bimax vs bsso

[PloskoPlus]

16 mm must be some kind of record.

[PloskoPlus]

You really ought to ask him what’s the biggest downgrafti he’s done and what material did he use. What material does he plan on using on you?

[Post bimax]

You really ought to ask him what’s the biggest downgrafti he’s done and what material did he use. What material does he plan on using on you?

Almost certainly HA blocks. That’s what Gunson told me when I asked him. Alfaro too.

What I don’t understand is how relapse is possible with HA blocks since they don’t disintegrate. I guess the bone can still resorb.

[lsubuilder]

I actually forgot to ask him that. You’re right Alfaro told me Ha blocks. I did not realize this much rotation is not common. I’ll have to ask what he’s done before

[kavan]

Jesus Christ. Shocking what they want to do to work around your ANS. eg. Gunson's OVER ROTATION to shift the point of the ANS upwards where some of the over rotation goes toward minimizing the ANS horizontal advancement. Gunson's ceph tracing of the before is better than Relle's though because it shows the 'tethering' aspect of the upper lip to the nose base. Are the tracings from the same ceph? I ask because Relle's ceph tracing which gives AP advancement of approx 6 does not show the same extent of the tethering of the upper lip. IF Relle's tracing was from same ceph, they it looks like he FUDGED the before tracing. Then you have Alfaro wanting to cut around the ANS. So, extra cuts in addition to a 3 piece L1.

What I see is that the surgery proposals are MORE than they would be if you went in there with a deprojection rhinoplasty where the ANS was addressed.

[kavan]

I actually forgot to ask him that. You’re right Alfaro told me Ha blocks. I did not realize this much rotation is not common. I’ll have to ask what he’s done before

No. It's not that common. It's like what I said, where they are doing too much due to work arounds re. the ANS. None of them are humble enough to suggest you first get a rhino to address the ANS so they don't have to OVER ROTATE you to work around the ANS given that none of them are in capacity to do the type of rhino  you would need.

[kavan]

Relle's plan looks nice. Walline is a great guy. Met him on the elevator while consulting with Relle...super nice, and I think he assists.
G's plan looks aggressive, but you are quite recessed so it makes sense to go that dramatic. You'd have to wonder if that large a rotation would remain stable. That would be my only concern there.

Sure it looks nice. It's because he FUDGED the lip contour in his before tracing. I am assuming the SAME ceph was used in the OP's 'remote' or 'cyber' consults.

[lsubuilder]

Alfaro responded. He doesnt do any 2D tracings. Either wait until i go for surgery or go in for an in person consult

[Gadwins]

No. It's not that common. It's like what I said, where they are doing too much due to work arounds re. the ANS. None of them are humble enough to suggest you first get a rhino to address the ANS so they don't have to OVER ROTATE you to work around the ANS given that none of them are in capacity to do the type of rhino  you would need.

I thought that you should never do a rhino before, because the nose will change anyway after a jawsurgery.

[Post bimax]

Alfaro responded. He doesnt do any 2D tracings. Either wait until i go for surgery or go in for an in person consult

Whoever from his office told you this is misinformed or being dishonest.  This is the 2D CEPH tracing I received when I requested it after my consult in December: https://imgur.com/a/s4vXfP1

Maybe his policies have changed, not sure.

[Post bimax]

I thought that you should never do a rhino before, because the nose will change anyway after a jawsurgery.

Read the rest of the thread for context and justification

[lsubuilder]

I asked if they would provide any ceph tracing so i can get a rough idea and this is what i got back "We do not provide cephalogram, because all of our surgeries are planned in 3D software. You can discuss your 3D planning with Prof Hernandez Alfaro but it should be done right before the surgery (3days before), unless you would like to come to Barcelona and have an in-situ visit with the doctor and all the tests could be performed and then come back only for surgery"

Looks like ill have to go in person

[kavan]

Alfaro has access to software to do the 2-d ceph tracings.

During the time of CORONA VIRUS, where Spain is very hard hit and when many doctors are doing CYBER CONSULTS, Alfaro wants you to go in person. OK

[lsubuilder]

Kind of ridiculous. I’ve asked twice and that’s all they say

[kavan]

You say your consult with Alfaro was 'great'. But how great could a consult be in the absence of the type of information you wanted to get from it.