jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: FryGuy on January 01, 2016, 12:34:57 PM
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These guys massively improved from the profile view, so much so that i'm not even sure these results haven't been shopped.
Anyone ever heard of Dr. Antipov in California? I haven't seen any topics related to him on these forums and i'm curious if he's legit.
Apparently this guy can craft midfaces out of thin air. 0_0
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also, the only information available on what they had were vague terms like "bite correction" "nasal base correction" "upper and lower jaw forward" etc
Seems sketchy to me but if it's real, holy hell he's good.
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The afters look good I agree, but these both look like straightforward maxillary advancement cases to me. It's generally never that simple I'm sure, but I can't tell that either of these guys received rotation or BSSO or even genioplasty.
Edit: Coincidentally I ended up at his site after typing "orthognathic counterclockwise rotation" into Google and he does have some great before/afters though.
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The guy is like Dougie Howser.
Tooth show here is not ideal. She was probably over impacted:
https://www.drantipov.com/cases/corrective-jaw-surgery/oms000019/
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The guy is like Dougie Howser.
Tooth show here is not ideal. She was probably over impacted:
https://www.drantipov.com/cases/corrective-jaw-surgery/oms000019/
Yes overimpacted and unfortunate nose tipping with alar base widening. I had that unfortunate widening too but no obvious upward tipping, thank god for that. Btw to anyone reading, beyond the "unpredictability due to individual soft tissue responses" aka YMMV, anyone have a good answer as to why some patients of Dr. Gunson/Arnett or whoever don't get nose changes while other's do? If the preventative techniques are the same and the movements are similar.
The only con from my surgery beyond some small residual swelling form the HA, is my nose changing. Irritating considering my defects were corrected more or less fully and I traded it for another problem albeit a wider nose isn't a huge deal even for my face.
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The afters look good I agree, but these both look like straightforward maxillary advancement cases to me. It's generally never that simple I'm sure, but I can't tell that either of these guys received rotation or BSSO or even genioplasty.
Edit: Coincidentally I ended up at his site after typing "orthognathic counterclockwise rotation" into Google and he does have some great before/afters though.
I'm mainly impressed with how far forward the nasal base on those guy came forward, I haven't seen many results like that in terms of midface protrusion. Did they just have a really large maxillary advancements or can some other technique dig the nose out like that?
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Yes overimpacted and unfortunate nose tipping with alar base widening. I had that unfortunate widening too but no obvious upward tipping, thank god for that. Btw to anyone reading, beyond the "unpredictability due to individual soft tissue responses" aka YMMV, anyone have a good answer as to why some patients of Dr. Gunson/Arnett or whoever don't get nose changes while other's do? If the preventative techniques are the same and the movements are similar.
The only con from my surgery beyond some small residual swelling form the HA, is my nose changing. Irritating considering my defects were corrected more or less fully and I traded it for another problem albeit a wider nose isn't a huge deal even for my face.
Does alar base reduction have good results? Seems like nose widening is pretty unavoidable with maxillary advancement :/
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The first guy have cheek implants.
https://www.drantipov.com/cases/corrective-jaw-surgery/oms000034/
I looks better but his lateral zygo projection is weak so is 3/4 profile is sort of weak. Also I think the blond girls nose looks fine. People say the nose looks wider, sure but with a recessed maxilla the nose has no support so it looks longer and thinner.
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Does alar base reduction have good results? Seems like nose widening is pretty unavoidable with maxillary advancement :/
It can with the right technique/doctor. That's the rub, finding the right doctor who picks the right technique with the right experience to give you the right result :) Usually that means doing a wedge/slit combination procedure.
I plan on getting it done but won't do it until I feel 100% comfortable with the doc and the treatment plan. Nose's are easy to f**k up and ultimately I could just leave it alone and accept it if needed.
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It can with the right technique/doctor. That's the rub, finding the right doctor who picks the right technique with the right experience to give you the right result :) Usually that means doing a wedge/slit combination procedure.
I plan on getting it done but won't do it until I feel 100% comfortable with the doc and the treatment plan. Nose's are easy to f**k up and ultimately I could just leave it alone and accept it if needed.
well, happy to hear it isn't a huge problem for you :)
Question: Did your mouth widen at all to kind of balance the widening of the nose? Some lefort surgeries i've seen appear to have wider lips at rest along with the nose.
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well, happy to hear it isn't a huge problem for you :)
Question: Did your mouth widen at all to kind of balance the widening of the nose? Some lefort surgeries i've seen appear to have wider lips at rest along with the nose.
