jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: earl25 on March 03, 2014, 09:23:21 AM
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i have a 1cm orbital rim deficiency. i have seen just about every ps\maxfax\cranio doc in the usa . i was all ready to get custom orbital rim implants with dr. y when i saw some photos of dr. obwegesers lefort 3 girl aNd dr kellers lefort 2.these were the best orbital rim work i ever seen. so ive been consulting with top maxfaxs. i found 4 who will do it. they claim blindness isnt any higher risk with the lefort than orbital rim implants. other docs say this is the most dangerous surgery ever. what aRe your thoughts?
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Hey earl25,
I think getting Lazlo's opinion is going to be your best bet. I have consulted with Keller, but never discussed what you are asking about. I think Lazlo went to the Mayo, to meet with Keller, awhile back and discussed both the quadrangular Le Fort I and II.
It sounds amazing, my concern would be that so few surgeons are willing to do it.
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I wouldn't do it but my opinion is biased since that is the one thing I dread the most (going blind).
if a 10mm upper jaw advancement is already considered invasive I can't even imagine how dreadful a 10mm LeFort III must be
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I wouldn't do it but my opinion is biased since that is the one thing I dread the most (going blind).
if a 10mm upper jaw advancement is already considered invasive I can't even imagine how dreadful a 10mm LeFort III must be
well they wouldn't do 10mm they said 5-7mm. its weird ive seen the top of the top docs and they said blindness isn't a major risk or anymore risky than implants. other doctors who ive spoken with say this is the most dangerous and unpredictable surgery ever.
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well they wouldn't do 10mm they said 5-7mm. its weird ive seen the top of the top docs and they said blindness isn't a major risk or anymore risky than implants. other doctors who ive spoken with say this is the most dangerous and unpredictable surgery ever.
What did Keller say?
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What did Keller say?
never spoke with keller
I spoke with
Dr. schendel- said risk of blindness is no more than implants
Dr. Turvey tuvey - said it is an intense surgery and more risky than otherv max fax surgeries but said blindness shouldn't occur due to the orbital nerve not being near the cut
Dr. wolford- said blindness isn't an issue and not a major surgery in terms of blood loss(for a lefort II)
Dr. sinn- said not a major surgery in terms of blood loss and risk of blindness is no more than implants or any other surgery near the eye (lefort III)
Dr. obwegeser- said lefort III is not a dangerous surgery more intense than implants yes but not dangerous and fixes the problem unlike implants which mask it
Dr. heggie- said blindness isn't a major risk
Now for others who said the opposite
dr. Bartlett -said its a high morbidity surgery and told me to go get fat
dr. urata - just sent my letter,picture, ct scan back to me with no!!!!!!!!!! written on the letter in big letters (weird)
Dr. fearon - said it shouldn't be done for non syndrome patients
others maxfax doctors said its a risky surgery.
I don't know who to believe. I do know they all told me I will have double vision for 2-3 weeks
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never spoke with keller
you should try Keller and Kaban (online consult or whatever) just to be safe.
Turvey is well regarded in the maxillofacial/craniofacial field. His "opinion" carries a lot of weight.
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I'm really wondering as how bad your (supra) orbital rim recession (10mm?) must be, and what it looks like.
Do you have a lot of scleral show in the front? Without this support it must be so right?
I have some midface hypoplasia too - I consider it pretty bad - with scleral show, negative vector orbit, but I have never even thought yet about fixing it with LeFort III. Because I have read that it's a pretty horrible surgery and there is a reason they only like to perform it on Crouzon patients.
Personally, I find it useless to operate on Crouzon patients with LeFort III, because even in the after, they sadly remain inevitably ugly. Would it not be more useful for patients with moderate midfacial recession, because they can achieve a truly stunning result? I have only seen one result, that was not performed on a Crouzon patient:
(http://i.imgur.com/6toB1QD.jpg)
(http://i.imgur.com/yPWL2sU.jpg)
This girl had LeFort I + LeFort III + BSSO
Absolutely incredible result. She is a beauty afterwards ... I can understand OP and In my case, I'd hate to have double jaw surgery and being left with a flat midface and a recessed orbital rim ...
Greetings.
that's dr obwegeser's work.
