted here on jawsurgeryforum, but on a different forum there was a user with similiar stats, 2 chin wings + fillers.
This is the "result".
http://i.imgur.com/IB3KuAh.png
You can not achieve jaw width at all with a chin wing... all it does is moving the mandible forward(fixing receeding chin) and it also appears to be wider since it is more protruding. Chin Wing also helps with the lenght of the ramus and vertical height of the lower third.
To get results like this, no amount of chin wing will give you this width of the jaw like in your "before - after" ... there is not even anything that you could compare to check if those 2 are the same person since you even hide the shoulders and frame for some reason... yeah ok.
Okay let's say this is legit for a moment, it's not the result of a chin wing alone like you said that makes it superior to implants, its mostly the fillers that did the work here since the jaw angles will be very round after the cut of the bone to move it forward and you simply can not model the bone 3d to make the jaw more angular, only the whole jawline can be moved but no way augmented in a way to achieve this angular result. Also chin wing is no wear near as accurate as custom made implants... asymmetrie is a very common problem after CW.
It's simply fillers (trial implants for a year) that gave you the jaw width and angularity and not chin wing. The chin wing improved the chin and harmony or the lower third.
About Chin Wing again, it will not give you the results you desire for male jaw asthetics, imho its more suitable and gives far better results for females since you get round jaw angles and a more feminine ramus with a little bit more angularity and modify the chin more forward, narrow and pointy.
Let us be real here.
I am sure enough of you have examined the post-op CW 3d scans and you can clearly see what it does the the jaw angles and why it does that. It actually hurts the male jaw astetics and if you are going for a chin wing for to improve your jaw. The jaw angles will get broken and round. Its the best to get this surgery in a case where your chin needs to be a lot more forward and square.
This is what you can expect after a CW: a good natural, forward projected and square chin.
-
It's the side wing that creates the width and gives you the sharp gonial angle. Chin Wing won't be able to give you that sharp angle because you have to move the chin forward. A side wing can move the mandible in any direction without having to slide it forward, and if you move the gonial angle directly down you can create that square look. Stupid Jaws did the chin wing first, then did the side wing after, which is why he has that square and sharp shape. Granted he also had a bit of filler there as well, but his angles were pretty good before the filler
-
It's the side wing that creates the width and gives you the sharp gonial angle. Chin Wing won't be able to give you that sharp angle because you have to move the chin forward. A side wing can move the mandible in any direction without having to slide it forward, and if you move the gonial angle directly down you can create that square look. Stupid Jaws did the chin wing first, then did the side wing after, which is why he has that square and sharp shape. Granted he also had a bit of filler there as well, but his angles were pretty good before the filler
Well I'm pretty much convinced I'm going to pursue CW + zso at this point
can anyone tell me how being an international patient works with Zarrinbal? Does he do skype consults or anything like that? I'd really rather not pay for a flight to germany from australia JUST to consult.
-
It's the side wing that creates the width and gives you the sharp gonial angle. Chin Wing won't be able to give you that sharp angle because you have to move the chin forward. A side wing can move the mandible in any direction without having to slide it forward, and if you move the gonial angle directly down you can create that square look.
Hi Vic thank you for your clarification. But who told you that? Dr. Z? Or have you seen pictures? How sure are you? I hope it is not only speculation... We have to find out the truth!!!
Stupid Jaws did the chin wing first, then did the side wing after, which is why he has that square and sharp shape. Granted he also had a bit of filler there as well, but his angles were pretty good before the filler
Did Stupidjaws tell you that?
-
Hi Vic thank you for your clarification. But who told you that? Dr. Z? Or have you seen pictures? How sure are you? I hope it is not only speculation... We have to find out the truth!!!
Dr Z and I planned by side wing after my surgery and that's what he's planning to do on me
Did Stupidjaws tell you that?
Yes, stupid Jaws told me
-
as someone who has had fillers done with the leading dr on in the world for fillers (have literally watched Shakira walk in their jumping my spot, have seen gweneth paltrow there, this guy also treats Madonna), he told me that there is no way in hell to get defined jaw angles via absorbable fillers, which are the only Kind you ever want to consider.
this is the Problem when we look at the pics - many of the patients also had bimax, with our without rotations, more or less agressive. just look at a good gunson case - he gets tremendus gonial angle Definition and flattening improvements.
In my mind you would get the best result, if you did a bimax with maxium ccw Rotation, and then did cw with as Little Forward movement as needed and as much widening as possible. i feel that having the gne or the chin wing in the back pocket causes some doctors not maximise the Rotation aspect, maybe rightly so.
i wonder if there as doctors that truely believe us if we tell them we are willing to go up the risk reward continium a Little bit higher in order to reach our Goals...
-
My theory on why some get blunt gonials after only doing vertically movement (sidewing) is because of the technique used.
This is the cut we want to get (minus the anterior movement):
(http://i.imgur.com/drI7uhJ.png)
this is what some get instead which obviously is bad on the posterior ramus shape:
(https://www.researchgate.net/profile/Daniel_Brusco/publication/279313173/figure/fig1/AS:285853353689088@1445164158251/Fig-1-Former-design-of-the-chin-wing-osteotomy-In-patients-with-hyperdivergent.png)
Yeah, you are completely right. The second picture is what was done to me and it blunted my jaw angles (more things went wrong but there's no need to discuss it any more). If it's done like the first pic maybe it could create more jaw width and angles, but probably only after two or three chinwings, which is too much risk I guess. Also, the so called sidewing can't be performed to everyone (it depends on elasticity of the bone). Overall I think this procedure is too unpredictable and you would maybe need fillers or implants afterwards if you needed more angularity and width. Even SJ needed fillers. Maybe chinwing works well on patients who already have a good jaw and chin and only want or need minimal changes, although someone on this board was happy with his cw results and went to the same surgeon as me, so it probably depends on the individual case as well.
-
Yes, the side wing is the augmentation of the width and length of the jawline without touching the chin
Hey Vic! Can you ask him if it is still possible to have revisional BSSO AFTER a side wing? Basically, does a side-wing prevent you from having jaw surgery in the future. Thanks.
-
Hey Vic! Can you ask him if it is still possible to have revisional BSSO AFTER a side wing? Basically, does a side-wing prevent you from having jaw surgery in the future. Thanks.
Not the person you actually asked, but doing that would be kinda stupid since jaw surgery will remodel your whole lower third and what previously looked good might not look good after it.
For chin wing its possible, so I assume its the same for side wing. Still not advisable.
-
Is it possible to know which movements from a bimax later prevent you from getting a chin wing?
I'd want a chin wing post bimax, but I'm unsure how to tell my surgeon or ask if the bimax will prevent it (due to nerve, etc)
-
Is it possible to know which movements from a bimax later prevent you from getting a chin wing?
I'd want a chin wing post bimax, but I'm unsure how to tell my surgeon or ask if the bimax will prevent it (due to nerve, etc)
It's not the 'movements'. It's the CUT placement. Chin wing docs do a HIGH BSSO so the the border of the mandible which needs to be cut through for the chin wing remains un-cut. The most common cuts for the BSSOs are in back of the molars which leaves a SPLIT through the area the chin wing docs need to cut through. If you have the most common BSSO that most bimax docs do, it PRECLUDES a chin wing later on which is WHY a chin wing doc WANTS/needs to bimax (and/or bsso that goes with it). You can ask Dr. Z about which BSSO cut must not be done if you later want a chin wing if you need further clarification.