Author Topic: Wolford's new BSSO technique  (Read 4900 times)

molestrip

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Wolford's new BSSO technique
« on: November 12, 2015, 08:28:07 AM »
I noticed Wolford published a new BSSO technique in JOMS this year. Anyone have access to the publication by any chance? I discovered that there's a loophole in the mobile website and you can get some of the text that way. He mentioned it in my consult but didn't make a big deal of it, sad because it would really have excited me (maybe he didn't know the benefits at the time). In any case, he makes some striking claims about it. While the study was only about 100 people, he claims 100% IAN recovery by 1 year, complete elimination of the unaesthetic notch, near elimination of bad breaks, simultaneous removal of wisdom teeth, fixation using a single small bone plate no matter the magnitude of the movement, and reduced condylar sag. The main downside he cites is the extra cost of an inferior border saw but says it's justified given the benefits and I think he may be right. What do you all think?

Seems he gave a presentation on it at one of the annual AAOMS meetings. What do you all think? Big deal for those with large movements?

JimmyTheGent

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Re: Wolford's new BSSO technique
« Reply #1 on: November 16, 2015, 10:00:37 AM »
Molestrip is this surgeon the only guy who does piezosurgery in the US?  I know the surgeons in Spain use it and the recovery time is so much quicker.  I need a guy in NY to fix my sleep apnea and my god awful small chin!!
The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

molestrip

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Re: Wolford's new BSSO technique
« Reply #2 on: November 16, 2015, 10:25:43 AM »
No he is not. You are thinking of Dr Alfaro. However, it's not clear to me anymore that it makes a big difference. It can't be used for all cuts anyway. There are surgeons in the US who use or have used it. It's a pretty common tool actually, used for other procedures. Two I know of are Dr Viozi and Dr Ellis. There are many surgeons in NYC, a few of them very reputable. I don't have the names off hand right now but it'd be useful to make a list at some point.

JimmyTheGent

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Re: Wolford's new BSSO technique
« Reply #3 on: November 16, 2015, 12:33:14 PM »
Really? Reputable surgeons in NYC?  Can you name any or point me to the direction of finding them?

No he is not. You are thinking of Dr Alfaro. However, it's not clear to me anymore that it makes a big difference. It can't be used for all cuts anyway. There are surgeons in the US who use or have used it. It's a pretty common tool actually, used for other procedures. Two I know of are Dr Viozi and Dr Ellis. There are many surgeons in NYC, a few of them very reputable. I don't have the names off hand right now but it'd be useful to make a list at some point.
The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

JimmyTheGent

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Re: Wolford's new BSSO technique
« Reply #4 on: December 11, 2015, 09:24:09 AM »
No he is not. You are thinking of Dr Alfaro. However, it's not clear to me anymore that it makes a big difference. It can't be used for all cuts anyway. There are surgeons in the US who use or have used it. It's a pretty common tool actually, used for other procedures. Two I know of are Dr Viozi and Dr Ellis. There are many surgeons in NYC, a few of them very reputable. I don't have the names off hand right now but it'd be useful to make a list at some point.

I googled Dr Viozi  and it says he is in Minnisota not NY.  Is this correct?
The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

molestrip

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Re: Wolford's new BSSO technique
« Reply #5 on: December 11, 2015, 09:27:44 AM »
Yes he works at Mayo clinic. I'd have to look up the papers again but there's a new plasma based technology coming out that solves some problems of Piezo surgery and they mentioned the problems with piezo surgery. Unless you need multi-segment LeFort, I don't know that it's going to make a notable difference for you. Also, sorry I don't remember the names of guys in NYC. NYCOMs is one of the larger practices people tend ot refer to. There's Posnick in DC and other options in Boston, which are at least a train ride away.

JimmyTheGent

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Re: Wolford's new BSSO technique
« Reply #6 on: December 11, 2015, 09:52:14 AM »
Yes he works at Mayo clinic. I'd have to look up the papers again but there's a new plasma based technology coming out that solves some problems of Piezo surgery and they mentioned the problems with piezo surgery. Unless you need multi-segment LeFort, I don't know that it's going to make a notable difference for you. Also, sorry I don't remember the names of guys in NYC. NYCOMs is one of the larger practices people tend ot refer to. There's Posnick in DC and other options in Boston, which are at least a train ride away.

