Consulting with Sinn - modified lefort 3

[Lazlo]

Once more this whole topic seems hopeless.

First, the following pics are crap cause Dr. M. did other bi-max procedures on all patients, so of course they now look more normal. But they all supposedly had ZSO's. And guess what? None of their cheekbone/zygoma areas look any different if isolated in the before and afters. So the ZSO really does seem to be a waste of time.

https://www.academia.edu/6713049/2002_Aesthesic_malar_recontouring_zygomatic_sandwich_osteotomy._FPSCNA

[Lazlo]

We're just gonna have to wait to 2025. I thought 2020 would be the golden year of tissue re-engineering. But it looks like that date was optimistic.

[Lazlo]

Company like this could take our troubles away, but then we'd have to get the surgeons to use the bloody things.

http://www.bonusbiogroup.com/index.php/products/bonofill

[micjawsurgery]

So he moves the lateral orbital rim, zygoma and the inferior orbital rim. HA paste is used at the inferior orbital rim like beyondconfused said. Can't augment higher, he told me he could inject HA granules to augment the brow bone, but this procedure is only for cheekbone and eye support. He can change the cuts to do some lateral augmentation as well - I'm pretty interested if he can widen the lateral orbital rim by a few mm to widen the eyes.

He does a computer simulation surgery with a CT scan to pre shape the titanium plates that need to get put in as part of the surgery. Unfortunately soft tissue changes can't be modelled so the end result is not totally predictable. He said chance of blindless and vision problems is very low but I may lose some feeling in the sensory nerves in the orbital area.

I was told I'm a good candidate for the surgery. Will get a genio too if I can budget it in

[Lazlo]

So he moves the lateral orbital rim, zygoma and the inferior orbital rim. HA paste is used at the inferior orbital rim like beyondconfused said. Can't augment higher, he told me he could inject HA granules to augment the brow bone, but this procedure is only for cheekbone and eye support. He can change the cuts to do some lateral augmentation as well - I'm pretty interested if he can widen the lateral orbital rim by a few mm to widen the eyes.

He does a computer simulation surgery with a CT scan to pre shape the titanium plates that need to get put in as part of the surgery. Unfortunately soft tissue changes can't be modelled so the end result is not totally predictable. He said chance of blindless and vision problems is very low but I may lose some feeling in the sensory nerves in the orbital area.

I was told I'm a good candidate for the surgery. Will get a genio too if I can budget it in

Good luck. When is your surgery? A lot of us are rooting for you.

[micjawsurgery]

Waiting on a price quote and then I’ll probably book it in a couple months if I decide to go through with it. If I do go through I’ll be sure to follow up with some pictures after I heal.

I’ve seen the difference 4mm implants can make in this area so 7-8mm of augmentation sounds pretty good to me

[Lazlo]

Waiting on a price quote and then I’ll probably book it in a couple months if I decide to go through with it. If I do go through I’ll be sure to follow up with some pictures after I heal.

I’ve seen the difference 4mm implants can make in this area so 7-8mm of augmentation sounds pretty good to me

That's awesome. I have a couple questions of concern though. I have seen a before and after and I didn't think the changes were significant. But of course your mileage may vary.

Moreover, the operation does not seem to provide the type of augmentation us males (and females) are looking for. Specifically where the upper cheekbone has a chiseled and protrusive look. Instead, the modified lefort III, I have a fear may just provide more bulkiness or fullness in the anterior dimension in a way that isn't particularly aesthetic.

Here are some examples of what I mean:

https://www.semanticscholar.org/paper/%22Modified-Oblique-Le-Fort-III-Osteotomy%22-New-S%C3%A1nchez-Flores/e2a1b75323fa44c44c6f288a8ad7fe0542f1e815


Or I'm afraid you just end up with these sort of pudgy cheeks like this male patient below. I really see no evidence this operation provides you with the high, chiseled cheekbone look. Or even augments the cheekbone in the vectors that will give you the S curve.

http://jawsurgeryforums.com/index.php?topic=548.0

Have you thought about these issues or how to achieve a more aesthetic result?

