jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Lazlo on November 12, 2012, 08:18:52 PM
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So I keep posting this stuff, but no one seems to have any info. I will ask Schendel about it in December --it must be offered here too somewhere in the United States. I would never had needed the brutal extraction of my biscuspids had I had this done. Damn.
It seems the results are much more aesthetically pleasing. I inquired and YES, it can be performed on an adult as well. Watch the video and check this doctor's website and other videos.
Extreme makeover. Overbite and orthognathic jaw surgery treated by jaw distraction. Channel 10 news (http://www.youtube.com/watch?v=chU4ImyeZl8#ws)
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any benefits over traditional orthognathic surgery?
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http://www.drchudasama.com/hub_sites/chudasama-dipak/www/assets/uploads/files/jco_2010-04-227.pdf (http://www.drchudasama.com/hub_sites/chudasama-dipak/www/assets/uploads/files/jco_2010-04-227.pdf)
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http://www.drchudasama.com/hub_sites/chudasama-dipak/www/assets/uploads/files/jco_2010-04-227.pdf (http://www.drchudasama.com/hub_sites/chudasama-dipak/www/assets/uploads/files/jco_2010-04-227.pdf)
Interesting. But they might just not practice it and are thus dissing it, also there may have been advanced in the past 2 years.
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The doctor in this video said these operations can be done at any age. And I've seen some before after of adults and they look pretty good. they can even do distraction of the maxilla and cheekbone. I know Schendel has done it on adults too.
But yes, the stability, accuracy stuff is more of a concern as expressed in the arnett/gunson piece (if their response is still entirely accurate for 2012/2013.
yeah, i guess you have to consider the costs, benefits, risks etc.
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Distraction osteogenesis has a lot of advantages over traditional jaw surgery. Maybe surgeons were reluctant to use this technique in the past because the technology was not well enough developed yet. I think the intra-oral devices this australian surgeon uses are just the job though.
If you watch this video very carefully, you will find that it blows away one of the key myths peddled on this forum. The idea that you cannot widen the back of the mandible (the jaw angles). The editing could be a bit better, but it is still fairly obvious that this is exactly what the distraction device is used for. See the diagram (drawn over the x-ray) if you don't get this. Despite all the evidence to the contrary, many people here will swear blind that this is impossible. Even dismissing the evidence before their own eyes as some kind of optical illusion. Widening of the jaw angles is possible, by at least 5 to 6mm, maybe as much as 1cm. Also, the jaw can be widened from the chin, further enhancing this effect.
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Watch the video, the red lines and the green lines. The red line is the new wider jaw, it is definitely a lot wider.
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I hope to. The diagram is 1:07 on the vid if anyone wants a look.
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Watch the video, the red lines and the green lines. The red line is the new wider jaw, it is definitely a lot wider.
Um, it's a panoramic xray. It's a two dimensional view of the (naturally) three dimensional mandible and maxilla, and must therefore translate the three dimensions in to two. Thus, length is transcribed as width on the xray.
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http://messageboards.makemeheal.com/chin-jaw-implants/help-how-widen-jaw-make-angular-t72166.html (http://messageboards.makemeheal.com/chin-jaw-implants/help-how-widen-jaw-make-angular-t72166.html)
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http://messageboards.makemeheal.com/chin-jaw-implants/help-how-widen-jaw-make-angular-t72166.html (http://messageboards.makemeheal.com/chin-jaw-implants/help-how-widen-jaw-make-angular-t72166.html)
What exactly do you hope to accomplish by capturing 'human perfection'? Even if you get your v-jawline it probably won't look natural cause your face biologically isn't that shape. My guess is you'll never be happy with the results unless you adjust your expectations.
Me, I just want a face that doesn't look bloated and pre-pubescent.
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What exactly do you hope to accomplish by capturing 'human perfection'? Even if you get your v-jawline it probably won't look natural cause your face biologically isn't that shape. My guess is you'll never be happy with the results unless you adjust your expectations.
Me, I just want a face that doesn't look bloated and pre-pubescent.
There's no point here questioning the philosophical/psychological underpinnings motivating anyone to pursue whatever aesthetic ideal they wish --in this thread let's keep the conversation keyed to the means of achieving whatever ideal we want. You can start another thread pondering whatever more existential, speculative questions you're interested in discussing. But this thread is about distraction osteogenesis: it's benefits and disadvantages and the doctors and any info about it. Thanks.
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sounds good to me --article indicates maxillary advancement is reserved mostly for patients with certain kinds of tissue deformity --but I wonder if it can be done a midface or malar complex to give higher stronger cheekbones? Something worth asking Schendel about.
http://www.joms.org/article/S0278-2391(07)01809-5/abstract (http://www.joms.org/article/S0278-2391(07)01809-5/abstract)
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apparently devices already exist for distracting the orbital/malar complex.
