jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Lazlo on July 25, 2016, 08:44:29 PM
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I feel fine. Sure a bit sore with tugging and pulling of the lips and jaw.
no nausea
no real pain
feeling everywhere
even places I as supposed to have NO feeling I have feeling, like the roof of my mouth
slight loss of feeling in upper left segment on lip but not TOTAL by any means
I can breathe completely through my nose which i I was tolds I wouldn't be able to do.
So I'm just staying in Sinn's office for the night and I'm glad beause Cindy the nurse is SUPER SUPER nice and better company than my Dad would probably have been. I'm supposed to have the splint in for 30 days.
Honestly my face is visibly very swellen so I have no idea what I look like though.
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oh i got a clarification about HA graft for my gonial angles.
It's not onlay, it's between the joint for width.
upper jaw 3 piece lefort, 6mm advancement, plust downgraft
I had CCW but lower was also 6mm
and a 9 mm genioplasty with widening small lengthening and
V-Y plasty of borth upper and lower lip and turbinaite reduction
BSSO --man I thought I was gonna be wayway worse shape. Plus surgery was 5 hours, started at 7 am and woke up 5pm since which time I've kind of been I feel good enought to watch movies.
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yay! congratulations and i am SHOCKED and amazed you feel so good. seems unusual honestly but also excellent! rest up and look forward to hearing about your results!
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I feel fine. Sure a bit sore with tugging and pulling of the lips and jaw.
no nausea
no real pain
feeling everywhere
even places I as supposed to have NO feeling I have feeling, like the roof of my mouth
slight loss of feeling in upper left segment on lip but not TOTAL by any means
I can breathe completely through my nose which i I was tolds I wouldn't be able to do.
So I'm just staying in Sinn's office for the night and I'm glad beause Cindy the nurse is SUPER SUPER nice and better company than my Dad would probably have been. I'm supposed to have the splint in for 30 days.
Honestly my face is visibly very swellen so I have no idea what I look like though.
This is super good news. The more feeling you have right after surgery the more likely you're to have complete recovery of your nerves.
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My lips have a bit lesser feeling, I have full feeling everywhere.
I'll hold off an making an aesthetic judges till a month.
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yay! congratulations and i am SHOCKED and amazed you feel so good. seems unusual honestly but also excellent! rest up and look forward to hearing about your results!
Oh I guess I forgot to let you know my name is Logan!
But in all honestly, I did have a bit more swelling in my mouth. But again all healthy oh and I'm a "mature" patient too so really I would have expected recovery to be WAY tougher than this. I'm just so stoked I can breath. I mean this isn't even day 2 I had surgery yesterday morning.
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Oh I guess I forgot to let you know my name is Logan!
Hi Logan.
I am Lestat!
Good luck and all the best! ;)
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Lazlo it feels weird that you've had surgery after all these years...all the best!
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Wow congratulations
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Good luck with recovery, hope you get your desired outcome
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I know those who know me from the start of all this wow it does feel weird.
Let me make some observations about myself psychologically here. I expected recovery to be a lot tougher considering all the stuff i was having done.
But here are some observations I have to make. Yeah I'm basically day 2 of surgery, but I almost already feel I won't be quite satisfied by the results. Why? Well my chin is lining up to the tip of my nose (I have a very big nose) --now that might be ENTIRELY erroneous of an observation given the Splint if changing the shape of the mouth AND even though I can't really tell cause I'm so fat I probably have more swelling than an orangutan's anus.
Also, having seen now others get at least 2 chin wings to get their results I'm thinking it may be that a chin wing is necesarrily down the line for me too. But I'm quite surprised I'm experiencing a tad bit of buyer's remorse so soon.
I gotta tell you, one thing that really disappointed me is that Dr. Sinn said he'd have a visualization for me before surgery and then he left it till like 20 minutes before surgery and it wasn't a photographic picture it was just the skull.
I'm also a tad confused. He didn't execute Arnett's plan which called for something like 4mm upper and 7mm lower CCW (not counting any genioplasty).
Sinn's plan was 6 mm upper and 6 mm lower with CCW (how does that make sense? i thought ccw necessarily means that the lower is much bigger, but he also dropped the maxilla so maybe that brings it forward more?). That said Sinn did a 9mm genioplasty. I mean given that my lower jaw was moved so far back during extraction orthodontics I wonder if that's enough. I know it's 1.5 cm approximately. And I kept trying to drill into him how many mm I wanted far ahead tip of my chin aligned with the tip of my nose and provided tons of pics. Even a visualization done by a member of this forum.
See here's the thing, I've almost always found every surgeon doesn't give men that type of chin they're looking for, they hedge on the conservative (especially arnett and gunson). And I've heard the same greivance from almost every patient --I wish my surgeon had done more of genioplasty. I mean that is really one of the easiest parts of the surgery!!!
Also, I don't think Sinn doesn't anything for the notching, though he did say he sanded down the bone.
The HA bone graft went between the osteotomy to create width and he dropped the ramus not through osteotomy but just by angling it.
I've decided I'm going to drink only liquids for the entire month so I can lose a ton of weight and find out how these results look.
Now sure, judging results at 2 days is imprudent, but your results are pretty much fully there (at least what counts) at the 4-6 week mark. I've been on these forums long enough to know this is true.
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Mate, I wouldn't even look in the mirror until 3/4 weeks as passed. You can't judge anything 2 days after the surgery. You'll look completely different in a few weeks to how you look now
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Mate, I wouldn't even look in the mirror until 3/4 weeks as passed. You can't judge anything 2 days after the surgery. You'll look completely different in a few weeks to how you look now
yeah i know you're right, it's just hard to not want to project/predict what's going to happen. But it's great complication wise I'm fine. This is literally the second day and though I'm very swollen and drooling a lot, I feel periodically throughout the day I could very well even go back to work!
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Appearance shouldnt be judged til at least 3 months. Having said that it personally took me almost a year to adjust to my new appearance.
AlSo, after my SG my chin lined up w the tip of my nose and I thought it was slightly overdone. Gotta look natural
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Appearance shouldnt be judged til at least 3 months. Having said that it personally took me almost a year to adjust to my new appearance.
AlSo, after my SG my chin lined up w the tip of my nose and I thought it was slightly overdone. Gotta look natural
yeah i almost wish I was having that feeling. I feel like I just look the same as before surgery! Big issues is cause I got so fat beforehand so the bony segment changes are invisible.
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Congrats. I know the feeling of being surprised that it's not as bad as expected, hopefully it stays positive for you. Would also be great if you shared (censored) pictures down the line because this sounds like a very major aesthetic surgery on top of the benefits. I'm particularly interested in the chin widening you've had since I'm looking into that as well.
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yeah i almost wish I was having that feeling. I feel like I just look the same as before surgery! Big issues is cause I got so fat beforehand so the bony segment changes are invisible.
