I need help with finding maxfac's in europe

[josh5464]

I have a recessed midface/maxilla, decent ammount of scleral show and negative orbital vector. My face changed a lot from when I was a kid and before I began chronic mouthbreathing, 7-15 yo I breathed solely through my mouth day and night, the changes are clear everything I complain about now was never present before, I look like I'm aging at 16  . I have TMJ and possibly other functional issues I'm still being assessed by an orthodontist and getting scans/tests done. My appearance really affects my esteem, I have all the features that come with recessed maxilla but my bite is class 1 and obv I don't have any syndrome except for probably a short face pattern if that counts. I'm going to have a consult with a local maxillofacial surgeon here in New Zealand but I'm also traveling to Bulgaria with my family in June and from there I have access to anywhere in Bulgaria, Greece and Turkey up to Istanbul. I've been doing a lot of research into the Lefort III procedure and read Earl's story and many others, I am willing to accept the risks of a Lefort III for mainly aesthetic but to a lesser extent functional reasons. I think that as far as aesthetics I'm a perfect candidate for Lefort III, the changes to nose, eyes, cheeks, etc. fix all the aesthetic issues I+other people see in myself, none of the changes would have a negative effect on my face and in fact all of them would increase my looks. According to many people online US and Europe are both places where there's surgeons willing to do Lefort III's on non syndrome patients but although I found a list of surgeons names for the US there doesn't seem to be a lot of sources for Europe. I've searched online and I could barely find any maxfac surgeons in Bulgaria and strangely in Turkey I couldn't find many which ik is not true because Turkey is such a huge country and apparently a tourist destination for plastic surgery and maxillofacial surgery. I don't really know what terms to use or where to search, I've tried searching for boards but the board websites never list names of surgeons, I also found dental clinics with maxfac surgeons on staff but I'm not sure if this is where I should be looking for what I want. For Greece though I came up with tonnes of results for maxillofacial surgeons just in Athens which is strange because Athens is so small. Is Greece a better place to get surgery than Turkey? Will it be as affordable and will the surgeons be less willing to do invasive procedures? Any information is really helpful.

If anybody has reccomendations for any maxillofacial surgeons at all in these areas even ones they have heard nothing about just names that'd be really helpful or advice on where to look online/irl for reputable surgeons because atm I'm pretty confused on where I should be searching especially for surgeons who do/have done Lefort III osteotomies. A list of surgeons who are well known for cosmetic maxfac surgery or performing lefort III's on non syndrome patients like the one for the US would be even better.

Also I'm only researching this, if I can't/shouldn't get a Lefort III, I will probably get a Lefort I or SARPE anyway because I suspect I have sleep apnea and I already have been told by ortho I have narrow palate and referred me to some airway scans I'm taking next wednesday. If I do get either of the less invasive surgeries it will be only for functional, they will only make me look worse if my midface is still retruded. Nothing but a Lefort III can improve my midface or make it not retruded.

[temporeiches13]

Hey, first of all its quite unlikely any surgeon is going to offer a lefort 3 for aesthetic reasons. Secondly, and most importantly you are only 16 meaning surgeons are hesitant to perform such surgeries before your bones have settled in, since they are still very malleable. This means if you acquire the right oral posture and stop mouth breathing, then over time your face will develop into its natural form. There may also be less invasive methods available to fix your issues. I would wait and see until you are around 20 to go ahead with such a surgery for aesthetic reasons. For now just ask the doctor what can be done without any invasive surgery. Hope that helps.

[josh5464]

Hey, first of all its quite unlikely any surgeon is going to offer a lefort 3 for aesthetic reasons. Secondly, and most importantly you are only 16 meaning surgeons are hesitant to perform such surgeries before your bones have settled in, since they are still very malleable. This means if you acquire the right oral posture and stop mouth breathing, then over time your face will develop into its natural form. There may also be less invasive methods available to fix your issues. I would wait and see until you are around 20 to go ahead with such a surgery for aesthetic reasons. For now just ask the doctor what can be done without any invasive surgery. Hope that helps.

