Anyone Have any Experience with Dr. Yaremchuk in Boston?

[SavingFace]

I consulted with Dr. Sinn, because I thought maybe a "box osteotomy" might be the answer for my midface hypoplasia. He instead remmended a custom implant to correct orbital rim deficiency and cheeks. To the best of my knowledge, Dr. Sinn isn't really known for his skill in implants. So I consulted Dr. Michael Yaremchuk in Boston. He recommended a custom implant for cheeks and malar augmentation, an orbital rim implant, paranasal implants, and an angular jaw implant along with a rhinoplasty. That's a lot of surgery, but his rate is in the mid 20s for that, which is way less than an osteotomy.

Does anyone have any knowledge of Yaremchuk? I found a lot of information positive about him before I consulted with him, and these made me think he's a leading expert in implants. After I consulted with him, I found a lot of negative reviews on Vitals. I'm wondering if anyone here has any personal experience or thoughts on him? I'm not really a big fan of implants, but if even Dr. Sinn says I need an implant rather than something more invasive, maybe I do? 

Thanks!

[SavingFace]

Going to add this here rather than starting a new thread, in case it's helpful to anyone.

Dr. Y's office hasn't given me a final quote on everything, but in case you're thinking of going with him, here are a couple pointers on cost:

1) He recommended a company in Boston to do the CT Scan. The cost would have been right at $900. I decided to call around to hospitals back home (in the DC metro area) and found that Franklin Square Hospital in Baltimore would do the same scan for $65! So right off the bat, I saved over $800. It pays to shop around, because some hospitals will do a CT scan for a fraction of what other places will charge. He requires a CT scan (for me at least) from the chin through the orbital area, without contrast.

2) The cost for all of my procedures that he recommends (orbital rim implant, custom cheek implant, paranasal implant, angular jaw implant, and rhinoplasty) comes to about $20k. That's not including the fee to create the custom implant from the CT scan, which is about $5800, paid in advance.

Hope this information is helpful to someone who may be considering him. I'm still hoping someone will chime in with an opinion about Dr. Y! I've seen some reviews online that are really harsh about him (but I imagine you can find those kind of reviews with any doctor). And a lot of his online before and after examples are honestly less than remarkable. Sometimes I have a problem even seeing any difference, much less a notable aesthetic improvement, in his patients. Of course, not everyone allows their pictures to be posted publicly, so I've reached out to the office for some examples that are similar to my case. I'll see if they respond.

Any advice?? You guys know so much more than I do about this, so I would love to get some feedback, and happy to share photos in private.

[kavan]

You would have to go in person to see more photos than you see on his website. I think some patients (and this is true for a lot of doctors) allow their photos to be looked at during an office visit but not to be transmitted to another electronically (like via e mail).

[PloskoPlus]

Make sure the CT scan is the right resolution for his needs.  $65 is usually what you pay for a basic lateral ceph.  The same machine is used, but you don't get the 3D scan.

[SavingFace]

Yeah, Dr. Yaremchuk specified on the order that it had to be a 3D scan, and the hospital verified that they followed his order. I was surprised at the price as well! It pays to shop around!

[SavingFace]

You would have to go in person to see more photos than you see on his website. I think some patients (and this is true for a lot of doctors) allow their photos to be looked at during an office visit but not to be transmitted to another electronically (like via e mail).

I think you're right. Unfortunately, I forgot to ask this. I am doing a follow up Skype consult, so I think i'll ask if they can at least show me some then.

[Lestat]

Did you also ask him about bone erosion from these implants?

[SavingFace]

I didn't ask him, but Dr. Sinn did mention that when I consulted with him. He said that the MedPor implants don't have the same problem with bone erosion, but they are harder to remove in time. Since I'm not 100% sure how these implants are going to look, it's possible I will want to have them removed at some point. I already have a pair of silicone cheek implants, which are the wrong size, shape and location. So that is a concern. I will ask him about it in the follow up.

[Lestat]

I will ask him about it in the follow up.

Many Thanks. and please do not forget to tell us about it! Please also ask in detail for how many mm in how many years, etc.

[ben from UK]

Going to add this here rather than starting a new thread, in case it's helpful to anyone.

Dr. Y's office hasn't given me a final quote on everything, but in case you're thinking of going with him, here are a couple pointers on cost:

1) He recommended a company in Boston to do the CT Scan. The cost would have been right at $900. I decided to call around to hospitals back home (in the DC metro area) and found that Franklin Square Hospital in Baltimore would do the same scan for $65! So right off the bat, I saved over $800. It pays to shop around, because some hospitals will do a CT scan for a fraction of what other places will charge. He requires a CT scan (for me at least) from the chin through the orbital area, without contrast.

