jawsurgeryforums.com
General Category => Emotional Support => Topic started by: ben from UK on August 23, 2018, 02:26:59 PM
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I had custom jaw implants before, but these turned out too big. So i had the jaw angles removed, but the chin implant and sides of the chin implants were left in. This created a bit of disharmony, with the chin a bit too big compared to the jaw area. Furthermore, the jaw muscles contracted upwards as a counter reaction on the distress caused on the muscles, leaving a bit of an 'empty space' just right under the jaw muscles and the lower border of the jaw. You can see the phenomenon here: https://www.ncbi.nlm.nih.gov/pubmed/19944991
I decided to do a CW to adress this problem , and bring back the harmony in the face.
I did the CW yesterday, and i know you have to way a couple of weeks before the swelling is gone, but i saw the resultst just after the procedure, when the swelling didn't yet kicked in, and it looked WAY too big, even bigger than the jaw implants. Jaw implants obviousy cause way more swelling. The 2nd reason i think it will turn out too big (again), is that the surgeon just right after the surgery came to see me and told me the end result might not be as expected due to the excess fat i have( i know i have a bit of excess fat in the space due to not sporting the last couple of weeks, but i'm not a fat person, so a little bit op sport and i'm a bit leaner. but there's a difference between lack of definition because of a bit of too much soft tissue and something that is just too big. And this looks way too big. I already have experience with the jaw implants and i just can feel it when something is too big.This is my intuition. Also, the surgeon toldd me that if i want to do a revision it can be done within 3 months, just after surgery. Why is he telling me these things just after surgery, it's like he's already expecting it to be too big.
I don't understand. We discussed this thoroughly, that i only wanted very natural, subtle changes. He also said that he certainly didn't want to lower the jaw/jaw angle too low, because it would look unnatural/almost comical. And yet it seems that is exactly what he did. I know people are going to say 'wait a bit, you'lll see the endresultst later', and part of me wants to believe this, but like i said, just after i had the procedure for jawimplants, the swelling did not yet kick in, and it turned out the result right after the jaw implant procedure (the surgeon showed it to me before putting the bandage back on) was just like the end result after the swelling was gone (7 weeks later).
So i'm distressed right now, and i'm almost already hoping for a revision CW if that's even possible. Especially because the surgeon was talking about revision or doing another plastic surgery after things settle down (but maybe he was talking about something else).
I'm hoping that if the jaw angle is too low i can raise the jaw angle again by cutting the lower boarder and raising it again. I hope this is possible. My intuition says the jaw angle is way too low. I really don't need so much lowering it seems. I opted for small subtle changes, based on my experience with the jaw implants. I maybe ended with something that's even bigger than the previous jaw implants.
Anyone experience with revision CW?
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It sounds like the whole custom jaw complex with front chin, lateral chin and rest of mandible was too big for your liking. But then you left the CHIN part in there which left disproportion to the rest of the mandible. So, if you went into the next surgery with chin area that looked TOO BIG or out of proportion with the rest of your jaw and because you removed just the jaw area part and not the chin, the doctor may have made the chin wing proportional to the rest of your big chin which again, is going to be too big for you.
That or it's just volume from all the numbing fluids they put in there that you saw. Only time will tell.
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It sounds like the whole custom jaw complex with front chin, lateral chin and rest of mandible was too big for your liking. But then you left the CHIN part in there which left disproportion to the rest of the mandible. So, if you went into the next surgery with chin area that looked TOO BIG or out of proportion with the rest of your jaw and because you removed just the jaw area part and not the chin, the doctor may have made the chin wing proportional to the rest of your big chin which again, is going to be too big for you.
That or it's just volume from all the numbing fluids they put in there that you saw. Only time will tell.
The chin and jaw area was slightly too big, not a very big problem. The jaw implant was 7 millimeter, but the chin wing was 9 millimeter lateral + lowering jaw with 9 millimeter. That is just insane, looking back. I'm not a technician and i don't know how much width and lowering is needed with a chin wing, cause i'm not familiatr with this procedure. I trust a surgeon to know exactly till how far he can go with a surgery. He says to me before the surgery: I can see exactly till how far i can go during the surgery. Then after the surgery he tells me things might not be the same results as was planned, because of ecess soft tissue, which is just not true. It looks like he went overboard and then backpaddled on what was promised: natural and subtle results. I almost sure i will end up with a face that is way too dispropotional. Also, why doing approximtely the same size of CW while the problem in first place was caused by sometjing that size or even slightly less. This is what I'm thinking about now, and maybe i should have adressed it before, but as a client i just don't know how much mm there must be compared to an implant.
The only thing that is positive is that the 'empty space' under the jawmuscle is filled because the bone is pulled in a lateral way. But the lowering of the jawangle seemed to be a disaster and not needed at all (maybe only one or 2 millimeter, but 9 millimeter seemed to look way too unnatural/comical and hurting the overall harmony.
I don't know how fast a revision can be done. As the bone didn't close yet, is it possible in special occasions to do the revision just after the initial surgery, or not? I might be wrong but i trust too much on my intuition and the result just after the procedure to know this will not be a disired outcome.
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Well, since it looks like you are posting from a geo local in vicinity of where chin wings are done, (if that's the case), then you should be near by enough to just ask him in person what and when he can do next ASAP. 9mm lateral flare out + 9mm drop down is significant. Does your hip hurt from the harvest?
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post before and after pics. you can blank out the rest of your face.
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My hip doesn't hurt much, i can walk normally. There will probably be a scar tissue on the area where the hip graft is taken, just under the belly, but i don't really care about that. Also, i had numbness of the lip, but it seems to deminish since a couple of hours. I have not much pain, if you can even call it pain.
I just worry about it being way too much. One othere reason to think this, is that swelling with jaw implants was way more, and this is less swelling but seems even bigger than during the jaw implant swelling. So something seems not right.