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you should try Keller and Kaban (online consult or whatever) just to be safe.
Turvey is well regarded in the maxillofacial/craniofacial field. His "opinion" carries a lot of weight.
doug sinn is also, all the surgeons I listed are known names and leaders in the field.
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no joachim obwegeser
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Try fat with a hard filler first.
If you're still dissatisfied with the way you look after that, then maybe the risk is worth taking. Not wanting to sound harsh but if you are 10mm deficient now, then you do not have much to lose in terms of aesthetics so why not try a largely temporary procedure and if it looks s**t, it's not going to matter because it will dissolve a few months down the line if not topped up.
Over the time it's took you to have all those consultation, you probably could have tried it already since it's such a quick, (relatively) cheap procedure.
P.S. Good luck with whatever you decide.
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How did you contact him for his assessment of your situation? Have you travelled to Zurich? I would appreciate some input of him in my case.
I emailed him. he answered my first 2 e-mails then stopped responding. I wish I could get him to give specifics of that girl. how many mm,where he cut etc
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its difficult when ppl ask if your retarded and star at you and tell you you look weird
Pics, or it didn't happen (I kid!). Which Dr Heggie did you consult with? I presume you consulted with all these doctors remotely i.e. not face to face? Would you have any links to how this surgery is actually done? Are external incisions used? Can it be done at the same time as malocclusion surgery i.e. Le Fort 1, BSSO?
Thanks in advance
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I'm really wondering as how bad your (supra) orbital rim recession (10mm?) must be, and what it looks like.
Do you have a lot of scleral show in the front? Without this support it must be so right?
I have some midface hypoplasia too - I consider it pretty bad - with scleral show, negative vector orbit, but I have never even thought yet about fixing it with LeFort III. Because I have read that it's a pretty horrible surgery and there is a reason they only like to perform it on Crouzon patients.
Personally, I find it useless to operate on Crouzon patients with LeFort III, because even in the after, they sadly remain inevitably ugly. Would it not be more useful for patients with moderate midfacial recession, because they can achieve a truly stunning result? I have only seen one result, that was not performed on a Crouzon patient:
(http://i.imgur.com/6toB1QD.jpg)
(http://i.imgur.com/yPWL2sU.jpg)
This girl had LeFort I + LeFort III + BSSO
Absolutely incredible result. She is a beauty afterwards ... I can understand OP and In my case, I'd hate to have double jaw surgery and being left with a flat midface and a recessed orbital rim ...
Greetings.
Kizarq,
Great find! OK, I'm sure it's a cherry-picked case. But everybody cherry-picks. So we are really comparing the best against the best on the web. And this is the best Class III surgical case outcome I have ever seen by far. Better than anything from Arnett and Gunson. All LeFort I's seem to have this step off. You can't see it here. This girl looks like she has always looked that way in the after. Completely natural. I too have this pancake midface like she does in the before. I never thought it is possible to change it.
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if any europeN bros want to consult with obwegeser and get more info on the girl case i will contribute 50 usd towards your consult fee
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Pics, or it didn't happen (I kid!). Which Dr Heggie did you consult with? I presume you consulted with all these doctors remotely i.e. not face to face? Would you have any links to how this surgery is actually done? Are external incisions used? Can it be done at the same time as malocclusion surgery i.e. Le Fort 1, BSSO?
Thanks in advance
andrew heggis via email. i saw fhe us docs in person
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How do I get in contact with him?
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How do I get in contact with him?
googld dr joachim obwegeser and you will get his contact info. i dont have it handy right now
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andrew heggis via email. i saw fhe us docs in person
Why did you decide to contact him? He is by far the furthest surgeon from you. Do you wish to be more specific as to what he said? How serious was he about LeFort 3? How serious are you?! Thanks again.
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Why did you decide to contact him? He is by far the furthest surgeon from you. Do you wish to be more specific as to what he said? How serious was he about LeFort 3? How serious are you?! Thanks again.
