Gunson Consult

[kavan]

Man, I would rather achieve better asthetic results (if possible), and just use a CPAP long term for my sleep apnea. So maybe I should get another consult (Wolford?) with the approach of asthetics only, and see if there is a difference in the plans?

I just sent an email over to Gunsons office in regards to this question. Maybe a bold move, doesn't hurt to ask right?

Better aesthetic results than WHAT, the contour diagram you were given to determine if you liked the changed contour of the plan? Unless you are in the capacity to DRAW a 'better' aesthetic CONTOUR as to SHOW what YOUR concept of a 'better aesthetic' is and then ask IF your contour diagram of your preferred aesthetic can be achieved, than asking about a 'better aesthetic' that you can't define yourself or SHOW via a proposed different contour diagram, goes NO WHERE, NOR will a consult with Wolford in the event he also gives you a contour diagram and you need to ask the same questions as to whether or not he could have given a 'better aesthetic'.

It's a MEANINGLESS question to ask if you are not in the capacity to DRAW a contour diagram showing what you mean by 'better aesthetic' or don't have another plan by another doctor where people can SEE what aesthetic his contour plan has. No one can answer this based on your question alone in the absence of actually SEEING another doctor's plan for comparison.

[Post bimax]

Or at least describe what is meant by ‘better aesthetic’.

Does anyone know if you can make certain requests of Gunson? For example, if he wanted a stronger chin could he request a slightly stronger genio? (Assuming he went with Gunson)

[kavan]

Or at least describe what is meant by ‘better aesthetic’.

Does anyone know if you can make certain requests of Gunson? For example, if he wanted a stronger chin could he request a slightly stronger genio? (Assuming he went with Gunson)

Yes, one could request a stronger chin if he were in capacity to SHOW one by drawing one to his contour diagram OR if he could show a stronger chin proposed by ANOTHER surgeon. However, just asking about possibility for a 'better aesthetic' with NO visual demonstration of what he means by such and lacks knowledge of aesthetic relationships such that he doesn't even know what is meant by a 'better aesthetic', is a meaningless question to those to whom it's asked and goes NOWHERE.

[Dogmatix]

Yes, one could request a stronger chin if he were in capacity to SHOW one by drawing one to his contour diagram OR if he could show a stronger chin proposed by ANOTHER surgeon. However, just asking about possibility for a 'better aesthetic' with NO visual demonstration of what he means by such and lacks knowledge of aesthetic relationships such that he doesn't even know what is meant by a 'better aesthetic', is a meaningless question to those to whom it's asked and goes NOWHERE.

I think what the question resolves to is if there are any aesthetic trade offs in the plan to handle the functional issues. There is quite some research on the aesthetic guidelines and goals to balance the face with the soft tissue TVL, amount of tooth show, proportions of the face etc. Gunson is of course aware about all of this, but what I figure Austinou88 is grasping for is if Gunson on purpose have done any step of from these aesthetic guidelines in favour for treating the medical issues. "Best" aesthetic outcome can be interpreted in 2 ways, either objectively what is considered most aesthetic, or subjectively from patient preferences. No one can advice on subjective preferences, but objectively it can be discussed. From my own plan I know that if I would've had a plan from a less skillfull surgeon and complain about breething, I would probably be offered a plan without posterior down grafting, which probably would be a clear step off from the best aesthetic result, but solving the functional issues.

[kavan]

I think what the question resolves to is if there are any aesthetic trade offs in the plan to handle the functional issues. There is quite some research on the aesthetic guidelines and goals to balance the face with the soft tissue TVL, amount of tooth show, proportions of the face etc. Gunson is of course aware about all of this, but what I figure Austinou88 is grasping for is if Gunson on purpose have done any step of from these aesthetic guidelines in favour for treating the medical issues. "Best" aesthetic outcome can be interpreted in 2 ways, either objectively what is considered most aesthetic, or subjectively from patient preferences. No one can advice on subjective preferences, but objectively it can be discussed. From my own plan I know that if I would've had a plan from a less skillfull surgeon and complain about breething, I would probably be offered a plan without posterior down grafting, which probably would be a clear step off from the best aesthetic result, but solving the functional issues.

From my perspective, someone with sleep apnea (or sleep issues)--or just say someone who could stand to have their airway open more-- is NOT an 'aesthetics only' patient. An 'aesthetics only' patient is someone with NO OTHER functional issues and is all SELF PAY. In addition to that, from my POV, an 'aesthetics only' patient, needs to express, in no uncertain terms, preferably through a VISUAL depiction--but also could be by clear verbal description-- of a change on his own face as to what his PREFERRED aesthetic is.

It is because insurance will pay for some of this on grounds of FUNCTIONAL problem and also because he's not demonstrating capacity to define any preferred aesthetic he has as his objective that I don't view him as 'aesthetics only' patient and therefore don't engage in 'aesthetics only' questions.

From my POV, I expect an 'aesthetics only' patient to be able to define and make clear what aesthetic they are going for and THEN get feedback from others as to whether or not they think it's a good aesthetic preference or even possible with surgery. In situations where an 'aesthetic only' patient needs others to define, explain, depict aesthetics FOR THEM because they have no concept of what aesthetic they want, I don't engage with them too much either on 'aesthetics only' either. At most I will tell them whether or not I think a DEFINED aesthetic plan (for example one coming from a doctor with a contour diagram) is one I find aesthetically pleasing or a good aesthetic and I've already told him I think it's a good aesthetic.

[Dogmatix]

From my perspective, someone with sleep apnea (or sleep issues)--or just say someone who could stand to have their airway open more-- is NOT an 'aesthetics only' patient.

I agree, but just clarifying what question he is asking. "I would rather use CPAP for the rest of my life than not getting optimal aesthetic result", tells us a bit about his mindset.
I of course think this is ridiculous and it would be to shoot yourself to not resolve the functional issues. It's a setup for regret.
But I do think it's possible for someone planning the surgery or other who is knowledgable to say if there are any side steps from objectively aesthetic guidelines to treat the functional problems.

[kavan]

I agree, but just clarifying what question he is asking. "I would rather use CPAP for the rest of my life than not getting optimal aesthetic result", tells us a bit about his mindset.
I of course think this is ridiculous and it would be to shoot yourself to not resolve the functional issues. It's a setup for regret.
But I do think it's possible for someone planning the surgery or other who is knowledgable to say if there are any side steps from objectively aesthetic guidelines to treat the functional problems.

Thanx for the clarification. Problem is that he does not 'see' that the plan he got gives an optimal aesthetic result and no one else SEES what ever other possible 'aesthetics only' visual he might have in mind whereas he might not have any other aesthetic in mind. I contend that the 'aesthetics only' whether one likes them or not can be judged by simply LOOKING at the contour diagram. It is sufficient to determine 'only' the aesthetic improvement.

Besides, Gunson's office already told him the plan was based on both aesthetics and function and basically shows an aesthetic vision that is unlikely to change.