jawsurgeryforums.com
Surgeon Information => Surgeon Reviews and Leads => Topic started by: Leon on July 09, 2019, 08:35:25 AM
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Hello,
In the beginning of this year I underwent double jaw surgery+genioplasty with Prof. Raffaini. As I am very grateful both to him and his team and to this forum,too (I found his name on here), I would like to write down my experience.
If anyone has a question just ask them here, I will come back a few times and answer them before leaving this board ;)
Motivation for surgery
I had orthodontics in my youth to correct crooked teeth, an overbite and narrow jaws. This left me with a Class I bite.
However, this did of course not correct my recessed chin and my lip incompetence. I had in mind to correct this by surgery for a long time.
So, fast forward (I am somewhere in my twenties now) I decided to have surgery now to improve my chin position, to fix the gummy smile and the lip incompetence I had (around 9mm gap between the lips with relaxed face, measured by me).
Consultations
I had a few consultations which resulted in different treatment options offered by different surgeons (chinwing alone; genioplasty alone; bimax+genioplasty). In the end I decided to go with Prof. Raffaini for a few reasons: The results he showed me in consultation and the ones you find online all looked very good and exactly right, he seems to have an excellent eye for aesthetic proportions in my opinion; he is an experienced surgeon and seems to be highly regarded in general and additionally, his plan looked the most reasonable to me (my chin was advanced all in all 16mm, more later, to give you an idea of the recession, I did not see how the plans of the other surgeons would address this sufficiently+ his plan also addressed my gummy smile).
I found him and his whole team very nice, they all speak very good English, too.
Surgery and recovery
The surgery plan was (surgery first, as my occlusion was perfect due to past orthodontics and stayed the same):
-advance my mandible 11-12mm with the BSSO
-advance my chin 5mm (around a cut maybe 30° to the horizon, so a little bit of upward movement, too)
-advance my maxilla slightly (he showed me the plan but I did not ask for a copy, I only remember from my first consultation that he told me he will at most advance it 2mm as my upper lip area was already full looking)
-achieve CCW via both anterior impaction (I do not remember the number, my guess from photos would be maybe around 3mm) and posterior downward graft
The surgery was in Milan and went well. Recovery was uneventful and quicker than expected. I took walks after a few days and felt fit again in general after a week. The swelling, speech and eating recovery of course took longer; I would say 90% of the swelling were down after week 4 probably.
All in all I stayed there for two weeks (I am from a different European country). One week would have been enough but of course you do not know how well you react before.
Tips: I inclined the whole bed for the two weeks after surgery to a large degree by putting the head end on two chairs (so rotating the whole sleep surface). I feel like this helped to reduce the uncomfortable feeling and the swelling and is probably superior to pillows only.
For drinking I can recommend milk+jam (blended) out of a large syringe with an attached catheter for the first few days and after that potatoes/rice+ground beef+a little bit of eggshell powder (blended or mashed together) and jam and some blended fruits. This way I did not loose any weight.
Results
Functional
The functional result is very good. The occlusion is finetuned with a removable device I wear at home and at night.
-lip seal in relaxed position now
-breathing became way easier and I cannot block my airway by inclining my head which I could before
-head posture seems to be improved
Aesthetic
I am very happy with the aesthetic result. The change was actually more dramatic than I thought it would be, a few people barely recognized me before I told them who I am (+I was surprised that I look more different from the front than from the side, I expected it to be vice versa). People I talked with it about all said that it looks very good.
-chin is in a good position now
-you only see a tiny bit of gum show with a full smile now that does not look bad (this was planned, he said in the first consultation after the examination that a full correction would be overdone as my smiling muscles are very active)
-the smile in general looks better, probably due to the different occlusal plane
-whole face somehow looks different in other areas, too, for example my cheekbones look more prominent
I think many of you would like to see photos which I understand. I am not going to send them as I have no way of verifying who you are and that you will not share them. For the same reason in your own interest I will neither discuss the price as you could also be another surgeon.
If any of the moderators have time for this I could send them x-rays and maybe blurred out photos so they can tell you what they see.
I hope this is of help to some of you who need double jaw surgery, wish you all the best!
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Great post this was very informative, did you stay in the hospital or an Airbnb for recovery? And did you fly back to your home? Also I understand you don’t want to but a before and after of just the jaw could really help sway people like me looking to correct their class 1 bite by choosing Raffaini.
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Ive said it before, Raffaini is the best jaw surgeon in the EU.
Question for you: since your bite was class 1, did he have you in braces before the procedure? if so, how long?
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Ive said it before, Raffaini is the best jaw surgeon in the EU.
