jawsurgeryforums.com
Surgeon Information => Surgeon Reviews and Leads => Topic started by: Post bimax on March 20, 2019, 07:18:27 AM
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I'm wondering what the general opinion around here on Wolford is, especially with regard to revisions. I know Gunson is considered the 'best', but what do you think of Wolford's results? Gunson is particularly hard to get a consultation with; doubly so if you don't have a medical problem or referral.
I know Wolford is aggressive with CCW-r which is a plus for patients who need it. I see a lot of mixed reviews of him on the internet, but most of these seem to stem from TMJ reconstruction where it was not really necessary.
Thanks
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That's the reputation I've heard as well. He replaces the joints (and he invented the artificial joints he's using) when unnecessary. That alone is a red flag. There was a flawed study out of Washington (from memory, and I think he funded it?) claiming the benefits of the procedure. You might be able to find the paper.
I've heard he has some good results, but to me the above is too weird. He also owns a top 100 house in Dallas:
https://www.dmagazine.com/publications/d-magazine/2018/july/100-most-expensive-homes-in-dallas/
Selling unnecessary, expensive replacement joints seems like a way to do that.
Maybe he's good though? I really don't know, but that's what I've pieced together on him.
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I think he's one of the pioneers or 'movers and shakers' for CCW. I think the joint replacements are about his not wanting to do too much CCW on people with TMJ pain/problems.
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I think he's one of the pioneers or 'movers and shakers' for CCW. I think the joint replacements are about his not wanting to do too much CCW on people with TMJ pain/problems.
I wonder if he does multi-segment CCW's like Gunson often does. As you keenly pointed out, it's possible the 3-piece lefort relieves a good deal of muscle pressure on the TMJ when doing major posterior downgrafts, in comparison to a lesser-piece lefort.
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I wonder if he does multi-segment CCW's like Gunson often does. As you keenly pointed out, it's possible the 3-piece lefort relieves a good deal of muscle pressure on the TMJ when doing major posterior downgrafts, in comparison to a lesser-piece lefort.
Yes. He does. Because you can see it in the way he draw his diagrams where it's clear that it must be 3 piece. Gunson makes the diagram look like it could be 'see saw' rotation around 1 point where it is indeed a 3 piece L1 a lot of the time.
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Only a 10 million house? The man is a pauper!
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Wolford's results with CCW/CWR are outstanding. I don't know if I've ever seen one before-after that wasn't excellent.
That said, he will peddle his aritifical joint crap if he hears just a SINGLE click in your jaw. With no other symptoms. Actually he doesn't even need to hear it, you can tell him in writing you have no TMJ pain or issues but mention a rare click that happened years ago and he'll want to talk about replacing your joints. That's bonkers.
I have an e-mail where he did just that with me.
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I think this thread belongs in the private forum.
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It looks like his outstanding YELP reviews ARE from people that REALLY needed total reconstruction where the TMJ replacements were part of it and who had some way of knowing that was needed.
I would imagine that his happy patients had a LOT of $$ because it looks like insurance does NOT pay for everything done in the surgery and one YELP reviewer was LAUDING him for not limiting his surgery suggestions to only those insurance would pay for.
Outside of YELP there was a patient who clearly really needed the TMJ replacements and total reconstruction surgeries but she also needed to rustle up about 45 grand or so for the part of the surgery that was self pay and the insurance would not pay for. So I guess the surgeries with him were close to a quarter million.
ref= https://www.gofundme.com/moderndorcasdenise
The complaints (in general) look to be from people to whom he suggested joint replacements or something else where they probably had no way of 'knowing' if they really needed that. You know, not like the other patients who had some way of 'knowing' that particular suggestion rang true which would be something the patient would 'know' if they also knew they needed total jaw reconstruction or suffered from a lot of joint pain.
I guess the 'neutral' thing I would suggest is that if you go there for 'aesthetics' and he intimates or suggests joint replacement in situation where you, as patient, don't perceive any joint problems, would be to hold off or decline the surgery if it were contingent on joint repacement. Perhaps take a 'wait and see' approach and consider him later down the line in the event it 'feels' that way to you that you might need that.
As to the OP asking for feedback, it looks like you still need to resolve your initial question which was; 'Should I have had CCW?' I think you need to REFINE that question to:
'Would I have wanted a 3 piece Lefort in order JUST to have CCW?'
To that regard, you would need to factor in such things as insurance NOT paying for the 'extras' needed to do that when the solution was what you got to correct the bite. Also what ever other co-pays, travel expenses etc that would have been needed.
At this point in time, if you still want that, it's REVISION surgery and would tend to be TOTALLY SELF PAY given that insurance would not kick in for it.
