Opinions on results

[ScottMalkinson]

I'm not sure what the exact movements were, but he said before during a consult they'd be "moderate". Idk, its been almost 3 weeks since I took those pictures and I still feel like my face is too long, narrow, and ovalish. Its an improvement to my profile, but from the front and 3/4 view its still clear I could use additional procedures, especially in the midface/eye area.

[ditterbo]

I'm not sure what the exact movements were, but he said before during a consult they'd be "moderate". Idk, its been almost 3 weeks since I took those pictures and I still feel like my face is too long, narrow, and ovalish. Its an improvement to my profile, but from the front and 3/4 view its still clear I could use additional procedures, especially in the midface/eye area.

If I compare your two head-on shots, your face actually appears less narrow post op.  Interesting (for my own edification) that you don't like the fuller looking lower half. Before you had this sharply angled \/ kind of jaw to chin area.  Bimax I believe typically makes that whole thing appear wider, in frontal view, just by the nature of the forward mandibular advancement.  IMO maybe the easiest and biggest bang for buck/recovery would be to somehow correct the redness along your obvious (pre and post op) tear trough lines?

[ScottMalkinson]

It's not that I don't like the result of the lower half, I think the jaw surgery went pretty well overall, its just that now other parts look more left behind afterwards.

[kavan]

Yes. That's true and a good observation to note that the recessed other parts of the face that are not and were not advanced via the surgery you needed to the lower '1/3rd' of the face, recede more to the background by relative comparison. So, all you gotta do from here is go back to your doctor and ask him if he can bring some of the recessed parts of your face forward. He's probably in the capacity to do that. Ask him to show you a skull model with a bunch of CUTS to it connected to springs where on the bone model, you can move a lot of bony parts of the face. The parts you would want to bring forward would be found below the  eye sockets.

[Lestat]

I've seen some very disappointing results of this and a patient currently searching everywhere how to improve such a not good result after a ZSO, which seems nearly impossible.

Why wasn't he happy with his result? Can you please explain?

[kavan]

LOL! If it were all that simple as this Kavan-bloke seems to think we may as well close down the forum. OP forget about going to your doctor to tell him to bring forward some of the recessed parts of your face: do your due research first.
If a surgeon is good in bimax that won't tell you if he's any good with other osteotomies too as this guy Kavan assumes. There are different types of osteotomies and different surgeons performing one ore more of these types. Not to mention: your inferior orbital rims are recessed. There's no way to easily augment that with an osteotomy as Kavan (wrongly) suggests. Unless you're willing to get into (modified) LFIII territory:very few surgeons will do this on a non-syndromic patient, and they're right since this is massive risky surgery. Otherwise you're looking at a ZSO and that just augments the lower part of the cheek (look at the cuts), resulting in lowset cheeks. I've seen some very disappointing results of this and a patient currently searching everywhere how to improve such a not good result after a ZSO, which seems nearly impossible. Implants can augment the orbital rims and malar zones without massive surgery, but there are some drawbacks to them too.

I'm assuming it because I know who his doctor is and know he's good in other osteos to the face and am confident in his capacities to advise the OP on the prospect of augmenting the other parts of his face. You're assuming I had no familiarity with the capacities of his doctor when I told him to go back to him and consult about other things. No one here even knew who his doctor was when he first asked. All you know about is the highly talked up ones.

 He's observed he needs forward advancement to other parts of his face and I feel given the capacity of his doctor to carry out a variety of osteos and forthrightly advice, that's the first place he should inquire. Consulting first does not preclude him from later asking about the procedures here.

[kavan]

'All you know about is the highly talked up ones.' You post here a few times, and instantly know what surgeons we do and don't know about? Funny. Because I still don't know what surgeons other guys on here know about; and I'm sure they don't know all surgeons I have consulted with. But you apparently do.
I don't have to know the name of OP's surgeon to know he should do his due research and consult. To return to the same doctor automatically since he 'does it all' without proper research is a mistake. Surgeons that are well-versed in one procedure, are not necessarily outstanding in another procedure. Very few are best in all areas or procedures. To suggest that a surgeon would be best for all procedures, is typically how 'highly talked up surgeons' are created in the first place.

Indeed: going back to his doctor does not preclude OP from asking about procedures here. But his inferior orbital rims are recessed: very few (almost no) surgeons do an osteotomy that includes the orbital rims. As per your post his doctor would be in the capicity to move the recessed areas in his face forward. I and a lot of people here I'm sure too, doubt any surgeon is willing to do a (modified) LFIII on a non-syndromic patient with the exception of Sinn. And people have consulted with all kinds of surgeons, also the 'not highly talked up ones' to be informed about that.

