Author Topic: What surgical technique do I need? Images included.  (Read 1624 times)

kavan

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Re: What surgical technique do I need? Images included.
« Reply #60 on: October 04, 2017, 02:45:14 PM »
I think the Colorado place does no VSP, just 3d prints cutting guides, skull models etc.. I think Sinn uses them for skull models for his mod lf3s.

FWIW, in Australia planning is a separate billable item for orthognathic surgery (not sure about genioplasty). It's not optional.

Then maybe I'm getting confused by the way the OP is describing it as he said the doc wanted [2,100 (for vsp) planning]. However, with your clarification as to the skull models, it's making more sense. thanx.
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Lazlo

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Re: What surgical technique do I need? Images included.
« Reply #61 on: October 04, 2017, 10:48:02 PM »
Did they remove more on one side than the other? Sometimes, they can pop out the part directly in the buccal space. But if they keep pulling on it, it's connected higher UP the side of face and to the temple. So, pulling too much to get all of it out can remove from places where it's needed and wanted and result in some 'collapse' because some of  it supports the face.

Also, they never really know the size of it or the extent of it with regard to all it's connections above buccal space until they make the incision and start pulling on it. It's very uncertain surgery in terms of the ODDs of it doing the trick.

yeah one side looks completely different from the other side. one one side my cheek has collapsed up near the temple all the way down to the mid cheek. It just looks terrible and it was much better having fat there. People warned me it was a bad idea but Sinn kept insisting it was fine. As usual I exercised poor judgement. I'm beginning to realize we know much more than these surgeons.

JigJaw_:/

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Re: What surgical technique do I need? Images included.
« Reply #62 on: October 05, 2017, 06:44:50 AM »
I think that it gave an improvement.  I had it done over a decade ago.  I had lack of forward projection and a lot of vertical length.  The change was significant from the genioplasty alone.

I'm hoping that the genioplasty will do the same for me. If it's done right, I think it will probably give the result I'm seeking. Vertical aspect is probably going to offer the most change, but I need projection, too.


JigJaw_:/

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Re: What surgical technique do I need? Images included.
« Reply #63 on: October 05, 2017, 06:47:38 AM »
I think the Colorado place does no VSP, just 3d prints cutting guides, skull models etc.. I think Sinn uses them for skull models for his mod lf3s.

I think they are 3D cutting guides, but not sure about skull models. Gonna ask him today.
« Last Edit: October 05, 2017, 08:06:54 AM by kavan »

kavan

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Re: What surgical technique do I need? Images included.
« Reply #64 on: October 05, 2017, 09:41:37 AM »
yeah one side looks completely different from the other side. one one side my cheek has collapsed up near the temple all the way down to the mid cheek. It just looks terrible and it was much better having fat there. People warned me it was a bad idea but Sinn kept insisting it was fine. As usual I exercised poor judgement. I'm beginning to realize we know much more than these surgeons.

Tbh, if he's offering cosmetic surgery like facelifts, botox fillers, etc. and pulling out buccal fat pads while he's at it, it could reflect that despite his very impressive CV and his academic recognition for specialized bone cutting surgeries, he's not getting much of a demand for the specialty his reputation revolves around.

Sure, a maxfax can do plastic surgeries or also offer 'cosmetic surgery' if they want to but to keep up with the advances (techniques, pitfalls, etc), membership in specialized academic societies is where those advances are learned about. I don't see that in his CV.

Was this a thing where you narrowed him down for his specialty, for example his being able to do a modified L3 that earl isolated him for and then HE suggested buccal fat removal or did you you request that from him?
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lamb

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Re: What surgical technique do I need? Images included.
« Reply #65 on: October 05, 2017, 12:08:06 PM »
Las, didn't you have double jaw surgery with Sinn?  Are you happy with that aspect?

JigJaw_:/

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Re: What surgical technique do I need? Images included.
« Reply #66 on: October 06, 2017, 06:17:57 PM »
Had my consult with Dr. Sinn today. Went well. He said he actually prefers doing a free hand 3D sketch over computer image planning; regardless of the implant or asymmetry. He didn't really blink an eye on that. He offered me 3 options...all 3 of which include extraction of the implant. 1) Genioplasty, alone. 2) Genioplasty along with internal lip lift. 3) Leforte 1 (no forward movement, just down), and genioplasty. No braces!
He was pretty thorough with explanation, also easy to talk to. I might have been last patient of the day, but I don't think that really mattered. He didn't hurry. Easily the most skilled and knowledgeable I've talked with.
Looks like he makes a pretty broad cut of the chin for his genioplasty.