I came to do this procedure exactly for the reason that the implant was too big and i needed far more subtle changes to retain a natural harmonious appearance. I know that some people want heavy changes, and maybe it works for their faces, but not with my face. I have no big skull and also no big deficit in the lower half area. So a subtle change is what i definately need. So making the jaw area as big or even bigger than before, is creating the same problem all over again, if not a bigger problem seeing the size of the CW. The problem has been explained many times, 3d scan of the implants were send + pics were send. So if it stays like that, it's a very disappointing result. One of the surgeons i talked to after the jaw implants said it was way too big, and also added you can't exceed certain parameters when it comes to aestethics. You go overboard and you'll look unnatural, and in the worst case like a freak. His words are going through my mind after this cw as well. He's very right. Maybe a little bit too cautious, but never goes overboard as well. Unfortunately he didn't do CW.
People always talk about patience, but usually, just after the surgery, when the swelling haven't yet kicked in, is approximately what the end result will be, at least with the jaw implants. I have filmed the result just after the jaw implants and compared the result with after a couple of weeks of swelling, and it was pretty much the same: both too big. Swelling of jaw implants began 2-3 hours, maybe 4 hours after the surgery and the peak of the swelling was 4-5 days after the surgery. The swelling was gone for 90 percent after 7-8 weeks. So if it's too big by then, you can almost be sure it will be too big after half a year as well. It's not nice to have an implant that is too big, cause it can give a 'bloated' appearance.
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post before and after pics. you can blank out the rest of your face.
Pics without full face don't say much to me. I see blanked out faces with implants on google search, but i posted a blanked out face once on a forum with only lower half of the face after implants (although it wasn't high resolution, and a bit further away) and people said it looked good. While it was obvious in real life it was too big, which was admitted by the surgeon,without me even starting about it. Besides, with all due respect, and i understand that pics are very important, but i just don't like posting my pics on the net - blanked or not.
The swelling of the CW seems to have past its peak - or maybe it's the peak. Feelings in lip and under my lip seems to slowly coming back (but i won't draw too much conclusions about this yet, though that seems positive). I had a very small area at my left side between lower board of jaw and nerve, so the risk of damage was higher than with someone who has more space, because of the tiny space. The numbness is comparable to going to a dentist.
If you wouldn't know it was a chin wing, you would think it was an easy procedure: minimal pain, numbness diminishing, et cetera. But it is probably no easy procedure and they have to cut from the beginning of the jaw all the way around the chin back to other side of the jaw. Jaw implants are probaly a bit easier, but the difficulty with implants is that you have to put them under the masseter without seeing how exactly the end result will be. So it'will always be a bit of a gamble of how ig they must be. With CW, the surgeon probably can see during the surgery how it will look like. That's why it surprises me it seems to look way too big.
Combined with the fact the surgeon begins to talk about the size just after the surgery, makes me think he feels it's going to end up too big.
Having experienced both procedures, the only thing i want to say is be carefull. I can't stop thinking that some good results have to do with luck as well. It's very difficult to predict what the results of a procedure will be, and most results are probaly subpar, mostly due to surgeons going overboard, so watch out for this.If you have a normal face, be subtle with tha changes you want. But if you are way too subtle, of course not much will change.
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Swelling would tend to be more with a bone CUT and a graft put in there...more than with custom implants and if you just had it yesterday, swelling can hit its MAX on day #3. If you are in a recovery ward with access to the doctor, ask him more questions and report back.
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Swelling would tend to be more with a bone CUT and a graft put in there...more than with custom implants and if you just had it yesterday, swelling can hit its MAX on day #3. If you are in a recovery ward with access to the doctor, ask him more questions and report back.
I'm not in a recovery ward, thanks (will speak the surgeon monday, but he seems defensive). Swelling seems less than jaw implants. Could be due to the fact jaw implants (at least the ones used by American surgeons) take alot of space in the face (whole area underneath the masseter), and custom jaw even more (look at the pics of implants and you see alot of areas covered with blue, compared to CW, which is only lower peace of lower jaw. Also, the masseter has to be pulled with implant, in order to place the implant, and there is no good blood flow with silicone, causing things to heal much slower. So, maybe you're right and swelling of CW will be much more, but until now swelling of jaw implants seems more (balloon face)
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By the way, alot of useless areas are covered with implants it seems. I see pics of custom implant areas between chin and jaw angle going way up, which isn't needed.
I'm pretty sure implants can better some faces if there's subtle improvement and you don't do it too much times (revision - although revision percentage is something like 35%). It will probably always look unnatural though, cause of scar tissue that forms around it instead of being part of the body and bloodflow.
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sorry this happened. I also am going to do a CW for subtle changes. I hope the same doesn’t happen to me. Can I ask who your surgeon was ? The only thing you can do now my friend is wait and be firm with the surgeon about your wanting a revision. That’s very disappointing he went too big when you not only specifically asked for subtlety, but you experienced first hand implants that were too big - you think the point would be driven home.
So he said the reason he went big was because of excess soft tissue? This variable should’ve been discussed beforehand.
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sorry this happened. I also am going to do a CW for subtle changes. I hope the same doesn’t happen to me. Can I ask who your surgeon was ? The only thing you can do now my friend is wait and be firm with the surgeon about your wanting a revision. That’s very disappointing he went too big when you not only specifically asked for subtlety, but you experienced first hand implants that were too big - you think the point would be driven home.
So he said the reason he went big was because of excess soft tissue? This variable should’ve been discussed beforehand.
Thanks for your support. Although i can analyze things rationally, all kind of emotions go through my body: anger, anxiety, dissappointment, insecurity, et cetera.
but you experienced first hand implants that were too big - you think the point would be driven home.
Absolutely. I can blame myself but what do i know about the sizes of CW? Now i know, in case of my face. Waiting is a hell of a process. Rollercoaster emotions and i noticed people act even more nagitive on unnatural results than on ugy faces. Again, i'm talking about my face. So i probaly have to go through the same sh*t all over again, but even worse.
I'd rather not name the name of the surgeon as i still have to speak to him on monday (its in switzerland). I lost my patience now, after the bad experience with implants. I won't accept s**t anymore. I'm angry but trying to control my anger.
