Results from chin wing surgeries

[LeFort 3000]

Hey now this is ridiculously precise question...but does anyone know how big the distance between the border of the mandible and the "foramen mentale" (i guess thats how they figure where the mental nerve is) must be so you can even do the chin-wing?



my "green zone" is about 1cm. is that enough to cut a piece of jaw away, not damage the nerve and then fixate the wing back onto the mandible? doesnt sound like a whole lot of room to make that happen 

[strongjawman]

I got it done in London then brought it with me. It allowed us to see my exact bone structure and what I wanted to change. It's really useful because you can see the exact size and position of your cheekbones, so Dr Z spoke to me about the cheekbone surgery he also performs.

Where in London and how much did it cost if you don't mind me asking? Would love to do this.

[Vic]

Where in London and how much did it cost if you don't mind me asking? Would love to do this.

Got it done at Cavendish imaging on Harley Street. Cost £450 I think. You'll need to get a referral letter from a doctor or surgeon like that

[baldguy83]

Is Dr. Z's cheekbone surgery any good, like, have you seen good results on other patients?

It's good if you need lateral widening of your face at the cheekbone level. If won't magically give you model-tier high cheekbones. Nor will it give much, if any, anterior projection.

Also, if can worsen under-eye hollowing. It did for me, had to get additional surgery for that (from which I'm currently recovering).

[PloskoPlus]

It's good if you need lateral widening of your face at the cheekbone level. If won't magically give you model-tier high cheekbones. Nor will it give much, if any, anterior projection.

Also, if can worsen under-eye hollowing. It did for me, had to get additional surgery for that (from which I'm currently recovering).

What did you have? Did you have rhino with dr z as well?

[JimmyTheGent]

It's good if you need lateral widening of your face at the cheekbone level. If won't magically give you model-tier high cheekbones. Nor will it give much, if any, anterior projection.

Also, if can worsen under-eye hollowing. It did for me, had to get additional surgery for that (from which I'm currently recovering).

what surgery did you get and how is the recovery going?

[baldguy83]

What did you have? Did you have rhino with dr z as well?

I had bone grafted on top of my cheekbones by dr. Van der Dussen, alongside a malar fat pad resuspension. This to address the under-eye hollowing and general flat midface. In the same surgery he also performed a genioplasty since dr. Z's chin wing ultimately made my chin too long and asymmetric. Looks good so far, but I'm only 2,5 weeks post-op, so there's still swelling.

I had the rhino done by dr. De Jong here in the Netherlands. It's an improvement, but it needs some further fine-tuning. I will see him later this month.

[Lazlo]

SO when I showed Sinn the cut made by Zarinabbal et al. for the chin wing he said he would never do that as it's very high risk for severing the lower jaw nerve and creating all sorts of problems, esp. full numbness. I'm very attracted to the procedure though. A few people on the board have had the procedure, but not a ton. I wanna have a better sense about the complications involved with this procedure.

[baldguy83]

AFAIK the risk of mandibular nerve damage is not that high since Zarrinbal requires a CBCT scan to be made beforehand, so he can easily identify the nerve's position. Still, could happen that the nerve is disturbed somehow. There's no guarantee of success. I had zero nerve damage myself, even when the chin wing was combined with a BSSO.

A higher risk is that of significant introduced asymmetry, which happened to me and some other chin wing patients. A crooked chin does not look good, trust me. I had to get a revision genioplasty for that. Also, Zarrinbal really likes to exaggerate movements to create dramatic effects it seems. He's not always very subtle. Not everyone looks good with a heavy jawline or a massive chin. A couple of post-ops he flipped through during consultation looked pretty horrifying (jawlines/chins like The Joker), for instance. Ofcourse, maybe that is exactly what those patients wanted, and he simply obliged them. In that case he cannot be blamed I guess.

[UnderMunch]

AFAIK the risk of mandibular nerve damage is not that high since Zarrinbal requires a CBCT scan to be made beforehand, so he can easily identify the nerve's position. Still, could happen that the nerve is disturbed somehow. There's no guarantee of success. I had zero nerve damage myself, even when the chin wing was combined with a BSSO.

