jawsurgeryforums.com

General Category => Aesthetics => Topic started by: Lefortitude on January 18, 2017, 09:30:57 PM

Title: Which Surgeon Does The Best Aesthetic Bimax?
Post by: Lefortitude on January 18, 2017, 09:30:57 PM
I know Arnet and Gunson both do really good work, CCW movements, multisegmented lefort1s the whole 9 yards.  I was just wondering what other surgeons i should consult with before goin through with it.

thanks
Title: Re: Which Surgeon Does The Best Aesthetic Bimax?
Post by: ppsk on January 19, 2017, 02:33:44 AM
I'm not sure how much stock i place into the "big names"

I know the excuse is always "the best results are kept secret only to be seen in a office consult" but comparing publicly published work, I really dont A&G results as being significantly better than lesser names, certainly not to the extent that justifies prices in the 60-100k range.

I'm not disputing their talent, but the recognition surrounding their name is absolutely the product of marketing. Its worth noting that a lot of the more transformative results out there also have significant other work done; HA augmentation, implants, genio, rhino etc.

some results I've been impressed with:

Dr. Birbe
Dr. Antipov (although one result he also installed malar implants, which were clearly a mistake.)
Dr. Raffaini
Dr. Alfaro Hernandez
Dr. Pelo

I'm sure theres more, but thats off the top of my head. The notion here that the outcome really depends on your starting point seems to be very true. Most of the people who become really attractive after already have good eyes and midfaces, usually its just a malformed or retruded lower jaw that is holding them back. For example:

(https://fi.realself.com/340/c51a13e26282d612b6eb5f1b9b6ac033/4/a/a/Orthognathic-Surgery-before-1324647-2017099.JPG)
(https://fi.realself.com/340/c51a13e26282d612b6eb5f1b9b6ac033/5/3/9/Orthognathic-Surgery-after-1324647-2017100.jpg)


Title: Re: Which Surgeon Does The Best Aesthetic Bimax?
Post by: Lefortitude on January 20, 2017, 01:28:13 PM
Wow thank you for this list!

i would agree that, although A&G are widely regarded as the best in the world, their prices are likely inflated due to their hype

I wish there was any maxfac in canada who did aesthetics, but sadly i dont believe there is
Title: Re: Which Surgeon Does The Best Aesthetic Bimax?
Post by: ppsk on January 20, 2017, 06:09:39 PM
Wow thank you for this list!

i would agree that, although A&G are widely regarded as the best in the world, their prices are likely inflated due to their hype

I wish there was any maxfac in canada who did aesthetics, but sadly i dont believe there is

the point I'm making is there is not a difference between "aesthetic maxfac" and normal maxfac work. Ideally, maxfac intervention should always result in a more harmonious profile/balance of the jaws.

Obviously there are some things that can result in a better outcome, like it would seem CCW rotation is almost always better looking than CW rotation or linear advancement. But thats about it. Bimax is not a great aesthetic procedure........... but it might be a necessary first step to get the jaws in a good position.

consider user StupidJaws who had bimax initially, but then went on to have various bony contouring surgeries like the chin wing and what not.
Title: Re: Which Surgeon Does The Best Aesthetic Bimax?
Post by: Kingusia87 on January 20, 2017, 11:23:12 PM
Who did this case ?
I had one appointment with prof . Raffaini and I think I can go with him but have one objection - he said that he doesn't use hip bone to fill a gap in Le Fort 1 but some mixture from my blood and some Paste (HA paste I assume). This is a new method and I assume there is no research how it will behave I body after let say 20 years or so. And there is a question about stability as well. I think I will prefer to have a hip bone graft instead of this " mixture " even if it involves additional pain

I'm not sure how much stock i place into the "big names"

I know the excuse is always "the best results are kept secret only to be seen in a office consult" but comparing publicly published work, I really dont A&G results as being significantly better than lesser names, certainly not to the extent that justifies prices in the 60-100k range.

