Author Topic: Surgeon gave me a morph, should I be adding vertical height?  (Read 12911 times)

notrain

  • Private
  • Sr. Member
  • *****
  • Posts: 480
  • Karma: 77
  • Gender: Male
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #15 on: March 23, 2014, 01:41:49 PM »
the morph looks good. i still would not make hasty decisions wrt to chin wing. consult with a good maxfac and ask how long braces treatment would supposedly take.

MrRochester

  • Jr. Member
  • **
  • Posts: 89
  • Karma: 2
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #16 on: March 23, 2014, 05:43:57 PM »
the morph looks good. i still would not make hasty decisions wrt to chin wing. consult with a good maxfac and ask how long braces treatment would supposedly take.

I can't even get chin wing. Triaca is too expensive, Zarrinbal never responds to phone calls or emails, and Mommaerts is not a surgeon I'm willing to let perform on me. I'm going to have to get regular sliding genioplasty here in America it seems. 

Optimistic

  • Hero Member
  • *****
  • Posts: 579
  • Karma: 18
  • Gender: Male
  • I am class I
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #17 on: March 23, 2014, 06:10:00 PM »
I can't even get chin wing. Triaca is too expensive, Zarrinbal never responds to phone calls or emails, and Mommaerts is not a surgeon I'm willing to let perform on me. I'm going to have to get regular sliding genioplasty here in America it seems.

What does triaca charge for a chin wing?
01/10/14 - Last night I spilt spaghetti sauce on my chin for the very first time in my life and cried.

MrRochester

  • Jr. Member
  • **
  • Posts: 89
  • Karma: 2
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #18 on: March 23, 2014, 07:57:36 PM »
What does triaca charge for a chin wing?

I'm not sure if Triaca is actively performing surgery or if Brusco, his assistant, is doing them these days. Here is a quote from the email he sent me. It's actually less than I remembered because I was adding in the hospital stay. Maybe I will consider him after all.

The price is 10000.- CHF for the surgeon and about 2500.- for the Anesthesia if the operation is performed on a outpatient base. If you prefer to stay 1 or 2 nights in the hospital, which is not mandatory, you would have to calculate about 8000.- CHF more.
« Last Edit: March 23, 2014, 08:34:51 PM by MrRochester »

falcao

  • Full Member
  • ***
  • Posts: 226
  • Karma: 23
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #19 on: March 24, 2014, 12:49:43 AM »
Some words of encouragement:
I think a SG may be the way to go. Your expectations are very, very realistic. Your lower lip does not sit noticeably behind your upper and you're not looking to change your jaw angles. Sure BSSO +SG would be ideal, but you're one of those cases where SG alone may work very well as well, given your expectations. I would be more concerned about your expectations around the nose job. That lowering of the nostrils that you showed there is very difficult to achieve to that degree.

Have you heard of a surgeon in Cleveland called Guyuron? He's one of the best rhinoplasty surgeons in the world and does a fair bit of sliding genioplasties as well - including complex revisions of both noses and chins. He's a plastic surgeon as well as a craniofacial surgeon, widely published and with a name immediately recognized by any surgeon in the field in US and even overseas. I've seen surgeons mentioning him and putting pictures of themselves with Guyuron on their web sites just to increase their own credibility. I think you could benefit from a consult with him. You can probably do both the nose and the chin for pretty much that preposterous amount in swiss franks that you quoted here for a SG only.

You're lucky you're in US. If only I were in your place. I would never leave US to do a surgery elsewhere, not even Germany which is scientifically and medically more advanced than any other European country.

sean89

  • Full Member
  • ***
  • Posts: 181
  • Karma: 10
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #20 on: March 24, 2014, 07:46:16 AM »
I tend to agree. You could probably get genio and rhino done by a reputable surgeon for a much, much cheaper price (and only one anasthesia) than paying all that money to fly to Europe and getting a wing osteotomy since it is projection you need more than anything. And i agree that you should definitely not get a BSSO. And you do not need vertical height added to your chin either.

MrRochester

  • Jr. Member
  • **
  • Posts: 89
  • Karma: 2
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #21 on: March 24, 2014, 12:00:37 PM »
I tend to agree. You could probably get genio and rhino done by a reputable surgeon for a much, much cheaper price (and only one anasthesia) than paying all that money to fly to Europe and getting a wing osteotomy since it is projection you need more than anything. And i agree that you should definitely not get a BSSO. And you do not need vertical height added to your chin either.

Do you know what the advantage for me of chin wing over sliding genioplasty would be? I might try to schedule with Triaca tomorrow since I had no luck scheduling with Zarrinbal. I asked Triaca and he said:

"The advantage is that the line of the lower border of the mandible is not interrupted like in the normal genioplasty and that the soft tissue in the chin area is not detached but repositioned together with the bony segment, in order to produce the best possible sublabial fold and achieve natural lip competence."

