@ lazlo
Thanks very much for that information, it was useful. Especially about the case that had asymmetry as a result of HA augmentation in the jaw angles. Too bad he didn't post afterwards for us to see if that may have had to do with residual swelling. Or was it long after the surgery? I have to look him up.
I am also a very busy individual and do not find it easy to post often here or even read posts regularly. Most of the time I don't have anything useful to add though.
Yes, I will have the surgery with Mommaerts. I did have several consults in the past year, and explored the options for implants as well. I talked to maxilofacial as well as cosmetic surgeons to understand the pros and cons of different approaches. I have been recommended various options by various surgeons - surgeon will often recommend whatever they know and whatever they are comfortable with - not necessarily what's best for you. It's imperfect world, so we have to do our own research. The hardest decision for me was deciding between bi-max and single jaw surgery, but that's another topic.
I'm aware of some unhappy Mommaerts patients and I have exchanged emails with one of them. He seemed legitimate and it appeared in his case that Mommaerts made some misjudgments. I have not seen any pics though. I have also seen another M's patient's pictures here - he had a bi-max surgery. When I saw the pictures I was very disappointed with his sub-optimal result. What scares me is that there aren't really any posts about him from happy patients (apart from one I found on lyb), and the few that have posted are not happy with the results. Scary s**t!!!
The lesson for me is not to take at face value anything a surgeon says but to use what you know and what your surgeon knows in combination to come up with the best plan. The reason why I decided to go with Mommaerts is because he does tons of cosmetic work apart from the orthognathic surgeries he also performs regularly. I'd rather have an aesthetically great outcome than a perfect bite or whatever, so I need a surgeon who understands aesthetics. That man has written books and writes articles not only on orthognathic and cosmetic work, but also on beauty. In a recent article he analysed faces of the People magazine's most beautiful people, both men and women. He has a scientific interest in what makes people beautiful and he does research to answer this question. He also chaired an international conference on facial makeover with cosmetic surgeons from all over the world only a few months ago. He seems to understand bones but also soft tissue. I want a surgeon who is passionate about people looking beautiful, not a surgeon passionate about occlusion. I'm very careful about promoting him as a great surgeon - I have no idea if he really is, but for me he feels like the right choice. Most obviously because I do not know anyone else who can do all three procedures I mentioned above on me. How many other maxillofacial surgeons in the world you know who do so much cosmetic work and study, publish and read on beauty constantly? None? And he's been doing this for 30 plus years. He even does things like face lifts and lip lifts and s**t. You would assume he would have figured out by now in his 30 years of operating and so many books he's written on cosmetic surgery what works and what makes people beautiful. And the best for me is that he's kept up with orthognathic surgery - he continuously operates on jaw as well as other part of the face. Aside from all his cosmetic work, he still does more jaw surgeries in one year than most surgeons do in 10.
There is always the risk that things will not turn out well for some people. Chance plays a big role in every surgical outcome, even if you have the greatest surgeon and the greatest surgical plan. That's the f**ked up reality. Maybe in the 23rd century things will be different, but now you either take risk and hopefully benefit from it, or you don't. As simple as that. All you can do is communicate clearly with your surgeon. Show him pictures of models if you have to. If he dismisses such approach, walk away. Because otherwise you increase your chances of having a bad outcome if he's not on the same page as you aesthetically. It's a fact that most cosmetic surgeons, let alone maxillofacial surgeons, do not understand male beauty. They don't have a f**king clue about what makes men beautiful. I know people who had cosmetic surgeons suggesting them the most ridiculous and inappropriate for their case things because (1) they want to make easy money with what they know how to do (2) they don't know any better (3) (in the case of maxillofacial surgeons) all they know about is occlusions, TMJs etc. Certainly not beauty. And that's how you end up with a reduced feminine nose, when you already have a great masculine nose and you absolutely do not need rhinoplasty.
About the ZSO - Mommaerts says in his article that the chances for asymmetry are much lower with this procedure, than with implants. He himself has not seen asymetry from this procedure. He cites data for this, it's not only an observation he makes. Implants, especially those that we are discussing here - the high malar type that augments the zygomatic arch, even if you find the ideal for you, can still be and are often misplaced. Another heavy weight surgeon - you may have heard of him - Yaremchuk, explained to me that it's hard or down right impossible to address that area with implants intraorally. He said that if he was going to do implants on me, he would tailor them (custom-made) according to my CT scans and then place them both intraorally and through another incision either in the lower eyelid or the temple (in the hairline). It's really complicated and you guessed right, it costs a fortune to have a custom-made model made of your skull and then implants engineered specifically for you. Most men do not benefit from implants because they are often misled (by ignorant surgeons who know s**t about male beauty) to choose the wrong off-the-shelf type for them, and more often than not, even in the case of the right type (if they find them or custom-made them) they end up placed incorrectly - not high enough, asymmetrically etc. The fact is there are not many types out there (if any at all, I have studied catalogues of implants thoroughly and spoke to surgeons) that cater to men and male aesthetical ideals. Strange, but true. For example, there aren't any acceptable ones for augmenting the zygomatic process of the zygomatic arch (the zygomatic process is the most lateral part that makes all those fashion models attractive). That's why Yaremchuk recommended custom-engineered ones for me.
Mommaerts also mentions in his article one male patient who was not happy with the ZSO outcome (THE ONLY ONE according to the article in his 20+ experience with this procedure) because the patient thought the result is too much, and that he successfully reversed the result. I don't know if that is the same man who posted on MissJ forums - I haven't been following that forum. But the bloody good news is - the procedure is easily reversible ("easily" according to Mommaerts, I'm not adding this myself). Another good news is you can achieve significant results with this procedure if the variables are controlled successfully. My fears as a matter of fact are in the opposite direction - that the result will be so subtle that I may end up wishing I opted for implants. I also liked the fact that at no time Mommaerts was trying to sell this procedure to me - as a matter of fact he did not even mention it on his own, and when I brought it up he was very reserved and cautious about it. I still have to discuss a lot of things with him, and all this will happen in the work up session one week before my surgery. I will not know what exactly I'm having done until one week before the surgery. However, as I posted before, I have a pretty good idea. I know exactly what I want to achieve, and the rest is discussing with Mommaerts what can be achieved in reality and how it will be achieved. He has more than 30 years of experience in both cosmetic and orthognathic work, so I have to rely on his assessment but always within the framework of what I want to achieve and him understanding my goals. He's happy to engage in debating options with you and can appreciate a well informed patient (unlike most asshole surgeons out there). The rest is chance, luck, or whatever. There is no way around it. But I simply can't think of anyone else in the world in this field who is willing and trying hard to listen to you, understand, implement and deliver results. And who is open minded and passionate about beauty, not occlusions. I may be wrong about him, I don't know. I hope not. Time will tell.