I'm not disputing their talent, but the recognition surrounding their name is absolutely the product of marketing. Its worth noting that a lot of the more transformative results out there also have significant other work done; HA augmentation, implants, genio, rhino etc.

some results I've been impressed with:

Dr. Birbe
Dr. Antipov (although one result he also installed malar implants, which were clearly a mistake.)
Dr. Raffaini
Dr. Alfaro Hernandez
Dr. Pelo

I'm sure theres more, but thats off the top of my head. The notion here that the outcome really depends on your starting point seems to be very true. Most of the people who become really attractive after already have good eyes and midfaces, usually its just a malformed or retruded lower jaw that is holding them back. For example:

(https://fi.realself.com/340/c51a13e26282d612b6eb5f1b9b6ac033/4/a/a/Orthognathic-Surgery-before-1324647-2017099.JPG)
(https://fi.realself.com/340/c51a13e26282d612b6eb5f1b9b6ac033/5/3/9/Orthognathic-Surgery-after-1324647-2017100.jpg)
Title: Re: Which Surgeon Does The Best Aesthetic Bimax?
Post by: ppsk on January 21, 2017, 12:56:39 AM
Who did this case ?
I had one appointment with prof . Raffaini and I think I can go with him but have one objection - he said that he doesn't use hip bone to fill a gap in Le Fort 1 but some mixture from my blood and some Paste (HA paste I assume). This is a new method and I assume there is no research how it will behave I body after let say 20 years or so. And there is a question about stability as well. I think I will prefer to have a hip bone graft instead of this " mixture " even if it involves additional pain

the case i posted was Dr. Joan Birbe of Clinica Birbe
Title: Re: Which Surgeon Does The Best Aesthetic Bimax?
Post by: Kingusia87 on January 21, 2017, 01:22:21 AM
the case i posted was Dr. Joan Birbe of Clinica Birbe

Thank you. Do you have more information about him ? I cannot find any results and opinions on internet
Title: Re: Which Surgeon Does The Best Aesthetic Bimax?
Post by: ppsk on January 21, 2017, 02:45:50 AM
Thank you. Do you have more information about him ? I cannot find any results and opinions on internet

he used to post on here, user DrBirbe

birbe.org/en is his website

he's in spain, so you probably wont find many patient experiences in english speaking forums.

Title: Re: Which Surgeon Does The Best Aesthetic Bimax?
Post by: ditterbo on January 21, 2017, 07:07:05 AM
the point I'm making is there is not a difference between "aesthetic maxfac" and normal maxfac work. Ideally, maxfac intervention should always result in a more harmonious profile/balance of the jaws.

Obviously there are some things that can result in a better outcome, like it would seem CCW rotation is almost always better looking than CW rotation or linear advancement. But thats about it. Bimax is not a great aesthetic procedure........... but it might be a necessary first step to get the jaws in a good position.

consider user StupidJaws who had bimax initially, but then went on to have various bony contouring surgeries like the chin wing and what not.

I think a larger ccw bimax + sg probably makes a big difference, mostly though the sg. Even bigger if you didn't do camouflage ortho work or have a gummy smile. But if you already masked the recession with a large sg or implant, the thought of bimax to look basically the same to people, but now be able to unlock more potential surgeries is quite demoralizing.
Title: Re: Which Surgeon Does The Best Aesthetic Bimax?
Post by: Lefortitude on January 21, 2017, 03:13:39 PM
I think a larger ccw bimax + sg probably makes a big difference, mostly though the sg. Even bigger if you didn't do camouflage ortho work or have a gummy smile. But if you already masked the recession with a large sg or implant, the thought of bimax to look basically the same to people, but now be able to unlock more potential surgeries is quite demoralizing.

I believe this may be my case, as my jaws recession isnt massive, and only has a slight negative impact on my breathing (about 5mm too far back due to s**tty extraction/retraction ortho)

However, when i synthetically open my occlusion and swing my mandible forward WOW do i like the way it looks and feels.

I would much rather address the skeletal issue, and solve the problem at its root, rather than my initial plan which was chin + jaw angle implants.

hence, looking at the bimax as the number one option. will likely get it with a SG or chin wing and potentially angle implants too if im not satisfied.  I think it could be a better alternative to the implants.