Modified Lefort 3 Cut by Sinn

[kavan]

I’ve never though my eye prominence was an issue, more so flat cheeks and under eye tear troughs

EXACTLY.  You DON'T have eye prominence which is what that type of surgery is actually aimed at addressing. Earl got it for the right reasons. But a lot of people 'chasing' that surgery cuz Earl got it aren't doing for the right reasons.

There's nothing wrong with some flatness to the area where you have it and even people with prominent orbital rims have tear troughs because the tear trough is in the soft tissue area superior to the orbital rim bone. I guess all you can do is see how it works out for you. But you are really not the typical candidate for that type of surgery.

[micjawsurgery]

I have tried filler in the cheeks and chin before. Not really any noticeable differences. It worked well for raising the nasal bridge temporarily though. I also went about looking for fat grafting in Korea but it’s not done in the under eye area for aesthetic issues, only cheeks. I saw what cheek fillers did so I have decided against it, but maybe I did not inject enough. I was also worried cheek augmentation without infraorbital augmentation would just make my troughs worse.

Not sure I’d even call them troughs - they show up when I’m standing under vertical lighting, so I’m almost sure they’re caused by the shadowing of the recessed area under the eye. I was also told a Blepharoplasty would be pointless when I saw a surgeon in person. So some sort of augmentation is needed to fix this issue.

Sinn told me I’d be ideal for his procedure, same thing with Eppley when I asked about custom infraorbital/malar implants. I have another consultation with Yaremchuk next week where I will ask more about the aesthetic outcome

[Sanj87]

You have bdd you need a pschologist not a surgeon

[Post bimax]

I have tried filler in the cheeks and chin before. Not really any noticeable differences. It worked well for raising the nasal bridge temporarily though. I also went about looking for fat grafting in Korea but it’s not done in the under eye area for aesthetic issues, only cheeks. I saw what cheek fillers did so I have decided against it, but maybe I did not inject enough. I was also worried cheek augmentation without infraorbital augmentation would just make my troughs worse.

Not sure I’d even call them troughs - they show up when I’m standing under vertical lighting, so I’m almost sure they’re caused by the shadowing of the recessed area under the eye. I was also told a Blepharoplasty would be pointless when I saw a surgeon in person. So some sort of augmentation is needed to fix this issue.

Sinn told me I’d be ideal for his procedure, same thing with Eppley when I asked about custom infraorbital/malar implants. I have another consultation with Yaremchuk next week where I will ask more about the aesthetic outcome

Dude seriously you're more likely to spend a lot of money and f**k up your face than anything. You're already handsome and don't look recessed. Don't do this

[GJ]

you're more likely to spend a lot of money and f**k up your face

He seems intent on doing that.
Sometimes you just can't stop an irrational mind, and people have to learn the hard way.
That Sinn would operate on him lowers my opinion of Sinn.

[micjawsurgery]

thanks guys. I appreciate the responses telling me to reconsider.

Talked to yaremchuk today who guessed 3-4mm of orbital rim augmentation would be good on me. He agreed with my aesthetic issues. Had a good experience with him, but I’ll probably go with Eppley who is younger and has more experience with silicone.

Sinn was a great guy to talk to during the last 2 weeks. Probably shot him 50 emails in total. He’s never had any blindness with a Lefort 3 or standard jaw surgery, so I felt barring horrible nerve damage I could live with the complications. But not being able to reverse the aesthetic outcome and his increasing age were the 2 factors that got to me.

[Lestat]

Talked to yaremchuk today who guessed 3-4mm of orbital rim augmentation would be good on me.

Is this the maximum augmentation for orbital rim implants?

[micjawsurgery]

Yes I've read that 3-4mm is usually the max. And that the MFL3 moves the bone about 7mm max.

The soft tissue does not move as much as 7mm though, probably can expect 5mm of soft tissue movement.
See https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200589#pone-0200589-t003
For how soft tissue generally responds to bone movements.


Also, the technique seems to be getting better for the MFLF3 procedure. Truth be told I'm not sure how risky it is with the recent advancments that have been made. Reading this paper was very interesting. If anyone else is concerned with Sinn's age, I would try contacting the authors here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444669/

J. M. García y Sánchez has published many research articles about the modified lefort 3

[micjawsurgery]

These results are amazing IMO. No scars to be seen.

https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&p=PMC3&id=5328863_12663_2016_893_Fig40_HTML.jpg

https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&p=PMC3&id=5328863_12663_2016_893_Fig46_HTML.jpg

Source
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328863/

[PloskoPlus]

Those are class iii patients with severe midface hypoplasia. That's not the case with you.

[kavan]

Those are class iii patients with severe midface hypoplasia. That's not the case with you.

Agree and will add that people entertaining L3 modified or otherwise, who DON'T have the extent of deformity shown in articles about L3, should be looking at photos of people who got the surgery just for 'cosmetics' as in people who did not really NEED what it corrects but just WANTED it for better cosmetics. For that, consults are needed with docs who have done it just for COSMETICS on those who just WANTED it but didn't really need it.

[Lestat]

Yes I've read that 3-4mm is usually the max. And that the MFL3 moves the bone about 7mm max.

Thanx!
Have you asked Sinn if there is a possible risk of relapse with this surgery (Mod. Lefort III)?

[forwardgrowth]

Relapse I think is often due to improper orthondotic posture, mouth breathing, posture etc 

[micjawsurgery]

Sinn told me relapse is possible but rare. I'll have my decision made tomorrow whether I'll go with Sinn or Eppley.

I'm pretty confident I won't have major functional issues after surgery with Sinn, although there is always a risk. He's done this surgery atleast 50 times now for cosmetic purposes so he understands it very well. He doesn't think its riskier than a standard Lefort 1 (which fair enough is relatively risky for cosmetic surgery)

I think Eppley can deliver a better aesthetic result because Sinn doesn't really have too much control over the movements. With Eppley I'd be consulting him the entire time over the implant design. But the potential minor bone erosion and eventually having to have the implant removed due to infection are not very appealing.

Perhaps I am being illogical in preferring the osteotomy over implants. From my viewpoint as long as the surgery and initial healing goes well I should be "good", whereas I'll always have a fear if I go with implants and how they'll look 10 years later

[Post bimax]

Sinn told me relapse is possible but rare. I'll have my decision made tomorrow whether I'll go with Sinn or Eppley.

I'm pretty confident I won't have major functional issues after surgery with Sinn, although there is always a risk. He's done this surgery atleast 50 times now for cosmetic purposes so he understands it very well. He doesn't think its riskier than a standard Lefort 1 (which fair enough is relatively risky for cosmetic surgery)

I think Eppley can deliver a better aesthetic result because Sinn doesn't really have too much control over the movements. With Eppley I'd be consulting him the entire time over the implant design. But the potential minor bone erosion and eventually having to have the implant removed due to infection are not very appealing.

Perhaps I am being illogical in preferring the osteotomy over implants. From my viewpoint as long as the surgery and initial healing goes well I should be "good", whereas I'll always have a fear if I go with implants and how they'll look 10 years later

I think you're making a terrible mistake either way. But I will point out that I have seen multiple horror stories and cases of unethical practice from Eppley. Your money your face though. Knock yourself out