Recent Posts

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General Chat / Re: Help, advice lots to consider
« Last post by Wellconfused on Today at 03:06:52 AM »
Thanks Kavan and April for your replies. Yes my main concern with the joint replacements is that its will not last forever and could as you say bring about new issues, are there any alternatives than the joint replacements that you have heard of ? I think the Consultant mentioned distraction osteogenesis at some point but again was concerned regarding relapse / stability of my jaw as is?
And on that am I like to have issues seeing as my condyles have resorbed ? Ie tmj / biting/ anythjg reLly. I dont at the minute but weird to think i dont have those top bits which attach to the upper jaw yet no isues?

Sliding genioplasty will definitely help profile but I read mixed reciews on the sleep apnea side.
Thanks again.
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Aesthetics / Re: I need help with finding maxfac's in europe
« Last post by josh5464 on Today at 01:54:39 AM »
Hey, first of all its quite unlikely any surgeon is going to offer a lefort 3 for aesthetic reasons. Secondly, and most importantly you are only 16 meaning surgeons are hesitant to perform such surgeries before your bones have settled in, since they are still very malleable. This means if you acquire the right oral posture and stop mouth breathing, then over time your face will develop into its natural form. There may also be less invasive methods available to fix your issues. I would wait and see until you are around 20 to go ahead with such a surgery for aesthetic reasons. For now just ask the doctor what can be done without any invasive surgery. Hope that helps.
Here in NZ yes but in the places I'm going I believe surgeons might be less hesitant. I'll accept that I'm too young and I go over to Bulgaria yearly so I can wait couple years but I wish I could be a confident normal looking teenager I feel like that was stolen from me. I am correcting my oral posture but aesthetically nothing will change, if it does itll be very gradual and my recession is really everywhere and will always be there without surgery maybe just to a slightly lesser extent, and it will happen so slowly possibly not at all. I'm at the end of puberty maybe even already finished.

 Invasive is really just a word to me, the surgery itself's gross as (I've watched videos of the procedure being done) but surgeons deal with that gruesome stuff all the time and I don't see why the invasiveness of the procedure is an issue at all, it just looks bad, what really matters to me is risks, and even then the only risk that I would not trade for the benefits of a Lefort is blindness and the chances of that happening are <1%, same as implants and those can be done on anybody. A Lefort 3 would have the same functional purposes as a Lefort 1 right? expand airway,etc. But it's true though that my functional problems can probably all be fixed with less invasive surgeries. But I' can't lie to myself and go out in public thinking that the clothes I brought were worth any money because they make me look good, or that my haircut makes me look smart, and I think that's an issue that affects people a lot more than it's easy to show. The girl in pic had a lefort 3 but like me she was ugly and unnatural/not normal looking but she wasn't deformed and she looks around my age but I can understand waiting till I'm older.
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Aesthetics / Re: I need help with finding maxfac's in europe
« Last post by temporeiches13 on Today at 01:29:19 AM »
Hey, first of all its quite unlikely any surgeon is going to offer a lefort 3 for aesthetic reasons. Secondly, and most importantly you are only 16 meaning surgeons are hesitant to perform such surgeries before your bones have settled in, since they are still very malleable. This means if you acquire the right oral posture and stop mouth breathing, then over time your face will develop into its natural form. There may also be less invasive methods available to fix your issues. I would wait and see until you are around 20 to go ahead with such a surgery for aesthetic reasons. For now just ask the doctor what can be done without any invasive surgery. Hope that helps.
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Aesthetics / CCW compared to jutting lower jaw forward?
« Last post by CuriousDonut on Today at 01:22:15 AM »
I am in obvious need of CCW rotation + bimax + MLFIII/zygomatic-suborbital advancement but I just wanted to understand the effects of CCW rotation.

If one juts their lower jaw out, then their mid face looks recessed. My midface is recessed whether I just my lower jaw out or not, so if CCW rotation has the equivalent effect of me jutting my lower jaw out then why should I even bother.

When I just my lower jaw forward my face becomes longer and features worse. Does CCW rotation mimic this or does it look different?
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Aesthetics / I need help with finding maxfac's in europe
« Last post by josh5464 on Today at 01:09:51 AM »
I have a recessed midface/maxilla, decent ammount of scleral show and negative orbital vector. My face changed a lot from when I was a kid and before I began chronic mouthbreathing, 7-15 yo I breathed solely through my mouth day and night, the changes are clear everything I complain about now was never present before, I look like I'm aging at 16  :-[. I have TMJ and possibly other functional issues I'm still being assessed by an orthodontist and getting scans/tests done. My appearance really affects my esteem, I have all the features that come with recessed maxilla but my bite is class 1 and obv I don't have any syndrome except for probably a short face pattern if that counts. I'm going to have a consult with a local maxillofacial surgeon here in New Zealand but I'm also traveling to Bulgaria with my family in June and from there I have access to anywhere in Bulgaria, Greece and Turkey up to Istanbul. I've been doing a lot of research into the Lefort III procedure and read Earl's story and many others, I am willing to accept the risks of a Lefort III for mainly aesthetic but to a lesser extent functional reasons. I think that as far as aesthetics I'm a perfect candidate for Lefort III, the changes to nose, eyes, cheeks, etc. fix all the aesthetic issues I+other people see in myself, none of the changes would have a negative effect on my face and in fact all of them would increase my looks. According to many people online US and Europe are both places where there's surgeons willing to do Lefort III's on non syndrome patients but although I found a list of surgeons names for the US there doesn't seem to be a lot of sources for Europe. I've searched online and I could barely find any maxfac surgeons in Bulgaria and strangely in Turkey I couldn't find many which ik is not true because Turkey is such a huge country and apparently a tourist destination for plastic surgery and maxillofacial surgery. I don't really know what terms to use or where to search, I've tried searching for boards but the board websites never list names of surgeons, I also found dental clinics with maxfac surgeons on staff but I'm not sure if this is where I should be looking for what I want. For Greece though I came up with tonnes of results for maxillofacial surgeons just in Athens which is strange because Athens is so small. Is Greece a better place to get surgery than Turkey? Will it be as affordable and will the surgeons be less willing to do invasive procedures? Any information is really helpful.

