jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: Eroica on June 08, 2012, 01:36:40 PM
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Well I'm a poor student with around £2000 to my name in savings. My jaw abnormality is sufficiently severe for me to qualify for free surgical treatment here in the UK, but really I would prefer to go to Arnett/Gunson, because NHS surgeons are far from aesthetically minded and generally have little interest in patient concerns or desires. Thing is, coming up with £35000 or thereabouts (which is what A/G charge) just seems nigh-on impossible for me...
How the hell do ya'll pay for this stuff??? :-\ Even if I put everything I possibly can from my student loans and part-time work towards it, it would still take several years to afford this. Just flying out from the UK for a consultation will cost me my entire savings.
I guess my only option is to harass my dad to help me out with some of the cost... but he'll probably just view it as "unnecessary" and "plastic surgery"... (easy enough for him to say, as he has a class I bite/profile) :(
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Well I'm a poor student with around £2000 to my name in savings. My jaw abnormality is sufficiently severe for me to qualify for free surgical treatment here in the UK, but really I would prefer to go to Arnett/Gunson, because NHS surgeons are far from aesthetically minded and generally have little interest in patient concerns or desires. Thing is, coming up with £35000 or thereabouts (which is what A/G charge) just seems nigh-on impossible for me...
How the hell do ya'll pay for this stuff??? :-\ Even if I put everything I possibly can from my student loans and part-time work towards it, it would still take several years to afford this. Just flying out from the UK for a consultation will cost me my entire savings.
NHS surgeons, from what I understand, do far more of these surgeries than any private practice surgeon. With the money that you can raise, find an aesthetically centered orthodontist to ensure that your cosmetic issues are addressed. Also, if given the choice, request an NHS surgeon that has many years under his/her belt. This will go a long way in terms of reducing odds of nerve damage.
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My case is not overly complex but not simple either, for a few reasons.
-I have a hyperplastic (overdeveloped) chin which protrudes too far horizontally but is vertically short. The 5 surgeons I've seen can't decide whether to leave my chin alone, to perform a reduction genioplasty, a lengthening genioplasty, or place an extended chin implant which masks the "pointy-ness" of my chin bone.
-My mandible is quite substantially recessed, which is masked by the prominent chin. My lower lip is especially recessive and falls substantially short of the upper lip in profile.
-I have a 10mm overbite
-My midface and maxilla also retrude, especially the lower orbital rims.
-I have an unusually prominent nose and browridge... which looks rather odd in comparison to my underdeveloped lower face. I played around with morphing my face and the morph that looked most aesthetically balanced depicted roughly 20mm of mandibular movement.
I've seen good results from NHS surgeons but I've also observed too many instances where the post-op photographs look practically indistinguishable from the pre-op. My sisters boyfriend had jaw surgery on the NHS and his jaw still looks notably recessed.
Is it worth flying over to see Arnett/Gunson just to see what they have to say? Or do they do long distance consults?
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@eroica, hello fellow overbiter !! Please post some pics so I can get a better understanding of whats going on.
It sounds like you have a number of things on your plate bugging you. Have you seen A/G work? It is quite the trip to meet them, do you like their work ? You could contact them via phone and see if they would be willing to do some kind of skype/phone consult, but from my experience they like having you in office and playing with your face etc....
Emmm the thing is our faces, even if we balance the jaw lets say there could be other components that are over or under developed that make this a bit harder to calculate...
Consults dont hurt, but it would be challenging if you decided to move forward with them as they like to see you every month for like 6 months post op and so on.
You could just go to hear what they have to say, get their opinion and bring some of their cephs and works ups back with you home.
Honestly as much as I hear the NHS being a pain to some, the fact that one doesnt have to worry about the costs of surgery is surreal !