Did you are least shave before surgery?
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Did you are least shave before surgery?
lol yeah i did and i even shaved my head entirely bald with a bic so there'd be no hair in the doc's way
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Sounds like a lot of surgery through 5 hours time, but really hoping it works out well for you! That's amazing how little nerve damage you seem have to gotten so far. TBH I'm a little surprised your lower jaw was only moved forward 6mm. Did you not have sleep apnea? Also, did he use HA around your cheeks?
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i just spent the 2 weeks caring for someone who had double jaw surgery. just an fyi, the stuffed up nose didn't settle in really strongly until day 3 or 4 after surgery. granted, the movements were larger than yours and surgery time longer but still i suggest you have some children's sudafed, chap stick and maybe some afrin on hand. just don't get too used to the afrin, use it sparingly and avoid drinking dairy or dairy based protein powders.
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i just spent the 2 weeks caring for someone who had double jaw surgery. just an fyi, the stuffed up nose didn't settle in really strongly until day 3 or 4 after surgery. granted, the movements were larger than yours and surgery time longer but still i suggest you have some children's sudafed, chap stick and maybe some afrin on hand. just don't get too used to the afrin, use it sparingly and avoid drinking dairy or dairy based protein powders.
Thanks for the tips! I'm not too worried about pain and all that. I just hope I got the results I was banking on. I mean I don't know why my movements were so low. is 1.5 cm for the lower jaw low? I mean I had a weak jaw/chin but not like one of those condyle absorption patients. Oh well, we'll see how things end up after a couple months and if I'm unhappy I'll go with a chin wing to push it further.
Honestly, I've been watching this stuff for a long time and it takes 6 weeks to see 95 percent of results and that last 5 percent is negligible. Anyone wanna show me visual evidence to the contrary? That whole 3-6 months BS is from doctors who wanna shake unsatisfied patients off their back.
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Swelling keeps going on residually for at least minimum 3 months
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Swelling keeps going on residually for at least minimum 3 months
sure but do you have an accurate gauge of your results by 6 weeks, at least in terms of the balance of the chin to nose in profile or the squareness, shape of the frontal view etc. YUP.
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i agree with you that by week 8 at the latest you can make pretty accurate judgements on aesthetic outcomes.
i think 15mm is probably a very average movement. def significant but not enormous. 9mm seems like a enormous movement for a genioplasty though! you must have ended up with a very strong chin which i don't think necessarily means it lines up with the tip of your nose!
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i agree with you that by week 8 at the latest you can make pretty accurate judgements on aesthetic outcomes.
i think 15mm is probably a very average movement. def significant but not enormous. 9mm seems like a enormous movement for a genioplasty though! you must have ended up with a very strong chin which i don't think necessarily means it lines up with the tip of your nose!
Yup I asked for a VERY strong chin so if that's the implication, fantastic. He also widened the mandibles at the sides. Honestly given all the horror stories and botched surgeries out there the fact that things went off without any (as yet) complications I'm pretty stoked.
Well everyone always says the Day 3 mark is the toughest so I'll report back to y'all tomorrow on how that's turned out.
One interesting thing, no expansion of my nose whatsoever. In fact my nose looks smaller and sharper and a lot straighter than it did before. Sinn said he did that with his cinch and the trimming of the alar base (no external scars or anything).
Hoenstly I may not need a rhionplasty at all I think! But again, here I am falling prey to what I always warned others about, drawing conclusions too early.
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Thanks for the tips! I'm not too worried about pain and all that. I just hope I got the results I was banking on. I mean I don't know why my movements were so low. is 1.5 cm for the lower jaw low? I mean I had a weak jaw/chin but not like one of those condyle absorption patients. Oh well, we'll see how things end up after a couple months and if I'm unhappy I'll go with a chin wing to push it further.
Honestly, I've been watching this stuff for a long time and it takes 6 weeks to see 95 percent of results and that last 5 percent is negligible. Anyone wanna show me visual evidence to the contrary? That whole 3-6 months BS is from doctors who wanna shake unsatisfied patients off their back.
For lower jaw I can 100% say that it takes quite some time before you can tell. For instance at 3 months I had a good feeling of the outcome, but still required another 2 months for more swelling to go. You'll be surprised at hte degree of residual swelling that exists.
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sure but do you have an accurate gauge of your results by 6 weeks, at least in terms of the balance of the chin to nose in profile or the squareness, shape of the frontal view etc. YUP.
By 8 weeks 90% of swelling is gone. You can safely judge your result then.
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Yup I asked for a VERY strong chin so if that's the implication, fantastic. He also widened the mandibles at the sides. Honestly given all the horror stories and botched surgeries out there the fact that things went off without any (as yet) complications I'm pretty stoked.
Well everyone always says the Day 3 mark is the toughest so I'll report back to y'all tomorrow on how that's turned out.
One interesting thing, no expansion of my nose whatsoever. In fact my nose looks smaller and sharper and a lot straighter than it did before. Sinn said he did that with his cinch and the trimming of the alar base (no external scars or anything).
Hoenstly I may not need a rhionplasty at all I think! But again, here I am falling prey to what I always warned others about, drawing conclusions too early.
Can you explain what you mean by alar base trimming? Did he file down the maxilla under the nose or did he actually do a weir resection of your nostrils?
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Can you explain what you mean by alar base trimming? Did he file down the maxilla under the nose or did he actually do a weir resection of your nostrils?
I'll ask him when I see him today. Whatever he did it made a bit of a difference in making my nose look better.
So it's morning of Day 3. I'm so surprised most of you aren't shocked and asking me tons of questions but then most of yuo are newbies and don't remember the old days of this forum, the disasterously heart-crushing meeting with Arnett when he told me my ortho had ruined my looks, and then the false hope I briefly had that Schendel could help. And let's not forget the Mayo clinic. This has been a journey ongoing since 2011 for me and the major part of it is finally, and thankfully done.
Yeah so my face hasn't gotten any MORE swollen. But the lower part is really swollen. Thanks for that comment molestrip I think you're right as I think the type of swelling I have is distortin how my jaw and bite look right now.
Not gonna lie, I get the occasional shooting pain a long nerves in my mouth, but again the hydrocodone does the trick. ]
I'm a tad irritable with all the drueling and not being able to speak very well.
Anyway......
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The alar cinch is keeping your nostrils together and probably raised your tip. Combined with swollen more forward cheeks your nose looks smaller. As the cinch dissolves the nostrils will widen and the tip will drop - the nose will widen eventually. In the first weeks after my lefortI I ttoo thought "hey i don't need a nose job anymore".
