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General Category => Functional Surgery Questions => Topic started by: adelv on March 08, 2014, 07:25:40 AM

Title: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: adelv on March 08, 2014, 07:25:40 AM
hello

i'm looking to do a rhinoplasty and jaw augmentation in europe, i heard about Dr Mommaerts and apparetly he is pretty good is this true ? is there better surgeon than him ?
did someone have experience with him ?
does anyone have his contact info ?

Thank you alot !
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Gregor Samsa on March 08, 2014, 07:34:31 AM
There is a whole forum section dedicated to discussing different surgeons in case you have missed it. There are several threads about Mommaerts there. This is the most active one: http://jawsurgeryforums.com/index.php/topic,748.0.html (http://jawsurgeryforums.com/index.php/topic,748.0.html)
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: adelv on March 08, 2014, 11:44:17 AM
hey thank you gregor
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Optimistic on March 11, 2014, 12:31:37 AM
hello

i'm looking to do a rhinoplasty and jaw augmentation in europe, i heard about Dr Mommaerts and apparetly he is pretty good is this true ? is there better surgeon than him ?
did someone have experience with him ?
does anyone have his contact info ?

Thank you alot !

What kind of rhinoplasty are you looking at? If it's something basic like removing a dorsal hump then having Mommaerts do that wouldn't be a problem. However I wouldn't let someone who doesn't specialise in rhinoplasty / revision rhinoplasty touch the tip of my nose, for example.

As for jaw augmentation then yes I believe he's one of the best in Europe. He's one of the few who offer Chin Wing Osteotomies and has a pretty keen eye for aesthetics.

All the results I've seen from him have been quite good, although there are some who disagree. I guess it's important to see pictures and decide for yourself really.
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Tiny on March 11, 2014, 03:48:32 AM
What kind of rhinoplasty are you looking at? If it's something basic like removing a dorsal hump then having Mommaerts do that wouldn't be a problem. However I wouldn't let someone who doesn't specialise in rhinoplasty / revision rhinoplasty touch the tip of my nose, for example.

Agree, agree.  Rhinoplasty is SO difficult.  See a specialist.  And don't be surprised if you need a revision
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: PloskoPlus on March 11, 2014, 04:21:24 AM
Agree, agree.  Rhinoplasty is SO difficult.  See a specialist.  And don't be surprised if you need a revision

Even of its only septoplasty and shaving down the bump ie. no cartilage touched?  These are basically osteotomies, and a maxfac should have more practice with them than a PS.
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Tiny on March 11, 2014, 05:53:53 AM
Even of its only septoplasty and shaving down the bump ie. no cartilage touched?  These are basically osteotomies, and a maxfac should have more practice with them than a PS.

I guess this part isn't that hard.  But I don't think it's super-common to just have that done.   Septoplasty involves cartilage work not just bone.  A lot of people need additional work to reducing the hump.  I got the bump shaved down, a septoplasty, columella reduction and a stitch put in the tip to make it less bulbous.  And that's not even a lot of things compared to some.  I didn't get the tip rotated or any nostril work, etc.

Also, how you 'open' the nose will affect things too (internal and external scarring), and a PS is going to be more experienced with that than a max fac.  I am not happy with my rhino result and plan on a revision but I will say, that I have absolutely no external scarring despite having an open rhino.

Communication with the surgeon is key. I do believe that my rhino surgeon is skilled, but I requested less projection and he said I didn't need it.  Now I really feel that my entire nose is too big hence (and bulbous) why I want a revision.  I have a reeeeeeaaally small chin, as we know, and I feel I need a pretty small nose to match and look more balanced.  I should have been more insistent about what I wanted; the surgeon I chose generally goes for more subtle results.  I should have seen a Lebanese or Persian or Pakistani surgeon who is used to making noses significantly smaller.