A little I guess but no amount of mouth widening can offset a nose that's too wide for your face. Still, any lip widening that happened was due to eliminating vertical excess and my lower lip posture improving. Generally when upper jaw is impacted to reduce incisor exposure, the upper lip flattens (philtrum lengthens relative to the commissures) so it gets wider which in my case was good. And my lower lip used to be really droopy and it's a lot better now, much more self supporting so it also sits more horizontal if you look straight on. Make sense?
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The guy is like Dougie Howser.
Tooth show here is not ideal. She was probably over impacted:
https://www.drantipov.com/cases/corrective-jaw-surgery/oms000019/
A LOT of the "after" pictures are either photoshopped or they have a lot of makeup applied on the after pictures that are not present on the "before" pictures. That always makes me wonder.
He is a dentist / max/fac. Not a plastic surgeon and not craniofacial trained.
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A little I guess but no amount of mouth widening can offset a nose that's too wide for your face. Still, any lip widening that happened was due to eliminating vertical excess and my lower lip posture improving. Generally when upper jaw is impacted to reduce incisor exposure, the upper lip flattens (philtrum lengthens relative to the commissures) so it gets wider which in my case was good. And my lower lip used to be really droopy and it's a lot better now, much more self supporting so it also sits more horizontal if you look straight on. Make sense?
ah, I see. Personally, I have somewhat of a thin mouth and was wondering if that could be an indirect benefit.
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A LOT of the "after" pictures are either photoshopped or they have a lot of makeup applied on the after pictures that are not present on the "before" pictures. That always makes me wonder.
He is a dentist / max/fac. Not a plastic surgeon and not craniofacial trained.
Yeah, I kind of figured it was fraudulent given that no one around here had ever heard of him. Shame
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Yeah, I kind of figured it was fraudulent given that no one around here had ever heard of him. Shame
Nothing amazing at all about these results. Mine is the same, chimp lip included.
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I had a consult with Dr. Antipov. I haven't gone through surgery with him. He is very personable, but I had a hard time finding reviews on his work except for wisdom teeth removal. The office staff are very nice, but a little casual. The office is in a strip mall, kind of an odd location. I know that doesn't tell you about results, but if there are any questions I could answer, feel free to pm me. Also, if you have questions about his work, call his office. The ladies are very helpful; I'm sure they would be happy to answer your before/after questions.
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Yeah, I kind of figured it was fraudulent given that no one around here had ever heard of him. Shame
I don't know if fraudulent the right word. But it is certainly deceptive.
The problem with altered/photoshopped before and after pictures has become so common - - that some of the very best plastic surgeons no longer post before/after pictures on their web sites.
However, if you do a consult at their offices - - they will show you a hard drive full of before/after pictures - - all taken under the same controlled conditions so as to give legitimate before and after comparisons.
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He's got some videos on Youtube. Sounds like he uses the same basic technique as A&G, cheekbone augmentations with HA paste and drugs for joint degeneration. Not sure how he works around patent, A&G may just not know about his violation yet.
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He's got some videos on Youtube. Sounds like he uses the same basic technique as A&G, cheekbone augmentations with HA paste and drugs for joint degeneration. Not sure how he works around patent, A&G may just not know about his violation yet.
What patent, the stupid soup of bone chips?
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Nothing exceptional about these results in fact I think they're on the bad side considering the lak of finesse, the chimp lip and the negative vectors under the eyes.
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What is "chimp lip"?
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What is "chimp lip"?
convex and protruding philtrum
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Nothing exceptional about these results in fact I think they're on the bad side considering the lak of finesse, the chimp lip and the negative vectors under the eyes.
Lazlo,
I think the results are "ok". Would you elaborate on what you mean by "lack of finesse" ? And I don't see the lip as anything not pretty close to 1/2 std dev from the center of the curve for "normal". So help me understand why this is an example of a chimp lip ?
I do strongly object to what appears to be a significant use of photoshop / makeup and otherwise publishing pictures that do not meet the typical professional standards for objective before/after documentation.
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are you guys talking about the first guy in regards to the chimp lip?
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convex and protruding philtrum
I see... I definitely see it going on with the first guy.
Here's something I was thinking about previously regarding upward turning of the nose which I think also has everything to do with the chimp lip thing:
When a person has maxillary advancement performed, the maxilla is cut and moved forward as one piece. It is purposely cut as a Lefort I fracture so as to not cut into the nerve endings of the upper teeth. The entire piece is moved forward the same amount, so the top of the cut piece (bottom of nasal cavity) is moved forward the same as the bottom (top teeth).
