A Hypothetical Jaw Surgery with Functional and Cosmetic Benefits - The Biramal Split Osteotomy

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idkwhattoputhere

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i would make this super high effort but i cba. heres the fracture line, ill explain the rest below
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for a month leading up to the surgery, the patient would be mandated to perform masster stretching and loosening exercises in order to accomodate for the new length of the masseter muscle after the surgery. on the day of the surgery, an intense muscle relaxant would be topically administered to the masseter to allow for maximum stretching during the procedure. the surgeon would cut the bone around the muscle insertion and bring the bone down by the desired amount similar to how a genioplasty works. a metal plat with screws would be installed until the patient makes a full recovery, and chewing would be avoided all together for the first few weeks.

this is a - in my opinion - better option than gonial implants as the masseter would still insert at the bottom of the ramus, making it indistinguishable from a naturally well developed jaw. the function benefits would include better chewing leverages, and cosmetically the patient would reap the benefits of a tighter hyoid, longer ramus, and potenitally more flared gonions depending on how the disconnected piece is reattatched by the surgeon.

lmk what you think, idk why this doesnt exist as it doesnt seem too complicated compared to something like a lefort and yeah the recovery would be annoying but gonions can make or break a face so imo its worth it.
 
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i would make this super high effort but i cba. heres the fracture line, ill explain the rest below View attachment 3022551

for a month leading up to the surgery, the patient would be mandated to perform masster stretching and loosening exercises in order to accomodate for the new length of the masseter muscle after the surgery. on the day of the surgery, an intense muscle relaxant would be topically administered to the masseter to allow for maximum stretching during the procedure. the surgeon would cut the bone around the muscle insertion and bring the bone down by the desired amount similar to how a genioplasty works. a metal plat with screws would be installed until the patient makes a full recovery, and chewing would be avoided all together for the first few weeks.

this is a - in my opinion - better option than gonial implants as the masseter would still insert at the bottom of the ramus, making it indistinguishable from a naturally well developed jaw. the function benefits would include better chewing leverages, and cosmetically the patient would reap the benefits of a tighter hyoid, longer ramus, and potenitally more flared gonions depending on how the disconnected piece is reattatched by the surgeon.

lmk what you think, idk why this doesnt exist as it doesnt seem too complicated compared to something like a lefort and yeah the recovery would be annoying but gonions can make or break a face so imo its worth it.
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What do you think would help "homeoblock guy", "hbg" or whatever

Here is his story

More drama about how the dentist involved tried to give him a hard time

@samilves shared some pictures and a recording. he's planning to make a full thread with more information and media.

But this guy developed a long midface from homeoblock. I think it was a 1:1 midface ratio before to a 0.90 ratio in the after.

BEFORE AND AFTER COLLAGE
BEFORE AND AFTER COLLAGE 2
BEFORE AFTER MIDFACE RATIO UP CLOSE
BEFORE AFTER MIDFACE RATIO WITH DRAWINGS ON KEY POINTS
The recording when he visited the dentist to fix the damage

Jaw Hacks brought him on for an interview but couldn't help him. Just helps to have another person's opinion in the field I guess :rolleyes:


If you have any ideas there's an ongoing thread to figure out how to help this guy
 
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illl get back to you later i have some stuff to do first, interesting story tho
 
What do you think would help "homeoblock guy", "hbg" or whatever

Here is his story

More drama about how the dentist involved tried to give him a hard time

@samilves shared some pictures and a recording. he's planning to make a full thread with more information and media.

But this guy developed a long midface from homeoblock. I think it was a 1:1 midface ratio before to a 0.90 ratio in the after.

BEFORE AND AFTER COLLAGE
BEFORE AND AFTER COLLAGE 2
BEFORE AFTER MIDFACE RATIO UP CLOSE
BEFORE AFTER MIDFACE RATIO WITH DRAWINGS ON KEY POINTS
The recording when he visited the dentist to fix the damage

Jaw Hacks brought him on for an interview but couldn't help him. Just helps to have another person's opinion in the field I guess :rolleyes:


If you have any ideas there's an ongoing thread to figure out how to help this guy

i’ll get back to you later i’m a bit busy but interesting story
 
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i would make this super high effort but i cba. heres the fracture line, ill explain the rest below View attachment 3022551

for a month leading up to the surgery, the patient would be mandated to perform masster stretching and loosening exercises in order to accomodate for the new length of the masseter muscle after the surgery. on the day of the surgery, an intense muscle relaxant would be topically administered to the masseter to allow for maximum stretching during the procedure. the surgeon would cut the bone around the muscle insertion and bring the bone down by the desired amount similar to how a genioplasty works. a metal plat with screws would be installed until the patient makes a full recovery, and chewing would be avoided all together for the first few weeks.

this is a - in my opinion - better option than gonial implants as the masseter would still insert at the bottom of the ramus, making it indistinguishable from a naturally well developed jaw. the function benefits would include better chewing leverages, and cosmetically the patient would reap the benefits of a tighter hyoid, longer ramus, and potenitally more flared gonions depending on how the disconnected piece is reattatched by the surgeon.

lmk what you think, idk why this doesnt exist as it doesnt seem too complicated compared to something like a lefort and yeah the recovery would be annoying but gonions can make or break a face so imo its worth it.
@RealSurgerymax is this just mental masturbation or is it an actual possible surgery?
 
