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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by kavan on January 15, 2018, 03:52:48 PM »
But how would that look in practice when using it as an onlay? The graft has cuts on three sides with only the top being protected by it's natural form. Shouldn't there still be significant absorption then, since not all sides can be protected from being exposed? (btw. I'm actually just assuming how the graft is harvested here, I don't really know how anybody does it.)

Hm, actually the only method that comes to my mind that could only damage one side of the graft would be if they cut through the highest point of the arch (can't really explain what I mean here 😅)

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.
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by triot on January 15, 2018, 03:13:54 PM »
Well, the surface of the CUT aspect of the iliac crest bone needs contact with either bone or other material so it does not resorb. You know.. the 'raw' part or part that the knife went through to harvest it can't be left exposed. However, the non 'raw' part eg. the very top of the illiac spine would not tend to resorb.

But how would that look in practice when using it as an onlay? The graft has cuts on three sides with only the top being protected by it's natural form. Shouldn't there still be significant absorption then, since not all sides can be protected from being exposed? (btw. I'm actually just assuming how the graft is harvested here, I don't really know how anybody does it.)

Hm, actually the only method that comes to my mind that could only damage one side of the graft would be if they cut through the highest point of the arch (can't really explain what I mean here 😅)

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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by Lazlo on January 15, 2018, 03:04:49 PM »
No I think it would be great to have your own bone. Fuck implants and lypholized cartilege

I think Grendelbro is gonna do really well. I'm rooting for him! But Grendel, make sure to give us a full report. Also try and note any resorption at the 3 month mark.
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by tim06 on January 15, 2018, 02:04:36 PM »
I really hope that GrendelGegongan's graft stays, I thought other surgeons had said hip grafts don't last in the face.

Edit- Actually this Australian Professor also uses hip grafts for cheekbone augmentation! http://www.ddms.com.au/cosmetic-procedures/autogenous-cheek-augmentation/


He should have got an implant placed which is a lot less pain and bone work and it will not resorb after a few years. It is also cheaper.
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by Bowie on January 15, 2018, 12:33:39 PM »
I really hope that GrendelGegongan's graft stays, I thought other surgeons had said hip grafts don't last in the face.

Edit- Actually this Australian Professor also uses hip grafts for cheekbone augmentation! http://www.ddms.com.au/cosmetic-procedures/autogenous-cheek-augmentation/
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by kavan on January 15, 2018, 12:18:35 PM »
I do not want to promote anyone here. Besides, I never mentioned the name Sailer. I'd just like to discuss whether it might not have been better to use Lyocartilage instead of the iliac crest bone. Myself being an insensate opportunist? There must be room for the truth. But probably I should have been more sensitive.

Consider the mods here would know which doctor was being referred to here whether or not you mention the name.

 You need to stop using this patient's experience (while he is HEALING) to undermine, challenge, call into question, his doctor's technique or materials, especially so when you are using him as a spring board to interject your preference for what Sailer does. It's not the right time and place to shake his confidence in the surgery he got.

If you want to discuss the pros vs cons of lyocartilage vs ilac crest bone, it is preferable just to start a NEW separate topic on that.
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by Lestat on January 15, 2018, 12:04:55 PM »
IMO, you are being an insensate opportunist, quite possibly at the emotional expense of this patient (GrendalGong) in an attempt to shake his confidence and call into question whether his doctor did something 'wrong'. I don't have an issue with your liking Sailer. The issue here, as I see it, is you are attempting to undermine the confidence of this patient as to what his doctor did and using that as an opportune time to interject a type of promotion of Sailer.

I do not want to promote anyone here. Besides, I never mentioned the name Sailer. I'd just like to discuss whether it might not have been better to use Lyocartilage instead of the iliac crest bone. Myself being an insensate opportunist? There must be room for the truth. But probably I should have been more sensitive.
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by kavan on January 15, 2018, 11:48:58 AM »
I only said that I prefer lyophilized cartilage to iliac crest bone for the reasons I have stated.

You should not try to read any other motivation into that - but this is entirely up to you.

Naturally, this is just my personal opinion, and it could be controversial a bit, but in any case I hope it will stir up some discussion.

IMO, you are being an insensate opportunist, quite possibly at the emotional expense of this patient (GrendalGong) in an attempt to shake his confidence and call into question whether his doctor did something 'wrong'. I don't have an issue with your liking Sailer. The issue here, as I see it, is you are attempting to undermine the confidence of this patient as to what his doctor did and using that as an opportune time to interject a type of promotion of Sailer.
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Aesthetics / Re: Chin wing + zygomatic osteotomy with DR Z. in October
« Last post by Lestat on January 15, 2018, 11:35:21 AM »
The fact that you are asking me, 'what that means specifically' reflects that you might not understand the GENERAL PRINCIPLE I've explained here.

Clarify to me what you don't understand here:

a: The general principle I've explained

b: The fact that there are people who would elect to go to a surgeon OTHER than Sailer

It's looking more like b to me.

I only said that I prefer lyophilized cartilage to iliac crest bone for the reasons I have stated.

You should not try to read any other motivation into that - but this is entirely up to you.

Naturally, this is not just only my personal opinion but it is scientifically proven. Of course, it could be controversial a bit, but in any case I hope it will stir up some discussion.
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Hello, did anyone get this procedure done? OP I sent you a PM :)
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