Lazlo

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Re: What surgical technique do I need? Images included.
« Reply #67 on: October 07, 2017, 12:50:17 AM »
Las, didn't you have double jaw surgery with Sinn?  Are you happy with that aspect?

yeah you know i am relatively happy right now. i feel what messed up my result was my ortho not Sinn's surgery so much. I don't really have any problems with the surgery except bottom lip is slightly numb. The profile is "okay" given I have a very thick upper lip. I would say I'd give my result a B-. He could have done some CCW but didn't. And yeah he is pretty confident in doing some extreme things. I'm sure he knows how to do things like an internal lip lift (which is news to me frankly!). But what I'm most disappointed about is the buccal fat removal which was a HUGE mistake and totally asymmetric on me. SO I would say just proceed with caution.

JigJaw_:/

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Re: What surgical technique do I need? Images included.
« Reply #68 on: October 07, 2017, 09:43:00 AM »
yeah you know i am relatively happy right now. i feel what messed up my result was my ortho not Sinn's surgery so much. I don't really have any problems with the surgery except bottom lip is slightly numb. The profile is "okay" given I have a very thick upper lip. I would say I'd give my result a B-. He could have done some CCW but didn't. And yeah he is pretty confident in doing some extreme things. I'm sure he knows how to do things like an internal lip lift (which is news to me frankly!). But what I'm most disappointed about is the buccal fat removal which was a HUGE mistake and totally asymmetric on me. SO I would say just proceed with caution.


Hey Lazlo,
Mind me asking what your total price tag with Sinn was? You had both Jaws + Genio, right? Was yours straight out of pocket? Was your surgery at his office/facility, in Mansfield?
I feel pretty good about him doing the chin. Have to ask more questions about the lip; from what I found on web, it only removes tissue from inside the lip (as it obviously states), thereby allowing more tooth show.
Leforte is a possibility. Don't know what stability looks like long term, though. Seems to be one of the less stable procedures. He said my bite was good enough. Just wondering what it would cost. He's emailing quote next week.

GJ

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Re: What surgical technique do I need? Images included.
« Reply #69 on: October 07, 2017, 10:51:31 AM »
Don't talk prices in public.

Adonia

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Re: What surgical technique do I need? Images included.
« Reply #70 on: October 18, 2017, 02:13:14 PM »
lYou look like you would really benefit from more chin height

Framboise

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Re: What surgical technique do I need? Images included.
« Reply #71 on: October 18, 2017, 11:10:33 PM »
I think  a Clockwise rotation of your jaws will be beneficial for you.

JigJaw_:/

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Re: What surgical technique do I need? Images included.
« Reply #72 on: October 19, 2017, 08:08:32 AM »
I think  a Clockwise rotation of your jaws will be beneficial for you.

I once thought so too, now...I don't know. I think cc rotation would benefit me the most, but not sure. Most recent surgeon I saw didn't seem to think I needed any forward movement. Maybe I was just hearing what my mind thought was the easiest solution. He suggested a Leforte1 downgraft and geniplasty. Going to have AT LEAST one more consult.

JigJaw_:/

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Re: What surgical technique do I need? Images included.
« Reply #73 on: October 19, 2017, 08:12:45 AM »
lYou look like you would really benefit from more chin height

Agreed. My facial height gets WAY skewed when you get to my chin area. I think adding vertical to the chin (even if that's all I do) should solve most of the vertical issues.

JigJaw_:/

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Re: What surgical technique do I need? Images included.
« Reply #74 on: October 19, 2017, 09:28:01 AM »
I know that Leforte with CCR changes the nasal base.. What about Leforte with dowgraft, but no forward rotation/movement?
What happens with the nose with no rotation? What changes manifest?
« Last Edit: October 19, 2017, 09:51:56 AM by JigJaw_:/ »