Do any surgeons perform chin wings?

[HarrierDuBois]

I know Ramieri used to perform them but stopped for some reason. Does any reputable surgeon perform chin wings?

Chin wing seem to be much better than genio just like @DayGuyYouLike said:

Genioplasty can give you an overly pointy and separated from the mandible chin, whereas mini chin wing brings your mid mandible forward WITH the chin, so that way you keep the harmony, and most importantly YOUR JAW IS FORWARD GROWN, NOT YOUR CHIN.

@anticel @temporomandibular32 @slop slinger @SeriousAscension @User49

 

[Deleted member 7725]

if he stopped it is probably for good reason

 

[HarrierDuBois]

if he stopped it is probably for good reason

No one complained about it affecting them aesthetically or medically negatively he just stopped doing them for comfort it seems since genios are quicker than chin wings.

 

[extremchange628181]

Yes I know theree Dr Brusco,Dr Zarrinbal and one russian guy I think it’s something with a

 

[Deleted member 7725]

No one complained about it affecting them aesthetically or medically negatively he just stopped doing them for comfort it seems since genios are quicker than chin wings.

chinwings are surely much easier than bimaxes. the results were probably shitty so he didn't do them.

 

[HarrierDuBois]

chinwings are surely much easier than bimaxes. the results were probably shitty so he didn't do them.

No man bimax paired with chin wing as opposed to bimax paired with genio.
Chin wings look so much better.

 

[SeriousAscension]

Yes Zarinbal. Or Triaca would be an option, he created the chin wing osteonomy.

 

[HarrierDuBois]

Yes Zarinbal. Or Triaca would be an option, he created the chin wing osteonomy.

Yes I know theree Dr Brusco,Dr Zarrinbal and one russian guy I think it’s something with a

Got any good before and afters?

 

[Deleted member 18582]

The virtue of a chin wing osteotomy is that it pulls forward the lower jaw without altering the gonial angles, which is what you might get by doing more bsso advancement to obtain that projection. At least with traditional techniques. But it leads to a bad step off and this is why Ramieri for instance stopped performing them. I don't remember what its called, but Safi and Coceancig and I'm sure any other maxillofacial surgeon worth their salt is capable of cutting the jaw in such a way that moves forward the gonions altogether instead of leaving them in place while the rest of the lower jaw is moved forward. I am under the impression chin wing is an obselete procedure and any advancement you might need can come from a genioplasty and creative bsso.

If you get a genioplasty and get the kind of result that deleted user describes it is because they did not widen the chin enough.

 

[HarrierDuBois]

The virtue of a chin wing osteotomy is that it pulls forward the lower jaw without altering the gonial angles, which is what you might get by doing more bsso advancement to obtain that projection. At least with traditional techniques. But it leads to a bad step off and this is why Ramieri for instance stopped performing them. I don't remember what its called, but Safi and Coceancig and I'm sure any other maxillofacial surgeon worth their salt is capable of cutting the jaw in such a way that moves forward the gonions altogether instead of leaving them in place while the rest of the lower jaw is moved forward. I am under the impression chin wing is an obselete procedure and any advancement you might need can come from a genioplasty and creative bsso.

If you get a genioplasty and get the kind of result that deleted user describes it is because they did not widen the chin enough.

I need bimax + chin advancement.

 

[antsosa]

is there a mini-chin wing that dosent extend all the way back to the gonials? instead stopping at the mid mandible at most. does anyone do this? I need gonial implants for bigonial width but dont want a narrow chin/front mandible

 

[HarrierDuBois]

is there a mini-chin wing that dosent extend all the way back to the gonials? instead stopping at the mid mandible at most. does anyone do this? I need gonial implants for bigonial width but dont want a narrow chin/front mandible

@TheLordMadness had a mini chin wing iirc.

Best TRIMAX on .org of all time.

Holy shit at this ascencion, @TheLordMadness went from below average to mogger from one procedure. All thanks to Ramieri, he spent 8000€ for the surgery + travels, visit.. total around 9000€. Measurements: 4 mm advancement of the maxilla, 9mm BSSO and 8mm genioplasty. Side B/A: Front PRE...

looksmax.org

 

[antsosa]

@TheLordMadness had a mini chin wing iirc.

Best TRIMAX on .org of all time.

Holy shit at this ascencion, @TheLordMadness went from below average to mogger from one procedure. All thanks to Ramieri, he spent 8000€ for the surgery + travels, visit.. total around 9000€. Measurements: 4 mm advancement of the maxilla, 9mm BSSO and 8mm genioplasty. Side B/A: Front PRE...

looksmax.org

incredible results

 

[HarrierDuBois]

incredible results

Looks fucking ridiculously crazy good now that swelling is gone.

