Just had a bimax to cure Sleep Apnea - were the performed movements needed ?

[Baguettejaws]

Hi GJ,

Actually, I thought it may be useful to post some pictures.

[Baguettejaws]

Any thoughts, @GJ ?

[GJ]

Any thoughts, @GJ ?

Can you take photos from the side and front?
From those photos, it looks like you have the back teeth hitting first.

[Baguettejaws]

Hello guys,

Just a quick update:
I tried to see a French Doctor to have another feedback. The appointment was in Neuilly. The doctor told me GTFO, go to see your original surgeron. Total time: 2 min.

I finally went to Italy to see a surgeon. Very professional and welcoming. I did not share a lot of my thoughts with him before the appointment, just said that I underwent a bimax. He did an ICAT, here is his conclusions:
•   Over advanced maxilla
•   Mandible not enough advanced/bite incorrect
•   Swelling or infection that compress nerves on certain parts of the face
•   Implants misplaced
•   Nasal spine cut, he wouldn’t have did it
•   Cutting of the mandible is kind of weird (not traditional)
•   And the best : on the icat, you can see that there is a gap/void over the maxila. No bone here. According to him, this is because no “granules” or graft was done, making the bone formation impossible. The maxilla is just fixed with the plates and nothing else. It is not going to change unless a new surgery is done

He recommends operating again, probablysetting back the maxilla to +5mm with respect to the original position, with a CCW rotation. He can not operate before 6 to 8 months.
I knew that I had to do some research before undergoing this surgery, and I think that I did it more than most of the patients. I did not expect this surgery to fail so much.

Conclusion: Take your time, only go to the best surgeons. This mistake is going to cost me one year of my life and roughly the price of a brand new Porsche Macan.

[InvisalignOnly]

Sending you a PM.

[GJ]

Hello guys,

Just a quick update:
I tried to see a French Doctor to have another feedback. The appointment was in Neuilly. The doctor told me GTFO, go to see your original surgeron. Total time: 2 min.

I finally went to Italy to see a surgeon. Very professional and welcoming. I did not share a lot of my thoughts with him before the appointment, just said that I underwent a bimax. He did an ICAT, here is his conclusions:
•   Over advanced maxilla
•   Mandible not enough advanced/bite incorrect
•   Swelling or infection that compress nerves on certain parts of the face
•   Implants misplaced
•   Nasal spine cut, he wouldn’t have did it
•   Cutting of the mandible is kind of weird (not traditional)
•   And the best : on the icat, you can see that there is a gap/void over the maxila. No bone here. According to him, this is because no “granules” or graft was done, making the bone formation impossible. The maxilla is just fixed with the plates and nothing else. It is not going to change unless a new surgery is done

That sounds right. Regarding the void over the maxilla, did he think there was risk keeping it like that? I believe it will fill in with tissue not remain a void if left. At least that's how non unions form. If you press on your maxilla you can actually see it move, in these cases. The nasal spine likely had to be cut because of the large advancement, so it makes sense for the surgery you got, but you probably got the wrong plan.

That French guy sounds like a piece of work. Who was it?

[PloskoPlus]

Will he rebuild the nasal spine after moving your maxilla back?

[kavan]

Well as to the prior research you relay you did and say it was 'more than most patients', your first entry to JSF reflects a question AFTER THE FACT as to what would have been best movements to perform. So, I would wonder what your prior research actually was.

Presently, you don't give the name of the surgeon who's going to correct you. What ever research, which ever way you do it, isn't one of exploring if any members here used the same surgeon or have any feedback on him. So, no idea if this un named new sugeon is recognized as one of the 'best' or just another yahoo.

Hope you researched what a columellar strut graft is or his capacity in revision rhino as to re-supporting the base of the nose area where the ANS was cut. Because it doesn't seem to be enough info to me for him to just tell you he would not have cut it and not tell you how he's going to correct that area along with his set back.

[Baguettejaws]

@GJ
I am not sure about it. The fact is I do a lot of risky activities (racetrack for instance) and I would like to avoid having my maxilla get hurt in case of a light crash
French guy is Dr L.oncle.

@Plosko : we did not discuss about that, so I do not know

@kavan. Do not let the jsf average knowledge mistakes you. Other patients facebook groups for instance, which count thousands of people, show a relatively low awareness of what is going to be done on their face. Most of them have absolutely no idea on how mm millimeters their jaws are going to be moved, let alone more complex topics. Regarding the name of the surgeon who’s going to correct me, I do not have it yet as I did not made my choice. If you are looking for the name of the surgeon I saw in Parma, it is Mirco.
I am going to extract the Icat if you would like to see it

@Invisalign, replying to your PM

[PloskoPlus]

@kavan. Do not let the jsf average knowledge mistakes you. Other patients facebook groups for instance, which count thousands of people, show a relatively low awareness of what is going to be done on their face. Most of them have absolutely no idea on how mm millimeters their jaws are going to be moved, let alone more complex topics. Regarding the name of the surgeon who’s going to correct me, I do not have it yet as I did not made my choice. If you are looking for the name of the surgeon I saw in Parma, it is Mirco.
I am going to extract the Icat if you would like to see it

That would be an understatement.  If anything most display wilful ignorance (surgeons love these kinds of patients).  And if I had a dollar for every time I read "my guy is the best in the state"...

Good luck with your revision.  I hope you get a much better outcome second time around.  It is criminal what we let surgeons get away with.

[kavan]

@Plosko : we did not discuss about that, so I do not know

@kavan. Do not let the jsf average knowledge mistakes you. Other patients facebook groups for instance, which count thousands of people, show a relatively low awareness of what is going to be done on their face. Most of them have absolutely no idea on how mm millimeters their jaws are going to be moved, let alone more complex topics. Regarding the name of the surgeon who’s going to correct me, I do not have it yet as I did not made my choice. If you are looking for the name of the surgeon I saw in Parma, it is Mirco.
I am going to extract the Icat if you would like to see it

Are you telling me that I, myself recognize the average knowledge of people who come to jsf is above average? Quite the contrary. More often than not, I DON'T find that. The root of it is NOT just 'lack of information'. The root of it is LACK of such things as; the fundamental basis needed to RELATE to the basic concepts inherent in maxfax which happens to be simple grammar school geometry and logical thinking patterns. More often than not, the problem isn't lack of information or research. It's lack of ability to 'digest' it. That resolves to lack of a foundation to build on and to make order or put information into perspective. Your statement also seems to imply that 'awareness' of a mm measure of movement is needed to have. It's useless to a person who lacks the basic foundation to relate that to basic concepts such as displacements over a diagonal path.

I don't actually need to see the ICAT. But this 'awareness' and 'research' you speak of doesn't go far for anybody if a basis in conceptual relationships isn't the foundation one is working with. For example if one cuts down the support to the base of the nose to accommodate a large advancement, CONCEPTUALLY, one needs to be thinking in terms of 'what's going to happen when the area is pushed back where the prior base of nose support is no longer there. Hence the question Plosko asked as to what he's going to do to build up the nose support. I harked on similar. But I guess you weren't thinking in those terms.

As to Micro R. in Parma, that would be great if he panned out with a good revision result for you. His name has been bandied about here like in an echo chamber by people who see a few results on his web page who then go on to suggest others go to him. I've actually been WAITING to see one of his results on an actual JSF member.