I hope the same doesn’t happen to me
It probably depends on the face as well. I can say for sure that some results i saw of CW gave a more 'full/bloated' result instead of sharpness. Some results of CW were fantastic though. But that goes for implants as well. I saw extremely good implant results, especially from Dr. Neo in Rotterdam (he doesn't do custom implants, only jaw implants and chin implants). His results were by far the best results i saw. He's selective in his clients though and generally not a nice man. But you can't have the ideal guy i guess. If he think there's 'nothing wrong with your face', he will usually not do anything.Other surgeons like Eppley do everything a client asks. Dr. Y. is more subtle and seems to take alot of times to design the implant. He has eye for detail. Details are important. You don't want to end up with something that is too big, cause it will have an impact on the harmony ofthe face, especially if you don't have the typical bite problem. Some people think too easy about the size of implants and CW's. They think: the bigger the better. I can undersatand this logic. Now i know it's not true in most cases. Of course, if you're already good looking, it's more difficult to make you ugly than when you have an average or slightly above average face. But even then, you might end up with a face that is too bloated, or the inverse: something so subtle it doesn't change much if not anything.
So he said the reason he went big was because of excess soft tissue? This variable should’ve been discussed beforehand.
He talked about it just after the surgery. That is, i personally brought it up before the surgery, that i had to lose a bit of weight for a more lean face, but after that it was all said and discussed. No need to bring it up again after the surgery, saying 'things didn't went completely as expected/planned'. When surgeons begin to talk like this, i know they're trying to search for excuses. Because i also got exactly the same vibe as from the surgeon from the implant. He began to say 'i don't think it's too big' just after the surgery, when taking the bandage off. When a surgeon says something like that, without me asking about it, it means: d*mn, it's probly a bit too big, i hope he will accept it, or: i don't want to admit i went overboard, risking a refund or in the worst case a judicial procedure. He had to admit it was too big 2 months later.
This surgeon said it's all about definition. Yes, definition is important, but having experience i know it's also about things not being too big (again: for my face, i saw a girl with almost no jaw at all, adding more than 1 cm with CW and she looked great). I have a strong feeling he went overboard/made a mistake. If that's the case, he needs to revise it. There's no discussion about it for me if that's the case. I don't know when that could be possible with CW. If he says it could be done within a week due to the bone still not being healed, it would be great - but i doubt that is the case, as you normally have to wait 3-6 months with implants and with CW i hear even 1 year.
By the way, this surgeon said, after i explained i had a bad experience with the surgeon from the implant: 'Every patient gets the surgeon he deserves'. Very strange remark, cause it is true, but it is not something you should say. Also, if it is true - and it's probably true - it means he himself is as bad as the previous one. And by creating it too big again, yes, i got a bad surgeon again, so the statement proves to be true again. But he must solve his mistake.
A client might get the surgeon he deserves, but a surgeon also gets the client he deserves. And i won't accept bs anymore.
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sorry this happened. I also am going to do a CW for subtle changes
I don't know which surgeon you have. The surgeon is important. I usually attract the money driven ones. The reason is i have not a lot of patience. Some good surgeons don't react as fast as the moneydriven ones. I should have more patience. Yes, you get the surgeon you deserve.
The most ethical ones are very strict in accepting clients.
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It’s a tricky situation. These procedures aren’t cheap so you want results but subtle, but not too subtle. This is what makes me anxious about doing this procedure eventually. First I am getting a Lefort to correct underbite and crossbite in a few months, tthen CW after because my lower jaw is narrow and angle is high - face shape like an upside down triangle although it’s not a severe deformity. So I want a wider and dropped down lower jaw but it can’t make me look blocky or like I’ve obviously had work done. I need to entrust the surgeon to strike this balance. I’ve only talked to Dr. Zarrinbal about it.
Why are you saying you had no patience ? I’m sure Even the best surgeons will see you relatively soon if you want it done right away - there’s no need to go with a lower quality one, unless for a lower price but you keep saying patience was your mistake, not beint cheap.
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It’s a tricky situation. These procedures aren’t cheap so you want results but subtle, but not too subtle. This is what makes me anxious about doing this procedure eventually. First I am getting a Lefort to correct underbite and crossbite in a few months, tthen CW after because my lower jaw is narrow and angle is high - face shape like an upside down triangle although it’s not a severe deformity. So I want a wider and dropped down lower jaw but it can’t make me look blocky or like I’ve obviously had work done. I need to entrust the surgeon to strike this balance. I’ve only talked to Dr. Zarrinbal about it.
Why are you saying you had no patience ? I’m sure Even the best surgeons will see you relatively soon if you want it done right away - there’s no need to go with a lower quality one, unless for a lower price but you keep saying patience was your mistake, not beint cheap.
The problem is you just don't know if someone is low quality beforehand. But poor results can be an indication, so asking for resultst is always good.
I wanted to go with dr. Z first, but Z. didn't respnd to emails. Same goes for Y. for implants. My lack of patience is a problem.
I can tell now with almost 100% certainty the CW is way too big. I'm so angry and sad about it. It is so big it looks almost comical - based on post op result and experience with the swelling. For me, it is uncomprehensible, as i clearly showed the implant design, talked about it many times. If that design is too big, it means the CW must certainly not exceed it (unless there is some other rule going on with CW, which doesn't seem to be the case).
Surgeons always show their best results, so you only see the top of the iceberg. Of course, it's not easy to perform a good job, but exceeding something that was already too big is an unacceptable mistake, and i'm not here to pay so much money to get a horrible result. You're always the most important client he ever had, even if he operated on thousands. So be cautious. If a surgeon is going to talk about bs right after surgery, usually he's trying to defend his mistake by forehand, or denial kicks in. I heard too many bs from surgeons and my intuition almost never lies with these kind of things. Everyone has a bs detector. Your bs detector is right most of the time. You don't even need to have experience to detect bs. It's intuition. Very few act on it cause we are in a vulnerable position and we need help. Almost every surgeon thinks he's the best of the best. Very low self awareness. We payed alot of money though, and put alot of trustin the hand of another person. We deserve the best we can get.