A higher risk is that of significant introduced asymmetry, which happened to me and some other chin wing patients. A crooked chin does not look good, trust me. I had to get a revision genioplasty for that. Also, Zarrinbal really likes to exaggerate movements to create dramatic effects it seems. He's not always very subtle. Not everyone looks good with a heavy jawline or a massive chin. A couple of post-ops he flipped through during consultation looked pretty horrifying (jawlines/chins like The Joker), for instance. Ofcourse, maybe that is exactly what those patients wanted, and he simply obliged them. In that case he cannot be blamed I guess.

Dr. Z sounds like the man of my dreams! Jk, but I rarely see any dramatic, or in my opinion worthwhile results from chin implants and genio plastys, so I am happy to hear that there are doctors willing to give you your money's worth.

[baldguy83]

Subtle is usually better. Lots of people here seem to have long faces with poorly defined midfaces, and then a heavy jawline/chin can look very out of place, or make the face appear even longer (you do NOT want that). Midface is key. The best jaw surgery results I've seen so far have usually been people with well developed midfaces with plenty of forward growth, but weak chins (for whatever reason). Someone occasionally lucks out with a Le-Fort, but they seem to go wrong much more often than right.

[baldguy83]

ZO is a relatively safe intervention. You just need to have realistic expectations. It will add lateral width to your face at the cheekbone level, so if you have a narrow face (like I had) it will help. It will not make your cheekbones higher, not will it add anterior projection. You will not suddenly look like a model if you had low cheekbones priorly. They could be moved upwards a bit, but this is at a much greater risk of asymmetry, according to dr. Z. The ZO procedure also might worsen under-eye hollowing towards the cheekbones (makes sense). The latter can be resolved/mitigated with bone grafts or perhaps HA paste, but would require additional surgery (and downtime). Finally, expect a fair bit of swelling and major discolorations under your eyes. Might take a month or more to resolve.

[LeFort 3000]

I'm really starting to worry about going a head with chin-wing/ZO now. The asymmetry stories and complications are freaking me out. I keep thinking that i should maybe just save for longer and plan to go with triaca/brusco, or forget about it altogether and just stick with a second Genio from the quality UK surgeon i seen. It would give me the chin i desire, but my lack of jawline and cheekbones will remain.

what kind of asymmetry are you guys talking about?
i mean with this procedure some kind of asymmetry is a given due to the way the surgery is done...a unflexible bone wing with many asymmetrys itself must be moved intraorally in one piece from one position to another etc...i mean im not a surgeon but i imagine its more or less pure luck if you hit perfect symmetry when screwing in the bony wing back on the jaw...especially after soft tissue settles back into place.

i think asymmetry has alot more to do with the procedure itself than the surgeon. ive seen some youtube videos of jaw surgerys and im suprised how they get anything done really...theres only such a small opening where you can see what you are actually doing...blood everywhere too and everything must be done at an angle etc. i imagine chin wing is not easier to do.

[baldguy83]

Yeah, some asymmetry is definitely to be expected when doing a chin wing. In my case it turned out rather significant though, necessitating an additional genioplasty.

[heshian]

ZO is a relatively safe intervention. You just need to have realistic expectations. It will add lateral width to your face at the cheekbone level, so if you have a narrow face (like I had) it will help. It will not make your cheekbones higher, not will it add anterior projection. You will not suddenly look like a model if you had low cheekbones priorly. They could be moved upwards a bit, but this is at a much greater risk of asymmetry, according to dr. Z. The ZO procedure also might worsen under-eye hollowing towards the cheekbones (makes sense). The latter can be resolved/mitigated with bone grafts or perhaps HA paste, but would require additional surgery (and downtime). Finally, expect a fair bit of swelling and major discolorations under your eyes. Might take a month or more to resolve.

I'm glad you shared your experience. Very helpful.

You mentioned the ZO provides only lateral enhancement. Im wondering on what height excatly?
Since you're experiencing increased (lateral) under-eye hollowing I guess the inferior orbital rim stays untouched during surgery and the cut is made somewhere in the "middle" of the zygomatic bone (if that makes any sense). Would you confirm this?