Here in NZ yes but in the places I'm going I believe surgeons might be less hesitant. I'll accept that I'm too young and I go over to Bulgaria yearly so I can wait couple years but I wish I could be a confident normal looking teenager I feel like that was stolen from me. I am correcting my oral posture but aesthetically nothing will change, if it does itll be very gradual and my recession is really everywhere and will always be there without surgery maybe just to a slightly lesser extent, and it will happen so slowly possibly not at all. I'm at the end of puberty maybe even already finished.

 Invasive is really just a word to me, the surgery itself's gross as (I've watched videos of the procedure being done) but surgeons deal with that gruesome stuff all the time and I don't see why the invasiveness of the procedure is an issue at all, it just looks bad, what really matters to me is risks, and even then the only risk that I would not trade for the benefits of a Lefort is blindness and the chances of that happening are <1%, same as implants and those can be done on anybody. A Lefort 3 would have the same functional purposes as a Lefort 1 right? expand airway,etc. But it's true though that my functional problems can probably all be fixed with less invasive surgeries. But I' can't lie to myself and go out in public thinking that the clothes I brought were worth any money because they make me look good, or that my haircut makes me look smart, and I think that's an issue that affects people a lot more than it's easy to show. The girl in pic had a lefort 3 but like me she was ugly and unnatural/not normal looking but she wasn't deformed and she looks around my age but I can understand waiting till I'm older.

[temporeiches13]

LeFort 3 should really only be reserved for serious cases. Trust me, I wish I could have it done to magically improve everything that I complain about. But that's not going to happen since the risk is too great for the doctor and honestly for most people lefort 1 is more than enough if the cheekbones are also enhanced. So the little more you would get from LF3 is not worth the insane increase in costs and danger simply for aesthetic reasons. If you had some serious medical reasons then obviously this would be a different story. Best thing you can do for now is go see a surgeon with your parents. Before you do that just go on living life normally.

[kavan]

Oh, so you 'know' you are a perfect candidate for L3 do you and you want to follow Earl's story, do you?

Well, to the best of my knowledge (and Earl can correct me if I'm wrong), Earl spent a few YEARS reading med journal articles on Lefort3's and modified L3s. In each journal article about the topic there is a BIBLIOGRAPY of REFERENCES to other articles written by other doctors and he looked at the other articles and from there selected surgeons conversant in what he thought he needed and he CONSULTED with them.

He didn't ask, to be handed on a PLATTER, a list of (modified) L3 doctors in a variety of countries he was planning to visit for other reasons. So, the fact that you are wanting names of docs in countries you are visiting to be handed to you on a platter is not 'Earl's story'.

So, hunker down and start reading a LOT of journal articles. Let's hope at age 16 you are are somewhat of a PRODIGY with the intellectual capacity to 'digest' all that's conveyed in them in enough time to track down doctors in the countries you will be vacationing in.

Even Earl, who's very bright and older, more experienced than you, took a few years for this research and consulting and did this without being SPOON FED a list of docs to consult with. Let's see you do that. So, NO spoon feeding for you. If you want to follow Earl's story, do the ACADEMIC research which should allow you to track down doctors for this ALL BY YOURSELF.

End of story. Next case.

[Lestat]

@josh5464

Hello. I have read your story and would like to help you. There are very few surgeons who would perform a Mod. Lefort 3 on you purely for aesthetic reasons. I know five and only one of them is from Europe. If I were you, I would forget Lefort 3 and look for a High Lefort I. There are some surgeons doing this and the result is very similar to that of a Mod. Lefort 3 (at a much lower risk). I've seen before and after photos of High Leforts I and they are very similar to the girl you posted.

[temporeiches13]

@Lestat you seem like someone with a lot of experience... could you look at my post real quick and give me your opinion?

