WOKE UP FROM SURGERY WITH DR. SINN

[The Quest for Aesthetics]

overall the augmentation is much more than a ZSO, but it doesn't quite make the directly infraorbital rim higher or larger. So overall Sinn's operation is the best as far as both zygoma, malar and orbital rim, but it's not as effective just for the orbital rim, unless you combine an implant and do a canthoplasty as Dr. Yaremchuk does.

For me though, I'd go with Sinn first, then reassess.

Let me tell you this.

So am I correct in saying that both the ZSO and mod LF3 are ineffective at making the lower border of the orbital rim higher, and that the only way to achieve this is through a custom orbital implant that 'wraps under' the lower portion of the eyeball more closely? It seems to me that the key aesthetic issue with an entirely recessed orbital rim area is not only a lack of horizontal projection but also that the orbital rim doesn't surround the eyeball closely enough. This makes me doubt the real efficacy of a lf3 in its entirety for an optimal aesthetic outcome as opposed to complete custom periorbital augmentation with implants. Actually that reminds me, does Sinn's mod lf3 advance the superior portion of the orbital rim?? Does it even advance the entire portion of the lateral orbital rim?

[Lazlo]

So am I correct in saying that both the ZSO and mod LF3 are ineffective at making the lower border of the orbital rim higher, and that the only way to achieve this is through a custom orbital implant that 'wraps under' the lower portion of the eyeball more closely? It seems to me that the key aesthetic issue with an entirely recessed orbital rim area is not only a lack of horizontal projection but also that the orbital rim doesn't surround the eyeball closely enough. This makes me doubt the real efficacy of a lf3 in its entirety for an optimal aesthetic outcome as opposed to complete custom periorbital augmentation with implants. Actually that reminds me, does Sinn's mod lf3 advance the superior portion of the orbital rim?? Does it even advance the entire portion of the lateral orbital rim?

yeah i think you're correct, though i want to ask dr. sinn if by adding HA paste he can make the orbital rim higher and closer to the bone. as for the lateral part i have no idea, why don't you schedule a phone consult and ask him!!!???

[The Quest for Aesthetics]

yeah i think you're correct, though i want to ask dr. sinn if by adding HA paste he can make the orbital rim higher and closer to the bone. as for the lateral part i have no idea, why don't you schedule a phone consult and ask him!!!???

This sounds like a good idea, I wasn't aware that he offers phone consults. It's just that mobilising only part of the orbital rim for large movements would surely leave a discordant step off, I would imagine? And both the superior orbital rim and, more importantly, the lateral orbital rim is crucial in tackling the prominent-eye 'look', if the mod le fort 3 can't do this, well either ha paste or custom lateral orbital rim implant would be needed on top of the mod lf3 anyway.

[Lazlo]

This sounds like a good idea, I wasn't aware that he offers phone consults. It's just that mobilising only part of the orbital rim for large movements would surely leave a discordant step off, I would imagine? And both the superior orbital rim and, more importantly, the lateral orbital rim is crucial in tackling the prominent-eye 'look', if the mod le fort 3 can't do this, well either ha paste or custom lateral orbital rim implant would be needed on top of the mod lf3 anyway.

honestly i would love to hear you grill him on this and to find out his responses and share them with us here. i don't think i could articulate it all as well as you can and you'd be doing yourself and all of us a huge service. he's a very very kind and authentic man and I think he will answer your questions with total honesty.

[The Quest for Aesthetics]

honestly i would love to hear you grill him on this and to find out his responses and share them with us here. i don't think i could articulate it all as well as you can and you'd be doing yourself and all of us a huge service. he's a very very kind and authentic man and I think he will answer your questions with total honesty.

I'll look into this, it's pretty crucial stuff imo. Although I'm sure Earl has all this information sitting comfortably and squarely in that brain of his. Earl where are you!!!

[Lazlo]

I'll look into this, it's pretty crucial stuff imo. Although I'm sure Earl has all this information sitting comfortably and squarely in that brain of his. Earl where are you!!!

Brah that might be true, but we need more people gathering info. YOu need to call, make an appointment and find out the info for us.