2) The cost for all of my procedures that he recommends (orbital rim implant, custom cheek implant, paranasal implant, angular jaw implant, and rhinoplasty) comes to about $20k. That's not including the fee to create the custom implant from the CT scan, which is about $5800, paid in advance.

Hope this information is helpful to someone who may be considering him. I'm still hoping someone will chime in with an opinion about Dr. Y! I've seen some reviews online that are really harsh about him (but I imagine you can find those kind of reviews with any doctor). And a lot of his online before and after examples are honestly less than remarkable. Sometimes I have a problem even seeing any difference, much less a notable aesthetic improvement, in his patients. Of course, not everyone allows their pictures to be posted publicly, so I've reached out to the office for some examples that are similar to my case. I'll see if they respond.

Any advice?? You guys know so much more than I do about this, so I would love to get some feedback, and happy to share photos in private.

Almost every surgeon posts his best results online. Revision rate of implants is very high, no matter what surgeon you choose. It's nearly impossible to calculate the right dimensions based on a CT scan. Implants often turn out too big because of facial harmony. For example, you might get broader jaws but they might turn out too big compared to the chin, etc. The best results are when someone really has a big deficiency, for example a very retruded chin. Silicone should be avoided as an implant material imo.

Y. is called conservative, but I don't know if that's true. Nowadays, surgeons get crazy demands from young men to get 'a model look'. If the surgeon says he's not doing that, cause it wont give natural results, these men go to someone like Eppley, who does everything a client wants. Remember, plastic surgeons are businessmen as well.

[SavingFace]

Almost every surgeon posts his best results online. Revision rate of implants is very high, no matter what surgeon you choose. It's nearly impossible to calculate the right dimensions based on a CT scan. Implants often turn out too big because of facial harmony. For example, you might get broader jaws but they might turn out too big compared to the chin, etc. The best results are when someone really has a big deficiency, for example a very retruded chin. Silicone should be avoided as an implant material imo.

Y. is called conservative, but I don't know if that's true. Nowadays, surgeons get crazy demands from young men to get 'a model look'. If the surgeon says he's not doing that, cause it wont give natural results, these men go to someone like Eppley, who does everything a client wants. Remember, plastic surgeons are businessmen as well.

Good points. My case is additionally complicated by the fact that I already have implants in, XL implants in the submalar region! So I worry that there won't be enough augmentation, because looking at my face, it isn't as flat as if the previous implants were removed (which they must be to place the new ones). I also worry that the jaw implant could be too wide and give my face an odd triangular or square shape. I was reading some in the past couple days on Silicone vs. MedPor. Apparently Eppley argues that there is no bone loss problem with silicone implants.

I have a re-consult with Dr. Y this Thursday, so I'm hoping to ask some questions about bone loss with silicone vs. Medpor.

p.s. I have personal experience with Dr. Eppley, back before I knew ANYTHING about what I needed. His office basically agreed to do what I suggested, which I later found out no other surgeon would even consider. I'm a little too shy to say what that was on the forum, but would be happy to by PM if anyone actually cares!

[SavingFace]

I would also add that I asked Dr. Y during the consultation whether he thought I should get a temple augmentation. My left temple is a bit hollow. He looked at it briefly and said no, he would leave it alone. I always feel better when a surgeon talks me out of a procedure. It's kind of like going to a garage to get the car fixed and you ask them if it needs new tires, and they say no. I don't like being upsold, and I felt that Dr. Y was being realistic and honest about what I needed rather than trying to get me to do things that wouldn't really help.

[kavan]

Good points. My case is additionally complicated by the fact that I already have implants in, XL implants in the submalar region! So I worry that there won't be enough augmentation, because looking at my face, it isn't as flat as if the previous implants were removed (which they must be to place the new ones). I also worry that the jaw implant could be too wide and give my face an odd triangular or square shape. I was reading some in the past couple days on Silicone vs. MedPor. Apparently Eppley argues that there is no bone loss problem with silicone implants.

I have a re-consult with Dr. Y this Thursday, so I'm hoping to ask some questions about bone loss with silicone vs. Medpor.

p.s. I have personal experience with Dr. Eppley, back before I knew ANYTHING about what I needed. His office basically agreed to do what I suggested, which I later found out no other surgeon would even consider. I'm a little too shy to say what that was on the forum, but would be happy to by PM if anyone actually cares!

Let me take a GUESS--remember, it's just a guess--Eppley agreed to remove your ribs to make an extra long and hard penis augmentation.

[SavingFace]

Let me take a GUESS--remember, it's just a guess--Eppley agreed to remove your ribs to make an extra long and hard penis augmentation.

  HOW COULD YOU POSSIBLY!!>.....

(kidding! ... or am I!?)

[Reality]

Let me take a GUESS--remember, it's just a guess--Eppley agreed to remove your ribs to make an extra long and hard penis augmentation.

( ಠ ͜ʖ ಠ) ...Kavan! haha