 

[antsosa]

Looks fucking ridiculously crazy good now that swelling is gone.
View attachment 2362242View attachment 2362243View attachment 2362244

What's the diff between trimax and bimax? from what I understand, Bimax splits the jaw in half and moves it forward, then a lefort 1 impaction with movement forward (is CCW of the maxilla standard procedure is it something you ask/pay extra for), then a genio.

For my case, i dont think I have a recessed jaw although the gonial angle is a bit too obtuse and my jaw is a bit downard grown, even though I have a pretty decent ramus. I suspect this is mostly due to my long midface (insta death). My main issue is from the frontal view, my bigonial width is shit. Jaw angles would fix bigonial and lengthen the ramus to narrow up the gonial angle and compensate for downward growth. As for my chin, due to the downward growth, my chin has a 'chin strap' look to it (dont know how else to decribe it) can a mini chin wing be CCW'd a bit to make it more parallel with the ground?

 

[HarrierDuBois]

What's the diff between trimax and bimax? from what I understand, Bimax splits the jaw in half and moves it forward, then a lefort 1 impaction with movement forward (is CCW of the maxilla standard procedure is it something you ask/pay extra for), then a genio.

For my case, i dont think I have a recessed jaw although the gonial angle is a bit too obtuse and my jaw is a bit downard grown, even though I have a pretty decent ramus. I suspect this is mostly due to my long midface (insta death). My main issue is from the frontal view, my bigonial width is shit. Jaw angles would fix bigonial and lengthen the ramus to narrow up the gonial angle and compensate for downward growth. As for my chin, due to the downward growth, my chin has a 'chin strap' look to it (dont know how else to decribe it) can a mini chin wing be CCW'd a bit to make it more parallel with the ground?

Cut 1 - Lefort 1
Cut 2 - BSSO
Cut 3 - Genioplasty
Cut 1 and 2 are a bimax.
Cut 1, 2, and 3 are a trimax.

 

[antsosa]

Cut 1 - Lefort 1
Cut 2 - BSSO
Cut 3 - Genioplasty
Cut 1 and 2 are a bimax.
Cut 1, 2, and 3 are a trimax.
View attachment 2362277

can substantial lateral movement be made to the ramus/gonias after cut 2 to increase bigonial? And when I mean substantial bigonial width improvement, i mean quite substantial. if so this Id rather do this than jaw angles tbh. also ill DM you pics of my case for advice

 

[HarrierDuBois]

can substantial lateral movement be made to the ramus/gonias after cut 2 to increase bigonial? And when I mean substantial bigonial width improvement, i mean quite substantial. if so this Id rather do this than jaw angles tbh. also ill DM you pics of my case for advice

I am not sure tbh ask @anticel he has more direct knowledge on this.

 

[antsosa]

Looks fucking ridiculously crazy good now that swelling is gone.
View attachment 2362242View attachment 2362243View attachment 2362244

also just noticed, did he get a rhino as well after? nose looks a bit diff

 

[HarrierDuBois]

also just noticed, did he get a rhino as well after? nose looks a bit diff

No rhino, nose changed from bimax.

 

[anticel]

can substantial lateral movement be made to the ramus/gonias after cut 2 to increase bigonial? And when I mean substantial bigonial width improvement, i mean quite substantial. if so this Id rather do this than jaw angles tbh. also ill DM you pics of my case for advice

@HarrierDuBois thanks for tag. The answer is no in 99% of the cases. Some movement can be done if working with normal screws. My surgeon added width & even rotated the whole positions of the gonions a little bit forward & gave me more width. However those kind of movements can barely be planned. The surgeon has to look at the TMJs & how much movement is possible during the surgery - usually not too much
I only know Coceancig who does this with bigger movements but with he uses custom plates only & even then I think that what he does is actually risky & too dangerous.

 

[antsosa]

@HarrierDuBois thanks for tag. The answer is no in 99% of the cases. Some movement can be done if working with normal screws. My surgeon added width & even rotated the whole positions of the gonions a little bit forward & gave me more width. However those kind of movements can barely be planned. The surgeon has to look at the TMJs & how much movement is possible during the surgery - usually not too much
I only know Coceancig who does this with bigger movements but with he uses custom plates only & even then I think that what he does is actually risky & too dangerous.

thanks. I will get implants instead since bigonial is of utmost importance to me + implants have counturing (can make it flare) laterally moving my inward gonions still makes them inward. implants + mini chin-wing seems decent enough