Question for you: since your bite was class 1, did he have you in braces before the procedure? if so, how long?
Who would you say is the best in the US?
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Ive said it before, Raffaini is the best jaw surgeon in the EU.
Question for you: since your bite was class 1, did he have you in braces before the procedure? if so, how long?
No, his plan was to not change the occlusion at all and to create the space for the mandibular advancement solely by the CCW and the slight advancement of the maxilla.
So no braces before or after, I only got a removable device 2 months after surgery for "finetuning" by my orthodontist which I wear at home.
Great post this was very informative, did you stay in the hospital or an Airbnb for recovery? And did you fly back to your home? Also I understand you don’t want to but a before and after of just the jaw could really help sway people like me looking to correct their class 1 bite by choosing Raffaini.
I stayed one night in the hospital (they told me that I will stay either one or two nights before, depending how I feel the day after but I felt good to go) and after that two weeks in a rented flat in Parma (via Airbnb).
Yes, after the two weeks I flew home, that was no problem.
I understand that you want to see a picture but I have doubts over the internet, I will think about it.
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Man. I almost wish I had a gummy smile pre-op so I could have cut down on the maxilla advancement.
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Man. I almost wish I had a gummy smile pre-op so I could have cut down on the maxilla advancement.
Word.
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I recently visited Raffaini and am deciding between him or Gunson.
Did he offer you a morph of what results would look like?
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Im also essentially deciding between him or G.
Wondering if you had a online consult or did you travel for one? Also noticed he has no results from male patients, did he show you some in person?
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Im also essentially deciding between him or G.
Wondering if you had a online consult or did you travel for one? Also noticed he has no results from male patients, did he show you some in person?
If you are asking me, I traveled. We discussed a bit and he gave his initial impressions of a plan but didn't offer any morph or final comments unless I wanted surgery with him. He did have male results he showed in person and they looked ok to me.
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If you are asking me, I traveled. We discussed a bit and he gave his initial impressions of a plan but didn't offer any morph or final comments unless I wanted surgery with him. He did have male results he showed in person and they looked ok to me.
O.K or good? Gunsons male results look pretty damn good.
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If you are asking me, I traveled. We discussed a bit and he gave his initial impressions of a plan but didn't offer any morph or final comments unless I wanted surgery with him. He did have male results he showed in person and they looked ok to me.
Was that a full consult? I've got one in December and I'd like to know what I'm going to get out of it.
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Is that how far hes booking for consults? damn I better book something quick.
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Is that how far hes booking for consults? damn I better book something quick.
I scheduled a few months ago because I knew I wanted to get his opinion. They didn't have anything else scheduled around that time when i called though so I may be an outlier.
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I scheduled a few months ago because I knew I wanted to get his opinion. They didn't have anything else scheduled around that time when i called though so I may be an outlier.
Not sure you guys are taking about the same surgeon.
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Not sure you guys are taking about the same surgeon.
Sorry, I was referring to Gunson
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Sorry, I was referring to Gunson
That's what I thought.
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I should clear up any confusion as well.
I traveled to both (Gunson and Raffaini). I posted the experience with Raffaini on the last page. The results he showed seemed good, but the female results seemed much better than the males for some reason. I was able to book my consult rather quickly he had an opening the same month I wanted to go. The consult involved X-rays and molds and then reviewing photos. Spoke with the Dr but no concrete plan.
For Gunson, I had to book 7 months ahead of time and that was the earliest. His consult also had imaging and he walked me through everything he would be doing, the movements he thought would work well (and why), and even offered a morph. We spent about an hour discussing facial harmon and getting a good aesthetic result in addition to function. Probably the single best consultation out of all 5 surgeons I've visited.
Hopefully that clears things up. Don't mean to derail the thread.
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Raffaini?
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Consultations[/b]
I had a few consultations which resulted in different treatment options offered by different surgeons (chinwing alone; genioplasty alone; bimax+genioplasty). In the end I decided to go with Prof. Raffaini for a few reasons: The results he showed me in consultation and the ones you find online all looked very good and exactly right, he seems to have an excellent eye for aesthetic proportions in my opinion; he is an experienced surgeon and seems to be highly regarded in general and additionally, his plan looked the most reasonable to me (my chin was advanced all in all 16mm, more later, to give you an idea of the recession, I did not see how the plans of the other surgeons would address this sufficiently+ his plan also addressed my gummy smile).
Since you're from another EU country, how did you get in touch with their office originally? I've been trying to figure out a way to get a phone call or skype call with them but haven't received anything back.
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Thanks! Great post. It would be amazing if you could show us some blurred out photos. I'm just interested in seeing what the improvement to your lower third looks like!
I'd super appreciate it!