Surgery for jaw angles and ramus after Genioplasty.

[SnoopDawg]

My mandible has decent forward growth however I was a chinlet with no chin nor ramus height.

I got a genioplasty, so I have a decent height and projection chin now, thus my mandible body looks decent. However, my ramus is still pretty shit, and my gonial angle is around 125-130. Imagine a shittier version of Ryan Gosling's jaw.

I want to drop the jaw angle down and get sharper gonions with a decent ramus.

In theory, jaw angle implants should fix this. However, based on many Eppley blog posts, vertical lengthening is INSANELY limited in terms of aesthetic outcomes due to the masseter being the main "driver" of the gonions from the front view. I wonder if a lot of masseter botox could help fix this...? doubt it.

Case Study: Male Vertical Lengthening Jaw Angle Implants - Explore Plastic Surgery

Background: One of the emerging areas of facial implant augmentation is that of the jaw angles. While jaw angle implants have been around for nearly two decades, their designs have been exclusively made for increasing jaw angle width. While there are some patients who seek a wider and more...

exploreplasticsurgery.com

This was a great result all things considered (Ie significant vertical lengthening was achieved). However, he still looks kinda shit from the front, because the masseter is the main thing affecting the "height" of your jaw perceptions, and you can't change its insertion.

I know there is a ramus osteotomy but I don't think it would give sharper gonions from the front.

I don't want a significantly wider jaw because my mouth is narrow and it may look disharmonious, so the vertical lengthening+angularity is all I am asking for. Unfortunately, it sounds like a pipe dream because surgery can't help those much.



Options I am considering:

- Resign myself to getting fillers, forever, rip wallet.

- Jaw angle implants with Eppley (or Dhir as I live in the LA area...? Still seems overpriced)

-Wraparound implants with the above

-Get bimax with CCW?? I have seen people with similar bases to me get a longer ramus due to the CCW and that the ramus was just "hiding in the recession." This seems a bit extreme because my mandible itself isn't necessarily short, and my genio would essentially go to waste (although this is a cope I guess). I would be worried that I either get "dogmaxxed" or have such a minimal result that it's not worth the recovery. I have also already had braces and have a perfect bite. The recovery would be brutal for me too in terms of logistics, I'm not in a place to easily take months off.

Financially, I am in a position where I am a student with loans but with a high-income trajectory (think IB/consulting lined up post-grad) but nearly 6 figures of debt. I don't mind taking on more debt because you are only young once and I do believe I will be able to pay it off.

 

[depressionmaxxing]

high gonial angle? shit ramus?

why dont you get gonion implants?

 

[SnoopDawg]

high gonial angle? shit ramus?

why dont you get gonion implants?

Basically, because the masseter muscle. Implants go under it, and the masseter muscle plays a more significant role from the front view than anything else, with regards to the height of the jaw.

Due to that, it is very hard to achieve a good result from the front with vertical lengthening, because the masseter can't be vertically lengthened.

In this result, you see what I am talking about, he had kinda high set masseters so the implants only really bloated him.

 

[depressionmaxxing]

Basically, because the masseter muscle. Implants go under it, and the masseter muscle plays a more significant role from the front view than anything else, with regards to the height of the jaw.

Due to that, it is very hard to achieve a good result from the front with vertical lengthening, because the masseter can't be vertically lengthened. View attachment 2391797

In this result, you see what I am talking about, he had kinda high set masseters so the implants only really bloated him.

true

what about wrap-around implants, do they cause you the same issue?

 

[SnoopDawg]

true

what about wrap-around implants, do they cause you the same issue?

I am still researching this but I think so.

 

[grooxx]

Basically, because the masseter muscle. Implants go under it, and the masseter muscle plays a more significant role from the front view than anything else, with regards to the height of the jaw.

Due to that, it is very hard to achieve a good result from the front with vertical lengthening, because the masseter can't be vertically lengthened. View attachment 2391797

In this result, you see what I am talking about, he had kinda high set masseters so the implants only really bloated him.

Definitely the answer I was looking for.
Short rammus seems to be desperate cause

 

[Chinlet Ascension]

Trying to understand where OP is coming from with this question. The basic idea of jaw angle implants after a genioplasty should be fine.

This was a great result all things considered (Ie significant vertical lengthening was achieved). However, he still looks kinda shit from the front, because the masseter is the main thing affecting the "height" of your jaw perceptions, and you can't change its insertion.

I don't know what you mean by "affecting the "height" of your jaw perceptions", but it sounds like you are putting far too much emphasis on the masseter muscle. The masseter muscle is a small muscle (unless you have bruxism) and it doesn't affect your facial appearance much.

The guy in the pictures looks bad because he has unharmonious features overall (massive bloated face with thin lips, narrow long nose, etc.). The actual change to his jawline from the implants is impressive.

In this result, you see what I am talking about, he had kinda high set masseters so the implants only really bloated him.