Plosko, I'm not sure how 'private' this discussion needs to be given the OP posted his photos openly and is asking for GENERAL feedback. Not to mention, he is referencing PUBLIC feedback (open reviews) he's read.
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It looks like his outstanding YELP reviews ARE from people that REALLY needed total reconstruction where the TMJ replacements were part of it and who had some way of knowing that was needed.
I would imagine that his happy patients had a LOT of $$ because it looks like insurance does NOT pay for everything done in the surgery and one YELP reviewer was LAUDING him for not limiting his surgery suggestions to only those insurance would pay for.
Outside of YELP there was a patient who clearly really needed the TMJ replacements and total reconstruction surgeries but she also needed to rustle up about 45 grand or so for the part of the surgery that was self pay and the insurance would not pay for. So I guess the surgeries with him were close to a quarter million.
ref= https://www.gofundme.com/moderndorcasdenise
The complaints (in general) look to be from people to whom he suggested joint replacements or something else where they probably had no way of 'knowing' if they really needed that. You know, not like the other patients who had some way of 'knowing' that particular suggestion rang true which would be something the patient would 'know' if they also knew they needed total jaw reconstruction or suffered from a lot of joint pain.
I guess the 'neutral' thing I would suggest is that if you go there for 'aesthetics' and he intimates or suggests joint replacement in situation where you, as patient, don't perceive any joint problems, would be to hold off or decline the surgery if it were contingent on joint repacement. Perhaps take a 'wait and see' approach and consider him later down the line in the event it 'feels' that way to you that you might need that.
As to the OP asking for feedback, it looks like you still need to resolve your initial question which was; 'Should I have had CCW?' I think you need to REFINE that question to:
'Would I have wanted a 3 piece Lefort in order JUST to have CCW?'
To that regard, you would need to factor in such things as insurance NOT paying for the 'extras' needed to do that when the solution was what you got to correct the bite. Also what ever other co-pays, travel expenses etc that would have been needed.
At this point in time, if you still want that, it's REVISION surgery and would tend to be TOTALLY SELF PAY given that insurance would not kick in for it.
Plosko, I'm not sure how 'private' this discussion needs to be given the OP posted his photos openly and is asking for GENERAL feedback. Not to mention, he is referencing PUBLIC feedback (open reviews) he's read.
You are correct that I'm still after my initial question. The feedback on this forum has been useful, but I want another top surgeon's opinion to either a. settle my mind on what I actually had done or b. articulate some revision option.
Regarding my operation, I believe Posnick told me on the day of my surgery that my LF1 was in fact 3-piece. This was at like 6am right before the IV went in though so my memory could be playing tricks.
As for financing, I'm aware this would all be out of pocket. I'm an unmarried young professional with no (institutional) debt and a decent job. I figure achieving 'peace of mind' about my new facial aesthetics is worth more to me than maximizing my 401k balance at 60 years old. Peace of mind could be achieved through either a or b above. At the end of the day I want to be confident that I did all that could/should have been done. If the answer is "a", then I'd look at some minor lip, chin and/or nose work and be done with it.
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You are correct that I'm still after my initial question. The feedback on this forum has been useful, but I want another top surgeon's opinion to either a. settle my mind on what I actually had done or b. articulate some revision option.
Regarding my operation, I believe Posnick told me on the day of my surgery that my LF1 was in fact 3-piece. This was at like 6am right before the IV went in though so my memory could be playing tricks.
As for financing, I'm aware this would all be out of pocket. I'm an unmarried young professional with no (institutional) debt and a decent job. I figure achieving 'peace of mind' about my new facial aesthetics is worth more to me than maximizing my 401k balance at 60 years old. Peace of mind could be achieved through either a or b above. At the end of the day I want to be confident that I did all that could/should have been done. If the answer is "a", then I'd look at some minor lip, chin and/or nose work and be done with it.
Well, not suggesting that you shouldn't consult about revisions. Just suggesting what to consider when you do.
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You are correct that I'm still after my initial question. The feedback on this forum has been useful, but I want another top surgeon's opinion to either a. settle my mind on what I actually had done or b. articulate some revision option.
Regarding my operation, I believe Posnick told me on the day of my surgery that my LF1 was in fact 3-piece. This was at like 6am right before the IV went in though so my memory could be playing tricks.
As for financing, I'm aware this would all be out of pocket. I'm an unmarried young professional with no (institutional) debt and a decent job. I figure achieving 'peace of mind' about my new facial aesthetics is worth more to me than maximizing my 401k balance at 60 years old. Peace of mind could be achieved through either a or b above. At the end of the day I want to be confident that I did all that could/should have been done. If the answer is "a", then I'd look at some minor lip, chin and/or nose work and be done with it.
