Gunson Consult

[Austinou88]

Recently had a digital consult with Gunson. And also saw 2 of his main Ortho's in-person that he regularly uses.

He's proposing
- Le Fort I Osteotomy Multi-segment w/bone grafting
- Bilateral Sagittal Split Osteotomies w/bone grafting
- Chin Repositioning
- Cheekbone Augmentation

Do you think what he's proposed will make much of a difference in terms of aesthetics? I plan on bringing his Surgery Plans with me to my Military MaxFac.

https://imgur.com/a/vFqfBG8

[Dogmatix]

The displacements are significant and will make a noticeable difference in aesthetics.

[PloskoPlus]

Looks like most of the movement is linear. So lesser surgeons should be able to execute the plan. Not even sure if 2 mm posterior downgraft will make much difference.

[Lefortitude]

It will make a huge difference in terms of aesthetics.  He might even put midface augmentation on top which will help alot imo. 

However, you should be more concerned with correcting your "severe obstructive sleep apnea".   

[GJ]

I'd see him in person. "Can't tell from photos" would not make me feel great.
Your ortho will be prepping you based on Gunson's interpretation of photos, so the surgical plan could change dramatically the day of surgery because of this.

[Abdulrahman]

Looking at the diagram it seems your nasolabial angle will become too narrow possibly giving you the dreaded "chimp lip".

[kavan]

Looking at the diagram it seems your nasolabial angle will become too narrow possibly giving you the dreaded "chimp lip".

Chimps don't have a narrow nasio-labial angle. They have an exaggerated conVEX lip.

[jusken]

The angle of your head in your profile shot is being partially obscured by your jacket, but looks like you have forward head posture.  I did a quick morph assuming what your head angle would be possibly looking straight ahead.  One issue you'd have with these movements is that the angle of your nose currently matches your current facial development and has a  low angle.  If you went ahead with these movements, assuming you didn't do something about your nose angle, it would be heavily compressed by the forward movement and you'd have the wide flat nose look.  I changed this in the morph too.. so I guess it works if you factor all that in?

[kavan]

Recently had a digital consult with Gunson. And also saw 2 of his main Ortho's in-person that he regularly uses.

He's proposing
- Le Fort I Osteotomy Multi-segment w/bone grafting
- Bilateral Sagittal Split Osteotomies w/bone grafting
- Chin Repositioning
- Cheekbone Augmentation

Do you think what he's proposed will make much of a difference in terms of aesthetics?

https://imgur.com/a/vFqfBG8

Look at the contour displacement diagram, (the one where YOUR profile is shown in black and the proposed displacement contour is shown in red). From there, you should at least be able to self IDENTIFY with your OWN profile contour and SEE whether or not the proposed one (in red) makes a POSITIVE difference to your profile. Whether or not the proposed contour changes will make much of an aesthetic difference should be SELF EVIDENT. You should at least be able to observe which contour looks better. If not, there is no point in discussing 'aesthetics', motivation for 'better aesthetics' in the absence of knowing whether or not you could recognize one if you saw it diagrammed on your own face.

Here, you were given a visual. So, what does it look like to YOU...better aesthetic or not?

[Lefortitude]

Look at the contour displacement diagram, (the one where YOUR profile is shown in black and the proposed displacement contour is shown in red). From there, you should at least be able to self IDENTIFY with your OWN profile contour and SEE whether or not the proposed one (in red) makes a POSITIVE difference to your profile. Whether or not the proposed contour changes will make much of an aesthetic difference should be SELF EVIDENT. You should at least be able to observe which contour looks better. If not, there is no point in discussing 'aesthetics', motivation for 'better aesthetics' in the absence of knowing whether or not you could recognize one if you saw it diagrammed on your own face.

Here, you were given a visual. So, what does it look like to YOU...better aesthetic or not?

When I first noticed something was wrong, I could not put my finger on it for the longest time. Is it my chin? my nose? my maxillas fine, no my maxillas narrow, no recessed, no its my orbitals, must be my superior orbit, no my inferior orbit etc etc. Maybe I'm aesthetically blind, but it took me a lot of research, morphing, analyzing to understand facial aesthetics.  Maybe there are others like me, to varying degrees.

[kavan]

When I first noticed something was wrong, I could not put my finger on it for the longest time. Is it my chin? my nose? my maxillas fine, no my maxillas narrow, no recessed, no its my orbitals, must be my superior orbit, no my inferior orbit etc etc. Maybe I'm aesthetically blind, but it took me a lot of research, morphing, analyzing to understand facial aesthetics.  Maybe there are others like me, to varying degrees.

I hear what you're saying about how it's hard to put one's finger on what's wrong on ones face. It's just that here, I want him to look at the contour diagram because I want to know how evident to him the aesthetic change is. Indeed, it takes some work to understand aesthetic relationships. But the first step is observing a change, relative to one's own face, here a contour diagram and knowing whether one likes it or not. Well, I need to know someone has that baseline before I start addressing other questions.

[ODog]

I hear what you're saying about how it's hard to put one's finger on what's wrong on ones face. It's just that here, I want him to look at the contour diagram because I want to know how evident to him the aesthetic change is. Indeed, it takes some work to understand aesthetic relationships. But the first step is observing a change, relative to one's own face, here a contour diagram and knowing whether one likes it or not. Well, I need to know someone has that baseline before I start addressing other questions.

I think what OP meant to ask more specifically was: will the change in aesthetics be worth the hefty pricetag, recovery, and everything else that goes along with JS.

[kavan]

I think what OP meant to ask more specifically was: will the change in aesthetics be worth the hefty pricetag, recovery, and everything else that goes along with JS.

He didn't mean to ask that because he's not getting surgery with Gunson. He's just getting a plan/assessment from Gunson so he can take it to a military doctor.

ETA: To the best of my knowledge, military doctors are on his insurance plan and the military pays for surgery or most of it.

[april]

If you take this to a military doc to follow, know that this would still be considered a tentative plan. Think of it more as a guide. This is not because you need extensive ortho work first - you don't - but it's because Gunson hasn't evaluated in person and even if he had, his final plan for his patients isn't made until the week of surgery when he does the VSP. So basically what I'm saying is your military doc might not follow this to a T, but he can use it as a guide.

[Austinou88]

The displacements are significant and will make a noticeable difference in aesthetics.

So, would you consider me one of those cases that could end up benefiting greatly?