schrodinger: have you consulted with anyone yet regarding implants?
I have consulted for sliding genio, chinwing, implants.
About chinwing I said it can not elongate ramus vertically. I have difficulty explaining in English. Chinwing can elongate the ramus, but not without changing the steepness of the ramus since the lower border of the mandible slides forward. So if the border of the mandible is rotated the ramus is elongated but the steepness is changed too since the mandible border is slid forward. So you never get the sharp vertical shaped jaw angle, and the vertically orientated elongated ramus. The nice long vertical orientated ramus you see in men with strong jaw angle: you won't get it with the chinwing. Unless the mandible border is segmented with the surgery, but as I wrote it, Z. said he hardly does it. Segmenting the border will give stepoffs too and can give more asymmetry if not meticulously done.
Implants have their own negative points. But I do not agree it is the devil as some say. Many people have had implants in one or other place of their body and lived with them for decades. Also face implants. And if there is complication it can be removed and reinserted. Without long recovery, mostly days or week of recovery, often can be done under local anesthesia. The bone cutting surgery is big surgery which asks lot of recovery from the body.
However I would not choose a chin implant (I would not consider it). I would chose sliding genioplasty.
But mandible implants I find most of the time give far better and more predictable result then the chinwing. Infection rate is low. I do not understand why people are so against it here. It can give an artistically far better result. It is more predictable. You can change the outward rotation of the jaw angle, you can change the slope of the jawline. The chinwing by far has not that versatility. Also not when done two times. Unless you would also have the jawline shaved. But still have to find first patient wanting to do that too
But Optimistic has good result from chinwing so it is possible. I have seen a few good results, but also lot of not so remarkable results. The few good results: some had 2 surgeries. The difference was then good, but never as sleek as with jaw angle implants. And that is logical. Someone would have to have perfect foundation, good jawline slope, already good ramus, not too little sideward projection of jawline, outward rotated jaw angles at least a bit from the start, nicely shaped chin (although chin portion can be segmented too but not often done and still surgeon is limited to what you have), and then get a segmented chinwing to really get that masculine jawline with vertical oritentated ramus as very goodlooking of men often have. I still have to see first patient with such basis.
I also saw results that I found not good. I would love to see Optimistic's result and know who did his surgery. As said we all want good result so if I'm wrong, I would not mind, I would want to know. But technically chin wing can not give such artistically molded result as implants. You are not molding the bone, you are changing the shape only in segments and when the chinwing is not segmented only in a big segment that still has same fundamental shape. Whereas with implant you can change entire shape and your basis hardly matters.