Subtility is very important and highly underestimated within the community. You lack a couple of mm jaw width? just do a jaw implant bro. Just do a chin wing, just do a sliding genio. If it was so simple, everyone would be happy. Measuring the exact size is a hell of a job. A surgeon needs to have an eye for it, needs to take time to analyze your face and needs to be able to answer your aswers. Some others don't need it. Don't do something if it's not strictly necessary. The risk of exceeding aestethical parameters is way too high. In the end, there is probably a luck factor (and maybe this factor is much higher than we want to admit). Predicting the outcome for 100% is impossible.
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Talked to the surgeon. He is completely confident that i will get the result i wanted and needed. I heard this before, that's why i'm sceptical. Revision is possible after a couple of months. Revision is even possible now, but you risk losing the jaw angle due to resorption of the bone, and of course, he advices against it. In appr. 2 weeks 85-90 percent of the swelling will be gone. Still, he says i will probably still not be satisfied after 2 weeks, due to residual swelling. According to him, it's about definition. With the jaw implants, after 90 percent swelling was gone, that was pretty much the endresult. So I don't know why he insists on the last 10 percent. But i guess i have to wait it out.
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post before and after pics. you can blank out the rest of your face.
Reasonable request if the topic is to remain in the Aesthetic section. Thank you for pointing this out.
I'm moving this topic to the 'Emotional Support' section.
Because it's more of an emotional response to an extremely early post op (with swelling) aesthetic-- that only the OP can see but viewers can't-- than it is a query seeking aesthetic advice based on visuals.
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Peak swelling diminishing. I have to admit i had extreme panic attacks and was not completely reliable as a source, unless what i said was true, but that cannot be said yet until swelling is gone. I have to wait till the swelling is gone before any judgement. Sorry for this. I will come back after the swelling to give more information.
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Peak swelling diminishing. I have to admit i had extreme panic attacks and was not completely reliable as a source, unless what i said was true, but that cannot be said yet until swelling is gone. I have to wait till the swelling is gone before any judgement. Sorry for this. I will come back after the swelling to give more information.
Glad to hear you understand why this was transferred to the Emotional support section and also that you took my advice to just ask the doctor and realize that 'only time will tell'.
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Yes i understand what you said, no problem with that. Are you planning to have a cw or did you had one done?
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Yes i understand what you said, no problem with that. Are you planning to have a cw or did you had one done?
No.
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Hey so I am approximately 6 months out of my own chin wing surgery. You really do need to wait a significant amount of time to judge your results, and this is no moment to panic just yet. From my experience I think its untrue that 90% of swelling will be gone by 2 weeks. I think by 2 weeks 60-70% will be down by then, 1 month 80ish%, and by 2 months 90% down. I felt like even when a large amount of swelling was gone their was still significant changes going on (I think due to more extensive bone healing and remodeling going on after the 2 month point).
I did notice that my drop down of my angle was MUCH larger at the 2 week point compared to the 2 month point (maybe I lost 3-4mm of drop down of the angle from the 2 week point to 3 months).
Anyways, I know how much anxiety and stress this can cause, it is your face after all. I remember I would take pictures of my face every couple hours up until 1 month post-op because the swelling was really bothering me (appearance-wise). It is important to just RELAX at this point, you are still very far from your "final result."
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Hey so I am approximately 6 months out of my own chin wing surgery. You really do need to wait a significant amount of time to judge your results, and this is no moment to panic just yet. From my experience I think its untrue that 90% of swelling will be gone by 2 weeks. I think by 2 weeks 60-70% will be down by then, 1 month 80ish%, and by 2 months 90% down. I felt like even when a large amount of swelling was gone their was still significant changes going on (I think due to more extensive bone healing and remodeling going on after the 2 month point).
I did notice that my drop down of my angle was MUCH larger at the 2 week point compared to the 2 month point (maybe I lost 3-4mm of drop down of the angle from the 2 week point to 3 months).
Anyways, I know how much anxiety and stress this can cause, it is your face after all. I remember I would take pictures of my face every couple hours up until 1 month post-op because the swelling was really bothering me (appearance-wise). It is important to just RELAX at this point, you are still very far from your "final result."
Thanks for the information and support.
Really appreciate. I'm 3,5 days post op. The thing looks massive. I mean, it's like i'm carrying a pelican chin. My anxiety is so high i'm thinking to off myself. I'm thinking all the time: is this swelling or not. It looks very 'boxshape'. As we all know, boxsbape is aestethical unpleasant.
How are your cw results now?
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Thanks for the information and support.
Really appreciate. I'm 3,5 days post op. The thing looks massive. I mean, it's like i'm carrying a pelican chin. My anxiety is so high i'm thinking to off myself. I'm thinking all the time: is this swelling or not. It looks very 'boxshape'. As we all know, boxsbape is aestethical unpleasant.
How are your cw results now?
I told you SWELLING would PEAK on Day #3. Bone CUTS with GRAFTS, you are going to SWELL.
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I told you SWELLING would PEAK on Day #3. Bone CUTS with GRAFTS, you are going to SWELL.
This i understand. But i had jaw impants 2 times as well. I'm trying to calculate what will be left after the swelling, based on post op swelling with jaw implants (custom wraparound actually). I will wait i guess.
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Then stop trying to calculate something you won't be able to calculate because you can't posit or take as base line that insertion of custom implants kicks up the same trauma as cutting into your bones and placing grafts between them. Bone cuts and moving around of bones is more traumatic than is fitting in a custom implant. Not to mention the TIME a surgery takes will be a factor of trauma, longer times, more trauma. More trauma, more swelling.
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Thanks for the information and support.
Really appreciate. I'm 3,5 days post op. The thing looks massive. I mean, it's like i'm carrying a pelican chin. My anxiety is so high i'm thinking to off myself. I'm thinking all the time: is this swelling or not. It looks very 'boxshape'. As we all know, boxsbape is aestethical unpleasant.