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The alar cinch is keeping your nostrils together and probably raised your tip. Combined with swollen more forward cheeks your nose looks smaller. As the cinch dissolves the nostrils will widen and the tip will drop - the nose will widen eventually. In the first weeks after my lefortI I ttoo thought "hey i don't need a nose job anymore".
ugh thanks for bursting that bubble. yeah 2 months and you got your results (and that's me being way conservative) really I think it's at 6 weeks.
But you know what? If I gotta go for another one of these coulc totally do it.
I'm sure everyone here will be excited to know if Sinn is especially that best or whether I just got sucked in by the hype. Once again, the fact that I thus fara have zero to no complications is already mking me feel very lucky.
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Congrats :)
Do yourself a favor and take some rest now, don't start overanalyzing the results, swelling really depends on individuals,3 weeks after my SG,I was close to the final result, and I'm at 9 months now ;)
If you have sensations back, I bet your swelling isn't massive, he must have been very careful while operating
Can you tell me more about the widening osteotomy, and the mandibular widening as well?
You really picked my interest
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Congrats :)
Do yourself a favor and take some rest now, don't start overanalyzing the results, swelling really depends on individuals,3 weeks after my SG,I was close to the final result, and I'm at 9 months now ;)
If you have sensations back, I bet your swelling isn't massive, he must have been very careful while operating
Can you tell me more about the widening osteotomy, and the mandibular widening as well?
You really picked my interest
yeah well i told sinn i wanted a wider mandible and so he proposed widening with the use of an HA graft (i'm not sure if coral or bone, I'll ask when I see him tomorrow). He's a super nice guy.
Yeah I gotta just chill and relax, I'm so like hopped up about the results. I basically reasoned with myself that I'm not even gonna look at my face till Sept 1st 2016 an then every two weeks after that. But I dunno why, I feel positive and good. Saw Dr. Sinn again today, he says I'm healing really well. It's wonderful how accessible he makes himself to his patients.
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how exactly did he go about widening the mandible? did he lay HA along the entire jaw line or just beneath the masseter at the back? did you say he tilted the joint in the socket to flare it out or did something with HA at the joint??
also, wow! a 6mm maxillary down graft is huge. you must have started out with ample upper lip. are you worried about too much tooth show? maybe because the down graft was so large it made the gave less distance for the ccw rotation of the lower jaw? anyway, i can't imagine you didn't end up with a pretty manly lower third.
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how exactly did he go about widening the mandible? did he lay HA along the entire jaw line or just beneath the masseter at the back? did you say he tilted the joint in the socket to flare it out or did something with HA at the joint??
also, wow! a 6mm maxillary down graft is huge. you must have started out with ample upper lip. are you worried about too much tooth show? maybe because the down graft was so large it made the gave less distance for the ccw rotation of the lower jaw? anyway, i can't imagine you didn't end up with a pretty manly lower third.
no not worried about too much upper tooth show. It looks good with a full white smile. And oh yeah i've ended up with a jason statham jawline I think. It's just covered up with swelling right now. In fact if I don't like it after swelling goes down, Dr. Sinn said he can redo what I don't like. But I think it may be perfect.
I wish Sinn did more surgical operations cause he's such a gifted surgeon. He actually had an assistant just to hold things and stuff and my dad said that other surgeon came out during the surgery and said Dr. Sinn was amazing.
Also, holy s**t, my surgery lasted 7 hours. from 9-am -4pm. Can you friggin believe it!? And I feel great!
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If the alar cinch does not snap early and dissolves over 3 months as it should, technically you should see your final result at 3 months regarding the nose.
When I told Sinn that my le fort I lasted lless than 90 minutes, he exclaimed "that's good time!". I should have asked him to clarify. I suspect he meant rush job. Probably explains my nerve damage, poor tooth show. I had very persistent swelling in the right side. The side with all the numbness.
I don't want to be a negative ninny but the biggest concern now is the massive down graft stability. That's the main thing that concerns me about redoing my surgery with Sinn.
I should have done this earlier. Immediately after surgery I thought I could swing another surgery tomorrow. As the nerve damage failed to resolve im more and more reluctant to do anymore surgery.
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The increased swelling in the lower jaw is probably the midface swelling just flowing down.
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you finally done it. Congrats man!
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I'll ask him when I see him today. Whatever he did it made a bit of a difference in making my nose look better.
So it's morning of Day 3. I'm so surprised most of you aren't shocked and asking me tons of questions but then most of yuo are newbies and don't remember the old days of this forum, the disasterously heart-crushing meeting with Arnett when he told me my ortho had ruined my looks, and then the false hope I briefly had that Schendel could help. And let's not forget the Mayo clinic. This has been a journey ongoing since 2011 for me and the major part of it is finally, and thankfully done.
Yeah so my face hasn't gotten any MORE swollen. But the lower part is really swollen. Thanks for that comment molestrip I think you're right as I think the type of swelling I have is distortin how my jaw and bite look right now.
Not gonna lie, I get the occasional shooting pain a long nerves in my mouth, but again the hydrocodone does the trick. ]
I'm a tad irritable with all the drueling and not being able to speak very well.
Anyway......
No he just did a shaving down of the maxilla or whatever that part is (he said he did something to the septum) and greatly reduced the turbinates by cauterizing them.
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yeah well i told sinn i wanted a wider mandible and so he proposed widening with the use of an HA graft (i'm not sure if coral or bone, I'll ask when I see him tomorrow). He's a super nice guy.
Yeah I gotta just chill and relax, I'm so like hopped up about the results. I basically reasoned with myself that I'm not even gonna look at my face till Sept 1st 2016 an then every two weeks after that. But I dunno why, I feel positive and good. Saw Dr. Sinn again today, he says I'm healing really well. It's wonderful how accessible he makes himself to his patients.
I was just searching Gunson on this forum (just came back from consults w/him and Dechamps - might post about it soon), and I saw you had suggested a while ago to get a consult with Gunson and then have the surgery done by Dr. Sinn because he can widen the mandible. Dr. Gunson said he might use an HA graft to drop my ramus area more, so what are the differences really, you think, between Sinn and Gunson? I know Gunson doesn't like big SG's because he finds them unnatural looking and sometimes creates issues with lower lip thinning. Like in my case, he recommends a 3mm SG (on top of a ~15mm BSSO + LF1 CCW, no extractions ;D). I wasn't suggested, or recall hearing Gunson recommending chin widening procedures to people though. Your thoughts?
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I was just searching Gunson on this forum (just came back from consults w/him and Dechamps - might post about it soon), and I saw you had suggested a while ago to get a consult with Gunson and then have the surgery done by Dr. Sinn because he can widen the mandible. Dr. Gunson said he might use an HA graft to drop my ramus area more, so what are the differences really, you think, between Sinn and Gunson? I know Gunson doesn't like big SG's because he finds them unnatural looking and sometimes creates issues with lower lip thinning. Like in my case, he recommends a 3mm SG (on top of a ~15mm BSSO + LF1 CCW, no extractions ;D). I wasn't suggested, or recall hearing Gunson recommending chin widening procedures to people though. Your thoughts?
