jawsurgeryforums.com
General Category => Aesthetics => Topic started by: The Quest for Aesthetics on November 19, 2016, 04:46:08 PM
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So I contacted the Don himself, Dr. Sinn, enquiring whether a palpebral fissure osteotomy could be performed to elongate the palpebral fissures by cutting the lateral orbital rim and moving it laterally with the lateral canthus attached. He said that not only is is possible, but that it is "feasible" and that he's performed it "in the past with good outcomes" and also that "risks minimal".
Elongated palpebral fissures play a significant role in facial aesthetics. Most of the very top male models have elongated palpebral fissures - Sean o pry, David Gandy, Francisco Lachowski, Atesh Salih.
This is novel, and potentially revolutionary, news for us.
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So I contacted the Don himself, Dr. Sinn, enquiring whether a palpebral fissure osteotomy could be performed to elongate the palpebral fissures by cutting the lateral orbital rim and moving it laterally with the lateral canthus attached. He said that not only is is possible, but that it is "feasible" and that he's performed it "in the past with good outcomes" and also that "risks minimal".
Elongated palpebral fissures play a significant role in facial aesthetics. Most of the very top male models have elongated palpebral fissures - Sean o pry, David Gandy, Francisco Lachowski, Atesh Salih.
This is novel, and potentially revolutionary, news for us.
yeah so go have it done.
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So I contacted the Don himself, Dr. Sinn
"The Magician"!
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Sorry, if I ask, but I do not understand...
With "elongate the palpebral fissures" do you mean this?
(http://www.guwsmedical.info/head-circumference/images/4449_55_93-head-eye-position.jpg)
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So I contacted the Don himself, Dr. Sinn, enquiring whether a palpebral fissure osteotomy could be performed to elongate the palpebral fissures by cutting the lateral orbital rim and moving it laterally with the lateral canthus attached. He said that not only is is possible, but that it is "feasible" and that he's performed it "in the past with good outcomes" and also that "risks minimal".
Elongated palpebral fissures play a significant role in facial aesthetics. Most of the very top male models have elongated palpebral fissures - Sean o pry, David Gandy, Francisco Lachowski, Atesh Salih.
This is novel, and potentially revolutionary, news for us.
I have literally no idea what you're talking about fyi like could you show us before and after or whatever.
And by the way in the result of the modified lefort Sinn did which I saw I didn't see any change in the eyes.
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Yeah, I don't know how QfA came up with the name "palpebral fissure osteotomy" but it appears to me from his description that he simply means moving the lateral orbital rim more lateral with the lateral canthus, and thus more or less horizontally stretching the upper and lower eyelids (laterally). What I see not mentioned however is that the eyeball has a certain horizontal length that you obviously can not change. It may be obvious that this surgery is normally mostly performed on persons with craniofacial syndromes (for example if the eyeball does not have a proper position in the orbital cavity). So if the canthus moves with the lateral orbital rim, your eyeball stays the same length: and the goal of all this is? You risk that the canthus detaches from the eyeball if your eyeball does not have sufficient length to make up for a lateral movement of the canthus + lateral orbital rim (and very likely it has not). Those models you're referring to have a completely different eyeball size and thus their canthi naturally are in a more lateral position. Not everything can be altered, you know.
Multiple studies have confirmed that eyeball size is relatively constant amongst humans - although obviously this may not account for outliers. However factors such as orbital box dimensions, positioning of the orbital box inside the head, development of exterior orbital rim structures, eyelid and canthal positioning, and the positioning of the eyeball within the eye socket together accounts for most of perceived 'eye size'.
For what it's worth, Sinn implied that this procedure isn't necessarily restricted to syndrome patients - he told me it was a feasible procedure with minimal risks. Remember we all thought the lf3 was only reserved for syndrome patients some years back, so let's not jump to conclusions (unless you have some information that we don't - in which case I'd love to hear it).
I wonder why the lateral orbital rim would need to be moved rather than just reattaching the lateral canthus as in a canthoplasty? This makes me thing that there's more to this than just moving the lateral canthus laterally. I've see lateral canthoplasty results where the eye elongated slightly due to repositioning of the lateral canthus - I doubt the feasibility of this procedure if it isn't able to do anything more than a lateral canthoplasty.
