Chin Wing Osteotomy: Genioplasty on Steroids

[Extra Chromosome]

Hello and welcome.

Today I will shine the spotlight on very powerful, yet under-looked surgery. Keep in mind this is relatively new. The surgery is challenging to perform even for well-trained and experienced surgeons.

A new technique for an extended genioplasty, the mandibular wing osteotomy, is presented step by step. This osteotomy allows correcting the position of the chin-prominence, to change the aspect of the divergence in the mandibular angulus and to achieve a lip competence in cases where it is needed. All these movements of the lower border of the mandibula can be performed completely independently from the positioning of the bases that is necessary for the correction of the malocclusion. [1]

In human speak, the lower part of the mandible is sliced and moved forward for a better chin and stress-free lip positioning @FatmanO . The spaces created will be filled with bone grafts.


These figues illustrate the before and after skeletal changes from the surgery[2]

End result is this:

And before someone spouts the name of Dr. Epply. Here it is shown how he pussies out from doing the surgery despite him being blackpilled.

Chin Wing Osteotomy - Plastic Surgeon | Dr. Barry L. Eppley, MD

The chin wing osteotomy is designed to vertically lengthen the jawline by moving the entire inferior border of the mandible downward.

www.eppleyplasticsurgery.com

For more technical information I recommend these papers:

(PDF) Chin wing osteotomy for the correction of hyper-divergent skeletal class III deformity: Technical modification

PDF | On Jun 25, 2015, Albino Triaca and others published Chin wing osteotomy for the correction of hyper-divergent skeletal class III deformity: Technical modification

www.researchgate.net

https://www.ncbi.nlm.nih.gov/pubmed/29196229 (Use sci-hub.tw to unlock)

To see some intelligent discussion instead of child shit-posting then visit:

Time for a thread dedicated to the Chin Wing Osteotomy?

Time for a thread dedicated to the Chin Wing Osteotomy?

jawsurgeryforums.com

[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4304429/
[2]https://www.researchgate.net/public...al_class_III_deformity_Technical_modification

@The Dude Abides

 

[The Dude Abides]

It's almost midnight here and this is a lot of reading ngl, but to get the discussion going I did skim through some of the papers. So forgive me if I missed any details. From what I understand this can improve the ramus and mandible without affecting occlusion, so lurkers with mandible and ramus problems but are happy with bite this is some good reading. Also could be used for mandibular asymmetry. ANYONE considering a LEFORT Some of the papers said this can be combined with a lefort. On the topic of the docs unwillingness, this is a pretty hardcore surgery and its easy to puss out and recommend implants when his job is on the line. I would ask him about previous patients and what complications they had because he seemed like there was some. Maybe a slight error he never told the patient idk. So I think the big issue is finding a skilled enough surgeon who will actually do this

To anyone considering this, some things to think about

"Is the chin wing generally considered a safe procedure? In terms of blood supply to the osteotomized segment and healing etc?"

"I would say so. My main concern is how all this stuff actually heals. Whether it'll have a natural feel to the touch, or if it'll be an odd step-off."

 

[Extra Chromosome]

It's almost midnight here and this is a lot of reading ngl, but to get the discussion going I did skim through some of the papers. So forgive me if I missed any details. From what I understand this can improve the ramus and mandible without affecting occlusion, so lurkers with mandible and ramus problems but are happy with bite this is some good reading. Also could be used for mandibular asymmetry. ANYONE considering a LEFORT Some of the papers said this can be combined with a lefort. On the topic of the docs unwillingness, this is a pretty hardcore surgery and its easy to puss out and recommend implants when his job is on the line. I would ask him about previous patients and what complications they had because he seemed like there was some. Maybe a slight error he never told the patient idk. So I think the big issue is finding a skilled enough surgeon who will actually do this

To anyone considering this, some things to think about

"I would say so. My main concern is how all this stuff actually heals. Whether it'll have a natural feel to the touch, or if it'll be an odd step-off."

Thanks for your input. It is indeed beneficial to get a lefort with it.

 

[The Dude Abides]

Thanks for your input. It is indeed beneficial to get a lefort with it.

Can you break down how it heals so I can better understand?

 

[future chadlite]

Its too dangerous and the risk for bone loss is real, google lookism threads o it and ull find the consensus,

 

[FatmanO]

In human speak, the lower part of the mandible is sliced and moved forward for a better chin and stress-free lip positioning @FatmanO . The spaces created will be filled with bone grafts.