@josh5464 it seems that most members here have said what I told you before. I think you should really take the word of the other members, they are quite experienced. Do not let this get you down and rather focus on what you can improve right now to prevent your situation from "worsening".

[tim06]

@josh5464

Hello. I have read your story and would like to help you. There are very few surgeons who would perform a Mod. Lefort 3 on you purely for aesthetic reasons. I know five and only one of them is from Europe. If I were you, I would forget Lefort 3 and look for a High Lefort I. There are some surgeons doing this and the result is very similar to that of a Mod. Lefort 3 (at a much lower risk). I've seen before and after photos of High Leforts I and they are very similar to the girl you posted.

I would also be interested to know which doc would even consider to do a Lefort 1 only for aesthetic reasons from Germany/Europe.

[Lestat]

I would also be interested to know which doc would even consider to do a Lefort 1 only for aesthetic reasons from Germany/Europe.

If someone has a Retroface (opposite of Anteface), there are without any doubt a few surgeons who would agree to it (High Lefort I). Or did you not notice the before and after photo above?

[kavan]

That's the  Obwegeser girl in the photo. Lefort3.  Her retrusion was in the Lefort 3 area.

[kavan]

I would also be interested to know which doc would even consider to do a Lefort 1 only for aesthetic reasons from Germany/Europe.

Remember 'only for aesthetic reasons' implies it WOULD look better if done. If part of your problem is excess PROTRUSION, no doc is going to do a Lefort 1 advancement for 'aesthetic' reasons because it would be ANTI-aesthetic. Haven't you figured out by now given the feedback you got here as to where your protrusion is, in addition to doctors telling you the protrusion you have PRECLUDES their doing a L1 advance (with BSSO) that you're not a candidate for L1 advance???

[josh5464]

Honestly this is all bull, In my opinion I was failed by every doctor/orthodontist I went to as a kid, and now my orthodontist is recommending me braces for my perfectly straight teeth because he says it'll make my palate look wider. This is a joke. How is it my fault my nose was blocked for 8 years straight, 24/7? And now you make it sound like I'm being some entitled runt for asking for help on jawsurgeryforums.com.

Let's see you do that. So, NO spoon feeding for you. If you want to follow Earl's story, do the ACADEMIC research which should allow you to track down doctors for this ALL BY YOURSELF.

I don't care about following Earl's story, and this isn't a game for you or anybody to see if I'm smart enough to find the best maxillofacial specialists on my own. I just want some help and I know I will have to put work in because that's just simply how the world works, but I don't see why I deserve for it to be so difficult, it sounds to me like you want it to be harder for me to find maxillofacial surgeons. I've seen Earl's posts on other forums asking for similar help/advice. There IS a list of maxillofacial surgeons in the US who do this procedure on non-syndromes and if I was living in the US I would consult with these surgeons but I can't, no problem but it just makes it harder.

 That's impressive Earl did that he must've been very determined because I have the same determination for this as he did and I will read journals and find surgeons that same way because it sounds like I will learn a lot about the procedure I'm asking for but finding journals for in these countries is a lot harder online and I just wanted to know if there's any other methods.

Another reason I made this post is that Turkey has a huge online presence with similiar websites to this one and probably people discussing Lefort III's the way they are discussed here but it's difficult for me to get much information out of these sites so if anybody Turkish could help out with any info at all that would be greatly appreciated. Sorry there's not much I can offer.

[kavan]

Honestly this is all bull, In my opinion I was failed by every doctor/orthodontist I went to as a kid, and now my orthodontist is recommending me braces for my perfectly straight teeth because he says it'll make my palate look wider. This is a joke. How is it my fault my nose was blocked for 8 years straight, 24/7? And now you make it sound like I'm being some entitled runt for asking for help on jawsurgeryforums.com.

