Anyone Have any Experience with Dr. Yaremchuk in Boston?

[ben from UK]

I had a procedure done with Yaremchuk. My personal opinion, in my case: he's good and precise. The best I've been to. What i noticed was the tight discipline with him and his assistants. I had the feeling Yaremchuk was transfering his knowledge to his Asian American assistant, and I think his assistant is a talent. He was also honest to me when I asked him questions. Most important, the result is very good. Yaremchuk was the only surgeon that knew what to do aestehtically and executed it very well (and I've been to many). I don't know if yaremchuk did the procedure himself or his assistant did the procedure under supervision of yaremchuk. I don't think it matters. His assistant is clearly a talent and they're both perfectionists.  My story doesn't have to correspond with other people's experience of course. It's only my experience.

[Lefortitude]

hes certainly refined practice of using medpor for cosmetic facial surgery.

[ben from UK]

I think silicone will be replaced by PEEK or another material. Eppley is already offering PEEK (probably recently approved in the US for facial implants). There's not enough data yet about PEEK, but it will come.

[ben from UK]

By the way, i had an exterior approach, which is in my opinion way better than the interior approach.

1) I suppose there's little time before the swelling comes up. A surgeon needs to 'see' the result of an implant on the face. Suppose a surgeon does the interior approach. He puts the implant in, but it happens to be too big or there are parts that aren't suppose to be there and need to be cut off. How much needs to be shaven off? You just don't know precisely. With the exterior approach, it's easier to see what should be done to get it right (it's a matter of millimeters, sometimes 0.5 millimeters).
2) chances of infection are almost zero if not zero.
3) you get two small scars just under the chin on the neck. As ironically as it sounds, these scars slightly add to your attractiveness as a male (this is scientifically proven). They're not visible on the face, just at the right place.

Maybe I'm wrong, but I don't know why surgeons don't use the exterior approach more often.

[kavan]

By the way, i had an exterior approach, which is in my opinion way better than the interior approach.

1) I suppose there's little time before the swelling comes up. A surgeon needs to 'see' the result of an implant on the face. Suppose a surgeon does the interior approach. He puts the implant in, but it happens to be too big or there are parts that aren't suppose to be there and need to be cut off. How much needs to be shaven off? You just don't know precisely. With the exterior approach, it's easier to see what should be done to get it right (it's a matter of millimeters, sometimes 0.5 millimeters).
2) chances of infection are almost zero if not zero.
3) you get two small scars just under the chin on the neck. As ironically as it sounds, these scars slightly add to your attractiveness as a male (this is scientifically proven). They're not visible on the face, just at the right place.

Maybe I'm wrong, but I don't know why surgeons don't use the exterior approach more often.

Did Y change his technique. He used to do the jaw implants from inside the mouth where as Ramirez would sometimes place them from an outside incision.

[ben from UK]

Did Y change his technique. He used to do the jaw implants from inside the mouth where as Ramirez would sometimes place them from an outside incision.

No, it was an exception in my case because I needed the risdon approach.

But I just thought about it in general, it seems more logical to do it from the outside for practical and aestethical reasons.

Imagine putting it from the inside. Implant happens to be too big. Surgeon has to take it out, doesn't know precisely how much he should shave (and he needs to do it twice). As opposed to the exterior approach: put the implant in from the outside at both sides, immediately see if there's symmetry or not, if it's too big or not or if some parts need to be cut off. Then carving until both sides fit the face, immediately seeing the results.

I can immagine there's only so much time before swelling goes up and the surgeon can't 'see' anything anymore. Internal approach might take longer.

Maybe I'm wrong, I just thought about it. Even if an implant is too small, the surgeon might shave it in a way to improve the angularity or shave part of the upper side of jawbone (hypothetically). I immagine it would be easier to achieve the ideal aesthethic shape from the outside. It would be more like sculpturing instead of puzzling.

[kavan]

No, it was an exception in my case because I needed the risdon approach.

But I just thought about it in general, it seems more logical to do it from the outside for practical and aestethical reasons.

Imagine putting it from the inside. Implant happens to be too big. Surgeon has to take it out, doesn't know precisely how much he should shave (and he needs to do it twice). As opposed to the exterior approach: put the implant in from the outside at both sides, immediately see if there's symmetry or not, if it's too big or not or if some parts need to be cut off. Then carving until both sides fit the face, immediately seeing the results.

I can immagine there's only so much time before swelling goes up and the surgeon can't 'see' anything anymore. Internal approach might take longer.

Maybe I'm wrong, I just thought about it. Even if an implant is too small, the surgeon might shave it in a way to improve the angularity or shave part of the upper side of jawbone (hypothetically). I immagine it would be easier to achieve the ideal aesthethic shape from the outside. It would be more like sculpturing instead of puzzling.

Oh, OK. thanx

[Lestat]

Thanks for the infos Ben! What did Y tell you about bone erosion? And is it common that facial implants get infected?

[Bowie]

I had a procedure done with Yaremchuk. My personal opinion, in my case: he's good and precise. The best I've been to. What i noticed was the tight discipline with him and his assistants. I had the feeling Yaremchuk was transfering his knowledge to his Asian American assistant, and I think his assistant is a talent. He was also honest to me when I asked him questions. Most important, the result is very good. Yaremchuk was the only surgeon that knew what to do aestehtically and executed it very well (and I've been to many). I don't know if yaremchuk did the procedure himself or his assistant did the procedure under supervision of yaremchuk. I don't think it matters. His assistant is clearly a talent and they're both perfectionists.  My story doesn't have to correspond with other people's experience of course. It's only my experience.

That all sounds very encouraging, thanks for sharing. I look forward to consulting with him.

[Bowie]

He said the implants would be silicone in my case and that bone erosion is not an issue. He said it sometimes happens but not in a clinically significant amount.

Hmm I was told by a doctor - who will probably take over Sailer's practice when he retires - that when she worked in Zurich University she saw many cases where they removed chin implants and the erosion was *significant*.

[ditterbo]

No, it was an exception in my case because I needed the risdon approach.

But I just thought about it in general, it seems more logical to do it from the outside for practical and aestethical reasons.

Imagine putting it from the inside. Implant happens to be too big. Surgeon has to take it out, doesn't know precisely how much he should shave (and he needs to do it twice). As opposed to the exterior approach: put the implant in from the outside at both sides, immediately see if there's symmetry or not, if it's too big or not or if some parts need to be cut off. Then carving until both sides fit the face, immediately seeing the results.

I can immagine there's only so much time before swelling goes up and the surgeon can't 'see' anything anymore. Internal approach might take longer.

Maybe I'm wrong, I just thought about it. Even if an implant is too small, the surgeon might shave it in a way to improve the angularity or shave part of the upper side of jawbone (hypothetically). I immagine it would be easier to achieve the ideal aesthethic shape from the outside. It would be more like sculpturing instead of puzzling.

Doesn't the external approach create a somewhat obvious gap in beard coverage? 

[ben from UK]

Doesn't the external approach create a somewhat obvious gap in beard coverage?

It creates a scar underneath the face, at the neck area. I personally don't really mind. Some people don't like scars. It's not that bad imo (for a male).

It was only a suggestion from my part. Maybe I was wrong in my analysis and the internal approach is as difficult or easy.