I Contacted heggie because I wanted to get as many opinions about this surgery that I could get and especially from dr.?s who perform the surgery (I searched pubmed for lefort II or III then contacted those doctors). Now I don?t really know what to do r who to believe. Most of the dr.?s I saw who said they would do the surgery said its not so risky. Other doctors say this is the most dangerous surgery known to man. I don?t know who to believe. ALL DOCTORS LIE OR MANIPULATE THE TRUTH, It not always malicious as in , I want this guys money!, but cosmetic surgery and any elective surgery is a business at the end of the day. If a doctors discloses all the possible risks no one would have surgery. Medpor/porex is the perfect example. Ask the dr.?s who use it how easy it is to remove. They will removing in the future is no problem. Technically he isn?t lying. You can remove medpor , you can also remove an elbow, that doesn?t mean its easy and you will find people to do it. I have heard many stories of people who had medpor and wanted it out and they couldn?t find a doctor willing to do it. Even the top medpor guys (dr. y, R, Kim etc). Ive also heard stories of where the doctor couldn?t remove medpor jaw implants without breakingthe jaw so they brought him out of anesthesia and aborted the surgery. When I saw Ramirez , I pressed him hard about how easy it is to remove medpor, he eventually sighed and admitted its very difficult.
Now some of these same doctors who are telling me the lefort is the most dangerous surgery ever , are recommending I do fat grafts. Now Ive been on cosmetic boards since 2004, dr.?s today have a fat and filler fetish beause its cheap,easy and low risk to the surgeon. Search the internet there are very very few people happy with fat grafts to the under eye area. The ones who are happy with it and had a good result didn?t need much augmentation or neeed age related plumping. That?s very different from someone with a deficient bone structure. As missj says fat and filler will not go well if you don?t have the ?shelf? bone structure to put that stuff on to rest over. The people who have deficient bone structure normally look like s**t with fat or filler. Also fat isn?t easy to remove. I know one person who went to 3 different doctors to try to remove her under eye fat. Finally the 4th dr. was able to do it. The reason is fat grafts are little tiny honeycombed pearls. Its not like one chunk where you can just cut it out. Also when I saw hoeing he said even if fat graftds look good now, the fat is from your stomach and grows as you age. He has photos of people who looked ok post op then 5-10 years the grafts grew and had to be removed. Filler (restylyn) can give a tyndall effect.
On paper the lefort looks like the best way to go except I don?t know what the real blindness risk is. Also someone like me who has a deformed midface area, implants probably wont even do much. No dr. will go over the 3mm mark for an orbital rim implants because it will show through. And as you age IT WILL show through. Also many dr.s say orbital rim implants are risky as well.
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Have you consulted with Arnett and Gunson regarding HA grafts? That seems like a good option IMO and they seem to do it often as well.
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Have you consulted with Arnett and Gunson regarding HA grafts? That seems like a good option IMO and they seem to do it often as well.
I spoke with schendel about it. it wont give you much mm
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I'm not sure if Schendel is as experienced as Arnett and Gunson with HA.
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I'm not sure if Schendel is as experienced as Arnett and Gunson with HA.
ive read they tell ppl outright it wont give u more then a few mm
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side
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one ide of my face is lower and smaller than the other.
i dont know what u mean about the molars, i have had extractions.
but as u can see i have a non syndrome deformity
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the entire midface is compact small and assymytrical. also one side of my face is lower than the other. one eye bigger then the other.when i wear contact lenses ppl just stare at my fac and say i look weird. ive considered suicide before discovering ps and maxfax
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Hi earl25,
Sorry, for what you are going through, and for the different, inconclusive opinions you are getting from doctors. Based on the observations of a layperson, the implants have to be a less risky route, right? So long as you are not having any bite issues, pain issues, or functional issues, wouldn't implants be the way to go?
If you go with the other option, may I suggest that you make sure your private disability insurance is solid. I'm sure you would be completely fine, but I know I would personally feel a lot better knowing that I would be protected (or as protected as possible) if things were to go south. (There's no way I could do my job without my sight; and I'm sure the same goes for pretty much everyone else.)
Good luck with everything.
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im going to research disability policies cosmetic coverage. i know some do some dont. i do know state benefits dont exclude cosmetic
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You actually can get a disability insurance policy (I'm just talking about private disability insurance) that INCLUDES injury/disability from BOTH cosmetic and elective procedures. They are often lumped together in the policy. An example of a cosmetic procedure is a breast augmentation, and an example of an elective procedure is donating a kidney to a friend who is dying. Again, these two things are often found together in a policy, although not always (I didn't say it wasn't messed up).