So that could fix my lips?

 

[Tony]

Its too dangerous and the risk for bone loss is real, google lookism threads o it and ull find the consensus,

 

[Extra Chromosome]

Can you break down how it heals so I can better understand?

2.6. Closure Bilateral drainage is set up (Manovac1). After abundant washing of the site, the spaces created are filled with granules of BCP (biphasic phosphate calcium), autologous bone or other osteoconductive biomaterial. The mucosal sutures are carefully performed in two planes: muscular suture and mucosa closure by continuous suture (Monocryl1 5/0, Ethicon). [1]

The spaces made are filled with bone-regenerative promoting materials. Then the materials are sewed as shown in this video:




[1] https://www.ncbi.nlm.nih.gov/pubmed/29196229

Its too dangerous and the risk for bone loss is real, google lookism threads o it and ull find the consensus,

I would like you to give me exact links so I can address your doubts.

So that could fix my lips?

You should still consult a surgeon, if there is one.
But here are some pics.
First case:

Second case:

Third case:

Left is before and right is after in all pics.

God knows best.

@11gaijin Stop coping and pin this informative thread.

 

[The Dude Abides]

The spaces made are filled with bone-regenerative promoting materials

Go into detail on this, @future chadlite has a point about bone loss but if this bone regenerative material works then maybe not?

 

[Extra Chromosome]

Go into detail on this, @future chadlite has a point about bone loss but if this bone regenerative material works then maybe not?

Let us get into the details then.

I. After slicing the mandibular base, and positioning the base to get the required correction in aesthetics and functioning, The chin wing is fixed with 2, 4-screw, 1.5 mm plates (One per mandibular angle).[1]


II. An autologous iliac crest bone graft is then inserted at the osteotomy site between the lower border fragment and the mandibular body to fill the gap in the goniac and mandibular body areas. [2] That means the bone materials are placed in the space.



The process of filling the area then proceeds as follows:
1. Depending on the case. Pins, plates, screws, wires, or cables may be used to hold the spongy graft that is designed to fill the space.

2. In our case, CopiOs Bone Void Filler can be used.[3] Or it can be harvested from the iliac crest, as stated above.

3. The spongy graft has osteoconductive properties, which means that when the sponge is in contact with bone, it will induce regeneration in our filled site.

4. While bone is being built at the site, the sponge will be resorbed.

5. The graft has Biomorphogenic proteins which will induce bone generation. More Biomorphogenic protein solution can be used if the one present isn't sufficient. The presence of calcium and phosphate ions will also promote the generation of bone in the filled area.



III. The skin and muscle are then closed surgically, done under anesthesia of course. The grafting process needs to be under optimal PH levels.



IV. As for post-surgery, you might need to take blood thinners to prevent blood clots. You may also be advised to take supplements that promote bone health. The incision site may drain fluid, which is fine unless it is extreme. There could also be redness or swelling, this can be addressed more clearly by follow-up appointments[4]



V. A follow up x-ray appointments will determine how well the bone has healed, and the screwed plated are removed under anaesthesia.[2]

-----------------------------

Now, to address @future chadlite point about bone loss. This may happen if the regeneration is not complete or there is over-resorbtion, which is not what generally happens, but is the main cause for relapse[6]. This however, is a main concern in extreme deformities that may need repeated proceedures. Compliations include, self-perpetuating cycle of further devascularisation, resorption, and scarring, or even non-union.[6] The main concern generally would be the posterior tracing of the osteotomy at the mandibular angle and the association with a mandibular osteotomy.[5]

God knows best.

Chromosome.

[1]https://www.researchgate.net/public...al_class_III_deformity_Technical_modification

[2]https://sci-hub.tw/10.1097/SCS.0000000000001859

[3]https://www.zimmerbiomet.com/medical-professionals/spine/product/copios-bone-void1.html

[4]https://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/bone_grafting_135,316

[5]https://sci-hub.tw/10.1016/j.jormas.2017.11.015

[6]https://sci-hub.tw/10.1016/j.bjoms.2009.08.011

 

[The Dude Abides]

CopiOs Bone Void Filler can be used.[3] Or it can be harvested from the iliac crest, as stated above.

woah thats cool, well you have done your homework. Any users considering this? hope it gets pinned we need to encourage these types of posts.