Wild guess - Deschamps-Braly suggested a much more conservative plan.
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i wonder if dmso can help with the swelling and recovery. if you google it they claim it has serious anti inflamatory properties. eppley eferenced it in a response to someone on real self
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i wonder if dmso can help with the swelling and recovery. if you google it they claim it has serious anti inflamatory properties. eppley eferenced it in a response to someone on real self
Ditterbo, I have no idea. I don't usually like the final results on Arnett/Gunson patients. At the same time, it seems to be way better to get the huge lower jaw movement with a sliding genio but in actual practice I don't know.
Well folks, the must touted DAY 4 (or beginning of Day 3 after surgery). I am DEFINITELY AS SWOLLEN AS I WILL GET NOW. It sort of sucks just cause it's uncomfortable. I feel like Eddie Murphy in those Norbit movies. I have no idea what the outcome of this surgery will be.
You know I gotta say, I sort of took the biggest risk of all doing a friggin double jaw surgery with a surgeon no one has ever used for JAW SURGERY on this forum. I mean I consulted with every best known surgeon and then chose the one no one had ever used. So we'll find out in a few weeks how this turns out. But so far, Sinn's staff have been pleasant and kind. The nurses, especially Cindy, are angelic and Dr. Sinn is like a Samurai master of jaw surgery. Well the waiting game.....
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This is so exciting - when can we expect pics? ;D
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Ditterbo, I have no idea. I don't usually like the final results on Arnett/Gunson patients. At the same time, it seems to be way better to get the huge lower jaw movement with a sliding genio but in actual practice I don't know.
Well folks, the must touted DAY 4 (or beginning of Day 3 after surgery). I am DEFINITELY AS SWOLLEN AS I WILL GET NOW. It sort of sucks just cause it's uncomfortable. I feel like Eddie Murphy in those Norbit movies. I have no idea what the outcome of this surgery will be.
You know I gotta say, I sort of took the biggest risk of all doing a friggin double jaw surgery with a surgeon no one has ever used for JAW SURGERY on this forum. I mean I consulted with every best known surgeon and then chose the one no one had ever used. So we'll find out in a few weeks how this turns out. But so far, Sinn's staff have been pleasant and kind. The nurses, especially Cindy, are angelic and Dr. Sinn is like a Samurai master of jaw surgery. Well the waiting game.....
Hey Lazlo
I see that you are quite the avid poster in here, and also seem to have a ton of real life experience with jaw surgery.
So, I was wondering if you know a lot about Dr. Zarrinbal and did you consider him before going with Dr. Sinn? Zarrinbal seems to have done a lot of surgeries talked about on here, and a lot of people recommend him. So I am asking whether you have seen a decent amount of his results and if you'd recommend him?
I was also wondering what you "jaw background" is? You write something about orthodontics "destroying" your face; can you please elaborate on this?
Thanks a lot for sharing your journey with us!
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Congrats! I hope the good news keeps coming.
I keep going back and forth about jaw surgery. I know I need it but functionally I've gotten better with tongue posture, swallowing, etc. Still, my profile is terrible and both jaws are recessed, teeth flaw out, etc. it's especially tough since surgeons I have talked to recommend removing 2 bottom teeth to pull back and maximize BSSO... but I'd rather not.
And then there is the cost of the surgery.
Anyway, glad it seemed to have went well and keep healing! I hope the outcome is good for you and you don't need any other surgeries.
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With Day 4 comes some perspective. You know what? If you're gonna have this surgery you should really push for maximum movements. I don't even know how people end up with the pig nose and monkey upper lip, since I have 0 physical symptoms in that direction. But then maybe the alar cinch was just very effective.
ALSO Sinn like Arnett does the V-Y plasty on both lips. I mean I don't know if it's permanent. But I have Tom Hardy lips right now and I don't mind at all if they stay. I think this is something Sinn is just good at so it's further undermined any chimp lip that may have occurred.
But you know what I gotta say? The older you get, the less this surgery is really gonna make a difference in your life. I mean sure if you're a fit and healthy 24 year old male or young girl, and you have this surgery and it pops everything into place with your face --well you got like 20-30 good years to enjoy it. But as soon as you're in your 30s time is ticking and I just don't think it makes as much of a difference --even physically, the skin is so much slacker that it doesn't really show up as powerfully.
So if you're gonna have this surgery go balls to the wall and go early.
Oh well, nothing to report. Healing is fine, still swollen. I could totally be back to work or home at this point as long as I took breaks. That's pretty crazy considering I was in surgery for almost 9 hours.
But I've definitely found that people who have really good surgeons usually recover really fast, except for Arnett and Gunson patients, they always recover really really poorly. I don't know why, they often lose teeth, feeling, have complications with their HA etc. etc. etc.
Oh well, Dr. Sinn wants to take the splint out just to test bite and I think he'll do that tomorrow.
I'm not trying to be arrogant but all the nervous breakdowns and trauma and mental problems and horror stories about recovery sound so distant to me now. I mean it's not a walk in the park ,but it's not that big a deal whatsoever. If my surgeon said I had to go back into surgery RIGHT NOW for another procedure I wouldn't be concerned. But I think I'm gonna take the time out to let it all heal and stuff and then figure out if I want a chinwing later on (which I probably will).
Man the area where Sinn did the submental lipectomy feels really really hard (and it's of course swollen so it's delivering the opposite effect right now). Oh well..... I probably won't update much anymore. It is what it is.
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i have seen almost nothing but glowing praise for arnett and gunson on this forum. i am surprised to see you saying all these negative things about their results in this thread... i have a consult with gunson next month and you have me nervous now...
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Well gunson does massive bsso advancment. IMO the real issue with them is the onlay ha grafts. It's a massive irritant. The local ha maestro who does onlay cheek grafts which look absolutely pitiful says you need to take 4 weeks off work.
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it seems like this forum is still very unsure about HA. i know dr sinn uses HA but in a very different way than A&G. have you heard many complaints from A&G patients about HA either on the cheek bones or at the back of the mandible? dr sinn says it is great and he gets great results with it.
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it seems like this forum is still very unsure about HA. i know dr sinn uses HA but in a very different way than A&G. have you heard many complaints from A&G patients about HA either on the cheek bones or at the back of the mandible? dr sinn says it is great and he gets great results with it.
Afaik Sinn only uses it sparingly and only when there are no other options. I don't think he uses it as extensively as gunson.
