Surgeries per year

[PloskoPlus]

"Volume of procedures is absolutely important!"

So the best choice is MM

His students are probably the ones doing the surgeries.

[Gregor Samsa]

"Volume of procedures is absolutely important!"

So the best choice is MM

Do you know how many surgeries per year he does?

[Rico]

if you have to wait 4-6 months for a surgery, while average time in big hospitals is 2-3 months, then awfully a lot

[Rico]

Most patients do not know that some part of surgery may be done by students.

Don't be naive.  Young surgeons one day has to start to oparte on real patients . They get simple small procedures to more complicated with time.
The most important is main surgeon should not allow to do anything when a case is not typical and more demanding
But when surgery is typical and "simple" he should take control in the most crucial parts, like operating very close to nerves

and main surgeon should operate only himself if a patient ask about it. However many patients are not aware about this.

and at last.. you will never know what really is gonna happen during your surgery ...whatever paper you signed

Welcome to surgery world, where nothing is clear and nothing is for sure
If you can, run like hell

[PloskoPlus]

Most patients do not know that some part of surgery may be done by students.

Don't be naive.  Young surgeons one day has to start to oparte on real patients . They get simple small procedures to more complicated with time.
The most important is main surgeon should not allow to do anything when a case is not typical and more demanding
But when surgery is typical and "simple" he should take control in the most crucial parts, like operating very close to nerves

and main surgeon should operate only himself if a patient ask about it. However many patients are not aware about this.

You know, I wonder if my likely permanent nerve damage is thanks to giving a young one "a go".  That would really suck if it were true.

[Rico]

you know even the best surgeon may damage your nerve too much. in some part it depends on your body - how much your nerve are prone to damage due to stretching.. or if you do sports, etc etc

paradoxically a novice may not damage your nerve too much (somehow) and the best one may have little less fortune in your case

nerves = gamble.

and also what means permanently nerve damaged. It's never damaged in 100% (if it's not cut)
for some it's less than 90% of normal nerve function
for some less than 99%
for same less than 100.00000000%

it all depends

generally I repeat it many times if anyone problem seems to be mild (not so much bothering) and  if that person are very afraid of any nerve damage, I recommend avoid surgery. Mental cosequences for such person may be terrible. Some people may not bother slight feeling distirbuances on face... on some slight or even severe obsession may develop.  That condition may be devastating

Obsession - constant worrying about the thing with no relief

Fortunately such reaction is rather rare, especially if a patient after surgery gets what he wants.
It's better to get what you wanted and eventually pay(loss) a little for that (costs - something for something)

than not get what you expected and loose something at the same time - that is a problem

[Rico]

How to get it http://www.pnas.org/content/105/51/20505.full 
??

[molestrip]

@Plosko Sucks to have permanent nerve damage Yeah people say surgeon skill and you see sometimes crazy s**t on here, like that guy in southern CA recently. But other than rookie surgeons mostly I think it comes down to procedure, how much stretching, how much swelling, what other work did you have done, how old were you, what anatomic variants do you have, etc. I say this readily because it's not happened to me yet! :s Never had nerve loss but experience nerve dysfunction elsewhere in my body. I couldn't imagine having that on my face, anywhere else is manageable IMO.

[PloskoPlus]

I wonder if who did what would be in the Op Notes?
And by "who" I mean the surgeon Plosko hired to do his surgery or a resident/surgeon in training?

How do I even get these notes?

[PloskoPlus]

Faceinit,

Thank you very much.  But if I find out that an assistant did much of my surgery, then what?  I don't even know what I signed off on.
And if the assistant just handed the surgeon the tools?

[Bobbit]

like..

Find a really really good orthodontist who does a lot of the pre-surgery and post-surgery adjustments. 

Then find the orthognathic surgeon he sends his patients to see to do orthognathic surgery. 

The orthodontist will not send you to someone who is getting poor results - -  because it reflects poorly back on the orthodontist.

  Those orthodontist guys and gals  are one of the major referral sources for good orthognathic surgeons.  They have to work closely before and after jaw surgeries to get the ultimate right result.  A friend told me about one situation  where the "best orthodontist" in the city had some consistently less than good results from  an academic center doing the orthognathic surgeries on his patients.  He changed his referral pattern to a younger well trained orthognathic surgeon and ended up with outstanding results.  In short,  it may not be the number of surgeries,  but it may have more to do with who trained them.

This is sort of like asking your doctor which doctor he uses for his wife or children - -  When you need a surgery.

If the orthognathic surgeon can't point you to a local orthodontist that routinely refers his patients to the orthognathic surgeon you are talking to - -  then you should find another place to be having that conversation.

[molestrip]

I'm more of an ass man

[Bobbit]

Hmmm...   a lot there.   At times you confuse me a bit - -  as orthodontists normally do the adjustments of the teeth through their various means.  After they have done all they can do - -   they then send the patient to  an orthognathic surgeon to split the lower, upper, or both jaws and move them in accordance with the "plan" worked out between the two of them.  Often, after the jaw surgery,  the orthodontist gets the patient back for some further minor adjustments.   

If the orthognathic jaw surgeon is not getting consistently good results - -  it makes the job of the orthodontist much more difficult.  That is the reason to find out if the orthognathic surgeon you are working with has an ongoing referral pattern from one or more orthodontists.

You do point out something interesting.  It would not be surprising for there to be an increasing number of patients who self refer to a distant jaw surgeon. 

But there are not going to be any 30 year old orthognathic surgeons.  By the time they get to be both a plastic surgeon and trained to do jaw work - - they are going to be at least 34 or 35 years old.

[Lazlo]

I really love fake boobies.