I don't care about following Earl's story, and this isn't a game for you or anybody to see if I'm smart enough to find the best maxillofacial specialists on my own. I just want some help and I know I will have to put work in because that's just simply how the world works, but I don't see why I deserve for it to be so difficult, it sounds to me like you want it to be harder for me to find maxillofacial surgeons. I've seen Earl's posts on other forums asking for similar help/advice. There IS a list of maxillofacial surgeons in the US who do this procedure on non-syndromes and if I was living in the US I would consult with these surgeons but I can't, no problem but it just makes it harder.

 That's impressive Earl did that he must've been very determined because I have the same determination for this as he did and I will read journals and find surgeons that same way because it sounds like I will learn a lot about the procedure I'm asking for but finding journals for in these countries is a lot harder online and I just wanted to know if there's any other methods.

Another reason I made this post is that Turkey has a huge online presence with similiar websites to this one and probably people discussing Lefort III's the way they are discussed here but it's difficult for me to get much information out of these sites so if anybody Turkish could help out with any info at all that would be greatly appreciated. Sorry there's not much I can offer.

Look you little s**t, you came here diagnosing yourself for having what Earl had and wanting to do what Earl did and I told you how Earl went about finding the right procedure for him. He used his smarts and with no spoon feeding. If you want help, don't come off as IF you know 'exactly' what you need and related to exactly what someone else had and expect your assessment to be accepted a priori via no direct observation as to what you have.

I for one will not be doling out doctor's names for Lefort 3 in the absence of seeing if a person really needs that.

[josh5464]

Look you little s**t, you came here diagnosing yourself for having what Earl had and wanting to do what Earl did and I told you how Earl went about finding the right procedure for him. He used his smarts and with no spoon feeding. If you want help, don't come off as IF you know 'exactly' what you need and related to exactly what someone else had and expect your assessment to be accepted a priori via no direct observation as to what you have.

I for one will not be doling out doctor's names for Lefort 3 in the absence of seeing if a person really needs that.

If you have a retruded entire midface then you need a Lefort III advancement to fix that yes? Need not as in it's something that you need to get because Lefort 3 is obviously very invasive but need as in the lefort 3 advancement advances the whole midface and that's just a fact. Maybe I shouldve mentioned that I've been to an orthodontist who told me I had a narrow palate, that my chronic mouthbreathing had caused problems with the growth of both of my jaws and that he referred me to airway and other scans and xrays which I'm only getting done next week. I know that the next step after that is visiting a local maxfac surgeon for a consult, but I don't trust nz surgeons to perform anything on me, they are notoriously dodgy see Ben's posts. And I don't know if this could be relevant at all but he said my biggest problem was bruxism and "if you keep going the way you are there won't be much tooth enamel left in a couple of years". I also have trouble sleeping and I used to think it was unrelated but I have occasional night terrors (like sleepwalking but with thrashing/shouting), which rarely occurs in adults except for with sleep apnea.

Anyway here's a photo of me now and a photo of me as a kid before my nose started to be blocked. I'm 16 lean and fit. Usually when people see me they think I'm indian/arab or that the way I look is related to my ethnicity, no offense, because I have droopy "bug" eyes, weak jaw, seemingly over portruding nose, but to me I think these are all caused by the retrusion I'm not 100% sure though any of your opinions are welcome. My dad is a brit and my mum is bulgarian, I looked like both of them when I was a kid and none of the features I explained that I have now were present and nobody else in my family (mum, dad, sister) has them, because of that I look like a foreign exchange student when I'm in public with them lol. When I showed my mates a photo of me when I was younger they thought I was showing them a photo of some "white kid". I'm getting offtopic with this explanation of my race but I think it's relevant because of how many people assume I look this way because I'm an ethnicity which I'm not. I don't think I need to show you a profile of me when I was a kid to tell you that I was healthy, normally developed.

I know I'm not the worst case out there but I have the privilege of being able to fix my issues if needed with a maxfac surgeon if I can find one. Now will you tell me, does it look like my midface is retruded? And sorry for the way I came off before when I said this is all bull I was talking about past orthodontists/doctors who treated me, your responses are appreciated.

[josh5464]

here's another pic showing my eyes because last post hit attachment size limit