Let's assume that the eyeball and internal orbital cavity dimensions remain the same. Even if this was the case, does that mean that an optimal aesthetic result can't be achieved? I mean sure, movement would be limited by the eyeball but Dr Sinn wouldn't advertise the procedure as a palpebral fissure ostetomy (which is what he titled it when he emailed me), nor would he even offer it, if it didn't 'do anything' to the perceived width of the palpebral fissure. Who says that the length of the eyeball is what accounts for the aesthetically pleasing nature of an elongated eye?
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I mentioned moving the lateral orbital rim since you are talking about an osteotomy!! An osteostomy is a bony cut + movement! Plus you said the lateral orbital rim is moved in this "palpebral fissure osteotomy". Of course, once you're talking about osteotomies + moving the orbital rim whereas now you are simply referring to a canthoplasty you will cause a lot of confusion. Canthoplasty = soft tissue manipulation, not an osteotomy (=bony cut+movement)
Yes sure you can get a canthoplasty, but mind you: that's an entirely different procedure than any osteotomy obviously. Plus: you can seriously mess up your eyes with this. A canthopexy can be reversed, in a canthoplasty the canthal tendon is cut! This is permanent, and you thus permanently change the lateral structures of your eyes. No opthalmologic surgeon will be able to ever reverse that anymore. If any surgeon wants to mess up your young eyes with a canthoplasty that doesn't sound right to me.
That most people would have similar eyeball sizes is simply incorrect: please post your studies. Again: sure you can get a canthoplasty to lengthen your eyes, but it is not an osteotomy, my previous post was based upon your own reference to an osteotomy in which the lateral orbital rim is moved. A canthoplasty will permanently alter your canthal tendon, no way back anymore.
My point was that there would be no need for this osteotomy if it only produced the same outcome as a lateral canthoplasty which is done routinely for cosmetic reasons - however you are probably right in pointing out that the lateral canthal tendon may not be reattached with this ostetomy and that it is probably premature to speak of an ostetomy as not being a safer and more practical alternative. However, there is no use in speculating about this without further knowledge of the precise aesthetic consequences of the ostetomy v. canthoplasty. My instinct tells me that movement of the lateral orbital rim outward will offer space for the eyeball to set itself further in that direction. This doesn't seem impossible based on what Sinn said about being able to manipulate soft tissue during a mod lf3 to widen the IPD by up to 6mm. But again, no use in speculating at this moment and I may be completely wrong.
As for the eyeball size - I have read material on it in the past, I haven't found the studies just now but here's the encyclopaedia brittanica's entry: "The dimensions of the eye are reasonably constant, varying among individuals by only a millimetre or two; the sagittal (vertical) diameter is about 24 millimetres (about one inch) and is usually less than the transverse diameter."
Also it's well known that aging eyes appear smaller because they are propped up by less soft tissue behind the eyeball - which is to say that eyeball size is often a function of a set of visual illusions related to eyeball prominence, and there is no reason to suggest that other factors that influence orbital positioning do not contribute to that visual illusion.
In any case, this procedure exists, it's "feasible", and it has the ability to elongate the palpebral fissure. That is why I made this thread, and that is how it stands.
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Sure an optimal aesthetic result can be achieved: if someone actually needs what Sinn apparently coins a "Palpebral fissure osteotomy", in which he moves both the lateral orbital rim and the lateral canthus. And indeed of course the palpebral fissure length would increase in such a procedure. But not everyone is a candidate for such a procedure!! I'm sure Sinn offers orbital volume augmentation too, but not to someone who doesn't need it or the results would be a complete mess with not only aesthetic but also functional consequences. It's not different for the surgery you are now looking into.
Has Sinn seen your pics; did he actually offer you this procedure as you say after seeing your pics? I bet not.
If the lateral orbital rim is moved than the adjacent lateral orbital wall is moved as well, that changes the orbital volume. Perhaps Sinn makes up for this with orbital volume augmentation? It all sounds risky as hell, and if he did actually offer this to you after seeing your pics I'd eat my hat.
I would imagine that orbital volume augmentation would be done yes, otherwise I don't see how the positioning of the eyeball would remain stable. I believe that this also underlies what Sinn propounds as soft tissue manipulation to slightly increase the IPD during a mod lf3 too - but again it's speculation!! Myself and another user are consulting with Sinn about this in the coming months - if any of you would be willing to chip in with questions, comments, monetarily etc. it would be most welcome.