So if I use two lines, one for upper face and one for maxillary piece that is cut and repositioned, this:
Before:
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After:
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But when a person has a natural (& not ruined by environmental factors),nicely projected maxilla I think there is a more natural curve to it from the upper face like this:
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The only way to try to mimic the natural profile would be to make multiple horizontal cuts into the maxilla and layer them like steps. But that's not possible given nerves and a number of other factors.
I guess what I'm implying/theorizing/whatever is that if enough maxillary projection is achieved via surgery, "chimp lip" and "pig nose" are unavoidable to some degree. Yes/no?
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kjohnt,yes you are correct. the advancement creates a step off that is masked by tissue. I think the first guy was over advanced imo. But he still looks better in the after.
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When a person has maxillary advancement performed, the maxilla is cut and moved forward as one piece. It is purposely cut as a Lefort I fracture so as to not cut into the nerve endings of the upper teeth. The entire piece is moved forward the same amount, so the top of the cut piece (bottom of nasal cavity) is moved forward the same as the bottom (top teeth).
That's incorrect. There's a few reasons for the location of the fracture, the biggest one being that it's a fracture not a cut. A SARPE is a cut. The points chosen are natural fracture lines in the skull, remember this stuff started before mechanized instruments existed. It's a good location for one because the scars aren't visible in the smile and the step is masked well at that location as other mentioned, not the case for those going into the midface. Nerves to teeth are actually severed but they grow back quickly. In fact, the hard palate is nearly completely cut off from the rest of the body before it heals again. When nerves are severed, the unconnected portion dies but the trunk regrows in all directions to rediscover it then the unsuccessful branches die off or so I read. I've heard of one or two cases where the nerves regrew in the wrong places creating confusing sensations. Small nerve branches repair and regrow more readily, the larger branches like the IAN does not. At least that's my primitive understanding. Someone with more biology here care to chime in? I had to look this stuff up because I wanted to understand the impact of my 3-piece on nerve loss and it appears, as it happens, that for the most part nerves are spared by the variant used to level the front segment. The variant used for widening the jaw is not, however, and so sensation to the palate may be lost for a longer period of time.
The only way to try to mimic the natural profile would be to make multiple horizontal cuts into the maxilla and layer them like steps. But that's not possible given nerves and a number of other factors.
There's no way to fix them. The bone should remodel it slowly over time to some degree but it's still going to be a steep step. I know of one case where the lower segment was sharp and caused the person pain for 2 years until it healed because it was cutting into soft tissue around it. Maybe with custom resorbable bone grafts in the future they can smooth things out but still, not all sites are accessible. You have to work around key anatomy.
I guess what I'm implying/theorizing/whatever is that if enough maxillary projection is achieved via surgery, "chimp lip" and "pig nose" are unavoidable to some degree. Yes/no?
The way you avoid the chimp lip is by advancing the nasal base. Otherwise, you end up with like 7mm of volume added under the nose. In a typical surgical plan, the nose advances 3-4mm so only 3-4mm is added to the upper lip which also thins somewhat. A 3mm protrusion is still considered aesthetic, albeit at the upper limit. In this respect, ANS shaving isn't doing you any favors. For men I think widening the nose is better tolerated while for women tipping is better but in both cases, some combination of the two is best depending on starting point. Various sutures are used to minimize the broadening of the nose.
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I didn't read the OP but speaking of amazing surgery results, surely Raffani must be up there with the best, these look life changing:
http://www.facesurgery.it/chirurgia_ortognatica.php
Nice... but why do they have to "doctor" up the AFTER pictures. New hair color. Darker eyebrow makeup.... facial makeup.... etc, etc.
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@ most likely when the people come into the office after surgery they try and look their best. I know that when I go into Jaw surgery consults I usually look like complete s**t when they take pictures.
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Some cases are photographed 1-2 years apart after surgery
people easily can change hair color and put make up when they asked to come for final pictures
After such a drastic improvement and extreme face makeover people want to look better
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I don't get why people ALWAYS need to point this out on before afters.
Forget the makeup, forget the hair, you can easily see the massive improvement in front,3/4,side etc increased anterior projection
Tumerican,
When I ask around about this issue among a couple of guys who do plastic surgery (not jaw surgery) - - - they tell me there are explicit professional guidelines on how surgeons are required to document surgeries so that the before and after pictures are legitimate apples to apples comparisons. The surgeons that choose to post up those kinds of photo-shopped or make-up altered pictures know that their fellow surgeons would all call BS on those kinds of pictures.
