chinwing xray- cant see the osteotomy line?

[mediumdrinkofwater]

https://imgur.com/a/Qmfmgrq

Can somebody pls tell me where the osteotomy line is or where the cut was made here? Its hard to tell, because its a frontal view. 4mm forward advancement was supposedly done here.

[kavan]

It's easy to see between the screw holding plates. Lateral to the screw holding plates, it's also easy to see a faint line of demarcation of bone density which would be the osteotomy line.

[mediumdrinkofwater]

According to Bruscos instagram these two results were allegedly done via chin wing. The labiomental fold, the angularity of the jaw angles, it doesnt seem like a cw. Is It seems like there must have been at least a bsso involved as well for this to be achievable.  Is this kind of result actually possible with only a chin wing?

Both links portay different people, despite them looking similar.

1.https://www.instagram.com/p/BeybnYBBTsN/
2. https://www.instagram.com/p/BgiUO_3hOdt/

[kavan]

Probably, on THOSE 2 particular individuals who had very good start points for advancement of the lower border of the mandible via chin-wing. However, only an X ray could confirm absolutely.

[Tomasjohn]

I agree looks very possible, subtle and not unrealistic to achieve provided the starting point and I don't understand why a BSSO must have been involved.

[mediumdrinkofwater]

This is what most chin wings look like:

https://www.instagram.com/p/CXxaD_TIEnI/?igshid=YmMyMTA2M2Y=

https://www.instagram.com/p/CXxaHh9Ivb0/?igshid=YmMyMTA2M2Y=

Do we all agree that the front perspective after photo looks works than the before? His angularity is completely gone. A slightly better side profile does not justify a worse front view.

Same thing with this patient: https://www.instagram.com/p/B0jaYyOIrIf/?igshid=YmMyMTA2M2Y=

How do these prior CW patient results from my previous posts differ so drastically from this one?

[Tomasjohn]

Agree don't like this specific examples.

It's impossible to say without knowing what the movement or cut was. Soft tissue is also different for each person. There are many cases online that don't look worse after (also in scientific papers, so look for CW in Google scholar).

https://www.instagram.com/p/B0jaYyOIrIf/?igshid=YmMyMTA2M2Y=

For this link my pure SPECULATION: the mand. Border was moved forward and dropped down in the back resulting in a counter clockwise rotation. This can result in a more "block / U" look from the front. Also if you stretch masseter it can hypertrophy i heard OR the bloated look could be swelling.. so lots of speculation..

This doc also has examples where they make a cut in the middle and then widen the segment laterally outwards.