Author Topic: Dr Hernandez Alfaro  (Read 44398 times)

UKMaxfac

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Re: Dr Hernandez Alfaro
« Reply #75 on: July 10, 2017, 04:40:32 AM »
I have no idea who to go with. I'm stumped.

PloskoPlus

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Re: Dr Hernandez Alfaro
« Reply #76 on: July 10, 2017, 05:16:15 AM »
I have no idea who to go with. I'm stumped.
How long is your upper lip?

UKMaxfac

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Re: Dr Hernandez Alfaro
« Reply #77 on: July 10, 2017, 05:36:44 AM »
How long is your upper lip?

is that how long my philtrum is?

PloskoPlus

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Re: Dr Hernandez Alfaro
« Reply #78 on: July 10, 2017, 05:40:56 AM »
is that how long my philtrum is?
Yes.

Milli_Meters

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Re: Dr Hernandez Alfaro
« Reply #79 on: July 10, 2017, 06:27:59 AM »
He is confused regarding which max fac to choose , not lip lift, I think.

Milli_Meters

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Re: Dr Hernandez Alfaro
« Reply #80 on: July 10, 2017, 06:33:27 AM »
I dk if it is Gunson's general stance to have lip lift first.Maybe in some cases. In my instance I will need a downgraft and every lip lift surgeon I talked to told me to wait till I was done with the bimax. I'd actually love it if I could just go get the lip lift because otherwise I am living with a long philtrum and suffering for atleast 1.5 years or so.

UKMaxfac

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Re: Dr Hernandez Alfaro
« Reply #81 on: July 10, 2017, 07:26:22 AM »
He is confused regarding which max fac to choose , not lip lift, I think.

Im not gonna get a lip lift. No surgeon out of the 6 or 7 ive met has ever mentioned me needing one

UKMaxfac

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Re: Dr Hernandez Alfaro
« Reply #82 on: July 26, 2017, 01:14:04 AM »
Anyone else got any feedback on him? I'm very soon picking someone and it's either him or DeFrancq at the time being.

mike888miller

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Re: Dr Hernandez Alfaro
« Reply #83 on: July 27, 2017, 03:28:53 PM »
wow I really enjoyed reading this thread, people disagreeing but keeping things factual.

i had only seen one albeit amazing result from him on the facebook group. i am in the market for an aggressive ccw. this guy also got jaw implants afterwards, i wonder if he had with with dr alvaro also.

the point was made that the genio should be minimal, for me this depends on the shape of your chin to begin with. mine has no projection, so i think i can get away with more, but in general i agree that as much as possible of the pog movement should be achieved via maximal movement and rotation of max and mandible, in order for the cheek projection to not be left behind.

i believe that this is a more difficult approach compared to an aggressive gneio and a more conservative double jaw.

there is a german surgeon that has a reputation for also being quite agressive with his ccw, I think he is the professor in Leipzig, doe anyone have any infor on this?

UKMaxfac

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Re: Dr Hernandez Alfaro
« Reply #84 on: August 04, 2017, 05:35:56 AM »
wow I really enjoyed reading this thread, people disagreeing but keeping things factual.

i had only seen one albeit amazing result from him on the facebook group. i am in the market for an aggressive ccw. this guy also got jaw implants afterwards, i wonder if he had with with dr alvaro also.

the point was made that the genio should be minimal, for me this depends on the shape of your chin to begin with. mine has no projection, so i think i can get away with more, but in general i agree that as much as possible of the pog movement should be achieved via maximal movement and rotation of max and mandible, in order for the cheek projection to not be left behind.

i believe that this is a more difficult approach compared to an aggressive gneio and a more conservative double jaw.

there is a german surgeon that has a reputation for also being quite agressive with his ccw, I think he is the professor in Leipzig, doe anyone have any infor on this?

There is a Facebook group for his results?

If so would you mind sharing? Would help me a lot.
Are you referring to Zarrinbal?

UKMaxfac

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Re: Dr Hernandez Alfaro
« Reply #85 on: August 21, 2017, 04:20:42 AM »
I've been refused treatment because I questioned whether it was sensible to also do a revision rhinoplasty at the same time as bimax.

How dare I question a surgeons abilities, my mistake  ;D

girl

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Re: Dr Hernandez Alfaro
« Reply #86 on: August 21, 2017, 04:39:00 AM »
What exactly was the basis of their declining treatment?

Don't forget to type Instituto Maxilofacial into Google and give them a review.  8)
 

kavan

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Re: Dr Hernandez Alfaro
« Reply #87 on: August 21, 2017, 02:38:11 PM »
I've been refused treatment because I questioned whether it was sensible to also do a revision rhinoplasty at the same time as bimax.

How dare I question a surgeons abilities, my mistake  ;D

No offence but the doctor might expect you to know the relationship surgery to the maxilla has to a nose that has been prior altered directly THROUGH the maxilla, especially so if there was anything in your questioning him that came off as your assuming you were knowledgeable enough to 'question' this.

From his perspective, he knows that the prior 'septo rhino' you got (that you think is more 'sensible' to revise at a later time) was a direct surgery to and through the roof of the maxilla because the act of lowering the 'floor' of the nose (to alter the septum) is basically the SAME thing as lowering the roof of the maxilla. Look at a ceph diagram where there is an outline of the part of the maxilla that's displaced during bi max. ANS-PNS is anterior to posterior nasal spine as in 'floor' of the nose. The curve below it is the roof of the maxilla at the palate. So the act of lowering the floor of the nose through prior cutting through the maxilla to do it is basically the same thing as lowering the roof of the maxilla.

So, your question probably came off as you thinking it was more sensible to cut through the maxilla a 3rd time in a different operation to revise your prior septo rhino than revising it during the same surgery where they would be making a cut to the maxilla to do the bi max.

Seriously. If someone got the 'floor' of their nose lowered via direct access through the maxilla and then later wants bi max where the maxilla needs to be cut through again and a rev rhino is contingent on having similar acess to the maxilla as was the case with the septo rhino wanting to be revised, what kind of patient would think it was more 'sensible' to go through the maxilla again, a 3rd time to revise at a later time after bi-max.

He probably doesn't want a patient who thinks that's more sensible. It isn't.
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ditterbo

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Re: Dr Hernandez Alfaro
« Reply #88 on: August 21, 2017, 03:40:27 PM »
Welp here I'm left wondering why the heck did your rhino guy lower the "floor" of your nose.  Never heard of rhinoplasty incisions going through the mouth before.

kavan

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Re: Dr Hernandez Alfaro
« Reply #89 on: August 21, 2017, 04:50:12 PM »
Welp here I'm left wondering why the heck did your rhino guy lower the "floor" of your nose.  Never heard of rhinoplasty incisions going through the mouth before.

Also see my post on: http://jawsurgeryforums.com/index.php?topic=6882.msg58899#msg58899

It's a way of straightening out the septum.

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