My prediction is that within the next 5-10 years this is going to become the norm, and jaw surgery will be carefully phased out. Seems like you can in fact exhibit a far greater degree of precise control over what parts you want lengthened and how with these new intraoral distracting devices.
http://www.klsmartin.com/fileadmin/Inhalte/Downloads_Prospekte/90-777-02-04_03_02_Molina.pdf (http://www.klsmartin.com/fileadmin/Inhalte/Downloads_Prospekte/90-777-02-04_03_02_Molina.pdf)
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There's no point here questioning the philosophical/psychological underpinnings motivating anyone to pursue whatever aesthetic ideal they wish --in this thread let's keep the conversation keyed to the means of achieving whatever ideal we want. You can start another thread pondering whatever more existential, speculative questions you're interested in discussing. But this thread is about distraction osteogenesis: it's benefits and disadvantages and the doctors and any info about it. Thanks.
Wow, thanks for keeping us on track Mr. Gestapo ::)
Seems to me the other guy fired shots first, but whatever.
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My prediction is that within the next 5-10 years this is going to become the norm, and jaw surgery will be carefully phased out.
I hate to be that guy, but do you have a source?
Seems like you can in fact exhibit a far greater degree of precise control over what parts you want lengthened and how with these new intraoral distracting devices.
Again, source?
Traditional orthognathic surgery is still used precisely because osseous segments can be repositioned accurately and instantly.
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What exactly do you hope to accomplish by capturing 'human perfection'? Even if you get your v-jawline it probably won't look natural cause your face biologically isn't that shape. My guess is you'll never be happy with the results unless you adjust your expectations.
I don't know what you mean about "capturing 'human perfection'", I didn't comment on that thread I posted, I was just using it as an example that you can widen the lower jaw.
I'm not trying to look perfect by the way, alythough that would be nice (probably impossible). I just want to look normal, to me that means having a "slightly" wider jaw.
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I don't know what you mean about "capturing 'human perfection'", I didn't comment on that thread I posted, I was just using it as an example that you can widen the lower jaw.
I'm not trying to look perfect by the way, alythough that would be nice (probably impossible). I just want to look normal, to me that means having a "slightly" wider jaw.
Well you're recent comment that we're all laughing at sure seemed to suggest you had delusions of grandeur. I mean most of us here like to stay within the realm of reality.
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Reality means being true to yourself my friend. If you were in touch with reality you wouldn't be visiting jaw surgery websites and dreaming about having a different face.
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I hate to be that guy, but do you have a source?
Again, source?
Traditional orthognathic surgery is still used precisely because osseous segments can be repositioned accurately and instantly.
Oh no you're correct sharptoys. No source on this, that's why I said it was my "prediction," and just a speculation. Though I must say I do have several sources for devices that are being developed which allow for greater control and accuracy than the distraction devices available in the past decade. Moreover, if you do any google search on the term, you'll find distraction osteogenesis for many, many different applications is one of the most exciting areas of body augmentation out there. So I predict this technology is going to start making a major impact in the near future, especially for cosmetic purposes.
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Reality means being true to yourself my friend. If you were in touch with reality you wouldn't be visiting jaw surgery websites and dreaming about having a different face.
Uh, no. Reality means reality. I have the means to change my face and hopefully correct the issues. I want a normal face, that's it. Seems most jaw surgery at least accomplishes that. That's the reality of the situation.
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Uh, no. Reality means reality. I have the means to change my face and hopefully correct the issues. I want a normal face, that's it. Seems most jaw surgery at least accomplishes that. That's the reality of the situation.
Again, you're more than free to begin a separate thread dedicated to your epistemological speculations about the nature of "reality" If you wish. I can start you off by suggesting you wiki nominalist, naturalist, empiricist, post-modern/socially constructed, idealist, pragmatist etc.. positions. This thread is dedicated to DISTRACTION OSTEOGENESIS.
I really DO NOT UNDERSTAND what the big deal is with some of you people!!?? Some people just want to normalize their face....good for you! Some people may already have "normal-ish" faces and want to use jaw surgery as a means to attain some kind of aesthetic ideal...and good for you too! No one side is morally justified (or the many, indeed most people who exist somewhere between these polarities) in condemning the other with regards to their motivations.
Indeed, I would say that most everyone would like to maximize the aesthetic outcome of this operation.
I started this thread for people who are interested in the possibilities of distraction osteogenesis and it's aesthetic advantages and applications (if any!) --clearly there are doctors using this technology both in place of jaw surgery and to supplement the augmentation of other parts of the face related to jaw surgery. Indeed it's more widespread than we assume and more specific applications may be available in the future, but that's no reason we shouldn't keep an open mind about it and discuss it.
