jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: mike888miller on November 13, 2016, 09:27:27 AM
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For those in the final stages of planing, and exploring if there was a way to pay less than 20k vs the 80k a and g cost, i had a look at the key note Speakers that a and g invite to speak at their seminars, have any of you come across any of These names?
especially for those of us with easier cases, this could be worthwile investigating
http://www.arnettgunson.com/files/2014/06/2017-Lecture-Forum.pdf
Keynote Speakers:
Simonas Grybauskas, DDS, MD, PhD, MOS. RCSEd
Michael J. Gunson, DDS, MD
Johan P. Reyneke, MChD, FCMFOS(SA), PhD
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G. William Arnett, DDS, FACD
Julio Cifuentes, DDS
Octavio Cintra, DDS, DMD
Antonio D’Agostino, MD
Harry L. Dougherty, Jr., DDS, MS
Claudio Dutra, DDS
Lawrence Gottesman, DDS, PC
Richard F. Jackson, DDS, FACD
Jeffrey L. McClendon, DMD, FAGD, ABGD
Lorenzo Trevisiol, MD
David L. Way, DDS
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Seriously I need bimax but don't want to spend 100grand to do it, but I don't trust local top docs since my case is 10% functional, 90% aesthetic and a revision chin case. And I have very low tolerance for risk. Heck I have suspicions of Posnick as a good doc to do it with (& he's local) from the little I've found on people who've had surgery with him.
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Honestly, Sinn would do a great job on your jaw if you're not a hugely complicated functional case I think. And he'd achieve the aesthetic stuff you want.
I've heard of Reyeneke but he's in South Africa.
How do you know these other surgeons execute the surgeries in the same way? I.e. use PRP with HA paste and augement or even do huge CCW rotations?
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Lazlo - I spoke to Sinns Office and am preparing 3 slides of my case so i can have a phone consult with him.
i am hoping he would agree, in principle, to a surgery first (ie no de-compentation of my very upright max incisors, as my bite is fine), min 10mm lf 3, plus straight min 10mm bsso plus 10mm gne, plus HA past on gon angle and orbital rims.
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Lazlo - I spoke to Sinns Office and am preparing 3 slides of my case so i can have a phone consult with him.
i am hoping he would agree, in principle, to a surgery first (ie no de-compentation of my very upright max incisors, as my bite is fine), min 10mm lf 3, plus straight min 10mm bsso plus 10mm gne, plus HA past on gon angle and orbital rims.
Great let us know what he says.
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Great let us know what he says.
Yeah mike let us know what he says!!
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will do - let me know if you have any Thing specific you want me to ask , i am paying a lot of cash for this so might as well get the max benifit
for reference this is my case
http://jawsurgeryforums.com/index.php?topic=6074.0
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will do - let me know if you have any Thing specific you want me to ask , i am paying a lot of cash for this so might as well get the max benifit
for reference this is my case
http://jawsurgeryforums.com/index.php?topic=6074.0
I feel like Dr. SInn didn't give me enough forward projection at all and no change in airway because he didn't do CCW. Only 6mm of lower jaw advancement. I needed more like 11mm.
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I thought Sinn did a big CCW by dropping the posterior maxilla along w/your forward jaw movement? Or am I thinking of Gunson's plan??
My medical issue is primarily sleep apnea so I'll be needing CCW and lower jaw movement in the 17mm+ range (with a baby SG, or basically something similar to Gunson's plan).
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will do - let me know if you have any Thing specific you want me to ask , i am paying a lot of cash for this so might as well get the max benifit
for reference this is my case
http://jawsurgeryforums.com/index.php?topic=6074.0
Would you be willing to ask questions unrelated to your particular surgery? I mean I completely get if you aren't that's not a problem - there was a few information collecting questions that would be great to know from him.
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I thought Sinn did a big CCW by dropping the posterior maxilla along w/your forward jaw movement? Or am I thinking of Gunson's plan??
My medical issue is primarily sleep apnea so I'll be needing CCW and lower jaw movement in the 17mm+ range (with a baby SG, or basically something similar to Gunson's plan).
No that was Arnett's plan. I like what Sinn did and maybe he couldn't do both at the same time. But if I could have a second surgery I'd like more lower jaw advancement.
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i also suffer from sleep Apnoe, so fire away. why do you feel that Forward movement without Rotation will not provide you with increased air flow?
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i also suffer from sleep Apnoe, so fire away. why do you feel that Forward movement without Rotation will not provide you with increased air flow?
I didn't mean to imply straight advancement won't relieve sleep apnea. I bet it does.
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of course, was not impliying thats what you were Setting, sorry if i came across to brusk.
i think we are both trying to figure out if and how added Rotation would maximise our aestetic and airflow outcomes (and ideally figuare out around which anker you rotate
i wonder - does ccw Rotation, like for like, always provide a better result? sailer, gunson and others seem to imply this, hut i wonder if that is the case for People with a flat oc / curve of spee?
i think the reason is that by rotating, you maximise the distance by which the tongue is moved Forward, as the tongue musscle is attached to the chin bone.
have a look at the Simulation on this link halfway down the page, you think he would have gotten a better result with added Rotation?
http://schlafapnoe.tv/
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Seriously I need bimax but don't want to spend 100grand to do it, but I don't trust local top docs since my case is 10% functional, 90% aesthetic and a revision chin case. And I have very low tolerance for risk. Heck I have suspicions of Posnick as a good doc to do it with (& he's local) from the little I've found on people who've had surgery with him.
