Cut ramus for BSSO ?

[Ampere]

I have a recessed lower jaw and plan to do bimax, when jutting my lower jaw forward up until it lines up with my upper jaw, I achieve very nice aesthetics, from the side profile but ALSO front-facing. I go from a cucked round shaped face to a near diamond shape since the perspective causes the bigonial width to increase (when it actually doesn't), also it helps so much with definition cause the ramus gets "out of the neck"

Thing is, how BSSO cut is like this, but if you're jutting your jaw forward you're actually moving the ramus too not just the mandible. So I'm afraid that a BSSO wouldn't come close to the aesthetic results that jutting my jaw forward provide.

Does anyone know of a surgery that actually acts upon the ramus and does forward advancement from here instead of the mandible ?

 

[Deleted member 7725]

You would look like you have an underbite because your ramus would be so tilted.

 

[Ampere]

You would look like you have an underbite because your ramus would be so tilted.

TBH my ramus is completely vertical as of today (also short but that's another problem) so an advancement of the ramus wouldn't cause an overly tilted angle

 

[Deleted member 643]

This type of operation is called a vertical ramus osteotomy:

Although it's been many years since I've read the literature on these types of operations, I seem to recall that since the masseter is the strongest muscle in the human body, osteotomies in this area are more prone to relapse, as the masseter continuously exerts force, creating a stress field in the tissue, which causes bone remodeling. In the event of relapse, you would need a revision surgery.

 

[bimaximum]

I know what you mean, but you don't want your ramus to come forward.

 

[Ampere]

Sci-Hub | Vertical ramus elongation and mandibular advancement by endobuccal approach: Presentation of a new osteotomy technique. Journal of Stomatology, Oral and Maxillofacial Surgery, 118(1), 66–69 | 10.1016/j.jormas.2016.12.003

I've come across this paper which is fairly recent, it seems to treat doward growth, my case isn't as severe as illustrated but still it seems like the right osteotomy for me

This type of operation is called a vertical ramus osteotomy:

Although it's been many years since I've read the literature on these types of operations, I seem to recall that since the masseter is the strongest muscle in the human body, osteotomies in this area are more prone to relapse, as the masseter continuously exerts force, creating a stress field in the tissue, which causes bone remodeling. In the event of relapse, you would need a revision surgery.

The vertical one loses the advantage of moving the gonions forward "out of the neck" like I said for a lack of a better expression and indeed it's right under the masseter so... (But so is the one I pasted above..)

I know what you mean, but you don't want your ramus to come forward.

Why ? Is my only option standard BSSO + neck lift for definition ?

 

[bimaximum]

Because your jutted ramus isn't gl despite what you think.
An aesthetic ramus is LOW with stretched skin, not "out of the neck".
BSSO + genio will stretch your skin. If your ramus is still bad then consider chin wing or implant.

 

[Ampere]

Because your jutted ramus isn't gl despite what you think.
An aesthetic ramus is LOW with stretched skin, not "out of the neck".
BSSO + genio will stretch your skin. If your ramus is still bad then consider chin wing or implant.

Are vertical ramuses ok ?
If so, then I'll just get standard bimax and see what's up after that, as long as I'm not a recessed rat anymore

Also saves me the pain of finding specific surgeons, you got any recommendations about that by the way ?

 

[NarcyChadlite]

I dont think ud want a jutted ramus look boyo. It will most likely fuck up the "zygos must be slightly wider than jaw look".. all the way gonion to mid jaw.

 

[bimaximum]

Are vertical ramuses ok ?
If so, then I'll just get standard bimax and see what's up after that, as long as I'm not a recessed rat anymore

Also saves me the pain of finding specific surgeons, you got any recommendations about that by the way ?

Absolutely get the most advancement possible and then you can have a look on the width.
I suppose that you like your jutted ramus because it add width from the front. At least that's my case.
According to Dr. Ting, bimax makes your mandibule looks wider. Anyway focus on that heavy surgery, get your braces, and get as much knowledge as possible on surgeons, implants and chin wing. Good luck rat bro

 

[Ampere]

I dont think ud want a jutted ramus look boyo. It will most likely fuck up the "zygos must be slightly wider than jaw look".. all the way gonion to mid jaw.

Yeah bro I already got shit zygos... I'm so fucked facially lmao I have a "blockish" look from the front but not the right type
Prob cause no zygos