Depending on what you do for a living, how much money you make, and how much money you would need should something go wrong; you could look into a pure own-occupation contract/policy. They are a bit of a unicorn policy. Not may insurance companies offer them, many professions are excluded entirely, and they are hugely expensive, but they will protect you like no other.
Whatever company you go with, and with whatever policy you choose (if you go this route), I would make sure you read and understand anything and everything in the policy regarding eyes/vision.
Good luck with everything!
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i might back out and go for implanta with dr. y. i have been talking to another doc who does lefort 3.hez kin of scaring me. so far hez given me the most specific details of any doc pro or con has given before. he says ths main risk of blindness comes from the pterygomaxillary dysjunction. the optic nerve runs throigh it so if it gets fractured your finished. he also said blindness with lefort 1 have ths same risk. he said blindness is more common with lefort 1 since thats a more common procedure.
i dont know what to do. implants wont give thd same augmentation the lefort 3 will. i mean the 4 examples ive seen on non syndrome patients is better than any implant work i ever saw. but i mean if you go blind then ur lifes over
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all i know is i cant livs lik this. you will never know what it feels lik to b stared and told you look different
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I'm so sorry, it really sounds like you are in a tough spot. I would probably just go with implants, but I have an impossibly low risk tolerance, so I may not be the best person to ask. Do you think it would also be a good idea to consult with Keller? I'm not sure if he would have anything special to offer; it's just another thought.
I truly wish you the best of luck with whatever you choose to do. I hope you have a nice night, earl25.
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all i know is i cant livs lik this. you will never know what it feels lik to b stared and told you look different
I know it all too well unfortunately. I completely understand your "do or die" mentality because that's how I feel as well.
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im not scarsx of dying. im scared of going blind
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every doc i consulted with, keller, schendel etc. said blindness was NOT an issue and Keller does 15 of these a year. I dunno, I think you're in uncharted territory but I like Sinn's very comprehensive approach, I say go for it.
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I could be wrong but common sense tells me that the risk of permanent numbness in most of your face is very high with a lefort 3 like this. Also the fact that not many surgeons do this very often would scare me regarding necessary experience level for this to go well.
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i might back out and go for implanta with dr. y. i have been talking to another doc who does lefort 3.hez kin of scaring me. so far hez given me the most specific details of any doc pro or con has given before. he says ths main risk of blindness comes from the pterygomaxillary dysjunction. the optic nerve runs throigh it so if it gets fractured your finished. he also said blindness with lefort 1 have ths same risk. he said blindness is more common with lefort 1 since thats a more common procedure.
If that's the case, then go with LeFort III. Le Fort I looks bloody terrible on youtube, yet it's considered to produce fewer complications than BSSO. And I think you've already had a BSSO.
i dont know what to do. implants wont give thd same augmentation the lefort 3 will. i mean the 4 examples ive seen on non syndrome patients is better than any implant work i ever saw. but i mean if you go blind then ur lifes over
IMHO, nothing beats your own bone. Do you have links to those cases? BTW, how narrow is your face? How serious was Heggie about a LeFort III for you? Did he mention that it will make your face wider?
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I know it all too well unfortunately. I completely understand your "do or die" mentality because that's how I feel as well.
it one thing to be a normal ugly person.thatz livable. but to be strange or odd looking is unbearable. freaking little kids and mentally disabled ppl have told me i look weird
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it one thing to be a normal ugly person.thatz livable. but to be strange or odd looking is unbearable. freaking little kids and mentally disabled ppl have told me i look weird
dude i dunno just trust one doc. if one doc like sinn or schendel (of their caliber) tell you they can get you through this with good aesthetic results and without numbness and O blindness, then go for it, at least you'll know then. i've never found implants to be much of a solution for anything. yes it's a risk, but the payoff is big too.