tl;dr : I would not do a rhino with a max fac unless I knew he did a lot of rhinos and had a lot of before/after pictures that were consistent with what I wanted
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Gregor Samsa on March 11, 2014, 08:39:10 AM
I wouldn't even go with a plastic surgeon unless nose jobs is his speciality. You can't really compare a plastic surgeon that does ten rhinoplasty surgeries a year to someone who has done at least 100 a year for the past 20 years.
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: PloskoPlus on March 12, 2014, 03:44:07 AM
I guess this part isn't that hard.  But I don't think it's super-common to just have that done.   Septoplasty involves cartilage work not just bone.  A lot of people need additional work to reducing the hump.  I got the bump shaved down, a septoplasty, columella reduction and a stitch put in the tip to make it less bulbous.  And that's not even a lot of things compared to some.  I didn't get the tip rotated or any nostril work, etc.
The max fac says that I have a big face, and the nose needs to stay large.  He doesn't want to touch any soft tissue - tip, nostrils.  Just shave down the bump and make it straight.  He says the bump and the deviated septum make it bigger than it is.  But I keep thinking that my tip is too bulbous and fleshy.  I asked him if it's too risky to do the rhino at the same time as the surgery, and should I wait the oft-advised "12 months for the swelling to go down".  He answered  "you are not a model with a tiny tip that needs to be moved by a single mm". Hehe.

Also, how you 'open' the nose will affect things too (internal and external scarring), and a PS is going to be more experienced with that than a max fac.  I am not happy with my rhino result and plan on a revision but I will say, that I have absolutely no external scarring despite having an open rhino.
I was surprised to hear that he does closed rhinos.  From what I've read most PSs do open ones these days.  Perhaps because as a max fac he's used to working inside out.

Communication with the surgeon is key. I do believe that my rhino surgeon is skilled, but I requested less projection and he said I didn't need it.  Now I really feel that my entire nose is too big hence (and bulbous) why I want a revision.  I have a reeeeeeaaally small chin, as we know, and I feel I need a pretty small nose to match and look more balanced.  I should have been more insistent about what I wanted; the surgeon I chose generally goes for more subtle results.  I should have seen a Lebanese or Persian or Pakistani surgeon who is used to making noses significantly smaller.
I though you were going to get your maxilla advanced?  That will make the nose look significantly less projected (depending on how big the advancement is, of course).

tl;dr : I would not do a rhino with a max fac unless I knew he did a lot of rhinos and had a lot of before/after pictures that were consistent with what I wanted
What is really surprising is how cheap the rhino is by the max fac compared with the 2 top PS rhino specialists in my city.  Less than 1/3 the price!  Australia is kind of strange.  PS here costs more than orthognathic surgery.  I'm a bit dumbfounded by those Gunson & Arnett numbers floating around.  Anyway, I really want to get all this surgery business out of the way in one go if possible.  So do the basic rhino (bump and septoplasty) at the time of the jaw surgery, and if I'm not happy with the tip and nostrils, have them revised by a specialist 12 months later.

Do you think that the "straightness" and the nose tip/nostrils are independent, or are they heavily interrelated? 

(OTOH, I'm also considering leaving the nose alone for 12 months.  My maxilla will be advanced, which will make the nose less projected and turn up the tip some.  And maybe straight septums and symmetry in general are overrated.  Daniel Day Lewis has a broken nose, which I didn't realise until someone pointed it out here.  I've seen pictures of models with deviated noses.)
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Gregor Samsa on March 12, 2014, 04:34:47 AM
I don't see how you can get rhinoplasty at the same time as jaw surgery either way since you need to have tubes through your nose during the jaw surgery. I bled constantly from the nose for over a week after my surgery and that's supposely normal.
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Tiny on March 12, 2014, 12:58:42 PM
The max fac says that I have a big face, and the nose needs to stay large.  He doesn't want to touch any soft tissue - tip, nostrils.  Just shave down the bump and make it straight.  He says the bump and the deviated septum make it bigger than it is.  But I keep thinking that my tip is too bulbous and fleshy.  I asked him if it's too risky to do the rhino at the same time as the surgery, and should I wait the oft-advised "12 months for the swelling to go down".  He answered  "you are not a model with a tiny tip that needs to be moved by a single mm". Hehe.
PM me a pic and I'm happy to give you my thoughts

