how to make the most of a consultation?

[beautyislife]

I feel like I'm not making the most of my consultations. I want to make sure I'm using both my time and the doctor's time wisely. I tend to ask the same set of questions, but I'd like some extra input on what more I could be doing and could be asking. I have started to realize I'm getting some different responses from surgeons though.

Question I tend to ask (these are the important concerns to me, which I understand may be a place for subjectivity depending on what people value):
- Measurements / CCW rotation?
- How will the movements impact my mid face? I have a flat cheek area and am worried about this being exaggerated and what can be done to compensate?
- How will the operation impact my eye area? Will this appear more deficient?
- What are the plans to mitigate my nose widening?
- Will my jaw angles be more towards 90deg? By how much?
- What is the impact on the ramus?
- Will my upper lip curvature be fixed?
- What is the stability of the movements? How often do you see relapse? What can be done to prevent this?
- What happens in cases of me needing revision?
- Material used to fill in gaps?
- Will you remove the plates + screws? How difficult is this? Does this impact any of the cosmetic results/soft tissue?


I've often debated bringing in some images that Ive edited that look ok result wise to see if they can match that, but I'm unsure how wise that is.

[kavan]

I've labeled some questions as; 'WOT'= Waste of Time. Others with suggestions to ask a better question and others as 'NOWOT'= No Waste of Time.



- Measurements / CCW rotation?    WOT
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It's not as if numbers and degrees of rotation alone are going to allow you to visualize the outcome.
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- How will the movements impact my mid face? I have a flat cheek area and am worried about this being exaggerated and what can be done to compensate?
- How will the operation impact my eye area? Will this appear more deficient? WOT
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Those questions are only applicable if you are getting the UPPER midface cut into or if you are getting any kind of augmentation to the orbital rim and/or cheek bone area. They are not applicable to a standard Lefort 1 which doesn't actually alter the area. The simple answer is: 'That area won't change.' You would have to use your own imagination regarding whether or not a more advanced Lefort 1 area will make the deficient area ABOVE that BOTHER you MORE than it bothers you NOW.
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- What are the plans to mitigate my nose widening?
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Would depend on if you're getting surgery for better breathing. If so, wider nose base makes for better breathing--OR--you could just ask if an ALAR CINCH (used to decrease excess widening) will be done.
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- Will my jaw angles be more towards 90deg? By how much?
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The jaw angle itself doesn't change with bi-max surgery. If it's however, a chin wing you're getting that cuts into the jaw angle, it can be pryed down to 'drop' the jaw angle providing the movement of the chin wing is not also aimed at forward advancement to augment the chin area. Otherwise, it could tend to blunt the jaw angle.
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- What is the impact on the ramus?
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Better question is: 'How will the BORDER OF THE MANDIBLE change?'
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- Will my upper lip curvature be fixed?
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You would have to be able to tell the doctor what's bothering you about it
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- What is the stability of the movements? How often do you see relapse? What can be done to prevent this? NOWOT
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- What happens in cases of me needing revision? NOWOT
---------------------------------------------
- Material used to fill in gaps? NOWOT
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- Will you remove the plates + screws? How difficult is this? Does this impact any of the cosmetic results/soft tissue?


ETA: Ultimately what you want to ask is:

'Can you show me a visual of your aesthetic vision for me?'

[beautyislife]

- How will the movements impact my mid face? I have a flat cheek area and am worried about this being exaggerated and what can be done to compensate?
- How will the operation impact my eye area? Will this appear more deficient? WOT
-------------------------------------------------------------------------------
Those questions are only applicable if you are getting the UPPER midface cut into or if you are getting any kind of augmentation to the orbital rim and/or cheek bone area. They are not applicable to a standard Lefort 1 which doesn't actually alter the area. The simple answer is: 'That area won't change.' You would have to use your own imagination regarding whether or not a more advanced Lefort 1 area will make the deficient area ABOVE that BOTHER you MORE than it bothers you NOW.
----------------------------------------
- Will my jaw angles be more towards 90deg? By how much?
-------------------------------------------------------
The jaw angle itself doesn't change with bi-max surgery. If it's however, a chin wing you're getting that cuts into the jaw angle, it can be pryed down to 'drop' the jaw angle providing the movement of the chin wing is not also aimed at forward advancement to augment the chin area. Otherwise, it could tend to blunt the jaw angle.
---------------------------------------
- What is the impact on the ramus?
---------------------------------------
Better question is: 'How will the BORDER OF THE MANDIBLE change?'

ETA: Ultimately what you want to ask is:

'Can you show me a visual of your aesthetic vision for me?'

Thanks. I quoted the above since I had questions.

The mid face - are you saying that I will need to decide whether the illusion of a more recessed mid face is better or worse for me? Since there's no movement, I imagine it will just look more setback

Jaw angle - I was always under the impression that CCW achieved a more flat jawline/closer to 90deg? If that not the case? Does this mean that even with a CCW, the lower jaw is simply slid forward keeping the current angle? Does bimax itself blunt the angle or are you saying a chin wing with focus on chin would?

Border of Mandible - do you know if the ramus length is not impacted during bimax?

[kavan]

Thanks. I quoted the above since I had questions.

The mid face - are you saying that I will need to decide whether the illusion of a more recessed mid face is better or worse for me? Since there's no movement, I imagine it will just look more setback

Jaw angle - I was always under the impression that CCW achieved a more flat jawline/closer to 90deg? If that not the case? Does this mean that even with a CCW, the lower jaw is simply slid forward keeping the current angle? Does bimax itself blunt the angle or are you saying a chin wing with focus on chin would?

Border of Mandible - do you know if the ramus length is not impacted during bimax?

Yes. I am saying you will have to use your imagination whether or not your upper midface will look more set back to YOU.

The angle of the back of your jaw bone is the angle the ramus makes with the 'body' of the mandible. THAT particular angle stays SAME. However, that whole angle is ROTATED with CCW.
bIMAX does NOT blunt the angle.

ramus length should stay the same with most BSSO techniques.