I really don't see how the sublabial fold created by chin wing would be any different. You are still pushing out the soft tissue and sliding bone out. You're just doing it from further back along the mandible. Why would the resultant sublabial fold be any different? Maybe I'm not visualizing this correctly.

sean89

  • Full Member
  • ***
  • Posts: 181
  • Karma: 10
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #22 on: March 24, 2014, 12:46:41 PM »
Do you know what the advantage for me of chin wing over sliding genioplasty would be? I might try to schedule with Triaca tomorrow since I had no luck scheduling with Zarrinbal. I asked Triaca and he said:

"The advantage is that the line of the lower border of the mandible is not interrupted like in the normal genioplasty and that the soft tissue in the chin area is not detached but repositioned together with the bony segment, in order to produce the best possible sublabial fold and achieve natural lip competence."

I really don't see how the sublabial fold created by chin wing would be any different. You are still pushing out the soft tissue and sliding bone out. You're just doing it from further back along the mandible. Why would the resultant sublabial fold be any different? Maybe I'm not visualizing this correctly.

I don't understand either. Either way, a deep sublabial fold won't be the end of the world for me.

Gregor Samsa

  • Guest
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #23 on: March 24, 2014, 01:20:49 PM »
Have you heard of a surgeon in Cleveland called Guyuron? He's one of the best rhinoplasty surgeons in the world and does a fair bit of sliding genioplasties as well - including complex revisions of both noses and chins. He's a plastic surgeon as well as a craniofacial surgeon, widely published and with a name immediately recognized by any surgeon in the field in US and even overseas. I've seen surgeons mentioning him and putting pictures of themselves with Guyuron on their web sites just to increase their own credibility. I think you could benefit from a consult with him. You can probably do both the nose and the chin for pretty much that preposterous amount in swiss franks that you quoted here for a SG only.

I've heard about him before but the before/after pictures on his website are pretty underwhelming. I can't even see any difference in most of the cases and one guy even ended up with a nose that was more crooked than it was before.

MrRochester

  • Jr. Member
  • **
  • Posts: 89
  • Karma: 2
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #24 on: March 24, 2014, 03:17:50 PM »
I don't understand either. Either way, a deep sublabial fold won't be the end of the world for me.

What do you hope to get from chin wing that you cannot obtain through a regular sliding genioplasty?

PloskoPlus

  • Hero Member
  • *****
  • Posts: 3044
  • Karma: 140
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #25 on: March 25, 2014, 01:58:54 AM »
I've heard about him before but the before/after pictures on his website are pretty underwhelming. I can't even see any difference in most of the cases and one guy even ended up with a nose that was more crooked than it was before.

What about this surgeon?
http://www.facialsurgery.com/BAPgnc01xhb.html

I'm considering seeing this guy
http://www.andrewgreensmithrhinoplasty.com.au/patient-results/

PloskoPlus

  • Hero Member
  • *****
  • Posts: 3044
  • Karma: 140
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #26 on: March 25, 2014, 02:03:05 AM »
What do you hope to get from chin wing that you cannot obtain through a regular sliding genioplasty?

IMO, your chin is not your problem.  There are male models with a chin like yours.  Brad Pitt's chin has bugger all horizontal projection.  Your biggest problem is your eyes.  This may be resolved with maxillary advancement (and mandibular as well since your bite is normal).

PloskoPlus

  • Hero Member
  • *****
  • Posts: 3044
  • Karma: 140
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #27 on: March 25, 2014, 04:03:50 AM »
How would a maxillary advancement emulate such orbital rim support that the eyes become better? Why do you think that?
The paper in the "scleral show" thread.  Le Fort I will never yield the results of the Le Fort III girl you posted (BTW, do you have link to where that image comes from?), but at least it's something.  My hunch is that maxillary advancement should have the most under-eye "tenting" effect on broad faces.

sean89

  • Full Member
  • ***
  • Posts: 181
  • Karma: 10
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #28 on: March 25, 2014, 06:08:05 AM »
What do you hope to get from chin wing that you cannot obtain through a regular sliding genioplasty?

I have a mandibular asymmetry that I would like to correct.

PloskoPlus

  • Hero Member
  • *****
  • Posts: 3044
  • Karma: 140
Re: Surgeon gave me a morph, should I be adding vertical height?
« Reply #29 on: March 26, 2014, 12:55:59 AM »
I have a mandibular asymmetry that I would like to correct.

On the Jaw Surgery Blog there is a girl who is going to get BSSO on one side and IVRO on the other.