Author Topic: Zygomatic osteotomy result  (Read 2563 times)

ODog

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Zygomatic osteotomy result
« on: May 16, 2020, 07:00:12 AM »
There’s been a lot of talk that zygomatic osteotomies give rounded feminine cheekbones. I’ve heard this over and over but haven’t seen the results to confirm this.

This result is on a woman so that kind of effect would be welcome and yet I still don’t see rounded feminine cheekbones. Where are the apple cheeks? I just see a wider jaw and wider zygo arches - that’s it. Probably got a chin wing too.

Very subtle, Nothing special, but this result on a male wouldn’t be a bad thing IMO.

https://imgur.com/a/IjVJ5wV

Thoughts ?

Post bimax

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Re: Zygomatic osteotomy result
« Reply #1 on: May 16, 2020, 07:41:12 AM »
I think she got a bimax too.. her bite/tooth show is different.  Her nose also looks wider/shorter which is characteristic of LF1 advancement. I think the only reason the zyg result would be acceptable for a male is because her mandible looks significantly broader too.

My guess is she got a zyg osteomy with a bimax; maybe with ccw because her mpa looks less steep and ccw also tends to make the mandible appear wider in cases of steep mpa.

IMO the main aesthetic improvement is coming from the lip/chin area and the bite.  That's the part that looked 'off' in the before photo.  It's a shame about the nose though.  You would think they'd be able to control that better.  I have a very similar nose-type to her.

I could be way off base here because i don't know much about zyg osteotomy.

kavan

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Re: Zygomatic osteotomy result
« Reply #2 on: May 16, 2020, 10:36:58 AM »
Can you confirm where those pics come from (like link the web site where there might be a description of her surgery)  so we can cross reference what she actually had.

I'm not seeing any zyg osteo or chin wings. What I'm seeing is bimax surgery that balanced her jaw imbalance where that allowed her unaltered cheek bones to be better visually appreciated.
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ben from UK

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Re: Zygomatic osteotomy result
« Reply #3 on: May 16, 2020, 11:24:24 AM »
She had more than only zygos. Look at her chin post and pre op.

Gadwins

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Re: Zygomatic osteotomy result
« Reply #4 on: May 16, 2020, 11:33:34 AM »
Maybe I will have a surgery soon with ZSO. I talked with my surgeon and asked him directly, if zso would give me round, apple shaped cheeks. He said no, it would give´me more a "sharp, pointed" cheek shape. I will also see some results soon and maybe go for this kind of surgery, if I could live with the cheek results. My main goal is to give me a more broader look like this woman in the link.

Post bimax

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Re: Zygomatic osteotomy result
« Reply #5 on: May 16, 2020, 12:35:25 PM »
Can you confirm where those pics come from (like link the web site where there might be a description of her surgery)  so we can cross reference what she actually had.

I'm not seeing any zyg osteo or chin wings. What I'm seeing is bimax surgery that balanced her jaw imbalance where that allowed her unaltered cheek bones to be better visually appreciated.

This is what I'm seeing as well.  The change to her mandible is characteristic of BSSO, especially with CCW-r.  There's also no other way to explain the changes to her nose.

I think she looks better in the after but the nose really throws things off.  It's like a +3 for fixing the chin, jaw and lips and then -2 for creating a problem with the nose.

I think the problem would be difficult to fix because the skin on her nasal tip looks thick to my untrained eye.

kavan

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Re: Zygomatic osteotomy result
« Reply #6 on: May 16, 2020, 03:27:05 PM »
This is what I'm seeing as well.  The change to her mandible is characteristic of BSSO, especially with CCW-r.  There's also no other way to explain the changes to her nose.

I think she looks better in the after but the nose really throws things off.  It's like a +3 for fixing the chin, jaw and lips and then -2 for creating a problem with the nose.

I think the problem would be difficult to fix because the skin on her nasal tip looks thick to my untrained eye.

Pre-surgery with BRACES would be in preparation for maxfax surgery and not for a chin wing or zyg osteo. OP will need to list link where this came from and back up information as to what was done because the photo does NOT look like a zyg osteo or chin wing was done. Looks like she may have had maxillary advancement given the nose outcome and also  reduction of the maxilla.
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ODog

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Re: Zygomatic osteotomy result
« Reply #7 on: May 17, 2020, 05:54:53 AM »
She had bi-max with impaction/ CCW-r, genioplasty, and malar osteotomy.

Here’s a post-op where you can see the swollen cheeks. 
https://imgur.com/a/qfxYRrp

I agree the main comes from the impaction and chin shortening alleviating her lip strain.

She didn’t have chin wing after all. I’m surprised about this. Her jaw clearly looks wider. CCW-r only creates the perception of a wider back jaw but it’s so subtle as to be basically unnoticeable. Maybe fat loss too.

