jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: ismic on August 17, 2016, 04:03:19 AM
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Hello everyone,
I've been looking to get my deficient lower jaw surgically corrected for a long time and collecting infos mainly by lurking on this forum. The options I had in mind were either Bimax surgery which would bring some functional improvements (I snore like a pig, so I probably have a small airway. I had an overbite when I was a kid, had braces and all), or just get a chin wing and be done with it. But Lazlo's adventures got me a bit scared of heavy surgery, so I might only go for the second option.
Anyway, I finally took the first step in this journey and booked a consultation with Triaca in a couple of weeks and get the opinion of an expert. Initially I planned on going with Zarrinbal since everyone in this forum seems to love him. And money is a bit tight for me, so Dr. Z is more affordable. But Triaca is only a 2h train ride away, so no plane and no border crossing, makes things a bit easier.
So I come to you with a question: how do I prepare for the consultation? What important questions do I have to ask? I don't want to leave empty-handed so I want to be absolutely certain to cover everything I can in the time he accords me.
Also do you guys have any personal questions you want me to ask? I'll try to give you answers when I come back.
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ill be visiting z soon, so i can do the same.
please ask him what is the cost for the chin-wing and how much extra costs the segmenting of the wing. z only rarely does segmenting ive read...but thats what ill probably need because as i understand it, its the only way to add significant width.
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Good luck on your consultation. I would be interested in finding out what would the cost of a bimax surgery w/ Dr. Triaca? Does Triaca do malar osteotomy? The cost of a consultation? Please inform us of the costs w/ Dr. Triaca because he seems to be an excellent surgeon. Thank you.
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ill be visiting z soon, so i can do the same.
please ask him what is the cost for the chin-wing and how much extra costs the segmenting of the wing. z only rarely does segmenting ive read...but thats what ill probably need because as i understand it, its the only way to add significant width.
What does "segmenting of the wing" do?
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Could you ask him if this is possible with a zso?
http://www.intechopen.com/source/html/48013/media/fig27.png
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When is your consult? Another question is does he use distraction osteogenesis?
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The question is "how do I prepare and what relevant Qs should I ask?" Not "let me ask him all of your questions about maxofacial procedures"
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My crystal ball says the consultation will be very short and he will suggest a chin wing. He may also provide you with a hasty comical morph. But given the demand he's in, I don't think he needs to try any harder.
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Could you ask him if this is possible with a zso?
http://www.intechopen.com/source/html/48013/media/fig27.png
Can you please ask him this one question for me?
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Holy f**k, email him or have a consult yourself.. I'll see him next week and I won't ask for you :P
why do you visit him over zarrinbal?
btw zarrinbal told me price for cw is 7k, cw+chin broadening is 8.5k, max jaw width increase is about 1cm, max ramus length increase is 1cm too. also limit of the advancement is basically the mandibular nerve...you cant stretch it too much or else it can get seriously damaged...thats why sometimes you need two cw...to let the nerve adapt to the stretch and after it settled you can stretch it further
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why do you visit him over zarrinbal?
btw zarrinbal told me price for cw is 7k, cw+chin broadening is 8.5k, max jaw width increase is about 1cm, max ramus length increase is 1cm too. also limit of the advancement is basically the mandibular nerve...you cant stretch it too much or else it can get seriously damaged...thats why sometimes you need two cw...to let the nerve adapt to the stretch and after it settled you can stretch it further
Thank you for these helpful informations you are welcone!
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why do you visit him over zarrinbal?
btw zarrinbal told me price for cw is 7k, cw+chin broadening is 8.5k, max jaw width increase is about 1cm, max ramus length increase is 1cm too. also limit of the advancement is basically the mandibular nerve...you cant stretch it too much or else it can get seriously damaged...thats why sometimes you need two cw...to let the nerve adapt to the stretch and after it settled you can stretch it further
What does he do for chin broadening? Is that part of the chin wing osteotomy?
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Thats true. I have also heard that the problem with chin wing is that you can do nothing to "change" the jaw angles (make them more prominent)!
