Jawline Divots

[mazilla]

I have 2 huge divots on my jawline where the cuts were made.

Is this common for BSSO? I don't see people with divots in their afters.

Why could this have happened?

[PloskoPlus]

Large advancement.

[kavan]

They are called 'step-offs'.

Here is an illustration found on Spanish max fax doc's site (Alfaro) where he gets a good CCW and also maintain some 'drop' or good length to the back angle of the mandible in addition to a good forward advancement. The step off is seen in the computer simulated plan.

The lines on the illustration are drawn by me to show that one does NOT cut off the step offs in order to make the jaw line 'stream line'. If that were done, bone structure would be lost. Also bone paste is not used on a VACANT space which is the angled area between the part of the red line and the yellow line. INSTEAD, later on, a thick filler (Macrolane) can be use to fill the soft tissue above the yellow line. In that way, the whole jaw line will look EVEN.

[kavan]

Cant' predict if a set back would remove them. Macrolane is a thick soft tissue filler that can last about a year.

ETA: The filler is injected by OTHER practitioners. Not the max fax.

[kavan]

Thanks Kavan,

But people with smaller jaw advancement do not have step-offs, right?

I don't want to use the filler to be honest.

Even people with no jaw advancement can have somewhat of a natural step off where the back angle is lower and not 'flush' with the rest of jaw.

[kavan]

I know what you mean, but I didnt have that preop, and now it is very noticeable.

I gave you the method of blending them in. If you don't want to do that, there's not much I can suggest .

[CCW]

Even people with no jaw advancement can have somewhat of a natural step off where the back angle is lower and not 'flush' with the rest of jaw.

Do you mean an antegonial notch? A prominent antegonial notch is common with LFS.

[kavan]

Do you mean an antegonial notch? A prominent antegonial notch is common with LFS.

see arrow

[David_D]

I have 2 huge divots on my jawline where the cuts were made.

Is this common for BSSO? I don't see people with divots in their afters.

Why could this have happened?

I had some jawline irregularity addressed with surgical removal of segments of bone.  I think that the jawline contour issue addressed with the bone removal was actually caused by reduction genioplasty and not lower jaw surgery.  Just thought I'd add this to the discussion of post-surgical jawline contour issues.

[jawline]

If you're not against implants being placed - then there's also this:

http://www.matrixsurgicalusa.com/geniomandibular-implants.htm



From the above site:

Osteotomy Gap Implant
The Osteotomy Gap Implant is designed to correct the inferior border contour irregularities of the mandible which inevitably occur after sagittal split osteotomy or sliding genioplasty.

[kavan]

If you're not against implants being placed - then there's also this:

http://www.matrixsurgicalusa.com/geniomandibular-implants.htm



From the above site:

Osteotomy Gap Implant
The Osteotomy Gap Implant is designed to correct the inferior border contour irregularities of the mandible which inevitably occur after sagittal split osteotomy or sliding genioplasty.

Thanks for the entry because it addresses the 'is it common to have irregularities after BSSO?' question. It would also seem to address the 'is it common to still have irregularities after having them patched up with that implant?' question IF then that came up.