So the issue is maybe not whether you or I can "evaluate " our way around the make-up and photo-shopping in the "after" pictures - but rather the issue is that the routine use of those kind of non-conforming (to routine practice professional standards) pictures suggests an attempt on the part of the surgeon who sponsors those pictures to deceive or mislead the uninformed prospective patients. That casts doubt on the character of the surgeon.
This is one reason that some of the very best plastic surgeons do not even publish before and after galleries. They do not want to try to "compete" with the photo-shopped presentations that are ubiquitous.
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Im one of the guys above (first two pics).
Wanted to mention right way, that my pics were not modified, photoshopped, make-uped, etc.
The after picture was taken 7 weeks after surgery, i was still super swollen.
I was really lucky to have met Dr. Antipov. It took me almost 2.5 years to find the right surgeon.
After meeting him, i realized that this is the guy i want to trust work on my face.
First of all, he was one of the three surgeons, who told me that i'd only have to get my upper jaw done only (bring it forward), instead of cutting lower one as well, like the other two surgeons told me.
Second of all, Dr. Antipov is a very precise, professional guy, who spent so much of his time on me to make sure i fully understand the whole process that was going to happen to me.
Third of all, he did a 3D surgery on the computer to show me how I'm gonna look like after, which was really helpful.
And the last thing, Galleria Oral and Maxillofacial Surgery's stuff has been amazing, i didn't have to worry about anything like calling my insurance, collecting paperwork, X-rays, to get the surgery approved, they took care of everything.
Its been 4 months since my surgery. I fell like nothing ever happened to me. Couldn't be happier with the results. Oh, yea, i haven't had a single pain killer after my surgery, literally not one. Here is a day before pics and after pics the i just took.
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Im one of the guys above (first two pics).
Wanted to mention right way, that my pics were not modified, photoshopped, make-uped, etc.
The after picture was taken 7 weeks after surgery, i was still super swollen.
I was really lucky to have met Dr. Antipov. It took me almost 2.5 years to find the right surgeon.
After meeting him, i realized that this is the guy i want to trust work on my face.
First of all, he was one of the three surgeons, who told me that i'd only have to get my upper jaw done only (bring it forward), instead of cutting lower one as well, like the other two surgeons told me.
Second of all, Dr. Antipov is a very precise, professional guy, who spent so much of his time on me to make sure i fully understand the whole process that was going to happen to me.
Third of all, he did a 3D surgery on the computer to show me how I'm gonna look like after, which was really helpful.
And the last thing, Galleria Oral and Maxillofacial Surgery's stuff has been amazing, i didn't have to worry about anything like calling my insurance, collecting paperwork, X-rays, to get the surgery approved, they took care of everything.
Its been 4 months since my surgery. I fell like nothing ever happened to me. Couldn't be happier with the results. Oh, yea, i haven't had a single pain killer after my surgery, literally not one. Here is a day before pics and after pics the i just took.
It must be kind of weird to visit a forum and see your pictures posted in a thread with people giving their opinions huh? Thanks for posting; it is appreciated.
I see the issues discussed about your lips were due to just swelling, because it's not there anymore. You now have a very "ante face" in that there is a lot of projection, and I think partially reducing the mandible could have been a reasonable option, but I think I'd also have opted to leave the mandible alone as you did if I was in your shoes. It's also in part due to that you occlusal plane is flat(ish) I believe, because your gonial angles sit well in front of your ears. Mine are basically under my ear canals which makes me think I need CCW rotation, which Antipov can perform.
I'm interested to know more about the process from consultation to surgery. I'm sending a PM.
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Its been 4 months since my surgery. I fell like nothing ever happened to me. Couldn't be happier with the results. Oh, yea, i haven't had a single pain killer after my surgery, literally not one. Here is a day before pics and after pics the i just took.
How's your tooth show at rest and smiling? How big was your movement?
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I see the issues discussed about your lips were due to just swelling, because it's not there anymore. You now have a very "ante face" in that there is a lot of projection, and I think partially reducing the mandible could have been a reasonable option, but I think I'd also have opted to leave the mandible alone as you did if I was in your shoes. It's also in part due to that you occlusal plane is flat(ish) I believe, because your gonial angles sit well in front of your ears. Mine are basically under my ear canals which makes me think I need CCW rotation, which Antipov can perform.
