CHING WING AFTER BSSO

[PloskoPlus]

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.

[Picollo30]

i think she looks way better than before

[Breakingbad]

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.

[terry947]

@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.

[mike888miller]

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.

[Sinsajo]

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 ...

[Optimistic]

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.

[Optimistic]

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.

[Sinsajo]

Your face is longer now ?? I say this because with two ching wings down...

[BlueShark]

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

[Optimistic]

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.

[BlueShark]

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.

[boyo]

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?

[Sinsajo]

bone graft or chin visor osteotomy??? what is this?

[MaxilloMandibular]

How long would I have to wait after double jaw surgery to have a chin wing?