How are your cw results now?
Yes your chin and jaw angles will look huge for a while. Your face will also have a boxed shape for at least the first month or two. You really do need to be patient to start seeing your final result without swelling, I'm talking MONTHS not weeks. Also I don't believe a jaw implant would cause more swelling then a procedure that involves bone cuts including a bone graft. Their is much more trauma in bone cuts than simply just putting a implant in, meaning more swelling and downtime.
My result was outstanding, I got above and beyond what I was expecting. Their were times during my recovery I was just so worried about my outcome, thinking it just didn't look right, it was too big in some areas, too small in others, or assymetrical, or that i would never regain sensation in my lips or chin. However, given some time, the swelling went down and everything turned out great, I came out with about the same amount of asymmetry, if not better symmetry, and I regained what feels like 100% sensation again.
You say your only 3.5 days out, so you may not even be at the peak of your swelling, you have a long recovery ahead of you. Try to find something to distract you for the next while (books, movies, etc) to keep your mind off the surgery for now.
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Yes your chin and jaw angles will look huge for a while. Your face will also have a boxed shape for at least the first month or two. You really do need to be patient to start seeing your final result without swelling, I'm talking MONTHS not weeks. Also I don't believe a jaw implant would cause more swelling then a procedure that involves bone cuts including a bone graft. Their is much more trauma in bone cuts than simply just putting a implant in, meaning more swelling and downtime.
My result was outstanding, I got above and beyond what I was expecting. Their were times during my recovery I was just so worried about my outcome, thinking it just didn't look right, it was too big in some areas, too small in others, or assymetrical, or that i would never regain sensation in my lips or chin. However, given some time, the swelling went down and everything turned out great, I came out with about the same amount of asymmetry, if not better symmetry, and I regained what feels like 100% sensation again.
You say your only 3.5 days out, so you may not even be at the peak of your swelling, you have a long recovery ahead of you. Try to find something to distract you for the next while (books, movies, etc) to keep your mind off the surgery for now.
Great feedback. With the custom jas implants, my face seemed to be more swollen, maybe because it covered a bigger area. They go underneath almost half of the masseter for example. With this CW it seems to be less swollen but 'bigger' face. Maybe the 'bigness' is an optical illusion and it's all swelling.
Anyway, don't do silicone implants guys: the stories are true: they blow up your face, don't look naturel. Awful stuff, unless you do a very small increase, but even then it is not an ideal solution.
I read the swelling of CW was mostly the first two weeks, and with implants the big swelling period lasts 7-8 weeks. But maybe it's the same period and same swelling pattern.
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Then stop trying to calculate something you won't be able to calculate because you can't posit or take as base line that insertion of custom implants kicks up the same trauma as cutting into your bones and placing grafts between them. Bone cuts and moving around of bones is more traumatic than is fitting in a custom implant. Not to mention the TIME a surgery takes will be a factor of trauma, longer times, more trauma. More trauma, more swelling.
I think you underestimate implants, with all due respect. Quite alot of force needs to be used to place them underneath the masseters. Also, it takes a long time to heal because of the silicone between skin and bone. With osteotomy this is not the case. There is no silicone, that diminishes good bloodsupply. When bloodsupply is less, the healing takes longer and there is probably more swelling as well.
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Update: had a convo with the surgeon. He tried to reassure me he did not do too much and to trust him. Of course, this is what you want as a client, to trust someone. I began to trust him again, until i saw the X Ray with the bone change. Seems to be a huge lateral displacement (not only drop down). Certainly bigger than the width of the implants, which was already too big for my face (and no drop down). What i needed was max 4 mm additional width. Exceeding that border makes my face looks unnatural. It's about millimeters. Adding a 10mm drop down on top of that, makes it even more unbalanced. I mean, i understand the idea behind that. Theoretically, he wanted to create that 'square' look. But I've been there, done that with the implants, and it made my face look out of proportions. So I asked for a small change this time. But i get the same nightmare, if it's not worse. Pffff.
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I think you underestimate implants, with all due respect. Quite alot of force needs to be used to place them underneath the masseters. Also, it takes a long time to heal because of the silicone between skin and bone. With osteotomy this is not the case. There is no silicone, that diminishes good bloodsupply. When bloodsupply is less, the healing takes longer and there is probably more swelling as well.
Good. Have your freak out WITHOUT my feedback.
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Good. Have your freak out WITHOUT my feedback.
There's really no need to be rude. I have done both procedures and i can tell 6 days post op that the swelling with custom wrap around implants was way more. I don't know why that was, but it could be because of bloodsupply or the fact more skin had to be detached.
At the moment, quite some swelling seems to be gone. I walk around with a weird long face, additional asymmetry and overall a strange overdone look. Some more swelling will be gone the next week, but my intuition says this won't end well. I may be wrong and i hope so. But if i'm not it is what it is. I have been offered a free revision already if the results don't satisfy me, but i'm afraid new damage has been done to my skin and tissue. I wish i could say something positive.
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I meant what I said: Good. Have your freak out WITHOUT my feedback.
Polite translation= I'm electing to IGNORE, not waste any more time and attention to your ruminations about swelling. Seek attention from OTHERS. I'm DONE with it.
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Results untill now:
- Face is too square
- Bit of banana shape
- More rounded jawangles
- Lost V-line
Not happy with the result unfortunately. I'm aiming for a revision atm, even though there is still some swelling. But the overall structure is still not good.
The procedure, in my case, doesn't seem superior to implants. The only difference is that implants look a bit more fake and can bloat up your face if there's too much width. I heard from someone some people that done CW got a banana look. Pretty killling for your looks. I think it's always better to do less instead of too much, unless you have extreme overbite or very high jaw angle.
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The swelling reduced alot today compared to yesterday. I am 17 days post op. The surgeon says i have to wait till the end of recovery process. I had several bad implants before, so I am more stressed about the potential results.
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Yeah there's definitely lot of change still the first year. Took me well over a year to see the first result. It didn't give me width, not that I notice. It did give me some drop down. Banana shape and rounded jaw angle: you are not the first to mention but I think that also depend on how much it was moved forward?