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This is my profile and my personal morph of what I would like my profile to look like. A maxfax I was in contact with guessed that this would require almost 20mm of movement from eyeballing the pic. Granted the "after" pic shows a very prominent chin/jaw but I feel this is what would suit my face given the prominence of my nose/browridge.
edit:pics removed
Don't get me wrong, my surgeon seems talented and he is experienced. But I have a specific aesthetic in mind. Arnett/Gunson really take things like the nasal prominence etc into account when deciding what movements to make and they would also augment my deficient orbital rims.
I may fly over to consult with A/G afterall and see what they have to say. In the end maybe I'll be satisfied with my current surgeons plan. We'll see.
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Typically a 20mm mandible advancement is a lot, but if your before/after pictures are relatively accurate... it would be a movement that works aesthetically ! For men a strong jaw is seen as attractive, but not too strong because it give you that overbite/serious look that people avoid.
It cant hurt to meet with A/G and see what they have to say, they might help your surgeons come to a more concrete plan or something. I know there are a few highly reputable surgeons in Europe with almost the same caliber as A/G, if you dig around on online jaw/ortho forums Im sure a few names will pop up.
I do not know anything about orbital rim deficiency so cannot comment there.
I understand your frustration, and if you feel the NHS cant help you get the results you want, consult elsewhere and then line it up with what they've proposed to you and make an informed decision.
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Typically a 20mm mandible advancement is a lot, but if your before/after pictures are relatively accurate... it would be a movement that works aesthetically ! For men a strong jaw is seen as attractive, but not too strong because it give you that overbite/serious look that people avoid.
It cant hurt to meet with A/G and see what they have to say, they might help your surgeons come to a more concrete plan or something. I know there are a few highly reputable surgeons in Europe with almost the same caliber as A/G, if you dig around on online jaw/ortho forums Im sure a few names will pop up.
I do not know anything about orbital rim deficiency so cannot comment there.
I understand your frustration, and if you feel the NHS cant help you get the results you want, consult elsewhere and then line it up with what they've proposed to you and make an informed decision.
I did consider consulting with Raffaini in Italy. He trained with Arnett. One of the guys on his website has a pretty similar "before" pic to me and the post-surgery result is superb.
http://www.facesurgery.it/gallery-ortognatica.php
(http://www.facesurgery.it/images/gallery/gallery02.jpg)
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WOOOW thats a really great before/after, might be worth consulting with him !!
The orbital rim implants seem fascinating!
Definitely do your research and consult with a few surgeons before pulling the trigger NHS or elsewhere. You have one jaw, go with whom you feel can give you the results you are looking for !
:)
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OMG Thats the est before/after Ive ever seen!!!! I had to look at the pictures for quite a while to convince myself its the same guy....
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What was done on each row? The Last two rows of pics.
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What was done on each row? The Last two rows of pics.
I was wondering about the last two, as well.
According the link, he had bi-max, rhinoplasty and genio. He had a pretty deep bite and gummy smile.
Comparing the second set to the last, I see longer, darkened hair, groomed and darkened brows, whitened teeth, longer face and maturity. What am I missing? The head tilt and smile are not consistent between the two, so it's throwing me off.
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His smile looks less gummy and wider on the last one. Older and hair different too.
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The two sets of B/A are a few months after the surgery and then six years after.
In the six year after set it appears that he's had his teeth built up with laminates to make his smile wider, had his teeth whitened, and he's plucked his eyebrows. No plastic surgery.
I wouldn't say it's the absolute best transformation I've seen though. You can see that he had good features even before the surgery (eyes, orbital rims, spacing between the features).
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The two sets of B/A are a few months after the surgery and then six years after.
In the six year after set it appears that he's had his teeth built up with laminates to make his smile wider, had his teeth whitened, and he's plucked his eyebrows. No plastic surgery.
I was wondering about cosmetic dentistry. His arch does look wider, but, then, he's not smiling widely in the last set so hard to be sure.
I wouldn't say it's the absolute best transformation I've seen though. You can see that he had good features even before the surgery (eyes, orbital rims, spacing between the features).