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i have seen almost nothing but glowing praise for arnett and gunson on this forum. i am surprised to see you saying all these negative things about their results in this thread... i have a consult with gunson next month and you have me nervous now...
well a lot of people consult with them because f**k they just have a great marketing team. I mean you gotta give it to them they offer something that no other max facs do --a really streamlined approach to getting your surgery with lots of boxes to check off and a cute little before and after photo and a bunch of other little stuff you get in a nice little box at the end of your consult. I mean they must literally make millions on their consults alone.
Also, they specialize in fixing botched operations (of which I'm sure around 75 percent of jaw surgeries are in some way botched).
And yeah, as Plosko said they specially in massive advancements because of their whole CCW philosophy.
Anyway, something that I'm being blown more and more away by is how little people actually pay attention to your physical appearance or any sort of issue you have that would make you look either significantly better or significantly worse. Ugly people are lucky insofar at least they get noticed. Sorry I'm really high on my painkillers .
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Lazlo, just curious... what is cost of Sinn? Did it covered at all by insurance (are you from US?) and I wonder if there is an insurance that generally covers jaw surgery at least out of network so you can just pay your maximum out of network deductible (say $5K) and be done.
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Lazlo, just curious... what is cost of Sinn? Did it covered at all by insurance (are you from US?) and I wonder if there is an insurance that generally covers jaw surgery at least out of network so you can just pay your maximum out of network deductible (say $5K) and be done.
sorry I don't answer questions about price.
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No worries. I understand. What about insurance... when these surgeons say they are out if network, does that mean (if approved by insurance) it is covered in out of network deductible/out of pocket amount?
Since I really just dont think in my life I can swing 20k, 30k, 40k or whatever these usually are.
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No worries. I understand. What about insurance... when these surgeons say they are out if network, does that mean (if approved by insurance) it is covered in out of network deductible/out of pocket amount?
Since I really just dont think in my life I can swing 20k, 30k, 40k or whatever these usually are.
My understanding is out of network doctors can balance bill any amount above your insurance's smaller "allowed amount", regardless of if you've reached your out of pocket maximum. You can still get out of network benefits, if the insurance company approves the surgery, but they are typically peanuts in benefits compared to the 20k+ out of network doctors ask for.
Plosko, Deschamps was pretty radical in a very different way ;)
Sounds like the bigger the jaw movements, the tougher the recovery? That'd make sense as Lazlo's movement of 6mm seems small to me. Especially considering he had extractions ???
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Ah... That sucks.
So an insurance company says they will pay $10K for it. You pay the out of pocket $5K and if the surgery is $30K you pay another $20K for balance doctor didn't get from insurance?
Man... seems more and more likely won't get it done. Maybe just SG or chin wing as a less expensive alternative.
Lazlo, I know you can't tell yet but you mention more work done on jaw with chin wing. But what about cheekbones? The one thing I always worry about is that if you bring maxilla forward then you get that concave 3/4 appearance because the cheekbones are now set back comparatively.
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for molestrip
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But what about cheekbones? The one thing I always worry about is that if you bring maxilla forward then you get that concave 3/4 appearance because the cheekbones are now set back comparatively.
Then you augment the cheekbones and the eyes become deep set and it still doesn't help the infraorbital rims. When you're older and the fat pads thin, the true contours of them show. There's just no winning here, this new Xilloc product holds promise but ultimately we're fighting against only changing part of the face. Ultimately, the less you need to change the face as a whole the better.
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There are combined implants, they may be ok except they're still implants. One thing I don't like about them is they have a small cutout for the infraorbital nerve, if it ever shifts then that nerve could be at risk. The osteoinductive augmentations are nice in that they won't shift much or at least as much as surrounding bone. I messaged them on FB and they're still not available. Don't recall what the update was, nothing interesting enough to remember.
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My understanding is out of network doctors can balance bill any amount above your insurance's smaller "allowed amount", regardless of if you've reached your out of pocket maximum. You can still get out of network benefits, if the insurance company approves the surgery, but they are typically peanuts in benefits compared to the 20k+ out of network doctors ask for.
Plosko, Deschamps was pretty radical in a very different way ;)
Sounds like the bigger the jaw movements, the tougher the recovery? That'd make sense as Lazlo's movement of 6mm seems small to me. Especially considering he had extractions ???
6mm isn't exactly small imo
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Alright folks, there was a bit of a crisis over the night where I big time panicked and thought Sinn had botched things since he hadn't followed Arnett's plan.
Requires a slight digression. Sinn had been given Arnett's plan when I consulted with him just causse I needed to send him a ceph. He basically said he would do Sinn's plan. Now there are a lot of aspects to this surgery I do not understand at all. Like why a HUGE lower progression CCW actually ends up giving a very weak lower chin most of the time or why you can't just lengthen then chin and blah blah blah. But these are tacit restrictions.
Anyway, it's all fine since what Sinn did is he gave me a 6mm advancement of lower jaw PLUS a 4 mm CCW so it's actually 10 mm altogether and the airway is huge, the bite is slam bam like a f**king hand in a bespoke leather glove. I have ZERO pain, or even really tiredness. I just have enough swelling to very terribly distort the aesthetic results but I can tell they're going to fall perfectly into place. This is just FANTASTSIC! !!!!!
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Oh and Sinn through in so many extras like the rhinoplasty he did from the inside completely. NO SCAR i have a straight septum, the nose looks f**king SMALL and SHARP . I didn't even know doing a rhino (yeah weird resection) from inside was possible!!!!
He inverted both the lips and now i have the most amazing shaped tom hardy lips, the full smile, not bunny rabbit at all, more like Alex Pettyfer smile.
I'm just so overall stoked how this surgery will have set the foundation for my dreams. Take everyone. I'm gonna take a long nice break from this forum since this has weighed so heavily on me for so many years and wait fo rthis swelling to go down.
Will I ever get future procedures? For sure! I'm a starchild baby! I will use all of the future to help me.
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i know you are ready to take a break from the forum and i think its a great idea. but if you haven't yet, could you explain exactly how dr sinn created more visible width of the mandible (other than the multi piece genio). you said he put HA between the joints in your 1st or 2nd post. could you explain a bit more and if there was anything else he did to add width of the lower jaw, at the gonial angle or along the mandibular body? how much, if any, width gonion to gonion do you think was achieved? thanks.
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i know you are ready to take a break from the forum and i think its a great idea. but if you haven't yet, could you explain exactly how dr sinn created more visible width of the mandible (other than the multi piece genio). you said he put HA between the joints in your 1st or 2nd post. could you explain a bit more and if there was anything else he did to add width of the lower jaw, at the gonial angle or along the mandibular body? how much, if any, width gonion to gonion do you think was achieved? thanks.
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he lists doing 5mm to either side so one cm altogether but it's somewhat slanted so it looks cool and dramatic and yeah he did it with an HA graft. Oh and the bigger tooth show also has to do with how he sowed the lips back down. In fact my lips (and amazing luke rockhold chin) are two of the thing I'm admiring so much from this surgery. Why more dudes and especially chicks don't get V-Y plasty's to their lip just blows my mind!