Have you consulted with Gunson? His consultations are the most informative and thorough in the business.
Wolford is one of the best jaw surgeons or arguably maybe even the best, but he's too eager to recommend TJR as has already been said.
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Have you consulted with Gunson? His consultations are the most informative and thorough in the business.
I've called and they reached out to me by email so I sent my pictures and xrays. I'm not sure if they'll grant me a consultation as my concerns are aesthetic now since my functional issues were corrected by my initial surgery.
I explained this in the materials I gave them so we'll see. I've head it's hard to get a consultation with him without an orthodontist's recommendation but I'm not sure if that's true.
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Gunson has no problem doing surgery for aesthetic reasons only if your dentofacial deformity wasn't properly corrected.
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Gunson has no problem doing surgery for aesthetic reasons only if your dentofacial deformity wasn't properly corrected.
Well my open bite was closed and jaws were both advanced but I got pretty bad 'chimp lip' from it and my maxilla/subnasal area now dominates my face, with my chin looking retrusive by comparison. So my actual deformity was corrected but the aesthetic impacts were poor. I'm not sure what he will make of that.
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Technically it wasn't if you still have a convex profile. He does revisions like that all the time.
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Technically it wasn't if you still have a convex profile. He does revisions like that all the time.
This is my current profile:
https://imgur.com/h6S9CDM (https://imgur.com/h6S9CDM)
To me, that looks like a convex profile mainly due to the dominant subnasal/upper lip area and retrusive chin by comparison. Would you agree?
In many ways it looks worse to me than my pre-op profile (not to mention the frontal view, since i got substantial nostril flaring with an upturned tip). The point of my surgery was to correct functional issues, and I thought any aesthetic changes would just be icing. But I feel as though I got the opposite.
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This is my current profile:
https://imgur.com/h6S9CDM (https://imgur.com/h6S9CDM)
To me, that looks like a convex profile mainly due to the dominant subnasal/upper lip area and retrusive chin by comparison. Would you agree?
In many ways it looks worse to me than my pre-op profile (not to mention the frontal view, since i got substantial nostril flaring with an upturned tip). The point of my surgery was to correct functional issues, and I thought any aesthetic changes would just be icing. But I feel as though I got the opposite.
That's the one where I did the morph to convey it's more of a matter of being convex LIP rather than a convex profile. Be sure to target what ever consults you go on on what will be needed to specifically target the upper lip.
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That's the one where I did the morph to convey it's more of a matter of being convex LIP rather than a convex profile. Be sure to target what ever consults you go on on what will be needed to specifically target the upper lip.
That’s correct, I’m just not sure the two can be separated. The convexity was caused by the advancement, so at consults I’d ask the surgeon about the effects of any revision plan on both chin projection and lip curve. I’m not sure a PS alone can make a convex lip flat or concave but I am planning to consult one in my area anyway in several months when I’m certain swelling is gone. The main lip procedures I can find are lip lifts which is not what I need.
I’m not ‘dead set’ on a revision by any means, especially if surgeons do not offer CCW for my case. I just suspect it may be the only way to adequately address the issue. Honestly if a PS was confident he could fix the lip I’d be ecstatic because I could do that and the nose all in one go.
In real life I perpetually look like my upper lip was stung by a bee. Which is sort of funny but also something I don’t want to live with for the rest of my life.
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That’s correct, I’m just not sure the two can be separated. The convexity was caused by the advancement, so at consults I’d ask the surgeon about the effects of any revision plan on both chin projection and lip curve. I’m not sure a PS alone can make a convex lip flat or concave but I am planning to consult one in my area anyway in several months when I’m certain swelling is gone. The main lip procedures I can find are lip lifts which is not what I need.
I’m not ‘dead set’ on a revision by any means, especially if surgeons do not offer CCW for my case. I just suspect it may be the only way to adequately address the issue. Honestly if a PS was confident he could fix the lip I’d be ecstatic because I could do that and the nose all in one go.
In real life I perpetually look like my upper lip was stung by a bee. Which is sort of funny but also something I don’t want to live with for the rest of my life.
Have just sent a PM.
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I've called and they reached out to me by email so I sent my pictures and xrays. I'm not sure if they'll grant me a consultation as my concerns are aesthetic now since my functional issues were corrected by my initial surgery.
I explained this in the materials I gave them so we'll see. I've head it's hard to get a consultation with him without an orthodontist's recommendation but I'm not sure if that's true.
I was able to get an (online) consult without an ortho referral - there was just an extra screening step involved.
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Update - got an email from Gunson's office today. They reviewed my pictures and xrays and offered a consultation for a revision. I'm going to schedule it for late November/December to give it the full year post-op. I think I'll hold off on Wolford for now until I see what Gunson says.