I for one believe that technologies for major aesthetic enhancement are currently in existence, but you have to be very careful about what procedures, surgeons etc. you use. For example, if you didn't know about maxillofacial surgery you might go to a PS as I did a few years back and get recommended a chin implant. I did a bit of research thankfully and found out that genioplasties are far superior both aesthetically and in relation to various health parameters than a genioplasty. I further found out that a BSSO could approximate many of the results of jaw angle implants, though not in all directions (i.e. width or gonal angle shape). I had teeth extracted by my ortho, but had I known about distraction osteogenesis I would have most certainly had that done first to make space for my crowded teeth instead of extractions, then I might have gone on and had traditional jaw surgery.
The point is, this site is a place for free discussion and indeed criticism(with evidence on both sides) but more often the discussion is devolving into ad hominem attacks based on the presumption that some people are harbouring "unrealistic" or more probably socially unsanctioned aspirations. I really don't care whether you aspire to look normal, heroic, subhuman, or monstrous, I just want to get a clearer sense of what technologies for craniofacial remodelling are out there and what they can do.
For those interested, "beauty," in my understanding is a "gestalt" that is, it is predominantly relational. I agree you cannot simply attain aesthetic harmony by augmenting one part of your face, though for some it may be all they need to complete the ideal gestalt. For others, tweaking or augmenting other parts of the face may be necessary which is why I think distraction osteogenesis needs to be thought about in relation to overall craniofacial remodelling.
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Again, you're more than free to begin a separate thread dedicated to your epistemological speculations about the nature of "reality" If you wish. I can start you off by suggesting you wiki nominalist, naturalist, empiricist, post-modern/socially constructed, idealist, pragmatist etc.. positions. This thread is dedicated to DISTRACTION OSTEOGENESIS.
Do me a favor and give it a rest. This is the second time jack's directed a post at me, I've responded to it, and then you've called me out for merely responding to him. You are not an admin on these forums, you don't have the power to tell me what I can and can't post.
You are free to discuss whatever you want. If someone quotes me though, I'm going to respond. Feel free to ignore my posts if it gives you peace of mind.
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Do me a favor and shut the f**k up. This is the second time jack's directed a post at me, I've responded to it, and then you've called me out for merely responding to him. You are not an admin on these forums, you don't have the power to tell me what I can and can't post.
You are free to discuss whatever you want. If someone quotes me though, I'm going to respond. Feel free to ignore my posts if it gives you peace of mind.
I don't believe you're following the forum decorum. see following:
http://jawsurgeryforums.com/general-chat/forum-decorum/ (http://jawsurgeryforums.com/general-chat/forum-decorum/)
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I don't believe you're following the forum decorum. see following:
http://jawsurgeryforums.com/general-chat/forum-decorum/ (http://jawsurgeryforums.com/general-chat/forum-decorum/)
As much as you'd like it that way, I don't think this place is run like Nazi Germany. The nature in which you police threads makes me think you're new to forums, or simply lack the ability to ignore posts that aren't pertinent to what you're trying to find out. So a.) get over it, and b.) stop baiting me by calling me out.
Secondly, you make a bunch of erroneous assumptions about me and my thought process in all this. No, I don't use "unrealistic" and "aesthetic ideal" interchangeably, you have nothing to go on except the posts I've made in this thread. Everything I said was directed at jack and his expectations, you are well within your rights to get surgery for whatever reason you see fit, so stop taking everything I say so damn personally.
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For those of you who are interested distraction osteogenesis is now commonly used in advanced orthodontic practices to grow more jawbone to fit in implants. This suggests to me that it renders the need for most extractions(a process I unfortunately was the victim of).
http://www.drsmilneandbozich.com/procedures/distraction-osteogenesis.asp (http://www.drsmilneandbozich.com/procedures/distraction-osteogenesis.asp)
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And I was correct, it has in fact already been done several years ago. If your ortho is recommending extractions of all four biscuspids, you might want to find an ortho and/or surgeon combo who would be willing to do this instead --aesthetically the results would be FAR superior and you can still continue on with traditional jaw surgery.
http://www.ncbi.nlm.nih.gov/pubmed/15024792 (http://www.ncbi.nlm.nih.gov/pubmed/15024792)
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Three surgeons here in Toronto Dr. Stephen Ho
Dr. Tocchio, Dr. CLokie --also head of max fac residency here in Toronto.
Spoken to Schendel on phone. Have Gunson/Arnett and Schendel apps next month.
Spoke to Dr. Kawamoto (student of Tessier as was Schendel) over the phone and he told me some interesting things as well,
suggested as far as possible never get implants of any kind, try and use your own bone whenever possible.