I was surprised to hear that he does closed rhinos.  From what I've read most PSs do open ones these days.  Perhaps because as a max fac he's used to working inside out.
Open rhinos are more accurate.  Given that the scar is tiny (mine is invisible but I do have fair skin which helps), then I would always recommend an open rhino

I though you were going to get your maxilla advanced?  That will make the nose look significantly less projected (depending on how big the advancement is, of course).
Mandible advanced.  Maxilla I want rotated and slightly downgrafted.  Yes, advancing the mandible will make the nose seem less projected but regardless of that the tip is still too bulbous for my taste.  It's either that he didn't take out enough cartilage or it's scare tissue.  I broke my nose badly prior to the rhino which I guess doesn't help

What is really surprising is how cheap the rhino is by the max fac compared with the 2 top PS rhino specialists in my city.  Less than 1/3 the price!  Australia is kind of strange.  PS here costs more than orthognathic surgery.  I'm a bit dumbfounded by those Gunson & Arnett numbers floating around.  Anyway, I really want to get all this surgery business out of the way in one go if possible.  So do the basic rhino (bump and septoplasty) at the time of the jaw surgery, and if I'm not happy with the tip and nostrils, have them revised by a specialist 12 months later.
several reasons for this
- supply and demand, top nose surgeons with excellent reputations can always charge a premium.  Because it's a difficult surgery, most people are less likely to go for budget rhino options
- if you're already under for jaw surgery you don't have all the anaesthetists costs etc.

I'm not sure I would advise doing rhino and jaw together.  It allows you to only have one GA which is good.  However, rhino with hump work is not an easy recovery.  Your nose will be totally (and I do mean totally) blocked for at least a week, maybe more.   I didn't sleep more than a 2-3 hours a night for 4 nights after my rhino.  If you have bump work you will be very swollen and probably have huge bruises.  Maybe it will be easier if your doc prescribes sleeping meds; mine did not.  After the first week I started using decongestant spray, even though I'd been told not to.  I was so desperate to sleep.  During the day the nose is totally blocked and you can't breathe at all.  At there's lots of hard scabs, too (and boogers)

Do you think that the "straightness" and the nose tip/nostrils are independent, or are they heavily interrelated? 
related but not heavily.  That how people can get "non-surgical nose jobs" with fillers.  Also a heavy columella/bulky tip can do funny things to how a nose with a bump looks.  Prior to my surgery my nose looked fine from some angles but from others it looked like a hook nose, but it wasn't.  A nose with a up-turned tip and a bump generally looks a lot straighter IMO, also it's easier to 'correct' with fillers

Here are some pics of nose reshaping using filler (usually radiesse, sculptra or artefil)
(http://www.drsimoni.com/images/nsr5.jpg)
(http://www.botonics.co.uk/wp-content/uploads/2013/07/non_surgical_nose_job_dorsal_hump_1_dermal_filler_botonics_naruschka_henriques.jpg)
(http://www.leadinginstanteyelift.com/wp/wp-content/uploads/2012/07/Dermal-filler-rhinoplasty-.png)


(OTOH, I'm also considering leaving the nose alone for 12 months.  My maxilla will be advanced, which will make the nose less projected and turn up the tip some.  And maybe straight septums and symmetry in general are overrated.  Daniel Day Lewis has a broken nose, which I didn't realise until someone pointed it out here.  I've seen pictures of models with deviated noses.)
My nose isn't straight.  The tip is twisted and one nostril is higher than the other and the main body isn't straight either.  You can only see it in photos, in real life I'm moving too much for it to be noticeable.
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: nrelax11 on March 12, 2014, 03:11:06 PM
Since were kind of talking about rhinos,  does anyone know the cost of just nose grafting?  I guess as I aged, my cartilage on my left side of my nose collapsed and I have a dent on the side there. It actually makes it more crooked looking than anything. Im hoping to get this fixed one day because I have a nice shaped nose, its jus that indentation ruins it.
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Tiny on March 12, 2014, 06:39:35 PM
Since were kind of talking about rhinos,  does anyone know the cost of just nose grafting?  I guess as I aged, my cartilage on my left side of my nose collapsed and I have a dent on the side there. It actually makes it more crooked looking than anything. Im hoping to get this fixed one day because I have a nice shaped nose, its jus that indentation ruins it.
I'd a few thousand.  I'd go for filler if I were you, it's good for depressions like this