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He is a Sluthate poster and has posted a similar topic over there.
I did post it there but I'm not a sluthate 'user'. I know that they're interested in aesthetics so if I find things out I also post for their benefit. I don't subscribe to their methodology or ideology in the slightest.
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Look at the topic title, kid: "Holy f**k.." and the rest, then stating this is BIG NEWS for all of us and that Sinn is the "donn". That practically everyone needs longer palpebral fissure length, that it is the thing that models have. Of course you are motivating kids to get into this super involved orbital surgery, if not directly then indirectly, as if it would be nothing, for the sake of your beliefs this is one of the reasons models look like models. Stating I'm wrong when I say that risks are plentiful, since Sinn says they are minimal. So, kid, if you don't need to respond, then don't respond. As said: this is starting to look a lot like Sluthate so I have little reason to come here myself anymore if this sets the tone for the future.
"I've analysed features of dozens and dozens of models both male and female -": clearly you did, let me tell you that you dedicated your life to this has become very clear.
end of discussion - no further reason to bicker with you
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end of discussion - no further reason to bicker with you
So what if he's a sluthate user he can expresss whatever he wants. I like that he attempts to be scientific. Though he probably does have Aspergers. :P
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So what if he's a sluthate user he can expresss whatever he wants. I like that he attempts to be scientific. Though he probably does have Aspergers. :P
That's my boy Lazlo 8) - and yeah I do have aspergers :-\
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This forum is starting to look like a Lookism or Sluthate forum to me.
Until you have a handful of abject morons posting stream of consciousness garbage threads literally every few minutes all day long and telling people to kill themselves or how life is a scam and schizophrenics telling you the "truth" about reality, not even close. As much as people think this kind of talk comes from there, both sites had surprisingly little sober minded discussion about surgeries, not least because they are technically complicated subjects and the average lookism poster has the attention span of a goldfish. I imagine the reason they come here instead of staying there is precisely because of that.
So what if people want to discuss prospective procedures that might make them look better? Its a worthy goal, as worthy as anything and arguably has the potential for a greater impact on quality of life than anything else you'd spend thousands of dollars on. Is this not the entire purpose of creating this very new sub forum?
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greyandblue:
Are you still booked to have surgery with Dr. Sinn in February?
I've consulted with him about modified le fort III and IPD. I think the potential superior movement of the lower lid is a great benefit of this procedure but the paper by Turvey et al. suggests that this might not be too predictable. I'm going to consult with him again about what superior and anterior movement of the orbital rim might be possible.
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good luck to greyandblue, i hope his surgery goes well and gets the results he desires, not least for selfish reasons ;D
I think some of you dont appreciate that you are among a small cohort of people that are pioneering a relatively new aspect of surgery that is chiefly concerned with aesthetic impacts. Plastic surgery has always existed of course, but AFAIK the notion of improving all areas of the face via highly invasive bone cutting and shifting procedures is quite a new trend.
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Why do you want a lefort 3 greyandblue? As in what aesthetic goals do you have that you hope this will achieve?
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greyandblue:
Are you still booked to have surgery with Dr. Sinn in February?
Greyandblue is getting the modified Lf3 done in January.
He told me that AFTER his LF3 surgery he will share everything he knows with me which is a LOT.
I wish him all the best for his surgery! 8)
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So I contacted the Don himself, Dr. Sinn, enquiring whether a palpebral fissure osteotomy could be performed to elongate the palpebral fissures by cutting the lateral orbital rim and moving it laterally with the lateral canthus attached. He said that not only is is possible, but that it is "feasible" and that he's performed it "in the past with good outcomes" and also that "risks minimal".
Elongated palpebral fissures play a significant role in facial aesthetics. Most of the very top male models have elongated palpebral fissures - Sean o pry, David Gandy, Francisco Lachowski, Atesh Salih.
This is novel, and potentially revolutionary, news for us.
TQFA,
Do you think a medial canthoplasty in addition to a lateral canthoplasty could increase palpebral fissure length?
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This appears to be a dead thread but I will post in it regardless.
I have established contact with the authors/surgeons of a few pubmed articles that discuss the widening of the palpebral fissure via epicanthoplasty (alteration of the inner canthus) and lateral canthoplasty (alteration of the outer canthus). Currently, undergoing both of these -plastys allow for an slight increase in the width of ones palpebral fissure (read; eye length).