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Yeah there's definitely lot of change still the first year. Took me well over a year to see the first result. It didn't give me width, not that I notice. It did give me some drop down. Banana shape and rounded jaw angle: you are not the first to mention but I think that also depend on how much it was moved forward?
The history of your posts reveals you made arguments against having the chin wing. Can you tell me what made you change your mind in favor of it?
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The history of your posts reveals you made arguments against having the chin wing. Can you tell me what made you change your mind in favor of it?
Very simple: I didnt' want implants after all. And the doctor said the worries I had were things he could prevent in surgery.
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Hi Schrodinger. In private messages you said you saw a good change until 7 months. But after that - maybe because of resorption or residual swelling - you didn't see much change and was left with asymmetry. Now you say it took more than a year to see results. Could you explain please?
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What I mean to say is that you should see changes for a very long time. After 7 months the width of my jaw didn't change much anymore I feel. So it took approximately 7 months to see what jaw width I was ending up with.
But there were still a lot of other changes: refinement, swelling on the jawline and chin resorbing showing details. So there was definitely still change yeah, and even up to a year or longer.
You must not sweat now already is what I say: it is way too early to sweat only a few weeks after surgery. You can judge nothing yet.
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As to assymmetry: I think any osteotomy or implant can put emphasis on already existing asymmetry. The point is: you don't see that assymmetry much until it is emphasized when you make the bone bigger with an implant or osteotomy. It is the augmenting that emphasizes asymmetry you already have is what I believe.
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Hi Schrodinger, am i right by saying you wanted horizontal width, but by dropping down the lower border of the jaw, it didn't give more width? Maybe you should have had some sidewing as well (if that's even possible). My question is also: when you drop the lower boarder, the area that had no bone, is now 'filled' with bone, if you understand what i mean. So the empty space underneath your original jaw angle has bone now. So it must be broader at that level, right? But not at the upper level?
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What about contact sports btw: I still feel some worries when I play soccer or do any contact sport. Others have it too?
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So there was definitely still change yeah, and even up to a year or longer.
I do not believe that. How could something like that be possible? ::)
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I do not believe that. How could something like that be possible? ::)
Your problem. Get it done yourself and see for yourself because it can be different for you. Everyone have different tissue reponses and heals at different speed. For me the finest details were getting visible after more than a year. I can see it in my images also.
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What about contact sports btw: I still feel some worries when I play soccer or do any contact sport. Others have it too?
Is it still a risk that you can break your mandible more easily even after a year or longer?
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Is it still a risk that you can break your mandible more easily even after a year or longer?
No, after a year everything should be completely healed.
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No, after a year everything should be completely healed.
Thanks man!
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Could it also be fat loss after a year, Schrodinger?
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Could it also be fat loss after a year, Schrodinger?
Could be, but I havent lost weight/fat. So I'm not sure why fat loss? If you ask people that had bimax lots will tell you it can take up to a year to see the finest details. Not sure why that sounds so unbelievable to some. They are cutting your bone: it is very traumatic for the surrounding tissues.
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Can you get jaw implants still after chin wing? Or is that not possible since the hardwire will get in the way of the implants? Just thinking of different ways that I could make this look better.
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I think it's possible. But implants don't look so natural and have a tendence to bloat up the face unless it's medpor or very small silicone implants.
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I think it's possible. But implants don't look so natural and have a tendence to bloat up the face unless it's medpor or very small silicone implants.
Thanks hesitating how to correct this: another osteotomy (not convinced yet) or implants.
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Thanks hesitating how to correct this: another osteotomy (not convinced yet) or implants.
I wouldn't go for implants. They don't look natural and easily bloat up your face.
I'm 4 weeks post op cw, and i must say it looks better atm. I still hope there is some residual swelling along the sides of the jaw, to make it more lean. There is some asymmetry but fortunately my face looks leaner.
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Endconclusion after consulting another surgeon for second opinion: there is improvement of jawangles and width on level of jawangles. jawangles are a bit too low, making my face longer. Chin implant with sides too big and need to be shaved down. Lower structure is too big overall. Also asymmetry (already had an asymmetric face, but now more asymmetry it seems). One jaw angle seems to be lower than the other. I can't say i'm very pleased with the results unfortunately.
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Sorry to read that man. I too still am dissatisfied with what my chin wing looks like. I am thinking of consulting Zarrinbal. He is supposed to be really good with chin wings. Here's to hoping he can do something about what this looks like.
Perhaps you can visit him too?
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Sorry to read that man. I too still am dissatisfied with what my chin wing looks like. I am thinking of consulting Zarrinbal. He is supposed to be really good with chin wings. Here's to hoping he can do something about what this looks like.
Perhaps you can visit him too?
No cause this procedure was not for me. Barely any change. From what i can see titanium and peek implants are way superior to cw, even silicone is superior but looks unnatural and ages badly, plus screws get loose after a while cause it's soft material. Cw barely creates width, it's only good for minor changes imo, but some people are happy with It. Another downside is that it's unpredictable and creates asymmetry. Wasted money in my case, wrong choice.
There is no perfect solution and you need to have luck as well. But i wouldn't advocate for cw if someone needs width + angularity. Basically, it drops down the jawangle, with the aim of creating the 'illusion' of more width. This does not create a better jawangle when you don't have a good one in the first place. I wasn't impressed with the results i have seen as well, only in cases where minor bonemovement was needed, but that means those people already looked (very) good. That being said, I have seen many s**t results with implants as well, especially silicone.
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I had custom jaw implants before, but these turned out too big. So i had the jaw angles removed, but the chin implant and sides of the chin implants were left in. This created a bit of disharmony, with the chin a bit too big compared to the jaw area. Furthermore, the jaw muscles contracted upwards as a counter reaction on the distress caused on the muscles, leaving a bit of an 'empty space' just right under the jaw muscles and the lower border of the jaw. You can see the phenomenon here: https://www.ncbi.nlm.nih.gov/pubmed/19944991
I decided to do a CW to adress this problem , and bring back the harmony in the face.
I did the CW yesterday, and i know you have to way a couple of weeks before the swelling is gone, but i saw the resultst just after the procedure, when the swelling didn't yet kicked in, and it looked WAY too big, even bigger than the jaw implants. Jaw implants obviousy cause way more swelling. The 2nd reason i think it will turn out too big (again), is that the surgeon just right after the surgery came to see me and told me the end result might not be as expected due to the excess fat i have( i know i have a bit of excess fat in the space due to not sporting the last couple of weeks, but i'm not a fat person, so a little bit op sport and i'm a bit leaner. but there's a difference between lack of definition because of a bit of too much soft tissue and something that is just too big. And this looks way too big. I already have experience with the jaw implants and i just can feel it when something is too big.This is my intuition. Also, the surgeon toldd me that if i want to do a revision it can be done within 3 months, just after surgery. Why is he telling me these things just after surgery, it's like he's already expecting it to be too big.
I don't understand. We discussed this thoroughly, that i only wanted very natural, subtle changes. He also said that he certainly didn't want to lower the jaw/jaw angle too low, because it would look unnatural/almost comical. And yet it seems that is exactly what he did. I know people are going to say 'wait a bit, you'lll see the endresultst later', and part of me wants to believe this, but like i said, just after i had the procedure for jawimplants, the swelling did not yet kick in, and it turned out the result right after the jaw implant procedure (the surgeon showed it to me before putting the bandage back on) was just like the end result after the swelling was gone (7 weeks later).
So i'm distressed right now, and i'm almost already hoping for a revision CW if that's even possible. Especially because the surgeon was talking about revision or doing another plastic surgery after things settle down (but maybe he was talking about something else).
I'm hoping that if the jaw angle is too low i can raise the jaw angle again by cutting the lower boarder and raising it again. I hope this is possible. My intuition says the jaw angle is way too low. I really don't need so much lowering it seems. I opted for small subtle changes, based on my experience with the jaw implants. I maybe ended with something that's even bigger than the previous jaw implants.
Anyone experience with revision CW?
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I read an article by dr Yaremchuk of an complication with a bulge of soft tissue on the lower mandible and a possible skeletonized area....this are possible complications after the placement of custom made wrap around implants for jaw and chin....
Myself had custom Made implants placed three months ago and i am pleased so far with the shape of the jaw and chin.....however i have serious complication with soft tissue now after 3 months....the left side look more than okay and is a good result....the right side however i have a big a bulge of hanging soft tissue on the right mandible....i have a hanging cheek of soft tissue on the front of my mandible...
Friday i see my surgeon to discuss this problem and what he can do about iT.....i don’t have the skeletonized area as mentioned in the article by dr Y....but i do have the bulge of soft tissue that seems to be also a possible complication with this procedure....
So i hope my surgeon can correct this problem by reattachment of the musculus masseter....
The left side is smooth and has a good decent shape....so iT can’t be swelling anymore after three months...because the difference with the right side is huge and enormous....
Do you know a expert maxillofacial surgeon in europe who is capable of reattachment of the musculus masseter?...in case my surgeon has No clue how to solve this problem?....so that i have a extra option...
I can find little information about this procedure except dr Yaremchuk in the US.....first i want to try my luck in europe close by the netherlands....
I hope you can name me a surgeon in Europe who is capable of this procedure....or maybe someone else on this forum?
With kind regard Gianluigi.....
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I read an article by dr Yaremchuk of an complication with a bulge of soft tissue on the lower mandible and a possible skeletonized area....this are possible complications after the placement of custom made wrap around implants for jaw and chin....
Myself had custom Made implants placed three months ago and i am pleased so far with the shape of the jaw and chin.....however i have serious complication with soft tissue now after 3 months....the left side look more than okay and is a good result....the right side however i have a big a bulge of hanging soft tissue on the right mandible....i have a hanging cheek of soft tissue on the front of my mandible...
Friday i see my surgeon to discuss this problem and what he can do about iT.....i don’t have the skeletonized area as mentioned in the article by dr Y....but i do have the bulge of soft tissue that seems to be also a possible complication with this procedure....
So i hope my surgeon can correct this problem by reattachment of the musculus masseter....
The left side is smooth and has a good decent shape....so iT can’t be swelling anymore after three months...because the difference with the right side is huge and enormous....
Do you know a expert maxillofacial surgeon in europe who is capable of reattachment of the musculus masseter?...in case my surgeon has No clue how to solve this problem?....so that i have a extra option...
I can find little information about this procedure except dr Yaremchuk in the US.....first i want to try my luck in europe close by the netherlands....
I hope you can name me a surgeon in Europe who is capable of this procedure....or maybe someone else on this forum?
With kind regard Gianluigi.....
Only Yaremchuk can do this I think. Well, some other surgeons could do it but lack experience. It can only be done through a Risdon approach, cutting beneath the jawline and then stretching the masseter till the lower border of the mandible. Then you pull masseter strings through small holes and attach them underneath. Most surgeons will say it cannot be done, but it can be done.
The Risdon approach has the additional advantage that an infection is less likely due to exterior insertion. Sometimes you don't even need antibiotics. The Risdon approach could also be used for people who are very afraid for infections.
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By the way, this post doesn't represent most cw outcomes. I've seen good cw outcomes. With me, looking back, something went wrong with pushing both sides of the jawangles outwards. I had cw + horizontal lower border outward push (forgot the name). But something went wrong. The bone from the jawangle must have been smashed into pieces and was all over the place, looking at the ct at the time. The consequence was a longface (long chin), which of course had to be balanced out by broader jawangles. But the jawangles were missing (broken off into pieces), so I got a disproportionate long chin. I still don't know why it went so wrong (nothing hit my face, so I guess it happened during surgery). I guess it's a delicate procedure if you cut off part of the lower jaw and push it outwards along with lowering the jaw/chin. I've seen cw ct scans and most of them have done the simple cw, that means lowering the lower border of the jaw. But what stupidjaws and I did was more complicated, with an additional horizontal flare.
