For what it's worth, here's some pics as promised that might help explain how you might want to position the jaws for tying on small hooks with the "Big Game" jaws of a Regal Medallion.
In addition to being able to rotate the jaws 360 degrees to view a fly from all sides, the Medallion also allows you to point the angle of the jaws up and down.
Here's a pic of a size 20 Blue Wing Olive Sparkle Dun in the Big Game jaws at a standard angle of around 30 degrees. The large jaws make it difficult to access the hook, especially behind the hook for tying on tails etc.
But by pointing the jaws straight up and then inserting the hook, you can get much better access for tying on small hooks. Here's the same size 20 with the jaws pointing up: