Hey guys.
I have a technical question regarding chin wing. Haven't consulted with a surgeon yet.
If a full Chin Wing is performed, i.e. the mandible border is seperated until the most posterior aspect including the ramus angle, you're also seperating the part where the masseter (outside) and pterygoid (inside) muscles insert. Not only that, The insertion area will most likely not be strictly limited to the ~ 5mm of mobilized mandible border, but rather extend cranially a bit. In other words, you're cutting off bone with no respect to your cut running THROUGH the muscle insertions.
The question is, is CW actually performed like that? If so, how? Can the surgeon sufficiently mobilize the muscle right at the insertion area to make space for the piezo saw to enter between muscle and bone? Or is the muscle cut before? If so, does that apply to both masseter and pterygoid?
No matter how it is performed, there's a second possible issue. If you flare out the now mobilized mandible border to angularize the face, and granted the lowest insertion area of the medial pterygoid muscle is still attached to the mobilized bone, moving it outward will result in the pterygoid muscle rubbing against the inner aspect of the main piece of the ramus.
To illustrate this, I created the attached graphic. View of the right mandible, from posterior to anterior.
Any input appreciated!