Fortunately, in my case, I could rebuild the jawangles with implants, otherwise I would have a deformed face with no jawangles.
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By the way, this post doesn't represent most cw outcomes. I've seen good cw outcomes. With me, looking back, something went wrong with pushing both sides of the jawangles outwards. I had cw + horizontal lower border outward push (forgot the name). But something went wrong. The bone from the jawangle must have been smashed into pieces and was all over the place, looking at the ct at the time. The consequence was a longface (long chin), which of course had to be balanced out by broader jawangles. But the jawangles were missing (broken off into pieces), so I got a disproportionate long chin. I still don't know why it went so wrong (nothing hit my face, so I guess it happened during surgery). I guess it's a delicate procedure if you cut off part of the lower jaw and push it outwards along with lowering the jaw/chin. I've seen cw ct scans and most of them have done the simple cw, that means lowering the lower border of the jaw. But what stupidjaws and I did was more complicated, with an additional horizontal flare.
Fortunately, in my case, I could rebuild the jawangles with implants, otherwise I would have a deformed face with no jawangles.
I think there's a lot they can do with these types of Ostetomies of the lower mandibular border
AKA, 'chin wings', as to the type of displacements they can do with it. But if they actually do a LOT in ONE surgery, something CAN snap. Pulling/displacing in too many directions at one time can result in elasticity failure. I think this is most likely the rational for having to under go MORE than one oesteotomy of the lower mandibular border to achieve multiple 'effects' with it.
Was this something where you wanted what SJ did but got done in one surgery?
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I think there's a lot they can do with these types of Ostetomies of the lower mandibular border
AKA, 'chin wings', as to the type of displacements they can do with it. But if they actually do a LOT in ONE surgery, something CAN snap. Pulling/displacing in too many directions at one time can result in elasticity failure. I think this is most likely the rational for having to under go MORE than one oesteotomy of the lower mandibular border to achieve multiple 'effects' with it.
Was this something where you wanted what SJ did but got done in one surgery?
Yes, in one surgery. Elastacity failure might have happened. Both sides probably scattered (one side more than the other). I saw it on the ct scan just after the surgery. Surgeon didn't want to tell what was wrong but I knew something wasn't right. Looking back, I think it must have been elastacity failure or if it wasn't that, something else went wrong. Tricky procedure.
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Yes, in one surgery. Elastacity failure might have happened. Both sides probably scattered (one side more than the other). I saw it on the ct scan just after the surgery. Surgeon didn't want to tell what was wrong but I knew something wasn't right. Looking back, I think it must have been elastacity failure or if it wasn't that, something else went wrong. Tricky procedure.
This is really unfortunate, I'm sorry. I hope you can fix this with implants if you choose to go that route.
I find that even just knowing there is a potential fix for a result you are unhappy with helps cope with the bad feelings. People might say "there's more to life than jaw angles" and yeah, that's true. But if it hurts to look in the mirror and the problem is both real and treatable, it's probably worth it for your quality of life.
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This is really unfortunate, I'm sorry. I hope you can fix this with implants if you choose to go that route.
I find that even just knowing there is a potential fix for a result you are unhappy with helps cope with the bad feelings. People might say "there's more to life than jaw angles" and yeah, that's true. But if it hurts to look in the mirror and the problem is both real and treatable, it's probably worth it for your quality of life.
Thanks. I already fixed the angles months ago, but it was a tough time.
I think jawangles are probably the most important feature in a male face. I've seen pics of people with for example flat faces, crooked noses, big noses or weak chins, and the right jaw can bring back the whole balance and make other flaws less visible. But of course, it differs from person to person.
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Yes, in one surgery. Elastacity failure might have happened. Both sides probably scattered (one side more than the other). I saw it on the ct scan just after the surgery. Surgeon didn't want to tell what was wrong but I knew something wasn't right. Looking back, I think it must have been elastacity failure or if it wasn't that, something else went wrong. Tricky procedure.
My GUESS--and this is based on your saying that you got the drop down of the mandibular border in addition to a 'wing out' or 'flare out to the back of the jaw, is that after he made the cut to free the mandibular border (to lower it), an attempt was made to PRY the back part outward and it snapped. Elasticity issues come into play when you attempt to PRY out a PART of something.
I really think that is why the first surgery is best devoted to to the release of the mandibular border in which the displacements can be a drop down and a forward advancement where there is NO prying at the back of the border. The drop down would be sandwiched with bone buttress, often your own hip bone.
The second surgery would involve a second CUT where the second cut would go through the first one and then a third cut to the back of the mandibular border to release it, re-orient it and regraft isolated displacement of that part so it 'wings out' from front.
Elasticity issues don't come into play when cuts are with aim to displace mandibular border or even parts of it. They come into play when parts of the mandibular border are PRIED away from the other parts.
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My GUESS--and this is based on your saying that you got the drop down of the mandibular border in addition to a 'wing out' or 'flare out to the back of the jaw, is that after he made the cut to free the mandibular border (to lower it), an attempt was made to PRY the back part outward and it snapped. Elasticity issues come into play when you attempt to PRY out a PART of something.
I really think that is why the first surgery is best devoted to to the release of the mandibular border in which the displacements can be a drop down and a forward advancement where there is NO prying at the back of the border. The drop down would be sandwiched with bone buttress, often your own hip bone.
The second surgery would involve a second CUT where the second cut would go through the first one and then a third cut to the back of the mandibular border to release it, re-orient it and regraft isolated displacement of that part so it 'wings out' from front.
Elasticity issues don't come into play when cuts are with aim to displace mandibular border or even parts of it. They come into play when parts of the mandibular border are PRIED away from the other parts.
Uhuh, I think you're right and it might have happened the way you describe it. Glad I could fix this whole mess.
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Uhuh, I think you're right and it might have happened the way you describe it. Glad I could fix this whole mess.
Well, glad you got a fix and it's now 'water under the bridge'.