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it all sounds very amazing! i hope you will consider sharing a photo from the nose down once you have healed.
where/how exactly did he use the HA to add all that width? is it an onlay molded to resemble a gonial angle?
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i know you are ready to take a break from the forum and i think its a great idea. but if you haven't yet, could you explain exactly how dr sinn created more visible width of the mandible (other than the multi piece genio). you said he put HA between the joints in your 1st or 2nd post. could you explain a bit more and if there was anything else he did to add width of the lower jaw, at the gonial angle or along the mandibular body? how much, if any, width gonion to gonion do you think was achieved? thanks.
sorry I wasn't sure if I answered you before yeah 5mm to each gonial angle in the widthwise direction. He was really excited today when looking at the results, he was like you can't even see right now how different and cool you're gonna look once the swelling goes down.
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it all sounds very amazing! i hope you will consider sharing a photo from the nose down once you have healed.
where/how exactly did he use the HA to add all that width? is it an onlay molded to resemble a gonial angle?
no way jose.
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i totally understand about that photos. no hard feelings :)
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Man you're really making me want to go check out Dr. Sinn.. he's so far away though gaaahh. If you're still around, I think I recall that you went on quite a few max facs consults, right? Could you share why you chose Dr. Sinn over the other, I presume big name docs?
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I still don't understand how you got any ccw rotation at all given that your maxilla was lowered linearly. Maybe what you had is a differential down graft after all because 6 mm at the front is a hell of a lot - that's short face syndrome territory and yours isn't. Maybe he down grafted you 6 at the back and something less at the frontt to achieve CCW?
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I still don't understand how you got any ccw rotation at all given that your maxilla was lowered linearly. Maybe what you had is a differential down graft after all because 6 mm at the front is a hell of a lot - that's short face syndrome territory and yours isn't. Maybe he down grafted you 6 at the back and something less at the frontt to achieve CCW?
oh i don't think it was lowered linearally. f**k I was afraid last night and this morning. Today Sinn explained what he did and it was beautiful. It was like finding the most elegant solution to a math problem. my airway is huge now, nose is sharp like JOhnny Depp's after swelling went down further this afternoon! I mean it's too good to be true I want to pinch myself.
What I'm so amazed by is that given such a dramatic foward movement I don't have even an iota pig nose or chimp face. I mean in fact quite the opposite. The nose is slimmer and sharp. The upper lip space looks shorter because he did a V-Y plasty turning the lip up so it's all the opposite of chimp face, i had f**king a sagging midface before. How did Sinn manage to pull all of that off? Oh and I just read my surgical notes, he threw in a f**king rhino for like pennies. And it's the nose I always wished I had been born with. But how the hell did he avoid chimp face without such a dramatic forward movement. I mean sorry I don't mean to sound insensitive but you literally look like a different person entirely in your before and after due to the puffing out and spreading of your face. It's not an entirely unappealing look, it looks a bit like lord hannuman in indian mythology but in your surgery the forward movement made you look so dramtically different but in a puffing out way. I have no puffing out at all, just smoothening, tautening, and then careful draping. I don't know.
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so what do you think is the difference between what dr sinn did with HA at the back of the mandible vs. what dr gunson does? i know that dr gunson actually shapes the HA before he places it, it is molded then placed with some pliability to shape in the following days. dr sinn just kind of "squirts" it onto the bone then shapes it from the outside of the tissue. they both mix it with your own blood.
@plosko do you really think HA is that irritating? is it better when used in a particular way?
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I still don't understand how you got any ccw rotation at all given that your maxilla was lowered linearly. Maybe what you had is a differential down graft after all because 6 mm at the front is a hell of a lot - that's short face syndrome territory and yours isn't. Maybe he down grafted you 6 at the back and something less at the frontt to achieve CCW?
just got back from seeing sinn. pressed him ad nauseum on all this as my dad freaked out once it was raised as a concern. What Sinn explained was very much like what you're suggesting --that down graft was at different levels compared to posterior and anterior. wow you're good plosko --i think you've surpassed molestrip as our resident expert.
anyway, Sinn is very very honest, has nothing to hide LOVES discussing the details of jaw surgery I mean he literally just showed up on a saturday afternoon in the office to just open it and hang out with us for a couple hours and talk us through everything, he brought out a skull explained what he had done, etc. etc. My mind is COMPLETELY at rest, the bite fits, he said he wants the rubber bands on for 6 weeks and that the bite is fitting perfectly.
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so what do you think is the difference between what dr sinn did with HA at the back of the mandible vs. what dr gunson does? i know that dr gunson actually shapes the HA before he places it, it is molded then placed with some pliability to shape in the following days. dr sinn just kind of "squirts" it onto the bone then shapes it from the outside of the tissue. they both mix it with your own blood.
@plosko do you really think HA is that irritating? is it better when used in a particular way?
no there's nothing wrong with HA. But Sinn did human bone in my grafts. Oh and I know this is of interest cause Lestat and some other people asked me about this.
Human bone is like some serious baller s**t it's 450 per half ounce. Anyway he differential downgrafted that s**t on me made my sinuses huge and straightened my septum too. Anyway I was like what happens to that human bone. He said this: cause it's genetically identical to your own bone it will get filled through with your own dna and then slowly over time it will be replaced entirely with your own bone.
That is some f**king BALLER s**t yo.
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I'm confused.. so no HA was used in your surgery?
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I'm confused.. so no HA was used in your surgery?
ha wasn't used for the differential downgraft of my maxilla, human bone was. For my mandible it was HA to booth elongate and widen the mandible at the gonial notches which he said he sanded down very carefully. He also rotated the ramus like quite around so the angle is now fierce and savage.
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OP, why you didn't undergo modified LeFort3 in case it was indicated that with this approach you'd get best results?
you can't do bi-max and modified lefort 3 at the same time. my lefort 3 is schedule for 6 months post this op.
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Do you honestly still feel the needs for a mod lefort 3 after what you've already gotten? Has it not done 'enough'?
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Do you honestly still feel the needs for a mod lefort 3 after what you've already gotten? Has it not done 'enough'?
No way man, I'm going for like this ultra bad-ass look like Jason statham and if you notice like Statham and a lot of really cool looking guys have the high and projected cheekbones. So I need a chin-wing and ZSO plus orbital rim advancement.
The lefort has been clinically very successful for me, but i'm not all that sure what kind of cosmetic different it really made other than giving me a lot of good teeth show and also being moved forward to really bring my lower jaw out.
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My oh my, this forum leads me to believe much more prevalent than I ever imagined
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My oh my, this forum leads me to believe much more prevalent than I ever imagined
what do you mean? what is more prevalent than you imagined?