So you don't think Piezo tools would make any type of difference in healing time if its used for MMA surgery for sleep apnea?
The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

molestrip

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Re: Wolford's new BSSO technique
« Reply #7 on: December 11, 2015, 10:56:33 AM »
Piezo technology is useful in that it doesn't damage soft tissue as much. Soft tissue healing finished by about 2 weeks anyway. If your goal is time to back to normal for an MMA, then the surgeon you want is Dr Clark Taylor. Rumor has it that Dr Schwartz can deliver the same results, unclear if they're using the same technique but I think so.

mike888miller

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Re: Wolford's new BSSO technique
« Reply #8 on: December 14, 2015, 09:10:01 AM »
do you know what the benefit is he is referring to:

The proximal segment and positioning of the condyle within the fossa can be controlled to prevent condylar sag as well as elimination of the esthetic defect at the gonial notch area commonly seen with the traditional BSSO technique

molestrip

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Re: Wolford's new BSSO technique
« Reply #9 on: December 14, 2015, 09:19:46 AM »
One problem surgeons struggle with is control of the condyle within the fossa. If malpositioned, then you end up with joint problems, not good for business. The larger the movement the greater the problems. Only a surgeon could comment on the significance of the new cut of course but qualitatively, it reportedly reduces these problems. As for the notch, with large movements, especially above 7mm, there's often a "notch" that appears in the jaw line. That notch is quite common already in fact in people with facial deformity. I never noticed before but feeling around I have it too soft tissue just masks it well. As you get older it can show with soft tissue changes. I've seen the plate on imaging, it's really small, which is a nice bonus. The NSD bonus is also quite amazing.

It seems like a huge deal for people needing large advancements. That being said, if I asked a reputable surgeon about it and they said they were familiar and weren't impressed, I'd probably go with their recommendation. I try to encourage people not to diagnose themselves but rather focus on finding people with the right knowledge base and then going with their recommendations. I try, I'm guilty too :)

JimmyTheGent

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Re: Wolford's new BSSO technique
« Reply #10 on: December 14, 2015, 01:56:12 PM »
Piezo technology is useful in that it doesn't damage soft tissue as much. Soft tissue healing finished by about 2 weeks anyway. If your goal is time to back to normal for an MMA, then the surgeon you want is Dr Clark Taylor. Rumor has it that Dr Schwartz can deliver the same results, unclear if they're using the same technique but I think so.

Thanks!  Are you referring to Dr. Schwartz from NYCOMS?
The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

molestrip

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Re: Wolford's new BSSO technique
« Reply #11 on: December 14, 2015, 02:04:13 PM »
Nope, Dr Shwartz in LA. Kaiser I think.

JimmyTheGent

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Re: Wolford's new BSSO technique
« Reply #12 on: December 15, 2015, 10:33:07 AM »
I noticed Wolford published a new BSSO technique in JOMS this year. Anyone have access to the publication by any chance? I discovered that there's a loophole in the mobile website and you can get some of the text that way. He mentioned it in my consult but didn't make a big deal of it, sad because it would really have excited me (maybe he didn't know the benefits at the time). In any case, he makes some striking claims about it. While the study was only about 100 people, he claims 100% IAN recovery by 1 year, complete elimination of the unaesthetic notch, near elimination of bad breaks, simultaneous removal of wisdom teeth, fixation using a single small bone plate no matter the magnitude of the movement, and reduced condylar sag. The main downside he cites is the extra cost of an inferior border saw but says it's justified given the benefits and I think he may be right. What do you all think?

Seems he gave a presentation on it at one of the annual AAOMS meetings. What do you all think? Big deal for those with large movements?

Have you seen Dr Larry Wolfords Yelp reviews?  He got all 1 stars and everyone says he is a rip-off who does horrible work?! 
The more I learn about the gamble that is jaw surgery the more afraid I become!!!   :-(

molestrip

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Re: Wolford's new BSSO technique
« Reply #13 on: December 15, 2015, 10:46:04 AM »
I have. I've also spoken to a few people online. There's definite survivorship bias there and he's enormously well respected among peers. He's done thousands of cases and a very small fraction of those have reviews online. There's a few Youtube videos as well. I'm steering clear for now for various reasons I won't describe in public. Nonetheless, I think his contribution here is a good one.

PloskoPlus

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Re: Wolford's new BSSO technique
« Reply #14 on: December 15, 2015, 11:45:47 AM »
Wolford does cases that none would touch with a ten foot pole. The before and afters I saw in his office were exquisite - direct proof that a couple of mms can make all the difference.