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dude i dunno just trust one doc. if one doc like sinn or schendel (of their caliber) tell you they can get you through this with good aesthetic results and without numbness and O blindness, then go for it, at least you'll know then. i've never found implants to be much of a solution for anything. yes it's a risk, but the payoff is big too.
implants will improve it, just not to the level that ive seen of th leforts, going blind means your life is over
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dude i dunno just trust one doc. if one doc like sinn or schendel (of their caliber) tell you they can get you through this with good aesthetic results and without numbness and O blindness, then go for it, at least you'll know then. i've never found implants to be much of a solution for anything. yes it's a risk, but the payoff is big too.
ths problem is this surgery is so rare you dont know whos right.
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every doc i consulted with, keller, schendel etc. said blindness was NOT an issue and Keller does 15 of these a year. I dunno, I think you're in uncharted territory but I like Sinn's very comprehensive approach, I say go for it.
Where is Keller located?
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Keller is at Mayo in Rochester, Mn.
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ths problem is this surgery is so rare you dont know whos right.
Granted, I've never seen your picture, but if multiple top surgeons are willing to do this surgery for you, that means your situation is serious enough to warrant the operation. And like you said before, implants are just camouflage.
The next question is, what kind of prices are they asking, and how much more expensive is it compared with what they charge for run-of-the-mill orthognathic surgery.
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Granted, I've never seen your picture, but if multiple top surgeons are willing to do this surgery for you, that means your situation is serious enough to warrant the operation. And like you said before, implants are just camouflage.
The next question is, what kind of prices are they asking, and how much more expensive is it compared with what they charge for run-of-the-mill orthognathic surgery.
surgeons fee ranges from 13-22k
for ths ones who waNted to do it in hospital,hospital 20-30k
for docs who do it in a surgical facility or accredited officd operating room 2-5k
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surgeons fee ranges from 13-22k
for ths ones who waNted to do it in hospital,hospital 20-30k
for docs who do it in a surgical facility or accredited officd operating room 2-5k
I think this is one surgery you definitely want to have done in a proper hospital. I wouldn't even go with a surgeon who is prepared to do it in an office lol. That just sounds nightmarish to me.
I would love to see a picture of your face by the way. I think everyone on this forum would. I can't believe you are really as bad as you say, and I can't even imagine how you look. You talk about yourself as though you have a monstrous face. I hope it's not true.
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I think this is one surgery you definitely want to have done in a proper hospital. I wouldn't even go with a surgeon who is prepared to do it in an office lol. That just sounds nightmarish to me.
I would love to see a picture of your face by the way. I think everyone on this forum would. I can't believe you are really as bad as you say, and I can't even imagine how you look. You talk about yourself as though you have a monstrous face. I hope it's not true.
the guy who said office operating rom, is a big respected name.
i cant post a pic. my overall face has improved sincs my other work,but my midface and orbis are still a wreck
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Had a long talk with keller . he doesn't think this surgery Is necessarily dangerous. He also thinks the risk of blindness is very very low since hes done many lefort III and II and never had any vision problems. His main concern is he said its a bad idea to do this surgery by not moving the maxilla also. he said just moving the midface without the maxilla is very technically difficult and he'd be afraid the whole peace would just break apart when being moved.He said that would concern him far more than risk of blindness.
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But why wouldn't you move the maxilla, is it in the correct position at the moment? Does moving the maxilla mean you would need another lower jaw surgery?
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But why wouldn't you move the maxilla, is it in the correct position at the moment? Does moving the maxilla mean you would need another lower jaw surgery?
my maxilla is in the correct position. I really dunno what to do. turvey and keller both said they would never do this surgery without moving the upper jaw with it and said its very technically difficult to do without moving the jaw. obwesgeser, schendel ,sinn don't think so (I don't know if any of them ever did it tho). I don't know what to do. im so f***cking angry that I was born like this. the orbital rims are so hard to fix when deficient. I always have the option of implants with dr, y but to be honest hes never really had any implant work that wowe me and almost all of his post op photos were taken a few days after surgery so theres still swelling which makes it look better. I loved Ramirez aesthetic eye and implant work ,but he ost his license in Maryland and 2 ppl died in his care and doesn't have malpractice insurance, imo going to him is out of the question.