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Lazlo, I think you're gonna look good. Hang in there, focus on healing right now!
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Lazlo, I think you're gonna look good. Hang in there, focus on healing right now!
THanks bro! I'm honestly touched by your support. I will hang in there. And f**k if I need something more afer, no biggie. Life is a marathon, not a sprint.
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I meant BDD is more prevalent than what I imagined.
Hate to see people planning more surgeries it makes my heart ache :'(
Love yourself man
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I meant BDD is more prevalent than what I imagined.
It is but Lazlo doesn't suffer from BDD. He just has high standards. I sympathize with the surgery conservatism but then I'm at the other end of the spectrum, which is also not wonderful. To be fair, I think the midface deficiency will cause problems down the line too with the eyes and some surgery will be needed at that point.
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So I need ZSO plus orbital rim advancement.
Are these procedures as invasive as double jaw surgery? What is the recovery like? Any risk of going blind or nerve damage?
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Are these procedures as invasive as double jaw surgery? What is the recovery like? Any risk of going blind or nerve damage?
nah they're probably less invasive given that they don't target important functional areas like your jaw joings and stuff.
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Congrats on finally getting the surgery. It seems like quite a lot to do on a non-syndrome patient (once you get the LF3 and all that), was your face kind of deformed before? Or did he agree to do it strictly for cosmetic purposes?
Also, could you elaborate on the V-Y plasty? I've never heard of that being done in combination with jaw surgery before. Was it solely to combat the chimp look or something else?
Glad your recovery is going so well
Edit: Just saw your other thread... Hope it gets better
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xx
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nah they're probably less invasive given that they don't target important functional areas like your jaw joings and stuff.
Did Rico have a ZSO? He ended up with joint problems. Haven't seen him post in a while actually. Last time we spoke he was suicidal because of the outcome, hope he's ok. In any case, there is no natural fracture line for these midface osteotomies so the risk of a bad break is higher. I don't believe there's any bony overlap so the risk of mal-union is higher, though offset somewhat by grafts if the surgeon can do them there. To me, the biggest risk remains poor results.
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It sounds like your surgery went really well. Hope the recovery goes well.
Before your surgery did you have any nasal breathing issues? How is your nasal breathing now?
Do you think this surgery would be suitable for someone with an upturned nose already? It seems like Dr Sinn has a technique for preventing it getting worse?
Thanks
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Rico had a zso but the result was a misbalance in the masseter and condylar resorption causing advanced tmj. his surgeon wasnt careful about his assymetries. a shame
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Rico had a zso
No that is not true. Rico had a ZMC reposition = repositioning of the whole zygomatic-maxillary complex. And not only for cosmetic reasons also for functional reasons. The surgery failed. He has a lot of complications now (deviated jaw, tmj problems, hearing loss and so on).
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A ZSO is an advanced procedure on the midface-the most easiest following the implant insertion. Rico did not have a ZSO he had a ZMC reposition - repositioning of whole zygomatic-maxillo complex.
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That's right. A very very complex procedure
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ZMC:
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How are you feeling Lazlo?
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How are you feeling Lazlo?
pretty okay, like i have these dull spots in my chin and it feels like playdough or clay --but i think that's just healing.
Everything is fine, but I think my mandible should have been advanced more. I'm just going to sit tight and wait till the 6 month mark before making any decisions. Thanks for asking.
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ZMC:
Although this is an extremely complex procedure, wouldn't it provide the best aesthetic outcome; for example someone with an asymmetry caused by an underdeveloped zygomatic bone on one side? It could be advanced anteriorly and laterally?
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Although this is an extremely complex procedure, wouldn't it provide the best aesthetic outcome; for example someone with an asymmetry caused by an underdeveloped zygomatic bone on one side? It could be advanced anteriorly and laterally?
i think that's basically what Dr. Sinn does with his too, no?
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i think that's basically what Dr. Sinn does with his too, no?
Honestly didn't realise this was an option tbh. Not sure if it provides better aesthetic outcome than an implant would though..
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Honestly didn't realise this was an option tbh. Not sure if it provides better aesthetic outcome than an implant would though..
dude the advancement i've seen with this is WAY bigger than any implant i've ever seen. Only problem is there's a scar but some of you are saying it's not "excessive" so your mileage may very as they say.
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dude the advancement i've seen with this is WAY bigger than any implant i've ever seen.
Sorry Lazlo but I am a bittle bit confused now...
Now let me tell you he showed me one patient —not Earl, but someone more recent who had the “modified lefort-3” yes there was a difference but it just resembled a weak ZSO to me. In fact, when I studied the before and after profiles there was no significant augmentation to the area directly beneath the eye and this was not as augmented as when I see Dr. Yaremchuck’s examples of orbital rim implants with “canthopexy” no Sir, not even close. Honestly from the example of the modified lefort 3 I saw this procedure is not the holy grail to your looks as many of you have been assuming I’m very sorry to report and I don’t think it can do a lot at all.
Can you explain this to me please?
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overall the augmentation is much more than a ZSO, but it doesn't quite make the directly infraorbital rim higher or larger. So overall Sinn's operation is the best as far as both zygoma, malar and orbital rim, but it's not as effective just for the orbital rim, unless you combine an implant and do a canthoplasty as Dr. Yaremchuk does.
For me though, I'd go with Sinn first, then reassess.
Let me tell you this.
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overall the augmentation is much more than a ZSO, but it doesn't quite make the directly infraorbital rim higher or larger. So overall Sinn's operation is the best as far as both zygoma, malar and orbital rim, but it's not as effective just for the orbital rim, unless you combine an implant and do a canthoplasty as Dr. Yaremchuk does.
For me though, I'd go with Sinn first, then reassess.
Let me tell you this.
So am I correct in saying that both the ZSO and mod LF3 are ineffective at making the lower border of the orbital rim higher, and that the only way to achieve this is through a custom orbital implant that 'wraps under' the lower portion of the eyeball more closely? It seems to me that the key aesthetic issue with an entirely recessed orbital rim area is not only a lack of horizontal projection but also that the orbital rim doesn't surround the eyeball closely enough. This makes me doubt the real efficacy of a lf3 in its entirety for an optimal aesthetic outcome as opposed to complete custom periorbital augmentation with implants. Actually that reminds me, does Sinn's mod lf3 advance the superior portion of the orbital rim?? Does it even advance the entire portion of the lateral orbital rim?