re: the original post

- having had rhino with bump work, no I would not recommend doing rhino with bump work at the same time as jaw surgery.  A lot of swelling, a lot of healing...
- personally I wouldn't do a rhino with a max fac
- a lot of people recently have not been happy with Mommaerts.  However, he does have a lot of experience, is affordable, and an eye for aesthetics.  I myself was just not taken with the surgical plan, which was for a relatively small advancement (5-6mm) and CW rotation to open the bite, when I feel I need significantly more than this, in the 8-10mm range, and CCW to flatten the plane and lengthen the face.  This seems to be consistent with some of the complaints that those who have had surgery with him recently - insufficient movement.  If I agreed with the surgical plan and it was something pretty simple (e.g. straight BSSO) then I'd have not much issue using him
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Gregor Samsa on March 12, 2014, 07:29:28 PM
- a lot of people recently have not been happy with Mommaerts.  However, he does have a lot of experience, is affordable, and an eye for aesthetics.  I myself was just not taken with the surgical plan, which was for a relatively small advancement (5-6mm) and CW rotation to open the bite, when I feel I need significantly more than this, in the 8-10mm range, and CCW to flatten the plane and lengthen the face.  This seems to be consistent with some of the complaints that those who have had surgery with him recently - insufficient movement.  If I agreed with the surgical plan and it was something pretty simple (e.g. straight BSSO) then I'd have not much issue using him

Don't you think it's a bit weird to say he has a good eye for aesthetics and then go on to state that the surgery plans he proposes are underwhelming? I'd say he is probably a very good surgeon from a technical point of view but there's no explanation for his surgery plans other than that he lacks a good eye for aesthetics. I mean, the surgery plan is where having a good eye for aesthetics really matters.
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Optimistic on March 12, 2014, 07:39:49 PM

Here are some pics of nose reshaping using filler (usually radiesse, sculptra or artefil)
(http://www.drsimoni.com/images/nsr5.jpg)
(http://www.botonics.co.uk/wp-content/uploads/2013/07/non_surgical_nose_job_dorsal_hump_1_dermal_filler_botonics_naruschka_henriques.jpg)
(http://www.leadinginstanteyelift.com/wp/wp-content/uploads/2012/07/Dermal-filler-rhinoplasty-.png)


The only thing that first guy got was photoshop. Why is his hair exactly the same? Typical scamming Indian doctors.
I suspect all of them have been modified to some extent.


forgive me based God I was wrong!
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: nrelax11 on March 12, 2014, 08:38:23 PM
I'd a few thousand.  I'd go for filler if I were you, it's good for depressions like this

re: the original post

- having had rhino with bump work, no I would not recommend doing rhino with bump work at the same time as jaw surgery.  A lot of swelling, a lot of healing...
- personally I wouldn't do a rhino with a max fac
- a lot of people recently have not been happy with Mommaerts.  However, he does have a lot of experience, is affordable, and an eye for aesthetics.  I myself was just not taken with the surgical plan, which was for a relatively small advancement (5-6mm) and CW rotation to open the bite, when I feel I need significantly more than this, in the 8-10mm range, and CCW to flatten the plane and lengthen the face.  This seems to be consistent with some of the complaints that those who have had surgery with him recently - insufficient movement.  If I agreed with the surgical plan and it was something pretty simple (e.g. straight BSSO) then I'd have not much issue using him

Sorry for hijacking the thread here, but one last quick question. What filler is good for the nose. Theres a plastic surgeon in San Francisco near me that does nose fillers and uses either artefill, radiesse, juvederm or restylane. Ive heard bad stuff about using artefill in the nose, so maybe I can go for restylane. I know it doesnt last that long, but I know that in places like the tear troughs and nose, it can last up to a year since they dont move around as much.
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Tiny on March 13, 2014, 12:17:06 PM
The only thing that first guy got was photoshop. Why is his hair exactly the same? Typical scamming Indian doctors.
I suspect all of them have been modified to some extent.