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part of me thinks if this surgery is so safe/predictable then it would be much more popular , but someone said that's not necessarily true because for the most part people don't like extensive surgeries.even doctors today more and more and moving towards filler for just about everything because theres no down time. also advances in anesthesia/monitoring etc have made it safer (this actually was taken from a paper by dr chin).
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part of me thinks if this surgery is so safe/predictable then it would be much more popular , but someone said that's not necessarily true because for the most part people don't like extensive surgeries.even doctors today more and more and moving towards filler for just about everything because theres no down time. also advances in anesthesia/monitoring etc have made it safer (this actually was taken from a paper by dr chin).
A lot of PS looks like a scam TBH. Face transplant recipients look more like themselves prior to surgery than the donors. Because Face = Skull. OTOH, look at this way. Many class III patients still look deficient under the eyes after Le Fort I. If Le Fort III is not such a big deal over Le Fort I, and trimax surgery is almost the norm now days anyway, why not go the whole hog and do it as well at the time of the jaw surgery? Because the blond Obwegesser girl in this thread is by far the best Class III outcome I've ever seen.
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you are right. beauty is ine bone structure. ppl get so caught up on antiaging and wrinkles but imo its meaningless.
the problem is my upper jaw is in perfect position. so the question is can the lefort 3 be done with just moving midface without the jaw. some docs say yes,some say no.i havent seen any picturss without the jaw moved. obwegesers emails are confusing because he says things like lefort iii plus lefort i, or in my case lefort iii minus lefort i.wtf does that mean. does plus mean its 2 seperate surgery cuts under 1 anesthesia or is it one surgery cutting both. he doesnt respond to me anymore
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i was able to find a study on pubmed where jaw wasnt moved .it from asian dr`s and again they write lefort iii minus lefort i
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I suppose the 'minus Lefort I' means a backwards shifting Lefort.
Why can't you get two surgeries? Especially if it's safer for you. Just get your mid face and upper jaw moved forwards, and then later on have the upper jaw moved back. It sounds like the best solution for you.
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I assumed it meant not moving the maxilla. when I emailed obwegeser I specifically asked if he can do lefort iii without moving the upper jaw. his response is he can do a lefort III minus lefort I, when I asked him about the girl he said she had a lefort III plus lefort I. unfortunately he no longer responded to my e-mails after the last one. if anyone can get him to discuss his lefort III it would be great .
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part of me thinks if this surgery is so safe/predictable then it would be much more popular , but someone said that's not necessarily true because for the most part people don't like extensive surgeries.even doctors today more and more and moving towards filler for just about everything because theres no down time. also advances in anesthesia/monitoring etc have made it safer (this actually was taken from a paper by dr chin).
OTOH, aren't eye socket and cheekbone fractures fairly common (fights, car accidents) and are fixed with Le Fort 3?
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Where are the incisions made?
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So I go and see yet another surgeon. This time I didn't blab who my surgeon was. He told me that no-one does more surgeries than him in the state, if not the country.
Le Fort I is all I need, and re-evaluate in 12 months.
My face is too wide for modified Le Fort III (it will make it wider).
My cheekbones are asymmetrical. Le Fort III would exacerbate the asymmetry. So maybe implants to fix give under-eye support. But implants suck. He really regrets putting them into patients when he was younger and was willing to "experiment" at patient's request (and they were the wrong patients - "lunatics", "but, hey no-one sued me"). He only does custom medpor a few times a year when someone's face is totally messed up by an accident. Other than that, they are evil for the same reason chin implants are bad - "facial bones and muscles want to be together". Oversize malar implants can in fact cause scleral show.
HA paste is bulls**t as well. It migrates, resorbs. Waste of time.
Other interesting tid bits:
BSSO does not change the genial angles, only IVRO does, but it's dangerous and no-one does it anymore.
New planning software now even has ethnicity options.
Modified Le Fort III is only really for syndromal cases (Crouzon and the like). Says he's done less than 5. 1% risk of blindness. But he showed me the modified Le Fort III he did on a Class III man. Name, operation pictures (cuts under the eyes) and all. I asked him "what about patient confidentiality?" - "I don't give a f**k". The dude looked old and haggard. Narrow face, eyeballs practically hanging out. Scleral show. All fixed. He did not become handsome, just normal. Was ugly before. I really wonder what his real age was. He looked 50 years old. Maybe it was because of the deformity. Anyway the good doc said you can jump one level when you fix your deformity. Said I was average, will be "good looking, but no model" after surgery. So if you are ugly due to the deformity, you become average, etc.. Anyway, apparently this dude's personality changed from introvert to extrovert and he lost his job because of it.