I let him know that he already had a good source of information to consult with.  Presumptuous to assume the doc is just well versed in one procedure. What's 'proper research'--your advice? His doc would be in capacity to advise on midface augmentation. Sorry you have a problem with that and practically personalize it as a threat to you and to the point you're doing the OP a disservice by telling him it's a 'mistake' to seek more info with his doc. Just LOL at your protestations.

ETA:
I didn't tell him to go in there asking about modified lefort 3. I suggested he go in there and look at the skull model where the bones that can be cut and moved are shown.

[kavan]

Your implication came off as such. Not to mention you had no problem 'reading into' my words with a misinterpretation. Whether or not the doc does modified L3 is for the OP to ascertain, whether or not he does it or advises against it . But not asking for it directly. Instead, just sitting down with the doc with a bone model and asking about procedures that could enhance his midface. If it's bone cuts, the doc will give his take on that. Likewise if other modality. I don't suggest he ask for mod L3 directly. Something like that is for the doc to suggest IF that's the thing he would suggest to bring out his midface.

I didn't assume his doc is just well versed in one procedure: I said few surgeons are well-versed in all procedures. You are quoting my words as something I never said and are giving an entirely different twist to my words, missy.
So his doc does the (modified) LFIII on non-syndromic patients? After all you said the OP should look into osteos to augment the recessed areas in his face. You said that his doc was the first to consult with since he does those osteos, and this is the only osteo that would augment the most recessed area in OP's face; the inferior orbital rims.

[kavan]

WTF is your problem with my suggesting he seek advice from his own doc and approaching as if he shouldn't. He can ask about possible bone cuts to bring out his mid face whether or not the doc performs them or suggests something else instead. His doc would be a good source of info whether or not he suggests a bone cut or other forms of augmentation. Seriously, you come off as affronted that I tell the OP he's got a good doc and HOW to discuss with him the prospect of midface augmenting.

Oh..and my apologies to the OP in the event he is affronted by my advice to him.

Indeed you didn't tell him to go in there and ask about modified LFIII. In detail you told him to go to his doc as he would be able to augment the recessed areas in his face via osteos. Again: the most recessed area in his face are the inferior orbital rims. It doesn't take an expert to reach that conclusion. There is only one osteo that can augment the inferior orbital rim: the (modified) LFIII. So your suggestion to ask his doctor to augment the recessed areas in his face via osteos would have been on spot only if his surgeon performs the (modified) LFIII (on non-syndromic patients). There's only one surgeon that has showed that he wants to do that, also among the 'not highly talked up ones' that we over here according to you don't know about, and that surgeon is Sinn.

With regard to your remark that you know his surgeon and I don't (have a clue what Im talking about): it doesn't take guesswork to know OP was not operated on by Sinn. Your advice is not solid in other words if you still maintain (as you did in your earlier post) the OP should consult with his surgeon as his surgeon does the osteos that would augment the recessed areas of his face.

As to your: "LOL at your protestations"

[kavan]

Again, sorry to hear you're all worked up and seem to take personal offence at my suggestions. Are you the OP's designated advice giver such that others are not allowed to give him feedback?

Sounds perfect. So if the doc doesn't do any osteos that move the inferior orbital rims (on non-syndromic patients), and I still think that chance is roughly 99,99999999999999% (even as someone who only knows the highly talked up docs if I rely on your accusations): you still think the doc is going to look into all avenues and recommend whatever may be best for OP.
It would be the same as asking an implant doc what would be better for OP: osteos or implants? Or asking a fat graft doc what would be better to augment the orbital rims: fat or osteos or implants. And to rely on that advice. You don't believe surgeons actually are selling stuff too and making an income?
OP, do your due research and inform yourself consulting with a lot of surgeons that perform the osteotomies/implant surgeries that could augment your zygoma's AND inferior orbital rims. Be aware that your own doc very likely does not perform an osteo that augments the most recessed area of your face: the inferior orbital rims if you consult with him, unlike what Kavan said in her post that she knows he can augment the recessed areas in your face with osteos. That doesn't mean he can't augment your inferior orbital rim using other modalities (fat/implants/fillers), just be aware that he likely won't advice you an osteotomy to augment the inferior orbital rim since he doesn't do it on non-syndromic patients. Not since he is offering you the best solution persé (not saying an osteo to the inferior orbital rim is a good idea as it is risky and invasive; just saying to inform yourself). Consult with lots of surgeons but also read up a lot in other words.

[kavan]

What you think or do in reaction to my post is not relevant and frankly: I can't care and don't want to spend time on that.

Same here.