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General Category => Functional Surgery Questions => Topic started by: terry947 on February 06, 2015, 11:44:10 PM

Title: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: terry947 on February 06, 2015, 11:44:10 PM: I just like to get peoples opinions on this.

Say if I can't get a lefort III, would It better to keep my retrognathic profile (class II) or get a lefort I/BSSO to have a normal profile but risk having a flatter looking mid-face?
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: mynameis on February 07, 2015, 01:48:10 PM: Hard to answer without pictures really. I'd say everybodies an individual case. There's the standardised ideal of whats good looking, you know like models or brad pitt.

But there's people with flat midfaces who can be good looking, and people with imperfect profiles that are still good looking.
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: PloskoPlus on February 07, 2015, 04:44:31 PM: Quote from: terry947 on February 06, 2015, 11:44:10 PM
I just like to get peoples opinions on this.

Say if I can't get a lefort III, would It better to keep my retrognathic profile (class II) or get a lefort I/BSSO to have a normal profile but risk having a flatter looking mid-face?

Well strictly speaking you would need a Le Fort I regardless, since your bite is messed up. While it is possible to correct the bite with an LFIII, it has a very limited range of movements. So it would have to be a combined: modified LFIII + LFI. The main problem with LFI is not that the mid face ends up being flat, but the opposite - a protrusive lower part of the mid face giving a chimp look if the upper part is still recessed.

I don't think you have very recessed orbits. LFI can still improve the way your under eye area looks. It does not touch the orbital area obviously, only tents up the the muscles somewhat. But it helps in the same way chin augmentation is like a free nose job in profile, if that makes sense.
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: terry947 on February 07, 2015, 10:14:44 PM: thanks plosko for the input!

@ mynameis - heres a dropbox link of my face. https://www.dropbox.com/sh/kfmezx6sre5pfpe/AAChETm8p18dLyP6WCKukWZ3a?dl=0
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: PloskoPlus on February 08, 2015, 10:11:57 PM: Quote from: 27F on February 08, 2015, 07:50:07 PM
^ I think fat grafting would be a viable option (if you have no other issues). It seems more of a soft tissue issue anyhow. I would def. give fat grafting a try before committing to actual surgery though (obviously).

Fat cells tend to get bigger with age. Fat grafts in general a unpredictable.
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: geijutsu on February 09, 2015, 04:14:46 PM: It's crazy how casually the word lefort III has been dropping here lately. I'm willing to bet that 90% of the people that post about it don't even need it the way syndrome cases do. Fix your occlusion first, then work your way around the rest with less risky, more controllable modalities.
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: PloskoPlus on February 09, 2015, 04:29:45 PM: Quote from: geijutsu on February 09, 2015, 04:14:46 PM
It's crazy how casually the word lefort III has been dropping here lately. I'm willing to bet that 90% of the people that post about it don't even need it the way syndrome cases do. Fix your occlusion first, then work your way around the rest with less risky, more controllable modalities.

My occlusion has been fixed, but my upper mid face is still recessed. What other modalities?
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: terry947 on February 09, 2015, 09:40:15 PM: I heard fat graphs are garbage since they look really bad when you start aging. Real bone movements are greater than anything else.

Also heres the thread of the girl I was talking about: http://jawsurgeryforums.com/index.php?topic=787.15

(http://i.imgur.com/4u2OCYT.jpg)

"the above is a lefort 2 quadrangular. incision is made at the lower orbital rim, but the nose remains untouched. midface is brought forward."

If this is a legit LF II, then these results are AMAZING!
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: Rico on February 10, 2015, 03:06:56 AM: Who operated that girl from photos above ? nice result
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: geijutsu on February 10, 2015, 03:30:11 AM: Quote from: PloskoPlus on February 09, 2015, 04:29:45 PM
My occlusion has been fixed, but my upper mid face is still recessed. What other modalities?

If you're looking into augmenting your cheekbones then customized implants would be a far more predictable, and less invasive route than having a lefort/modified lefort III.

What are exactly your main problem areas?
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: Rico on February 10, 2015, 03:59:33 AM: again I see everyone overlooked my post about ZSSO (not sandwich one)
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: geijutsu on February 10, 2015, 04:05:35 AM: Quote from: Rico :) on February 10, 2015, 03:59:33 AM
again I see everyone overlooked my post about ZSSO (not sandwich one)

Dr. Eugene E Keller
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: Rico on February 10, 2015, 06:17:08 AM: but what ;) ?
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: geijutsu on February 10, 2015, 06:53:05 AM: quadrangular Le Fort II osteotomy
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: Rico on February 10, 2015, 07:55:31 AM: but i'm writing about ZSSO
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: geijutsu on February 10, 2015, 09:53:29 AM: Quote from: Rico :) on February 10, 2015, 07:55:31 AM
but i'm writing about ZSSO
I don't know what you're talking about.
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: Rico on February 10, 2015, 02:31:41 PM: geijtsu: read some last posts in Lefort 2 / 3 thread
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: PloskoPlus on February 13, 2015, 01:06:13 AM: Quote from: 27F on February 09, 2015, 07:28:47 PM
That is true but, I've seen a lot of lasting and nice results from it too. I def. think the Koreans have it down. If I decide to go the "not so invasive" route, I'll be getting it done.

