jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Brianna-95 on June 02, 2017, 08:26:34 PM
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I'm 21 years old, I have an overbite and a small chin and I'm having so much trouble deciding what the hell to do about it. I've never had braces before but I am very interested in getting them at some point. I've looked into jaw surgery but the idea terrifies me. Lately ive been researching what I can about IMDO and I'm really interested in it but apparently it's no good for adults? I'm wondering if anybody could please tell me anything you know about it, I'm trying to decide whether it's worth it to pay for a consultation.
If anybody could offer some insight or tips or anything, even if it's not about IMDO specifically but if you have any ideas about what I should be looking into, it would be much appreciated.
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I'm including some pictures in case anybody has some insight into what the hell I should be looking into, lol.
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you'd have to consult Coceancig and ask him. I know when I inquired about it for my case he said he wouldn't do it, in favor of traditional jaw surgery. I didnt press as to why, if I had to guess its probably because in my case the results wouldve been more easily and readily achieved with BSSO and LF1 whereas I think IMDO in adults is probably only indicated for people with such physically small mandibles that they BSSO is not possible until the jaw has been distracted for enough "space" to operate so to speak....
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Thanks for the reply. I think I'm going to have a consult with him just to rule it out but yeah... I get the impression that he doesn't really like to do it in adults unless there aren't many other options, since there is pretty much nothing I can find on the internet about it. I'm seriously considering BSSO instead but the idea of surgery is so scary to me. I'll just have to get Over it I guess, lol. I think there's just so many things and procedures to consider that I'm finding it hard to narrow down the options. I'm just trying to get a good idea of what I should look into so I can be cost effective.
ETA: is there any surgery you would recommend for me to achieve an ideal profile, based on the pictures?
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Thanks for the reply. I think I'm going to have a consult with him just to rule it out but yeah... I get the impression that he doesn't really like to do it in adults unless there aren't many other options, since there is pretty much nothing I can find on the internet about it. I'm seriously considering BSSO instead but the idea of surgery is so scary to me. I'll just have to get Over it I guess, lol. I think there's just so many things and procedures to consider that I'm finding it hard to narrow down the options. I'm just trying to get a good idea of what I should look into so I can be cost effective.
ETA: is there any surgery you would recommend for me to achieve an ideal profile, based on the pictures?
you look like a candidate for bimax and some type of lengthening genioplasty..
I dont think you will go wrong with Coceancig.... IIRC he's about 10k per jaw which is absolutely in the normal price range for this kind of surgery in the 1st world. If you have insurance they will probably cover it.
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you look like a candidate for bimax and some type of lengthening genioplasty..
I dont think you will go wrong with Coceancig.... IIRC he's about 10k per jaw which is absolutely in the normal price range for this kind of surgery in the 1st world. If you have insurance they will probably cover it.
He doesn't do CCW. Any surgeon like that in this day and age is welcome to operate on his friends and family only.
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He doesn't do CCW. Any surgeon like that in this day and age is welcome to operate on his friends and family only.
1. AFAIK me and grey are the only guys who have actually consulted Coceancig on this forum, and the only thing i said on the matter was that he didn't seem keen on the movement, not that he doesn't do it.
2. When did this forum become the CCW forum? its not always indicated and honestly having now consulted with a surgeon who does almost exclusively CCW, the aesthetic difference is NOT what people on this forum make it out to be. Many of the best jaw surgery results ive seen have been purely linear (HTK for example)
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He doesn't do them period, even in cases where it's clearly indicated. Not everyone needs one, but there is no substitute where it's indicated. And of course a surgeon who doesn't do them will tell you that you don't need it.
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He doesn't do them period, even in cases where it's clearly indicated. Not everyone needs one, but there is no substitute where it's indicated. And of course a surgeon who doesn't do them will tell you that you don't need it.
What i mean is have you actually heard that from Coceancig?
this forum deals way too much in hearsay which leads to bulls**t "facts" being passed around. I remember some things I read about Triaca and Zarrinbal that turned out to be utterly false.
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What i mean is have you actually heard that from Coceancig?
this forum deals way too much in hearsay which leads to bulls**t "facts" being passed around. I remember some things I read about Triaca and Zarrinbal that turned out to be utterly false.
You don't realise what a backwater Australia is. No surgeon does CCW in Australia.
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Careful there jawjawbinks. He might come after the forum for slighting him.
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Thanks for the input everyone. I'm still just as confused as I was before ;D but I'm looking into Bimax at the moment
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Thanks for the input everyone. I'm still just as confused as I was before ;D but I'm looking into Bimax at the moment
Where do you live?
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Also I live about 20 minutes away from Coceancig's office so I am definitely having a consultation with him to see what he says. I also just went on his instagram and saw that somebody I went to school with had bimax surgery by him, which isn't really relevant, I just remember thinking that their results were amazing and i find it comforting to know someone who has Had jaw surgery themselves when you're looking into it :) this person would have been between 13-16 at the time.
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I think it really is a good indicitaor whether a surgeon does ccw or not as to their abilities and passion for the field. You want a surgeon who is foward thinking, not stuck in a rut of outdated medicine culture. By that I kind of mean doctors that just learn what they are taught in their diplomas and further studies but never keep up with new emerging procedures or techniques of even worse blankly dissaprove of them.
I heard *yes hearsay* that when students are in medical school and even when they go on to further specialize in surgery and maxillofacial surgery or plastic surgery, there is a culture that is encouraged by the teaching doctors and professors that seems to be very anti what is viewed as "cosmetic" surgery. In the U.K. at least, which would explain why doctors are body dysmorphia crazy in the UK, I sudspect it's the same in AU.
