Seeing a reputable pricey surgeon for consult? And any cheaper quality options?

[scramfranklin]

Hey all. This is a two part question. I decided to go through with double jaw surgery and most likely additional genioplasty. Obviously the first step is a consultation.

1. Would it be worth it to go to a very reputable, pricey surgeon for a consultation? Then use that info to get surgery from a cheaper option if out of network insurance doesn't come through for any reason?

2. If that ends up happening, any recommendations for cheaper, but high quality surgeons? You are welcome to pm me if you don't want to say it here. I don't really care where it is... but I can't afford 50-100k out of pocket right now.

[kavan]

Well, if you go to Gunson, who would be considered very reputable and pricey, and if his plan involves a significant posterior downgraft, the chances get LOWER for other less expensive doctors to carry out his plans. On the other hand, if your case is straight forward and the plan shows that, your chances are HIGHER of having the plan carried out by a less expensive doctor.

[ditterbo]

Well, if you go to Gunson, who would be considered very reputable and pricey, and if his plan involves a significant posterior downgraft, the chances get LOWER for other less expensive doctors to carry out his plans. On the other hand, if your case is straight forward and the plan shows that, your chances are HIGHER of having the plan carried out by a less expensive doctor.

...And if anyone happens to be in the former category and finds a "less expensive" doctor that can perform Gunson's posterior downgraft, PLEASE LET ME KNOW.

[PloskoPlus]

The problem is that some surgeons claim to do CCW with posterior down grafting, but in fact don't.

[Meefly]

I don't think there would be an issue per se with that approach, scramfranklin.  But you may find that a) The in demand reputable surgeon charges significant appropriate amount to draw up a plan, b) Another surgeon might not be prepared, nor able to carry out another doctor's plan.

 This is bad news for me re what Kavan said as I'm pretty sure I need some posterior down grafting; in the interest of not wasting mine and surgeries time, does anyone know which European surgeons routinely carry out posterior downgrafts?

[scramfranklin]

Well, if you go to Gunson, who would be considered very reputable and pricey, and if his plan involves a significant posterior downgraft, the chances get LOWER for other less expensive doctors to carry out his plans. On the other hand, if your case is straight forward and the plan shows that, your chances are HIGHER of having the plan carried out by a less expensive doctor.

Makes sense, thank you.

[kavan]

I don't think there would be an issue per se with that approach, scramfranklin.  But you may find that a) The in demand reputable surgeon charges significant appropriate amount to draw up a plan, b) Another surgeon might not be prepared, nor able to carry out another doctor's plan.

 This is bad news for me re what Kavan said as I'm pretty sure I need some posterior down grafting; in the interest of not wasting mine and surgeries time, does anyone know which European surgeons routinely carry out posterior downgrafts?

I think Gunson is over $500 for the in person consult where he draws up the plan. If the displacements aren't too 'esoteric' relative to what maxfax docs do/prefer to do and happen to be straight forward enough relative to what the local maxfax up the street could do, they might be happy their 'work is cut out for them' to follow a Gunson plan. In that scenario, an 'unknown' local guy who could do could also be significantly LE$$.

As to 'known reputable' docs who could be somewhat less $, they might not agree with Gunson's aesthetic and have a preference for their OWN plans.

As to docs in Europe who do the posterior down graft, Alfaro is 'known' to do that.

Also note that the ACT of DOING a posterior down graft can be done by a variety of docs. It is the EXTENT of it, that separates Gunson from a lot of other maxfax docs.

[Meefly]

As to docs in Europe who do the posterior down graft, Alfaro is 'known' to do that.

Also note that the ACT of DOING a posterior down graft can be done by a variety of docs. It is the EXTENT of it, that separates Gunson from a lot of other maxfax docs.

Ok, thanks Kavan; I was kind of veering away from alfaro after being messed around arranging an in person consult, and after seeing and reading a few things about his ability with combined bimax advancement and Rhino (of which I think mine is a relatively complex case). Do you know if Johnson or raffaini do posterior downgrafts?

[kavan]

As to docs in Europe who do the posterior down graft, Alfaro is 'known' to do that.

Ok, thanks Kavan; I was kind of veering away from alfaro after being messed around arranging an in person consult, and after seeing and reading a few things about his ability with combined bimax advancement and Rhino (of which I think mine is a relatively complex case). Do you know if Johnson or raffaini do posterior downgrafts?

I don't know.