Not too bad for fat, I suppose. I like how it turned out under the eyes and her browridge. She went from an egg head to having some shape.

(http://oi61.tinypic.com/14ccfo8.jpg)

I see a lot of make up in the after.
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: terry947 on February 13, 2015, 04:19:58 PM: implants suck because soft tissue might not sit properly, not to mention the rejection you body will make. Implants are not bio-compatible,so 10 years down the line you'll probably have bone loss, scar tissue, plus who knows what else. Plus I heard that If the implants are near the orbital rim, the risks stay the same.
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: geijutsu on February 13, 2015, 06:28:51 PM: Quote from: terry947 on February 13, 2015, 04:19:58 PM
implants suck because soft tissue might not sit properly, not to mention the rejection you body will make. Implants are not bio-compatible,so 10 years down the line you'll probably have bone loss, scar tissue, plus who knows what else. Plus I heard that If the implants are near the orbital rim, the risks stay the same.

I know some people who had midface implants for 15+ years with no problems whatsoever, and they're still happy with the results.
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: PloskoPlus on February 13, 2015, 10:01:35 PM: Quote from: geijutsu on February 13, 2015, 06:28:51 PM
I know some people who had midface implants for 15+ years with no problems whatsoever, and they're still happy with the results.

What kind of material? Who were the surgeons?
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: geijutsu on February 14, 2015, 03:58:27 AM: Quote from: PloskoPlus on February 13, 2015, 10:01:35 PM
What kind of material? Who were the surgeons?
don't know the surgeons but the material is silicon. One of them was a custom carved implant who had it since the mid to late 90s.
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: Rico on February 14, 2015, 04:24:03 AM: something what gives picture of malar advanced osteotomies regardless it's syndromic or nonsydromic patient
It's not a fun.
http://www.ncbi.nlm.nih.gov/pubmed/21752661

dr Koudstaal
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: PloskoPlus on February 14, 2015, 04:14:41 PM: Combined Le Fort III and Le Fort I in America
http://www.ncbi.nlm.nih.gov/pubmed/8530703

EDIT: LFIII must be a Texan thing.
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: earl25 on February 15, 2015, 07:04:17 AM: Quote from: PloskoPlus on February 14, 2015, 04:14:41 PM
Combined Le Fort III and Le Fort I in America
http://www.ncbi.nlm.nih.gov/pubmed/8530703

EDIT: LFIII must be a Texan thing.

I tried consulting with Schmidt but called it off because he said he will not review photos or pics before a consult. only in person
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: PloskoPlus on February 22, 2015, 03:34:42 AM: Quote from: geijutsu on February 10, 2015, 03:30:11 AM
If you're looking into augmenting your cheekbones then customized implants would be a far more predictable, and less invasive route than having a lefort/modified lefort III.

What are exactly your main problem areas?

From "Craniomaxillofacial Reconstructive and Corrective Bone Surgery":

Advantages and Disadvantages
The advantages of a midface osteotomy technique is that the results are more predictable than alternative choices. Alloplast placed in this region can become displaced. Onlay grafts re- sorb and remodel in an unpredictable fashion.
The greatest disadvantages are the time necessary to plan the case (models, etc.) and time of the surgical procedure.

Of course, another max fac textbook poo-poos Le Forts other than Le Fort I "we've done them all, but why bother, when when we now have such wonderful implants!"

[attachment deleted by admin]
Title: Re: If one can't get a mod-lefort III, would other options be better than nothing?
Post by: terry947 on February 22, 2015, 03:21:06 PM: wow so much cutting going on in the face, kind of scary lol. But if some were to have this, it'd create a big difference in apperance. I've also noticed on friends that their zygo/upper maxilla have good forward and side projection, which makes them good looking.

Also regarding implants I think anything except done movement wont look as good, plus these something foreign in your face for the rest of your life. Maybe in the future, they'll have an implant or substance that you can mold that will be 100% compatible with out real bone.

I've found this, not sure If anyone here has heard of it. Supposedly its the most bio-compatible substance that we can use compared to real bone.

http://www.biocoral.com/files/Questions%20-%20Answers%20actuel%20VA.pdf