This "palpebral fissure osteotomy" supposedly offered by Sinn however, if feasible would allow for better augmentation.
I will be discussing the feasibility of the following:
- A "palpebral fissure osteotomy" in which the lateral orbital rim is moved horizontally would hypothetically allow more of one's eyeball to present itself in the horizontal plane combined with whichever canthoplasty is applicable.
- The widening of ones IPD by undergoing the above, coupled with an epicanthoplasty (procedure that can either shorten or lengthen the inner canthus) to shorten the inner canthus in addition to some form of orbital volume compensation via implants.
Hypothetically this would allow for an increase in ones IPD in accordance to what Sinn describes as "soft tissue manipulation".
- Lateral orbital rim expanded horizontally
- More eyeball presents itself
- Epicanthoplasty to shorten inner canthus
- Posterior orbital volume compensation to either push the eyeball outwards or inner orbital volume compensation to push the eyeball further horizontally.
Wider IPD, longer palpebral fissure... what gives...
Anyway I am still corresponding with the authors of the article.
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1/2
[attachment deleted by admin]
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These images detail what I assume Dr Sinn referred to when he mentioned "Palpebral fissure osteotomy".
However these two images comprise one page in a journal as is literally the only reference or mention I have found that discussed such a procedure.
[attachment deleted by admin]
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This thread is absolutely hilarious. I have very narrow IPD and unattractive eyes. But the idea that everything in your face can be cut apart and repositioned like surgical photoshop is just laughable. You guys are gonna end up with horrible vision problems and nerve palsies plus scarring.
You guys have no idea what the f**k you're talking about. It's not a game and the orbital area is incredibly complex. Stick to basic implants like eppley offers if you're desperate for something.
Just basic cuts like lf1 and bsso are risky enough as it is. I'm guessing the idiots proposing things like this have never actually had jaw surgery or they would have some clue as to what I'm saying.
You guys are never gonna be male models and no amount of experimental surgery is going to change that.
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I still don't understand what this osteotomy does. Can someone please explain. What is the before and after here? On this drawing the left and right eyes are totally different. Is the right more narrow one the result of the palberal tissue osteotomy or whatever its called? Can someone please just f**king explain to me what this procedure does cosmeetically????
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seems super legit. wish we had more experience and information on this type of procedure.
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I still don't understand what this osteotomy does. Can someone please explain. What is the before and after here? On this drawing the left and right eyes are totally different. Is the right more narrow one the result of the palberal tissue osteotomy or whatever its called? Can someone please just f**king explain to me what this procedure does cosmeetically????
It looks to horizontally stretch out and vertically narrow the palpebral fissures. Instead of removing the lateral canthal tendon from the orbital rim and resuturing it (type of cantho procedure) which has a 'hammock' effect to the palprebal fissure shape (horizontally stretch and vertically narrowing), it just slices off a part of the lateral orbital rim and moves that sideways with the lateral canthal tendon already on it.
This is NOT to be confused with increasing the IPD though as it won't increase the distance BETWEEN the eyes. I suppose one could also get similar effect with a bridge of bone drill hole canthopexy.
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bump cus this sounds pretty cool 8)
I assume this osteotomy produces a similar effect to pulling your back on the outer corner of your eyes.
If you have weaker cheekbones/ orbitals the lack of support on the eyeball becomes apparent if you pull back more than just a few mm (a gap appears), so you'd have to pair this with another osteotomy and or implant/ ha/ filler that provides some framing for the eyes thus allowing for the desired outcome.
Also as kavan said you can probably get a similar result through a canthopexy procedure, assuming you have adequate under eye support. The only upside I can see is that this procedure would be permanent whereas from my understanding canthopexys/plastys are not.
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good luck to greyandblue, i hope his surgery goes well and gets the results he desires, not least for selfish reasons ;D
I think some of you dont appreciate that you are among a small cohort of people that are pioneering a relatively new aspect of surgery that is chiefly concerned with aesthetic impacts. Plastic surgery has always existed of course, but AFAIK the notion of improving all areas of the face via highly invasive bone cutting and shifting procedures is quite a new trend.
I really really really hope it takes off so the people who really need major changes can get them.