Admittedly, I have not raised the topic of distraction osteogenesis yet or the quadrangular Lefort 1 because I have only learned of them recently.
Had a virtual consultation with Mommaerts who analyzed my ceph and photos from every angle and bite --he said he could advance the malar complex and it
a routine, low risk procedure.
I will be especially interested to see what Schendel, and Keller at the Mayo clinic have to say about quadrangular lefort 1 and malar osteotomies or distraction.
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Three surgeons here in Toronto Dr. Stephen Ho
Dr. Tocchio, Dr. CLokie --also head of max fac residency here in Toronto.
Fantastic! Did they diagnose you with anything particular? Or perhaps suggestions for operations?
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Fantastic! Did they diagnose you with anything particular? Or perhaps suggestions for operations?
yes, one suggested just bsso with genioplasty, one suggested bi-max, no genioplasty, and one suggested bsso without genio.
one suggested implants for malar region, the other suggested malar osteotomy plus ha paste. (along with bsso).
I had only a class one, slightly retrusive lower jaw, which i belive the ortho treatement has made worse (sorry typos, typing without glasses)
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I've actually done my own research on that. I know you posted some videos on one of my threads about that. They originally did distraction osteogenesis for kids with Apert syndrome. It's quite a lengthy process.
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I've actually done my own research on that. I know you posted some videos on one of my threads about that. They originally did distraction osteogenesis for kids with Apert syndrome. It's quite a lengthy process.
iT used to be, especially with external devices. It seems that for jaw lengthening though you have an internal device and its life as usual during the lengthening phase (i.e. never more than 3 weeks to a month) then you just get braces. No big deal at all. If Paul Oceancig is producing good results this way I think it's amazing. I should also say that for those of us really obsessed about aesthetics. Getting distraction to lengthen the jaw in places and THEN having the bi-max surgery might actually be the way to go.
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iT used to be, especially with external devices. It seems that for jaw lengthening though you have an internal device and its life as usual during the lengthening phase (i.e. never more than 3 weeks to a month) then you just get braces. No big deal at all. If Paul Oceancig is producing good results this way I think it's amazing. I should also say that for those of us really obsessed about aesthetics. Getting distraction to lengthen the jaw in places and THEN having the bi-max surgery might actually be the way to go.
Sorry for bumping such an old thread, but I was just wondering what you meant exactly by getting DO first and then getting a bi-max, what would be the point in this?
Also, this might be a rudimentary question, but I have read that one of the advantages of DO is that it allows for bone regrowth, but doesn't regular jaw surgery also do this? I mean presumable the bone has to regrow as it heals anyway? Or is it that with the DO the bone regrowth is in the same pattern as it was before whereas with a simple BSSO the shape of the mandible is different (thinner?).
Lot of questions there lol
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Healing takes place in two phases. The first phase takes about 4mo, in which a basic bone is formed. It then remodels for the next 8mo. Relapse is most likely in the first 6mo during this time. DO avoids this risk in principal but I've read the movements are much harder to control in the jaw. In other parts of the body they happen in only two dimensions. I suspect it's not as strong as plates are too. Probably the biggest reason it's not used more often is that surgeons are simply unfamiliar with it. No one wants to undergo a new procedure and no surgeon wants to risk their reputation.
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Healing takes place in two phases. The first phase takes about 4mo, in which a basic bone is formed. It then remodels for the next 8mo. Relapse is most likely in the first 6mo during this time. DO avoids this risk in principal but I've read the movements are much harder to control in the jaw. In other parts of the body they happen in only two dimensions. I suspect it's not as strong as plates are too. Probably the biggest reason it's not used more often is that surgeons are simply unfamiliar with it. No one wants to undergo a new procedure and no surgeon wants to risk their reputation.
No there are plenty of problems. Instability, high rate of relapse, doctors are stupid and only a few can do it, but even the best ones who have invented the devices for this s**t don't want to do it.
The only real DO availabile right now is SARPE. Anyway, this thread is dead. NO ONE IS DOING THIS TECHNIQUE WITH ANY SUCCESS. GIVE IT UP.
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Paul Coceancig does mandibular and even maxillary DO. Whether it's worth it for non-syndromal adults... I have no idea.
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No there are plenty of problems. Instability, high rate of relapse, doctors are stupid and only a few can do it, but even the best ones who have invented the devices for this s**t don't want to do it.
The only real DO availabile right now is SARPE. Anyway, this thread is dead. NO ONE IS DOING THIS TECHNIQUE WITH ANY SUCCESS. GIVE IT UP.
SARPE and RME is the most common use of DO as you said, but there are a lot of surgeons in Europe (Switzerland, as you might guess - Obwegeser, Triaca et al) who are successfully using DO to distract anterior segments of the mandible and maxilla even though they are still reluctant to distract the whole complex.