I have two relevant surgical plans I'm trying to compare. One is from G and the other is from a local surgeon with a lot of experience. I am independently weighing the cost differences, because of G's large costs, and the risks each surgeon could come with. I'd appreciate some help comparing the actual differences between the two plans I have.
G's plan- https://imgur.com/a/XzEZgYj
Multisegment lefort I, BSSO, and genioplasty (said about 9mm lefort and 15mm BSSO)
Local Surgeon- https://imgur.com/a/XXuqtjU
lefort I,BSSO, (no genio or multisegment, although not because he doesn't do either just believes they are unnecessary)
The local surgeon's plan is a morph which I'm having trouble comparing to G's diagrams and visualizing myself. I think the morph looks good but have a few questions about comparing the two:
How accurate are morphs with experienced surgeons?
How different are the aesthetic and airway outcomes in both of these cases?
Ignoring risk, could I be leaving large aesthetic gains on the table by choosing the local surgeon based on these plans?
I'd also welcome any general discussion or comments on the plans themselves. Appreciate anyone taking the time to respond.
Firstly, you are not comparing 2 'plans'.
The local guy just gives you a morph. Gunson gives you an actual PLAN with a read-out of the displacements.
Gunson's plan gives you a better balanced profile than the local doctor's morph. Local guy shows improvement to your profile but less lower jaw projection than Gunson's. So, depends on whether or not you want more lower jaw projection than your local guy shows in his morph vision. It also depends on if your local guy can achieve the 'vision' he shows on the morph in the absence of DISPLACEMENT DATA that conforms to the morph.
I should also note that JUST a morph just shows the local guys 'vision' for you which can be combination of his preferred aesthetics and also his limitations to do more complex or involved surgical maneuvers. For it to be an actual surgical PLAN, it would need to come with all the DISPLACEMENTS in many areas that you see in Gunson's plan. I can't make a comparison between an actual PLAN and some morph that is absent of any 'plan'. Again, plans come with displacement readouts. So, in the absence of that, I hesitate to call your local guy's morph a 'plan'. However, if I were you, I'd ask the guy for his displacement readouts for that morph. Why? Because neither you nor I would know how accurate his morph was in the ABSENCE of a displacement readout that listed all the many displacements needed to achieve the 'vision' of the morph.
So, let's say your local guy's morph is something he can pull off on the operating table in the absence of charting out all the varied specific displacements that would achieve his vision for you. IF he can, then you would have an improvement for LESS cost than Gunson. It could work IF you also wanted LESS jaw advancement than Gunson shows in his contour diagram. Gunson's displacement read out lists all the varied displacements that CONFORM to his contour diagram. Your local guy doesn't do that.
In closing, I'd say your local guy's morph shows an improvement. But Gunson's contour diagram shows a better profile contour than your local guy's 'vision' for you. So, if improvement is a whole lot LESS $$$ than a better profile contour that Gunson shows (and with excessive costs), then go for the potential improvement the local guy offers. Also, ask yourself that IF money was not an object and both costs were the same, WHICH doctor would you go to; some local guy or Gunson?
ETA: Sometimes a local guy can do what Gunson does IF they have an actual displacement proposal PLAN that Gunson provides. So, it is possible to take Gunson's plan around to other doctors who might be able to do similar at lower price. However this is not the case here since your local guy said he would be doing things differently.