He did have a good starting point, but the transformation is still impressive to me. Hair and brow changes and "growing up" also had a big impact. He looks good.
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My oribital rim sucks ass
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I did consider consulting with Raffaini in Italy. He trained with Arnett. One of the guys on his website has a pretty similar "before" pic to me and the post-surgery result is superb.
http://www.facesurgery.it/gallery-ortognatica.php
(http://www.facesurgery.it/images/gallery/gallery02.jpg)
Wow, he is really handsome in the last set of photos. What a great result; he must be so happy!
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NHS surgeons, from what I understand, do far more of these surgeries than any private practice surgeon. With the money that you can raise, find an aesthetically centered orthodontist to ensure that your cosmetic issues are addressed. Also, if given the choice, request an NHS surgeon that has many years under his/her belt. This will go a long way in terms of reducing odds of nerve damage.
You can choose your ortho as they are not often covered by NHS but surgery covered on NHS means you have to work with who you're given. You can't request a particular surgeon. It depends where you live first and then how severe your case is considered to be. It's not within the patient's control unless they have some way of working the system.
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I was wondering about the last two, as well.
According the link, he had bi-max, rhinoplasty and genio. He had a pretty deep bite and gummy smile.
Comparing the second set to the last, I see longer, darkened hair, groomed and darkened brows, whitened teeth, longer face and maturity. What am I missing? The head tilt and smile are not consistent between the two, so it's throwing me off.
Maybe he had gum contouring? I also think there is some chin adjustment in the final pics, like they re-did genio or added a small
Implant or fillers for a little extra definition. Just incredible how some basically imperceptible changes turn him from
nice-looking to gorgeous. Lucky guy.
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if this actually happened, and he was trained by arnett, that definitely makes me feel a lot better. if something can be improved, particularly features or areas of the face maybe overlooked/not emphasized enough during the original surgery, a great surgeon will either recommend (sensible recommendations) or perform "adjustments"/touch-ups.
Aside from, perhaps, cosmetic dentistry, only changes were hair color/style, groomed brows and maturity. Last set of photos were taken six years post op, according to Eroica. No post-orthagnathic plastic surgery involved here.
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must have had more sun too because he isn't a pasty white dude anymore LOL.
Yeah, in the first set he was pretty pale. Sets two and three are about the same as far as skin tone. Still looks much better down the road with the hair/brow tweaks.
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It looks to me like this guy has had plastic surgery after he jaw surgery. If you look closely at the first picture of the first row you can see clearly that his eyes appear half closed. This is caused by loose skin on the eyelids. In the first picture of the third row his eyes appear to open much wider. The pictures are taken from approximately the same angle but the eyes look different. It is a result of having the loose skin removed.
Some of you might think his eyes look diferent because they are more fully open, but it is not the case. His eyes have a 'cleaner, fresher' look about them because of ps. It is good surgery though, subtle. A larger image would make these changes more obvious.
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I'm not seeing the PS.
1. People's eyes can change with upper jaw surgery. This dude on jawsurgeryblog is a good example, his eyes became much livelier: http://www.jawsurgeryblog.com/forums/viewtopic.php?f=6&t=2723 (http://www.jawsurgeryblog.com/forums/viewtopic.php?f=6&t=2723)
2. The lighting and angles are different. In some pics I look on the tired side and in others not at all
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Pretty obvious the guy didn't have any PS done.
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cleaner/fresher = PS? LOL. his eyes appear half closed because of his jaw. when the jaw was moved forward + grafting it took away that unfortunate im-always-high dope dealer look. now his eyes are more deep set i would say. plus he aged 6 years right?
Maybe. My eyes look like his before pictures, I think they have too much loose skin on the eyelids. So do you think if I had jaw surgery my eyes would look good/better, or would I need a blepharoplasty to fix them?
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I have this as well, one eyelid is more droopy or less open than the other. It's both amazing and depressing how much the jaw affects the rest of the face.