I also had a LF1 advancement to fix an underbite. My mandibular plane is much steeper than Jay.R's. So my upper lip now just hangs there vertically like a piece of crap and dominates my chin, my lower lip. I basically went from class III to looking like class II. Kind of like that girl complaining about a chimp lip after LF1. My surgery was done by a surgeon with 10x the surgical experience of this "Dougie Howser" surgeon.
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I also had a LF1 advancement to fix an underbite. My mandibular plane is much steeper than Jay.R's. So my upper lip now just hangs there vertically like a piece of crap and dominates my chin, my lower lip. I basically went from class III to looking like class II. Kind of like that girl complaining about a chimp lip after LF1. My surgery was done by a surgeon with 10x the surgical experience of this "Dougie Howser" surgeon.
I assume you'd have rather gone to Antipov knowing what you now know? Do you think it's because you needed CCW rotation along with the maxillary advancement?
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The first guy posted a review on realself.com
https://www.realself.com/review/roseville-ca-orthognathic-surgery-25-year-corrective-jaw-surgery-underbite#
I think he's the real deal.Only if I were in California :(
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Hey ForeverDet, I have that same problem with my lip! Glad you got it fixed :) who did your surgery?
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Just a tidbit to add on here ( name rhyme with)
I was at Dr Bronson for consult and asked them so show me before and after, I got told he doesn't have permission but showed me one anyway which he had permission for, I asked him to show me someone similar to me at least with similar movements ,he did not have one handy.
So I asked him if I could show him a case online and he could tell me if he had same movements, I showed him the guy with the short face on Dr krakow . He took one look and started rattling off mistakes then he paused and asked who did it, lets me know that he had been trained there as part of their program for a bit :)
Same thing happened with a surgeon in NY Dr NewGarden as soon as he saw the pic he started rattling on mistakes
The guy is new he's trying to build his skills and practice, def not a doogie howser
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The first guy posted a review on realself.com
https://www.realself.com/review/roseville-ca-orthognathic-surgery-25-year-corrective-jaw-surgery-underbite#
I think he's the real deal.Only if I were in California :(
He doesn't look any better after the surgery. I like his before picture better. Probably because his undereye/zygoma area was not advanced relative to the submalar anterior projection he gained, which can be feminizing.
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He doesn't look any better after the surgery. I like his before picture better. Probably because his undereye/zygoma area was not advanced relative to the submalar anterior projection he gained, which can be feminizing.
Sure, ok. He went from an obvious Class III appearance to completely normal, handsome even. Jaw surgery isn't magic, and the surgeon's job is only to get the jaws where they should've been had growth happened naturally. What you look like after surgery, depends on your other features. The amazing transformations that you sometimes see are young people, usually women, who have great features that are masked by their dentofacial deformity. That guy didn't want to have bimax and his doc was able to give him a good result without having touch his mandible. That way he also avoided the complications that are associated with BSSO. What more can you hope for?
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He doesn't look any better after the surgery. I like his before picture better. Probably because his undereye/zygoma area was not advanced relative to the submalar anterior projection he gained, which can be feminizing.
IMO the maxilla was over advanced. I have the same thing. Upper jaw only surgery rarely gives an optimal result.
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IMO the maxilla was over advanced. I have the same thing. Upper jaw only surgery rarely gives an optimal result.
Yeah, of course. A single jaw surgery is always a compromise because that's not how dentofacial deformities happen. It always affects both jaws, more or less. Every other jaw surgeon that guy saw recommended bimax, but he didn't want to have bimax. He acknowledged a single jaw operation was going to be a compromise, but he was willing to live with it. I think it looks good, and a normal person is not going to notice anything wrong with his jaws, even if the the treatment plan wasn't perfect. Most jaw surgery patients don't care as much about this s**t as people on here. They just want to have their operation, get a decent result and move on with their life.
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That guy looks bad. That excessive anteface is not normal at all in that phenotype imo. Too much maxilla projection
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The girl on Dr. Antipov's website does look good, but tooth show could have been better compensated by doing an upper lip lift. The problem with the Alar stitch is that it's not a very effective way of controlling the widening of the nasal floor.
I'm quoting this from realself.com from Surgeon Peter A. Aldea, MD, Memphis Plastic Surgeon
"The ONLY way the middle and base of the nose can be brought together and narrowed surgically with a fracture of the lateral sides of the nose and bringing them together."