I can give you names for $15k - $30k if you really want but surgeons in general tend to hate aesthetic customers. I believe there are two other high volume fellowship centers in DC which are also very cheap which would be local for you too. Posnick's textbook is certainly awesome but part of his price is the customization he's willing to give. Most surgeons want you in and out the door. Also, he doesn't do most of the surgery himself, the fellows do it and you don't typically get to meet them until day of surgery if at all. Their hands are steadier and vision better so maybe not a big deal but might be better to find a Posnick fellow who's 5-10 years out and still does a lot of surgery. One of my high school classmates trained under him actually and works near me but he doesn't do jaw surgery much I think.
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i wonder - does ccw Rotation, like for like, always provide a better result? sailer, gunson and others seem to imply this, hut i wonder if that is the case for People with a flat oc / curve of spee?
i think the reason is that by rotating, you maximise the distance by which the tongue is moved Forward, as the tongue musscle is attached to the chin bone.
Yes, it does when CCW-R is indicated (= steep occlusal plane, normal is 8 degrees +/- 4 degrees according to Wolford). If your occlusal plane is excessively flat, you get clockwise rotation and if your occlusal plane is normal, you get a straight advancement.
Yeah, with CCW-R you get a bigger movement at the base of tongue which also results in a bigger airway than a straight advancement. From an esthetic POV, you can advance the lower jaw more with CCW-R, so you can actually straighten the profile which wouldn't be possible with a straight advancement (if the occlusal plane is steep). With CCW-R, you also don't need to advance the maxilla as much, so the likelihood of the dreaded "chimp lip", weird fullness at the base of the nose and unwanted changes of the nose is smaller.
Effect of occlusal plane on smile attractiveness
Alterations in the occlusal plane angle did affect relative smile attractiveness for both
patients (n=66) and dentists (n=66). For patients, the 10 degree smile was rated better than the
0 and 20 degree smiles (P<.01); for dentists, the 15 degree smile was rated better than the 0 and
20 degree smiles (P<.01). The 5, 10, and 15 degree smiles were indistinguishable for patients,
and the 10 and 15 degree smiles were indistinguishable for dentists.
http://www.angle.org/doi/pdf/10.2319/050411-318.1
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interesting ccw. since i have steep incliners, and class 3 bite, and need 2cm advancement at the pog, ccw seems to be the way to go
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I found a blog by Chris who had corrective jaw surgery through arnett/gunson.
I believe the deal breaker in anyone having surgery done through them is the hospital cost.
$115,000 for 2 night stay at Goleta Valley Cottage Hospital???
http://www.archwired.com/phpbb2/viewtopic.php?f=15&t=38481&sid=474bbe055a19586b9919fdb686952d41&start=15
Granted the Surgeon's fee is reasonable ~ $48k to 55k
Anesthesiologist $7500 or $3k if paid in cash upfront
So This guy Chris says he had Cigna pay the full hospital bill. I would really like to go to this surgeon, only problem is i'm under state funded insurance.
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$115,000 for 2 night stay at Goleta Valley Cottage Hospital???
Holy hell! Zurich is cheaper for hospital stay
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I found a blog by Chris who had corrective jaw surgery through arnett/gunson.
I believe the deal breaker in anyone having surgery done through them is the hospital cost.
$115,000 for 2 night stay at Goleta Valley Cottage Hospital???
http://www.archwired.com/phpbb2/viewtopic.php?f=15&t=38481&sid=474bbe055a19586b9919fdb686952d41&start=15
Granted the Surgeon's fee is reasonable ~ $48k to 55k
Anesthesiologist $7500 or $3k if paid in cash upfront
So This guy Chris says he had Cigna pay the full hospital bill. I would really like to go to this surgeon, only problem is i'm under state funded insurance.
I think the hospital fee is typo - 100k more than what I was quoted.
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It's not clear to me though if their quote is for the surgery itself AND the hospital stay. I was quoted similarly to you Plosko but I can't believe that covers the over-night part.
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Does anyone know if A&G has a financing plan available?
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I think the hospital fee is typo - 100k more than what I was quoted.
Yeah I have heard the same. Also when insurance is paying typically the hospital fees is very high. I can not imagine anyone getting surgery with them privately if its that high.
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Absurd prices.
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Yeah I have heard the same. Also when insurance is paying typically the hospital fees is very high. I can not imagine anyone getting surgery with them privately if its that high.
That's crosswiring two different points. If the hospital is considered in-network, then you are only left with 10-20% or so of the contractual "allowed amount" charge. If the hospital is not in-network, they will charge you a (usually) almost reasonable amount upfront, or balance bill you that upfront amount after insurance coughs up their 40-50% or so of the insurance's allowed amount.
The huge numbers you see billed to insurance is just a tactic to get as much money from insurance as possible. It's never what they expect the patient to actually pay.
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trust me there are many from russia and the middle east that pay this price, i am an insider...
although they will sometimes pay only half upfront and the dissapear into their lawless countries...
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I can give you names for $15k - $30k if you really want but surgeons in general tend to hate aesthetic customers. I believe there are two other high volume fellowship centers in DC which are also very cheap which would be local for you too. Posnick's textbook is certainly awesome but part of his price is the customization he's willing to give. Most surgeons want you in and out the door. Also, he doesn't do most of the surgery himself, the fellows do it and you don't typically get to meet them until day of surgery if at all. Their hands are steadier and vision better so maybe not a big deal but might be better to find a Posnick fellow who's 5-10 years out and still does a lot of surgery. One of my high school classmates trained under him actually and works near me but he doesn't do jaw surgery much I think.
Care to say what two fellowship centers in DC you’re talking about?
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Had surgery done in Lithuania by Grybasukas. Terrible experience. Can read my review at http://myorthognathic.surgery