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So am I correct in saying that both the ZSO and mod LF3 are ineffective at making the lower border of the orbital rim higher, and that the only way to achieve this is through a custom orbital implant that 'wraps under' the lower portion of the eyeball more closely? It seems to me that the key aesthetic issue with an entirely recessed orbital rim area is not only a lack of horizontal projection but also that the orbital rim doesn't surround the eyeball closely enough. This makes me doubt the real efficacy of a lf3 in its entirety for an optimal aesthetic outcome as opposed to complete custom periorbital augmentation with implants. Actually that reminds me, does Sinn's mod lf3 advance the superior portion of the orbital rim?? Does it even advance the entire portion of the lateral orbital rim?
yeah i think you're correct, though i want to ask dr. sinn if by adding HA paste he can make the orbital rim higher and closer to the bone. as for the lateral part i have no idea, why don't you schedule a phone consult and ask him!!!???
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yeah i think you're correct, though i want to ask dr. sinn if by adding HA paste he can make the orbital rim higher and closer to the bone. as for the lateral part i have no idea, why don't you schedule a phone consult and ask him!!!???
This sounds like a good idea, I wasn't aware that he offers phone consults. It's just that mobilising only part of the orbital rim for large movements would surely leave a discordant step off, I would imagine? And both the superior orbital rim and, more importantly, the lateral orbital rim is crucial in tackling the prominent-eye 'look', if the mod le fort 3 can't do this, well either ha paste or custom lateral orbital rim implant would be needed on top of the mod lf3 anyway.
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This sounds like a good idea, I wasn't aware that he offers phone consults. It's just that mobilising only part of the orbital rim for large movements would surely leave a discordant step off, I would imagine? And both the superior orbital rim and, more importantly, the lateral orbital rim is crucial in tackling the prominent-eye 'look', if the mod le fort 3 can't do this, well either ha paste or custom lateral orbital rim implant would be needed on top of the mod lf3 anyway.
honestly i would love to hear you grill him on this and to find out his responses and share them with us here. i don't think i could articulate it all as well as you can and you'd be doing yourself and all of us a huge service. he's a very very kind and authentic man and I think he will answer your questions with total honesty.
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honestly i would love to hear you grill him on this and to find out his responses and share them with us here. i don't think i could articulate it all as well as you can and you'd be doing yourself and all of us a huge service. he's a very very kind and authentic man and I think he will answer your questions with total honesty.
I'll look into this, it's pretty crucial stuff imo. Although I'm sure Earl has all this information sitting comfortably and squarely in that brain of his. Earl where are you!!!
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I'll look into this, it's pretty crucial stuff imo. Although I'm sure Earl has all this information sitting comfortably and squarely in that brain of his. Earl where are you!!!
Brah that might be true, but we need more people gathering info. YOu need to call, make an appointment and find out the info for us.
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did you have any bite issues before your surgery?
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Brah that might be true, but we need more people gathering info. YOu need to call, make an appointment and find out the info for us.
Blablabla what is with your info you do not give us any example how you look after surgery by Sinn?
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Blablabla what is with your info you do not give us any example how you look after surgery by Sinn?
So that's my right. I don't have to give you s**t.
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So that's my right. I don't have to give you s**t.
Oh well when all others would act like you. We would not see any Post OP results.
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Btw is a zso or mod. Lf3 possible if you already have implants (ha or medpor) in your midface? Anyone knows? Thanks.
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Hey, I've been lurking for a while. A few questions for you Lazlo-
How much did this surgery cost if you don't mind me asking? Any insurance coverage?
Did you travel to Texas specifically for this surgery? I'm in MN and I'm looking for a competent doctor to possibly do a double jaw. I have family in Texas. What's the best way to contact Dr Sinn?
Was this surgery just cosmetic? Or functional as well? I don't have any "functional" issues, but think it would greatly benefit me cosmetically.
It was exciting following your journey!
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now that might be ENTIRELY erroneous of an observation given the Splint if changing the shape of the mouth
So you had a splint after surgery????????????
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how many mm of forward and lateral prjection can you achieve at the zygomatic bone?
le fort 3 as i understand it is different fro a le fort 1 done with three pieces. the advantaeg of the le fort 3 is where you cut higher, ie across the eyes and the zygomatic arch, which if done right has a tremendous positive cosmetic effect. augmentation of the malars via injection of dermo fillars in probably the most popular and effective dermo treatment to address age related laxitiy of the skin, because i lift the skin up and away. they fall it the v lift. i have seen a couple people that have done it and it looks incredible, game changer.
http://images.google.de/imgres?imgurl=http://mddirect.org/wp-content/uploads/2015/03/Zygomatic_bone_anterior.png&imgrefurl=http://mddirect.org/tag/zygomatic-bone/&h=900&w=900&tbnid=w6MzfFoRCt2hEM:&tbnh=102&tbnw=102&docid=UE4D0Ky3jWhzQM&usg=__OX8zwkIZurUTL6w7KduAqDDX-5w=&sa=X&ved=0ahUKEwidmtnWt9PPAhUGaxQKHRDJAuMQ9QEINzAD
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lateral projection are a bit tricky...
mostly for 99%, during mouth opening, you will have soft tissues deformation (not big) between zygomatic arch and border of the jaw
Rather you should not move more than 3mm laterally because of sunken eye issue - too big orbital volume.
More then 3mm might be a bit tricky for the eye even with orbital floor augumentation (resorbable sheet)
By moving the zygomatic bones forward on both side, you get more width at the same time - probably no more than 2mm (I'm not sure), because of the zygomatic arch shape.
Keep in mind that when you move your zygoma for example 7mm forward and 3mm outward, then in summay it will look like you had 5mm lateral projection and 5mm in lateral is very noticeable
LF3 is for forward movements, so You would need kinda modified LF3, which is much more difficult thing
Lateral projections are more criticial than the ones in forward direction for soft tissues including the muscles - for example masseter muscles
However when it comes to postop soft tissues asymmetry caused by lateral movements it's not a big deal when you do it on both sides. In such scenarion it will be the same "asymmetry" so it will symmetrical ;)
Mostly it's gonna look like, during mouth opening, your masseter area will get more in width , but the frontal area - the soft tissues on the sides between chin and masseter muscle (buccinator area) does not change. They will behave like you had the old zygoma positions.
To understand this, open your mouth widely an you will notice that masseters area on the back (near the ears) gets more in width, but frontal gets more kinda narrow or at least does not change
When you move your zygoma together with the masseter muscle (no other option) laterally the posterior part will get much more in width during mouth opening, while frontal part (near chin, and buccinator) won't change (perhaps a bit after many years)
So it's gonna be that kind of soft tissues asymmetry..so it depends on the patient if this is asymmetry for him or not
Hard to explain
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thanks for trying. have sent dr sinn my stuff, will ask him about this on the call. am looking to do bsso plus lf3
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Can you elaborate on this "human bone" stuff? What is the actual technical name for it?
If money is no issue, it sounds superior to HA paste as it gets entirely replaced with our own bone? I really don't mind dropping extra money so I end up getting something that ends up being my own bone a year later.
Cadaver bone. For big gaps there is little alternative to porous ha blocks. I don't think Sinn uses them.