It sounds like you are talking about the masseter muscle in terms of muscle insertions. I don't think there is any significant variation in muscle insertions between individuals for that particular muscle.

View attachment 2391797

I would like to see side pictures of this result. I think it might be a fairly good result, but he also might need more vertical lengthening.

 

[SnoopDawg]

Trying to understand where OP is coming from with this question. The basic idea of jaw angle implants after a genioplasty should be fine.


I don't know what you mean by "affecting the "height" of your jaw perceptions", but it sounds like you are putting far too much emphasis on the masseter muscle. The masseter muscle is a small muscle (unless you have bruxism) and it doesn't affect your facial appearance much.

eppley has explicitly said otherwise (from the front view, the masseter muscle effects the perceived jaw height, because the implant has to go underneath it)

The guy in the pictures looks bad because he has unharmonious features overall (massive bloated face with thin lips, narrow long nose, etc.). The actual change to his jawline from the implants is impressive.

really? the jawline change just looks bloated because of how high his gonions appear. if my software didn't just get paywalled I would post a morph I have but idk how to get the screenshot. He looks way better with lower gonions.

It sounds like you are talking about the masseter muscle in terms of muscle insertions. I don't think there is any significant variation in muscle insertions between individuals for that particular muscle.


I would like to see side pictures of this result. I think it might be a fairly good result, but he also might need more vertical lengthening.

whether or not its the masseter insertion itself or the gonion shape that effects where the masseter appears, the appearance or "set" of the masseter is important. if you have high set masseters your jaw will look rounded and softer.

 

[Chinlet Ascension]

The attached image is total broscience. Muscle fiber type is completely irrelevant when it comes to the jaw muscles. Do you really think you need fast twitch muscles in your jaw? It doesn't matter anyway because that is a functional, not an aesthetic, concept.

eppley has explicitly said otherwise (from the front view, the masseter muscle effects the perceived jaw height, because the implant has to go underneath it)

Show me that article and I will read it to try and understand what he means.

whether or not its the masseter insertion itself or the gonion shape that effects where the masseter appears, the appearance or "set" of the masseter is important. if you have high set masseters your jaw will look rounded and softer.

I have never seen any evidence of different muscle insertions for the masseter muscles. I think that if there is a difference in appearance, that is really a bone issue (how the muscle lays on top of the bones of the face).

 

[bobsmith03]

My mandible has decent forward growth however I was a chinlet with no chin nor ramus height.

I got a genioplasty, so I have a decent height and projection chin now, thus my mandible body looks decent. However, my ramus is still pretty shit, and my gonial angle is around 125-130. Imagine a shittier version of Ryan Gosling's jaw.

I want to drop the jaw angle down and get sharper gonions with a decent ramus.

In theory, jaw angle implants should fix this. However, based on many Eppley blog posts, vertical lengthening is INSANELY limited in terms of aesthetic outcomes due to the masseter being the main "driver" of the gonions from the front view. I wonder if a lot of masseter botox could help fix this...? doubt it.

Case Study: Male Vertical Lengthening Jaw Angle Implants - Explore Plastic Surgery

Background: One of the emerging areas of facial implant augmentation is that of the jaw angles. While jaw angle implants have been around for nearly two decades, their designs have been exclusively made for increasing jaw angle width. While there are some patients who seek a wider and more...

exploreplasticsurgery.com

This was a great result all things considered (Ie significant vertical lengthening was achieved). However, he still looks kinda shit from the front, because the masseter is the main thing affecting the "height" of your jaw perceptions, and you can't change its insertion.

I know there is a ramus osteotomy but I don't think it would give sharper gonions from the front.

I don't want a significantly wider jaw because my mouth is narrow and it may look disharmonious, so the vertical lengthening+angularity is all I am asking for. Unfortunately, it sounds like a pipe dream because surgery can't help those much.



Options I am considering:

- Resign myself to getting fillers, forever, rip wallet.

- Jaw angle implants with Eppley (or Dhir as I live in the LA area...? Still seems overpriced)

-Wraparound implants with the above

-Get bimax with CCW?? I have seen people with similar bases to me get a longer ramus due to the CCW and that the ramus was just "hiding in the recession." This seems a bit extreme because my mandible itself isn't necessarily short, and my genio would essentially go to waste (although this is a cope I guess). I would be worried that I either get "dogmaxxed" or have such a minimal result that it's not worth the recovery. I have also already had braces and have a perfect bite. The recovery would be brutal for me too in terms of logistics, I'm not in a place to easily take months off.

Financially, I am in a position where I am a student with loans but with a high-income trajectory (think IB/consulting lined up post-grad) but nearly 6 figures of debt. I don't mind taking on more debt because you are only young once and I do believe I will be able to pay it off.

we have the same issues, im planning to get a bimax ccw to address the downward growth, make mandible more parallel to ground, fix sloped nose, reduce philtrum length. A bimax basically bypasses the need for rhino, jaw implants, genio for me so its worth it and I will fix my asymmetries too.