Actually, his eyes are looking in different directions.  The lips are slightly different. The hair is exactly the same because the pictures are taken literally a few minutes apart.  I pulled them off google images so potential for 'shopping...but my friend had this procedure and it looked pretty good.
Also, Payman Simoni is not exactly an indian name

@gregor - yes, I guess so.  I guess I am confused myself because he has some good before/afters but his surgical plan for me, didn't seem so great

@nrelax - what good is filler for the nose?  Not too bad especially for cases like yours.  Google 'non surgical nose job'.  I'd go for radiesse if I were you.  Juvederm/restylane is a bit soft and doesn't last long enough.  Artefill is technically an implant, it is usually fine but sometimes, it gets rejected after a few years.
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: nrelax11 on March 13, 2014, 01:31:22 PM
@weakjawbrah Yea the photo is taken the same day. The injections dont take long and the results are pretty right there after. I cant wait to get this stupid dent in my nose fixed lol. Its annoying, I feel like my excessive vertical growth of my maxilla messed with my orbital rim because I have stupid hallows under my eyes. But a lot of the hallowness comes from my nasal bone when I smile. So this next month im getting restylane in my tear troughs and maybe by winter time Ill get my nose fixed and by then my jaw will be healed too! Gah, cant wait:)
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Optimistic on March 13, 2014, 04:42:13 PM
Actually, his eyes are looking in different directions.  The lips are slightly different. The hair is exactly the same because the pictures are taken literally a few minutes apart.  I pulled them off google images so potential for 'shopping...but my friend had this procedure and it looked pretty good.
Also, Payman Simoni is not exactly an indian name

@gregor - yes, I guess so.  I guess I am confused myself because he has some good before/afters but his surgical plan for me, didn't seem so great

@nrelax - what good is filler for the nose?  Not too bad especially for cases like yours.  Google 'non surgical nose job'.  I'd go for radiesse if I were you.  Juvederm/restylane is a bit soft and doesn't last long enough.  Artefill is technically an implant, it is usually fine but sometimes, it gets rejected after a few years.

Are there not harder, more permanent solutions to what they're offering here? Like bone grafting for example.
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: Optimistic on March 13, 2014, 04:43:20 PM
@weakjawbrah Yea the photo is taken the same day. The injections dont take long and the results are pretty right there after. I cant wait to get this stupid dent in my nose fixed lol. Its annoying, I feel like my excessive vertical growth of my maxilla messed with my orbital rim because I have stupid hallows under my eyes. But a lot of the hallowness comes from my nasal bone when I smile. So this next month im getting restylane in my tear troughs and maybe by winter time Ill get my nose fixed and by then my jaw will be healed too! Gah, cant wait:)

Sounds exciting, I hope it all works out for you. I'm in a similar situation. Hopefully within this year all my issues will be solved :)
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: nrelax11 on March 13, 2014, 05:45:35 PM
Sounds exciting, I hope it all works out for you. I'm in a similar situation. Hopefully within this year all my issues will be solved :)

Yes, I hope after all this is done,  we can be at peace with our looks :)
Title: Re: Rhinoplasty and Jaw augmentation Dr mommaerts ??
Post by: PloskoPlus on March 14, 2014, 04:11:22 AM
PM me a pic and I'm happy to give you my thoughts
I keep meaning to post my pics on the forum.  But I've lost some weight since my ortho took the pictures, so I would need new pictures.  But I think pictures not taken with a proper lens can be deceiving.  My face is a lot wider in ortho's photos compared with my phone camera.  I need to sort out a camera.