I guess I’m just wondering about this whole “zygomatic osteotomies only give feminine cheekbones” mantra... I’m not so sure it’s necessarily true. Maybe techniques have changed or surgeons are learning from past mistakes.
« Last Edit: May 17, 2020, 06:03:56 AM by ODog »

ODog

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Re: Zygomatic osteotomy result
« Reply #8 on: May 17, 2020, 05:58:44 AM »
Maybe I will have a surgery soon with ZSO. I talked with my surgeon and asked him directly, if zso would give me round, apple shaped cheeks. He said no, it would give´me more a "sharp, pointed" cheek shape. I will also see some results soon and maybe go for this kind of surgery, if I could live with the cheek results. My main goal is to give me a more broader look like this woman in the link.

That’s what I want too, this gives the ogee curve and broadens the face.

The results are VERY subtle though to be fair, but for me it’s sufficient because I can’t over-do it anyway due to my small IPD.


ODog

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Re: Zygomatic osteotomy result
« Reply #9 on: May 17, 2020, 06:00:16 AM »
Deleted.

ODog

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Re: Zygomatic osteotomy result
« Reply #10 on: May 17, 2020, 06:09:18 AM »
I think she looks better in the after but the nose really throws things off.  It's like a +3 for fixing the chin, jaw and lips and then -2 for creating a problem with the nose.

I think the problem would be difficult to fix because the skin on her nasal tip looks thick to my untrained eye.

True. The changes to the nose are unfortunate. In some sense it almost negates the other improvements. Like why get jaw surgery if your nose looks puggish afterward.

Males can handle a wider nose fine as it’s a masculine trait... therefore Post bi-max I still believe you’re being too hard on yourself. I saw a picture of your beard from an old post and your convex lip is not even noticeable. Masculine even.

It might be possible that some kind of VY plasty could up turn your upper lip and give it more support/ that upwards curl... because a big component of chimp lip is not just the convexity of the philthrum but the downwards hanging vermillion.

I have a bit of a chimp lip too and I’m considering this. PM and I can tell you what a surgeon told me could help.

PloskoPlus

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Re: Zygomatic osteotomy result
« Reply #11 on: May 17, 2020, 06:32:20 AM »
That nose is definitely fixable.  Overall a big win.

Post bimax

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Re: Zygomatic osteotomy result
« Reply #12 on: May 17, 2020, 09:29:21 AM »
She had bi-max with impaction/ CCW-r, genioplasty, and malar osteotomy.

Here’s a post-op where you can see the swollen cheeks. 
https://imgur.com/a/qfxYRrp

I agree the main comes from the impaction and chin shortening alleviating her lip strain.

She didn’t have chin wing after all. I’m surprised about this. Her jaw clearly looks wider. CCW-r only creates the perception of a wider back jaw but it’s so subtle as to be basically unnoticeable. Maybe fat loss too.

I guess I’m just wondering about this whole “zygomatic osteotomies only give feminine cheekbones” mantra... I’m not so sure it’s necessarily true. Maybe techniques have changed or surgeons are learning from past mistakes.

There was actually a study shared on a thread here that showed BSSO itself actually does physically increase bi-gonial width in a large majority of cases.  The effect was greatest immediately post-op and attenuated over the following year, but the 'stable' width was still greater than baseline.  The increase in BGW was not associated with the size of the movement.

Here's an example from Movahed (amazing result IMO) where real/perceived width increased in a similar way as the case you posted:
https://movahedoms.com/services/osa/case-study-4/


kavan

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Re: Zygomatic osteotomy result
« Reply #13 on: May 17, 2020, 09:54:10 AM »
You are wanting to discuss malar osteo based on photos where there is NO LINK to the SOURCE of the photos where a malar osteo can be cross referenced where the cheek area looks to be the LEAST changed thing in the photos. That leaves you as the ONLY one on here privy to what ever procedure she may have or may have not had to her cheeks and the rest of us guessing whether or not she had that.
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ODog

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Re: Zygomatic osteotomy result
« Reply #14 on: May 17, 2020, 11:10:05 AM »
There was actually a study shared on a thread here that showed BSSO itself actually does physically increase bi-gonial width in a large majority of cases.  The effect was greatest immediately post-op and attenuated over the following year, but the 'stable' width was still greater than baseline.  The increase in BGW was not associated with the size of the movement.

Here's an example from Movahed (amazing result IMO) where real/perceived width increased in a similar way as the case you posted:
https://movahedoms.com/services/osa/case-study-4/

Maybe it’s a little objectively wider from the BSSO alone. I didn’t know it objectively widened the jaw. So that does play a role.

However in the case you posted I think it’s mostly is the perceptional change from the reduced mandibular plane angle. It’s less steep and downwards at the sides and more forward, giving an improved GA and the illusion of a wider jaw... but it’s more like a well-balanced or harmonious jaw.

For example someone with a long and pointy chin is going to appear to have a narrower jaw than someone with a shorter chin, even if the GW is identical in both cases.

When I look JUST at the goinals of the Before and after I’m hard-pressed to notice widening. I’m sure it’s there, it’s just not too obvious.

When you step back and perceive the face as a whole and how the parts relate, the improved goinal angle seems to account more for the perceived facial width increase.