@RealSurgerymax is this just mental masturbation or is it an actual possible surgery?
It's not stretching further than a few mm. Master stretching exercises don't exist, not in a way to stretch them out of the normal ROM. Muscle relaxants aren't given "topically" they are given IV in every surgery in fact you are paralyzed in surgery (Rocuronium or similar paralytic agent) as the standard. Things are still tight. So those two things are intense mental masturbation. Botox might help more, and we've been trying it. No consensus yet.

I have a similar osteotomy, it probably wont work without disinheriting the muscles. We could try but they are probably going to need stripping.

IMG 6315



Actually if you wanted to do this we would be open to doing it 2 stage with a tissue expander to stretch the length of the muscle. Although probably not worth it, if the exact objective is "lengthen the ramus without disinserting the masseter" Then an osteotomy staged after tissue expansion, or distraction osteogenesis would be the only two ways using plastic surgery principles, with a risks.

Different tissue expander geometries are used in clinical practice We are interested in
 
It's not stretching further than a few mm. Master stretching exercises don't exist, not in a way to stretch them out of the normal ROM. Muscle relaxants aren't given "topically" they are given IV in every surgery in fact you are paralyzed in surgery (Rocuronium or similar paralytic agent) as the standard. Things are still tight. So those two things are intense mental masturbation. Botox might help more, and we've been trying it. No consensus yet.

I have a similar osteotomy, it probably wont work without disinheriting the muscles. We could try but they are probably going to need stripping.

View attachment 3023449


Actually if you wanted to do this we would be open to doing it 2 stage with a tissue expander to stretch the length of the muscle. Although probably not worth it, if the exact objective is "lengthen the ramus without disinserting the masseter" Then an osteotomy staged after tissue expansion, or distraction osteogenesis would be the only two ways using plastic surgery principles, with a risks.

View attachment 3023450
Thanks for the feedback, it obviously needs some refining and I have basically no medical knowledge. The goal isn’t to length the ramus without disinserting the masseter, it was just to lengthen the ramus so if detaching it would make it easier then that would work too. I’m currently 16 and am saving funds for a bimax at 18-20, and if the BRSO is refined to a state where it could be put into practice I would love to be in touch with you for the 3D modelling and surgical practices. I’m going to do more research and development, and hopefully by then it will be doable.
 
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Thanks for the feedback, it obviously needs some refining and I have basically no medical knowledge. The goal isn’t to length the ramus without disinserting the masseter, it was just to lengthen the ramus so if detaching it would make it easier then that would work too. I’m currently 16 and am saving funds for a bimax at 18-20, and if the BRSO is refined to a state where it could be put into practice I would love to be in touch with you for the 3D modelling and surgical practices. I’m going to do more research and development, and hopefully by then it will be doable.
You are still growing so do not put much energy or thought into planning surgeries right now. Focus on age appropriate things. Play sports and get good grades.
 
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You are still growing so do not put much energy or thought into planning surgeries right now. Focus on age appropriate things. Play sports and get good grades.
What about 21 year old age? Are my bones still growing or I can already start surgrery planning?
 
I guess BSSO with the condyles torqued outward remains the gold standard for jaw widening without stripping the masseter then.
 
What do you think would help "homeoblock guy", "hbg" or whatever

Here is his story

More drama about how the dentist involved tried to give him a hard time

@samilves shared some pictures and a recording. he's planning to make a full thread with more information and media.

But this guy developed a long midface from homeoblock. I think it was a 1:1 midface ratio before to a 0.90 ratio in the after.

BEFORE AND AFTER COLLAGE
BEFORE AND AFTER COLLAGE 2
BEFORE AFTER MIDFACE RATIO UP CLOSE
BEFORE AFTER MIDFACE RATIO WITH DRAWINGS ON KEY POINTS
The recording when he visited the dentist to fix the damage

Jaw Hacks brought him on for an interview but couldn't help him. Just helps to have another person's opinion in the field I guess :rolleyes:


If you have any ideas there's an ongoing thread to figure out how to help this guy

Full recordings from that appointment when he tried to work with her to fix the damages she caused from homeoblock:
PT 1 Roca AGGRESSIVE with SCARED HOMEOBLOCK PATIENT:feelsgiga:
PT2 Roca lies that he will be restored after he stops using homeoblock:lasereyes:
PT 3 Roca bitches about having to do her job (because it's a bad result) analyzing pictures and keeps cutting him off again:feelsree:
PT 4 Grown man homeoblock guy cries when Roca shows her psychotic behaviour. Homeoguy tried being respectful for a long time:feelsbadman:

Here is his original thread: https://looksmax.org/threads/beware-homeoblock-can-worsen-your-midface-ratio.552831/post-16241585

He's gone from Looksmax :(
 
Really want this guy to be heard. I and some other people were thinking of promoting this at mewcon. I'm not able to go, but it would be huge. And it would be a message to these butchers that they will be exposed if caught. There will be consequences.
 

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