[Lazlo]

I'd like to propose something for us to figure out. If surgeons regularly do CT scans of skulls, can we find the CT scan of a skull that has the features we would find most aesthetic. Like I'm thinking, a CT Scan of a skull that's close to Henry Cavill's proportions. IF we also had a CT scan of our own skull then we could lay one on top of another and figure out which areas need to augmented and in which vectors. Sure the soft tissue wouldn't be perfect, but that can be fixed through other means. It's figuring out the what parts of the skull are prominent in the most idealized types would at least allow us to figure out where and how bone needs to be moved.

Honestly, I think no matter how many times you might show a surgeon pics of what you want to achieve and they agree that they will produce those results --they either wilfully ignore you or dissimulate in their responses to get you to go along with the surgery.

So I think we need to get more scientific about these things.

My buccal fat removal procedure was indicated so that I would achieve my idealized type. But because I had weak cheekbones, and the surgeon should have known this if he already didn't, it was disastrous to my face making it look like I have two indentations from some sort of cancer in my face.  I'm going to have to spend thousands to fix this, if it can even be fixed.

So I'm not going forward with any surgery unless I know it will move me in the direction i actually want to go. I can't believe how much this mfl3 is being pushed when most of us have no idea what result it will produce.

[micjawsurgery]

I think the 2nd result is actually very good. First one his orbitals are very setback compared to his lower cheeks, the 7mm movement could never be enough.

I’m not to worried about angularity to be honest. I’m more hoping this procedure reduces my tear trough and dark circles that come from hollowness of the area. I look rather boyish to begin with so I’m ok with just more projection.

Fat storage and soft tissue play a pretty big role too. If I had more fat in the upper cheekbone and under eye region I probably wouldn’t need this procedure, it’s just all my fat is stored in he mid-low cheek region.

Will probably try soft tissue in the upper cheeks and lower eyes after this.

[Lazlo]

I think the 2nd result is actually very good. First one his orbitals are very setback compared to his lower cheeks, the 7mm movement could never be enough.

I’m not to worried about angularity to be honest. I’m more hoping this procedure reduces my tear trough and dark circles that come from hollowness of the area. I look rather boyish to begin with so I’m ok with just more projection.

Fat storage and soft tissue play a pretty big role too. If I had more fat in the upper cheekbone and under eye region I probably wouldn’t need this procedure, it’s just all my fat is stored in he mid-low cheek region.

Will probably try soft tissue in the upper cheeks and lower eyes after this.

well, i guess you are okay with having a full midface, without the S curve. The procedure may meet your goals, i really don't know. Regardless it will be helpful for us all to learn about your results so thanks for sharing.

To my mind, however, I think a combination of osteotomy and AGGRESSIVE filler work may be the only options.

I'm convinced only implants can actually solve the problem because the problem is one of shape, not projection necessarily. So....since I don't want synthetic implants I'll wait for bioprinting to take off in teh next several years...

[micjawsurgery]

Sorry I didn’t know you meant the ogee curve when you said S. I do have the S curve already since my face and cheekbones are actually too wide - I look better in selfies compared to photos from 5m away due to how it makes my inner face (eyes, nose, mouth) appear larger relative to my skull. It’s why cheekbones reduction and small skull sizes are very popular in Korea since it provides much better harmony.

I also think the upper part of the S curve isn’t really that important, it’s just most people have their lateral orbital rims setback compared to the cheeks.

[beyondconfusedtbh]

Sinn's procedure will definitely give you MORE of an ogee curve but the final product heavily depends on what you started with.

[Lazlo]

Sinn's procedure will definitely give you MORE of an ogee curve but the final product heavily depends on what you started with.

How do you know if it will give you more of an OGEE curve?

[ben from UK]

Ogee curves of the result of cheekbone, jawangles and chin. Very few people have the ogee curve, cause you need all three of that to have it. 

[beyondconfusedtbh]

Ogee curves of the result of cheekbone, jawangles and chin. Very few people have the ogee curve, cause you need all three of that to have it.

Too general. There's many other factors, the correct combination of these is what creates the ogee curve. I'd say the most important are cheekbones & projection of both jaws.