I wonder if the only way to change the jaw angles is to augment with HA paste as Arnett and Gunson do. I'm becomming more and more sold on their approach.
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Damn, quite disheartening to read. Thank you, though. The only good thing for me is that you suggest the chin becomes heavier looking - which is what i need. Shame about the jaw angles, I'm optimistic after reading about StupidJaws having good results with filler, that any further work on the angles may be improved using that, perhaps.
this is terrible, i mean f**k doesn't quite gel with the results (albeit from TWO CHINWINGS) that stupidjaws has achieved AFTER a first surgery so I'm kind of surprised. Also haven't others seen really good pictures resulting from the operations? Now I'm confused as I assumed Zarrinabal would definitely be part of my surgery result.
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now we have to guess who the f**k is right and wrong.
there is a HUGE effect amongst people of thinking surgeons or their consults or results are AMAAAAAAAZING cause that's wishful thinking and what they want to believe from the scant evidence out there.
but then sometimes there are people who are super objective and can cut through the dross to really assess things.
So I wouldn't doubt the critic here just cause we want to believe otherwise. maybe the chin wing doesn't do s**t. i mean i really haven't seen any great before and afters of just that procedure online. And same with the ZSO. Stupidjaws looks great but he was very handsome to begin with. So that doesn't mean s**t really.
Come on some one figure this s**t out.
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now we have to guess who the f**k is right and wrong.
there is a HUGE effect amongst people of thinking surgeons or their consults or results are AMAAAAAAAZING cause that's wishful thinking and what they want to believe from the scant evidence out there.
but then sometimes there are people who are super objective and can cut through the dross to really assess things.
So I wouldn't doubt the critic here just cause we want to believe otherwise. maybe the chin wing doesn't do s**t. i mean i really haven't seen any great before and afters of just that procedure online. And same with the ZSO. Stupidjaws looks great but he was very handsome to begin with. So that doesn't mean s**t really.
Come on some one figure this s**t out.
I've seen quite a few of Stupid Jaws before and after photo's from all angles and he looks completely different and a 100 times better in the after pics, so it means alot actually.
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I know, yeah. It's worrying when you start getting conflicting opinions when you think you've settled on a plan. Yeah, StupidJaws looked amazing from the photo he let me see, but as you say - he was probably really good looking before, too. The other guy, GreyandBlue, does anyone know how he is getting on now? He had nerve damage and a little asymmetry i think? I'll be seeing Zarrinbal soon, so i can at least report back with my subjective opinion on some of his before/afters.
Grey and Blue basically said it was the biggest mistake of his life, he was in a ton of pain and asymmetry and will never get another procedure again. So I'm going to say that balances out Stupidjaws. Stupidjaws also has had fillers and stuff so it's harder to tell and he was very good looking before hand. I'll trust that you will give us an accurate assessment for sure.
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Also do you guys have any personal questions you want me to ask? I'll try to give you answers when I come back.
Please ask him about this kind of modified CW and if it's doable. I did talk with Z about it, he has never performed it like that, and is unsure if the bone graft part and the added ramus lenght will get enough nutrition and thus survive without relapsing. Doing a multi -segment CW is apparently more risky but adding ramus lenght would possibly help adding more angularity so this is something which needs to be further investigated.
(http://i67.tinypic.com/1znyexh.jpg)
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What does he do for chin broadening? Is that part of the chin wing osteotomy?
yes its part of the chin-wing. afaik he will split the chin-wing-segment in two halves at the chin, then adds a piece of hip bone inbetween and closes it back together. but he also told me the chin will get bigger alone from moving it more forward due to projection. also by broadening the chin, the whole mandible itself will also broaden by that amount.
anyway he showed me some dude (he was a foreigner, not german...so im pretty sure he is/was a member around here or other related forums because he also said that guy wanted extreme change so i guess he researched alot like we all do) who really got himself a massive chin and jaw broadening with only a single chin-wing surgery (thats what z told me).it was the best example ive seen in the consult eventho any result he showed me were clear improvements. i dunno if this guy is known around here with the older members (its wasnt stupidjaws)...if yes, maybe somebody knows something more about him/his before&after