 

[Extra Chromosome]

woah thats cool, well you have done your homework. Any users considering this? hope it gets pinned we need to encourage these types of posts.

I am considering it along with a lefort 3. It should give an insane forward growth results, I am taking hardcore risks. However, I plan on fixing my brain first.

 

[The Dude Abides]

I am considering it along with a lefort 3. It should give an insane forward growth results, I am taking hardcore risks. However, I plan on fixing my brain first.

mental health? You can at least function in social setting right?

 

[Extra Chromosome]

mental health? You can at least function in social setting right?

Nope.

 

[The Dude Abides]

Nope.

What about 1 on 1 so you can talk to surgeons?

 

[Extra Chromosome]

What about 1 on 1 so you can talk to surgeons?

Yes that is possible.
If I can leave my room...

 

[The Dude Abides]

Yes that is possible.
If I can leave my room...

Just think about your goals boyo, every time you doubt think of your goals. And what about those androgen receptors? you gonna make a post?

 

[Extra Chromosome]

Forgot to tag my brother @Mad Science. He may find this thread informative.

Just think about your goals boyo, every time you doubt think of your goals. And what about those androgen receptors? you gonna make a post?

I will do what I can, already have a few solutions in mind.
Please remind me again later today or tomorrow to write the thread if I am online. The thread will feature a guest that you are familiar with his name.
Thanks for the support boyo.

 

[The Dude Abides]

Forgot to tag my brother @Mad Science. He may find this thread informative.

I will do what I can, already have a few solutions in mind.
Please remind me again later today or tomorrow to write the thread if I am online. The thread will feature a guest that you are familiar with his name.
Thanks for the support boyo.

No problem, boyo.

 

[Extra Chromosome]

I forgot to tag @AspiringChad as he requested this in PMs.

 

[The Dude Abides]

I will do what I can, already have a few solutions in mind.
Please remind me again later today or tomorrow to write the thread if I am online. The thread will feature a guest that you are familiar with his name.
Thanks for the support boyo.

^reminder, if you already typed it, link pls.

 

[Extra Chromosome]

^reminder, if you already typed it, link pls.

To be h, the method is very hypothetical, but will tag you.

 

[FMLplus]

I am considering it along with a lefort 3. It should give an insane forward growth results, I am taking hardcore risks. However, I plan on fixing my brain first.

lefort 3? you're nuts man

 

[FaceandHFD]

Lmao if you think your artificially decreased gonial angle fools anyone. 90 degree jaw angles dont fit a dolicho face. Generally not worth it to change your jaw angle too much because it already is in harmony with your facial development. The risks associated with the procedure arent worth it for such a small movement.

 

[Extra Chromosome]

Lmao if you think your artificially decreased gonial angle fools anyone. 90 degree jaw angles dont fit a dolicho face. Generally not worth it to change your jaw angle too much because it already is in harmony with your facial development. The risks associated with the procedure arent worth it for such a small movement.

Thanks for your input.
It is still a very intriguing procedure.

 

[Miro Chad]

What is supposed to be dangerous with that?
One user on lookism had Le-Fort 1 + high BSSO + Chin Wing and he reported that he had no pain at all.
He ascended from 1/10 to 9/10.

 

[The Dude Abides]

What is supposed to be dangerous with that?
One user on lookism had Le-Fort 1 + high BSSO + Chin Wing and he reported that he had no pain at all.
He ascended from 1/10 to 9/10.

link?

 

[x30001]

link?

 

[Pendejo]

link?

 

[The Dude Abides]

What is supposed to be dangerous with that?
One user on lookism had Le-Fort 1 + high BSSO + Chin Wing and he reported that he had no pain at all.
He ascended from 1/10 to 9/10.

link?

we demand answers

 

[Deleted member 685]

we demand answers

 

[mesr]

not everyone will look good with a chin wing. if the shape and angles of your jaw bone are round and not sharp, the chin wing will blunt the angle even more and your lower third will look like an egg.

 

[Pendejo]

not everyone will look good with a chin wing. if the shape and angles of your jaw bone are round and not sharp, the chin wing will blunt the angle even more and your lower third will look like an egg.

Exactly

 

[Deusmaximus]

I cant see any arguments against the Nr.1 custom wraparound jaw implant. Still the best surgery for lower third, when its all about aesthetics.

 

[kota]

I don't think I got egg shaped jaw angles from chin wing.