I'm rambling but my point is, if a surgeon has learnt ccw then it would seem that they could be an overall more dynamic and open-minded surgeon.
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Coceancig pioneered IMDO, so i do not think it is fair to say he is not open minded or forward thinking..
we need to wind our necks in on this forum sometimes, these people are trained, we are amateurs. So on one hand while we can say oh if so and so doesnt do <x> procedure they're not very good, we need to step back and consider they might have very good reasons for not doing <x> and <y>. I'm guilty of doing this myself in regard to a certain plastic surgeon's opinion on the chin wing procedure....
Its not fair to label Coceancig as some backward stone age ortho, because clearly he is not - PEEK implants, pioneering a distraction technique, using full 3D imaging etc. These are not things most surgeons in Australia do. The local maxfac in my city didn't even know it was possible to do surgery first / no pre-op braces.
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Thanks for the input. I'm definitely looking forward to consulting with him asap
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Very few people would benefit from Imdo. Most people just don't have the overjet to benefit from it. The other problem seems far more common - small overjet, yet a recessed profile due to a steep occlusal plane. The standard treatment is linear advancement of both jaws and a big ugly genioplasty. The results are always underwhelming. Only CCW helps.
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In adults with no overjet it's a 3 stage process which moves both jaws. It's long, painful and hard. The overall outcome expands the jaw in all three dimensions and changes the occlusal plane.
The imdo is a big bsso at the end of the day. Good surgeons can now manage 20mm advancements without imdo.
If you have a steep occlusal plan, no matter how much you advance both jaws, you will still look recessed and the face will just look longer from the front. The internet is full of these poor results.
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In adults with no overjet it's a 3 stage process which moves both jaws. It's long, painful and hard. The overall outcome expands the jaw in all three dimensions and changes the occlusal plane.
can you explain how the occlusal plane is changed if the IMDO follows the mandibular plane (should it be steep)? is it expanding and advancing the upper jaw enough for auto rotation?
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The imdo is a big bsso at the end of the day. Good surgeons can now manage 20mm advancements without imdo.
If you have a steep occlusal plan, no matter how much you advance both jaws, you will still look recessed and the face will just look longer from the front. The internet is full of these poor results.
Hi Ploskoplus ,
Someone shared their bimax + Chin Wing results with me , with 6 mm bsso and 6 mm CW (not SW) and it kinda looked like CCW ... Do you think its just my untrained eye?
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1. AFAIK me and grey are the only guys who have actually consulted Coceancig on this forum, and the only thing i said on the matter was that he didn't seem keen on the movement, not that he doesn't do it.
Not quite, my daughter had IMDO with him. http://jawsurgeryforums.com/index.php?topic=4475.0
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Not quite, my daughter had IMDO with him. http://jawsurgeryforums.com/index.php?topic=4475.0
Ah yes sorry Jol I remember this thread but it skipped my mind, thanks.
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I'm 21 years old, I have an overbite and a small chin and I'm having so much trouble deciding what the hell to do about it. I've never had braces before but I am very interested in getting them at some point.
I'd suggest the first thing you need to do is see a good orthodontist - and one who is familiar with referring patients for jaw surgery, if you think that's what you might need.
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I'd suggest the first thing you need to do is see a good orthodontist - and one who is familiar with referring patients for jaw surgery, if you think that's what you might need.
Thanks very much I appreciate it. :)
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Thanks very much I appreciate it. :)
I'm of a pretty low opinion of our surgeons... But consider seeing someone who does a lot of surgeries. All surgeons lie - "I do 200 a year!" Believe me, when they say this, they count everything - tooth implants, wisdom teeth... Maybe a dozen of those will be orthognathic surgery. See Lydia Lim. I think she's done the most ORTHOGNATHIC surgeries in Sidney. I'm pretty sure she doesn't do CCW (which you might need), but she will have the most experience of all Sydney surgeons.
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https://www.youtube.com/watch?v=95c9fRxQ4Ec&list=PLjC4hIwmyQfjXgckxslgVI9BPkh6wcv-a
new imdo video, turn on the auto-translation - works okay
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Bump.
I've had a consult with Dr. C. Can't comment on his skills as a surgeon, his website has great results on it, but two things put me off a little:
1. Everytime I google anything to do research, his practice seems to be the first thing that shows up as the Ad result. Which might imply he's not exactly inundated with patients.
2. He was really pushing his I MDO for me, which would cost way way more than BBSO, but with seemingly comparative results (although potentially less risk of nerve damage). I think distraction is a great option for growing teens but not sure it's that worth it for adults, just IMO.
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Bump.
I've had a consult with Dr. C. Can't comment on his skills as a surgeon, his website has great results on it, but two things put me off a little:
1. Everytime I google anything to do research, his practice seems to be the first thing that shows up as the Ad result. Which might imply he's not exactly inundated with patients.
2. He was really pushing his I MDO for me, which would cost way way more than BBSO, but with seemingly comparative results (although potentially less risk of nerve damage). I think distraction is a great option for growing teens but not sure it's that worth it for adults, just IMO.
Are you from Australia? He might be pushing IMDO due to insurance coverage for locals, not so much for foreigners.
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Are you from Australia? He might be pushing IMDO due to insurance coverage for locals, not so much for foreigners.
Yep I'm in Aus.
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well FWIW, i too consulted Dr C, and he did NOT push IMDO for me, actually pushed in the exact opposite route saying he wouldn't do it on me. I am also aus citizen and was local at the time, so I dont think its an insurance consideration.
So if he's "pushing" it for you, its probably because he sincerely thinks its the best option in your case.
EDIT: did he give any indication of why IMDO would be better for you than traditional techniques?
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Nope - but I didn't push him on it.
In hindsight I probably should have asked....whoops.