Hi all
I’m at the point where I need to make my final decision between Dr. Gunson and Dr. Raffaini for double jaw surgery, and I’d really value input from people who have experience or thoughts with either surgeon or who have expertise in orthognathic surgery.
My case is somewhat unique (maybe not too unique haha) from many others because my primary goal is aesthetics rather than correcting a major functional problem. I understand this makes the decision much more subjective, which is exactly why I’m hoping to hear a variety of perspectives. Both surgeons have been professional and kind during my consultations, and I feel fortunate to have two excellent options. My challenge is deciding which approach is more likely to give the best long-term aesthetic and stable result.
Here are the details of my case and the questions I’m wrestling with:
*
Background * Choosing between Dr. Gunson and Dr. Raffaini.
* Primary goal is facial aesthetics.
* I have short face, Class 2.
* My bite is functional.
* My airway is good.
* Surgical plan (both surgeons similar) * minor Maxillary advancement.
* Greater mandibular advancement than the maxilla.
* Counterclockwise rotation.
* Vertical downgrafting of the maxilla.
* genioplasty.
* Midface augmentation.
* Main difference * Dr. Raffaini would perform midface augmentation with fat grafting, and some other soft tissue procedures with the lips and sutures for soft tissue management.
* Dr. Gunson would use custom hydroxyapatite-collagen grafts.
* Why I’m considering Dr. Raffaini * Exceptional aesthetic eye.
* Consistently beautiful facial outcomes.
* Strong emphasis on soft tissue management and overall facial harmony.
* Fat grafting appeals to me because it seems like a natural way to restore volume.
* My concerns about Dr. Raffaini * I’ve come across reports online describing inconsistent follow-up and postoperative communication.
DOES HE BOTCH? Please tell me if you’ve heard of real cases that went bad with him. An orthodontist told me he doesn’t recommend Raffaini because he’s “heard” some bad stories
* To be fair, I only found one or two identifiable patients reporting negative experiences firsthand. Much of the rest appears to be forum discussion or hearsay.
* Since he’s getting older, I also wonder about long-term availability if I ever needed advice or a revision several years down the road.
*
Why I’m considering Dr. Gunson * Extremely detailed consultation.
* Methodical planning process.
* Excellent communication.
* Gives me a high level of confidence in the surgical planning itself.
*
My concerns about Dr. Gunson * Uses hydroxyapatite-collagen grafts instead of fat grafting.
* I’m unsure about the long-term implications of these grafts in the cheeks or jaw.
* I’d especially like to understand whether they affect future procedures such as fat grafting, revision surgery, cheek implants, or a deep plane facelift because of scar tissue or changes to the tissue planes.
I also don’t know if Gunson has the same kind of elegant aesthetic eye as Raffaini?
*
Questions for the forum * If aesthetics were your primary goal, which surgeon would you choose?
* Has anyone here been treated by either surgeon?
* Does anyone have long-term experience with Gunson’s hydroxyapatite grafts?
* How do hydroxyapatite grafts compare with fat grafting over 10 to 20 years?
* If you were making this decision today, what would your reasoning be?