If anybody has reccomendations for any maxillofacial surgeons at all in these areas even ones they have heard nothing about just names that'd be really helpful or advice on where to look online/irl for reputable surgeons because atm I'm pretty confused on where I should be searching especially for surgeons who do/have done Lefort III osteotomies. A list of surgeons who are well known for cosmetic maxfac surgery or performing lefort III's on non syndrome patients like the one for the US would be even better.

Also I'm only researching this, if I can't/shouldn't get a Lefort III, I will probably get a Lefort I or SARPE anyway because I suspect I have sleep apnea and I already have been told by ortho I have narrow palate and referred me to some airway scans I'm taking next wednesday. If I do get either of the less invasive surgeries it will be only for functional, they will only make me look worse if my midface is still retruded. Nothing but a Lefort III can improve my midface or make it not retruded.

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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by Lazlo on January 15, 2018, 09:16:00 PM »
For the most part, it's used as a bone buttress, graft, sandwiched between a bone cut where separating the bone to either elongate, widen or wedge forward leaves a GAP to be FILLED.

As far as materials for face implants go, it's really the SHAPE of them that matters and docs ability to carve the right shape (or have it designed) if the implant is alloplastic (but bio-compatible) material like medpore or firm silicones.

As to hip bone and also cartilage, there would be resorption over time, just like there is in the aging process. I believe they anticipate some over time and for that reason compensate by some over correction.

As to my 'opinion', I'm not sure that even matters given the new phenomena of patients where the ones who would be better served by implants are the ones who want the bone cuts (and bone grafts) instead. Vice versa with the ones who need bone cuts and insist on implants.
So, there is a factor of 'risk aversion' people who are disproportionately averse to the 'risk' of one material over the other as in HYPER focused on the risks of one and HYPO focused on the risks of the other.


nah cuz, implants will gradually look awful as you age. that's a fact. i  mean you could have them done, but you'll eventually be looking like a bobble head cause they look really artificial as you lose fat and skin goes to shit. bone cuts look real brah. Go real or there's no deal.
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by kavan on January 15, 2018, 06:12:51 PM »
So in your opinion, is hip bone a good material for facial implants? It won't resorb too much?

For the most part, it's used as a bone buttress, graft, sandwiched between a bone cut where separating the bone to either elongate, widen or wedge forward leaves a GAP to be FILLED.

As far as materials for face implants go, it's really the SHAPE of them that matters and docs ability to carve the right shape (or have it designed) if the implant is alloplastic (but bio-compatible) material like medpore or firm silicones.

As to hip bone and also cartilage, there would be resorption over time, just like there is in the aging process. I believe they anticipate some over time and for that reason compensate by some over correction.

As to my 'opinion', I'm not sure that even matters given the new phenomena of patients where the ones who would be better served by implants are the ones who want the bone cuts (and bone grafts) instead. Vice versa with the ones who need bone cuts and insist on implants.
So, there is a factor of 'risk aversion' people who are disproportionately averse to the 'risk' of one material over the other as in HYPER focused on the risks of one and HYPO focused on the risks of the other.
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by Bowie on January 15, 2018, 04:39:12 PM »
Oh. OK. If there are 3 'raw' surface sides and one intact surface of a bone cut, one would use a thin slice of cancellous bone to 'patch' 2 of the exposed raw surfaces where as the other exposed surface would be used to make contact with the area below it. That or some other 'sealant' type of material to patch up any exposed surface.

So in your opinion, is hip bone a good material for facial implants? It won't resorb too much?
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by kavan on January 15, 2018, 04:32:12 PM »
I understood that. I just wanted to know what you think the theory would look like in practice. How would you cut out a graft from the iliac crest and use it as an onlay with only one "raw" side which can be put on the bone.
If you just cut a piece out, in the easiest way imaginable, you would have three "raw" sides. Since it's an onlay, you can only press one "raw" side on the bone. Two other "raw" sides would be exposed and thus vulnerable to absorption.

Oh. OK. If there are 3 'raw' surface sides and one intact surface of a bone cut, one would use a thin slice of cancellous bone to 'patch' 2 of the exposed raw surfaces where as the other exposed surface would be used to make contact with the area below it. That or some other 'sealant' type of material to patch up any exposed surface.
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by triot on January 15, 2018, 04:17:47 PM »
Your asking me to explain how something would look based on an assumption on how the bone is harvested????

All that is needed to be understood here is that the cut surface of the bone needs to make contact with another surface whether it be the cut surface of another bone (used as a bone buttress) or another bone butress material sandwiched between a bone cut.

If the bone slice from the iliac crest segment has an INTACT part to it, say the very 'top' part of the crest, that part is Cancellous bone. The cut under surface of it can be used as an onlay. But the intact part of it does not need to be covered with other bone or material.

I understood that. I just wanted to know what you think the theory would look like in practice. How would you cut out a graft from the iliac crest and use it as an onlay with only one "raw" side which can be put on the bone.
If you just cut a piece out, in the easiest way imaginable, you would have three "raw" sides. Since it's an onlay, you can only press one "raw" side on the bone. Two other "raw" sides would be exposed and thus vulnerable to absorption.
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