I finally mentioned my surgeon. He said no-one besides US does more orthognathic surgeries. Hehe. "And we won't ignore you if things go wrong. Other surgeons just go quiet and will send you for second opinions. We will fix you if we make a mistake". So it's either him or my surgeon. No-one else has their kind of volume of surgeries.
Said that my surgeon is a real Le Fort III expert, loves doing them and will do them any chance he gets. So the fact that he doesn't think it's a good idea for me, means that it's not a good idea period.
tldr; From all the non-syndromal modified Le Fort III pictures I've seen, you need to have serious scleral show and have bulging eyes practically hanging out of their orbits. But it's not the white-unicorn operation that it's made out to be. Surgeons that know how to perform it, do perform it when it's appropriate.
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Thanks for the information. That's some really useful stuff there.
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So nobody will do it on a normal looking person for aesthetic reasons?
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So nobody will do it on a normal looking person for aesthetic reasons?
Obwegeser did it on a girl that looked relatively normal.
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In what universe did she looked normal Pre-OP?
She didn't look like a syndrome case.
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Obwegeser did it on a girl that looked relatively normal.
Actually she would probably fall under the "dish face" deformity. Yes there is such a thing. Usually from badly healed facial fractures due to an accident. But it can occur normally.
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Actually she would probably fall under the "dish face" deformity. Yes there is such a thing. Usually from badly healed facial fractures due to an accident. But it can occur normally.
What is dish face exactly?
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you need to have serious scleral show
How much would count as serious?
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Hey,
Have you guys ever seen a video of the lefort 3 procedure? I mean is it even possible? the only one I can find is the crouzon syndrome girl on youtube. Does anybody have a link to one?
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Hey,
Have you guys ever seen a video of the lefort 3 procedure? I mean is it even possible? the only one I can find is the crouzon syndrome girl on youtube. Does anybody have a link to one?
i think the guys here are talking about this girl
(http://i.imgur.com/6toB1QD.jpg)
(http://i.imgur.com/yPWL2sU.jpg)
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That's a lefort 3?
Actually she would probably fall under the "dish face" deformity. Yes there is such a thing. Usually from badly healed facial fractures due to an accident. But it can occur normally.
You take her maxilla and mandible and move it way back and that's my case. :'( I'm just talking about her mid-face area, which looks a bit recessed but not syndrome -esque recessed. Mine was from wearing cervical headgear.
I didn't realize that case was a lefort 3.
In what universe did she looked normal Pre-OP?
I think you may have a unrealistic view of what normal is. I guess at the end of the day it's all relative. Normal≠Attractive
How many surgeons actually do lefort 3s?
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i think the guys here are talking about this girl
yeah... but thats just one case and there are tons of videos on other procedures but not even one video of lefort 3. I mean other than the poor crouzon syndrome girl.
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Obwegeser did it on a girl that looked relatively normal.
This guy was (as per the post) going to have one done, and he didn't look deformed at all.
http://i.imgur.com/EuRSy.jpg
http://i.imgur.com/8Rakl.jpg
After SARPE:
http://i.imgur.com/tFzjw.jpg
http://i.imgur.com/sgLyu.jpg
He cited 'breathing problems.'
Edit: oops, the link.
http://www.reddit.com/r/IAmA/comments/sxsv1/i_am_a_17_year_old_male_who_had_a_sarpe_upper_jaw/
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This guy was (as per the post) going to have one done, and he didn't look deformed at all.
You trolling me, bro?
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All the non-syndrome Le Fort III cases that I've seen were pretty severe class IIIs with bulging eyes.
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All the non-syndrome Le Fort III cases that I've seen were pretty severe class IIIs with bulging eyes.
could you please share links if you have?
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hi, do you really think it was a modified lf3? because her nose tipp and the maxilla around the nose was lifted also, i guess? Or was it a high lefort 1 plus mlf3? thanks