[thereishope]

did you have any bite issues before your surgery?

[Washingtoni]

Brah that might be true, but we need more people gathering info. YOu need to call, make an appointment and find out the info for us.

Blablabla what is with your info you do not give us any example how you look after surgery by Sinn?

[Lazlo]

Blablabla what is with your info you do not give us any example how you look after surgery by Sinn?

So that's my right. I don't have to give you s**t.

[Washingtoni]

So that's my right. I don't have to give you s**t.

Oh well when all others would act like you. We would not see any Post OP results.

[Lestat]

Btw is a zso or mod. Lf3 possible if you already have implants (ha or medpor) in your midface? Anyone knows? Thanks.

[onetwo34five]

Hey, I've been lurking for a while. A few questions for you Lazlo-

How much did this surgery cost if you don't mind me asking? Any insurance coverage?

Did you travel to Texas specifically for this surgery? I'm in MN and I'm looking for a competent doctor to possibly do a double jaw. I have family in Texas. What's the best way to contact Dr Sinn?

Was this surgery just cosmetic? Or functional as well? I don't have any "functional" issues, but think it would greatly benefit me cosmetically.

It was exciting following your journey!

[JimmyTheGent]

now that might be ENTIRELY erroneous of an observation given the Splint if changing the shape of the mouth 

So you had a splint after surgery???

[mike888miller]

how many mm of forward and lateral prjection can you achieve at the zygomatic bone?

le fort 3 as i understand it is different fro a le fort 1 done with three pieces. the advantaeg of the le fort 3 is where you cut higher, ie across the eyes and the zygomatic arch, which if done right has a tremendous positive cosmetic effect. augmentation of the malars via injection of dermo fillars in probably the most popular and effective dermo treatment to address age related laxitiy of the skin, because i lift the skin up and away. they fall it the v lift. i have seen a couple people that have done it and it looks incredible, game changer.


http://images.google.de/imgres?imgurl=http://mddirect.org/wp-content/uploads/2015/03/Zygomatic_bone_anterior.png&imgrefurl=http://mddirect.org/tag/zygomatic-bone/&h=900&w=900&tbnid=w6MzfFoRCt2hEM:&tbnh=102&tbnw=102&docid=UE4D0Ky3jWhzQM&usg=__OX8zwkIZurUTL6w7KduAqDDX-5w=&sa=X&ved=0ahUKEwidmtnWt9PPAhUGaxQKHRDJAuMQ9QEINzAD

[Rico]

lateral projection are a bit tricky...
mostly for 99%, during mouth opening, you will have soft tissues deformation (not big) between zygomatic arch and border of the jaw
Rather you should not move more than 3mm laterally  because of sunken eye issue - too big orbital volume.
More then 3mm might be a bit tricky for the eye even with orbital floor augumentation (resorbable sheet)

By moving the zygomatic bones forward on both side, you get more width at the same time - probably no more than 2mm (I'm not sure), because of the zygomatic arch shape.
Keep in mind that when you move your zygoma for example 7mm forward and 3mm outward, then in summay it will look like you had 5mm lateral  projection and 5mm in lateral is very noticeable

LF3 is for forward movements, so You would need kinda modified LF3, which is much more difficult thing

Lateral projections are more criticial than the ones in forward direction for soft tissues including the muscles - for example masseter muscles

However when it comes to postop soft tissues asymmetry caused by lateral movements it's not a big deal when you do it on both sides. In such scenarion it will be the same "asymmetry" so it will symmetrical

Mostly it's gonna look like, during  mouth opening, your masseter area will get more in width , but the frontal area - the soft tissues on the sides between chin and masseter muscle (buccinator area) does not change. They will behave like you had the old zygoma positions.

To understand this, open your mouth widely an you will notice that masseters area on the back (near the ears) gets more in width, but frontal gets more kinda narrow or at least does not change
When you move your zygoma together with the masseter muscle (no other option) laterally the posterior part will get much more in width during mouth opening, while frontal part (near chin, and buccinator) won't change (perhaps a bit after many years)
So it's gonna be that kind of soft tissues asymmetry..so it depends on the patient if this is asymmetry for him or not

Hard to explain