jawsurgeryforums.com
Surgeon Information => Surgeon Reviews and Leads => Topic started by: OHjawz on April 12, 2017, 04:45:45 AM
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Has anyone had any jaw work done by Dr. Descamps-Braly out in San Fran before?
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He has Yelp reviews. I'm consulting with him in May, but I already had a jaw procedure. I'm not happy with my whole face so I'm seeing what he thinks could be done including any revision or something else with the jaw. I know he's very expensive though.
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He has Yelp reviews. I'm consulting with him in May, but I already had a jaw procedure. I'm not happy with my whole face so I'm seeing what he thinks could be done including any revision or something else with the jaw. I know he's very expensive though.
Please update me once you have your consult with him. I too am looking at a revision instead of an original surgery so I am all the more interested in what you hear from him. I exchanged a few emails and sent in some pics/x-rays for him to look over real quick a few months ago. I know you can't hold a surgeon to any numbers or plans until they see you in person but he quoted estimated 25-30k for a double jaw in an email
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He seems to be a serious surgeon but his website does not seem to have any before/after pic.
Am I right?
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I called for a consultation about the revision jaw surgery. He's super expensive and the initial consultation + 3D CT fee is ~removed. Someone from this forum saying he quotes a ridiculous removed + for double jaw revision (including hospital, nurse and facility fee, no insurance). Need to hear more from his actual patients. Any more stories or pics?
UPDATE: my double jaw revision was quoted removedK. They told me their first-time jaw surgery patients quote is removed K. Not work with any insurance. Pay 6 weeks before the surgery. Non-refundable. I haven't decided yet so I desperately need some jaw surgery patients from him that can share some comments here.
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IMO, he's a conservative orthognathic surgeon and I wonder how good he can be given how widely he spreads himself with all the other stuff he does. From memory your case was simple - no down grafting or rotations required. Any high volume surgeon who specialises in orthognathic should do.
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Have you consulted with Gunson or Relle? I have never seen any of Deschamps-Braly's B/As or come across anyone who has had surgery with him. Gunson and Relle are known to consistently deliver good results, and there have been many satisfied Gunson patients on this forum. For a revision, I'd want to go with a known quantity. Their prices are similar as well.
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Moderation request from PhoenixHiker:
[I just had a consultation with Dr Deschamps-Braly. My previous info is misleading so I want to delete my post here.]
I removed the price quotes but not the whole post. I removed the quotes of her posts from those who quoted them.
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Re: my previous post. I just had an in-person ~1.5h consultation with Dr Deschamps-Braly, the good news is he told me I don't need a revision jaw surgery. He suggested something like a genioplasty. He's very professional and knowledgeable and willing to spend time answering all my goofy questions.
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Re: my previous post. I just had an in-person ~1.5h consultation with Dr Deschamps-Braly, the good news is he told me I don't need a revision jaw surgery. He suggested something like a genioplasty. He's very professional and knowledgeable and willing to spend time answering all my goofy questions.
Cool.
Just watch out people aren't telling you what you want to hear. From what I remember of your case, you needed revision...
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Re: my previous post. I just had an in-person ~1.5h consultation with Dr Deschamps-Braly, the good news is he told me I don't need a revision jaw surgery. He suggested something like a genioplasty. He's very professional and knowledgeable and willing to spend time answering all my goofy questions.
I kind of take that to mean "I can't figure out how to do your revision, so I will suggest a cover-up which will improve my bottom line and leave you somewhat happy/dissatisfied in equal measure". Get second opinions for sure. Dr D-B is an FFS surgeon (from memory) and has a fair few gobbledegook-sounding SEO articles on his website...
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I'd like to join in this posting -
I had BSSO and Le Fort surgery with Kaiser Oakland 1.5 years ago, then requested a sliding genioplasty 6-months later, thinking it would help my slightly recessed, long chin. The surgery actually made my chin appear longer from the frontal view and did nothing for the vertical length. I am also consulting with Dechamps Braly in a few months --- I've been trying to find a skilled maxillofacial surgeon who will take on my genioplasty reversal/revision, but having little luck. The surgeons I've talked to have all said they won't do piece work (genioplasty alone), but would only consider me for full revision.
I'm fairly happy with the functional outcomes of my DJS, just not the aesthetics. I guess you can't post $$$ on this board, but if the total revision would end up </= $30k, I might consider it worth it. In my searching it seems like genio alone can be $10-20k.
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I kind of take that to mean "I can't figure out how to do your revision, so I will suggest a cover-up which will improve my bottom line and leave you somewhat happy/dissatisfied in equal measure". Get second opinions for sure. Dr D-B is an FFS surgeon (from memory) and has a fair few gobbledegook-sounding SEO articles on his website...
I totally agree with this. I think it is the classic response from a surgeon who either cannot or does not want to do the surgery you are requesting, so suggests a lesser surgery or a masking procedure.
I actually consulted with him a couple of years ago. Although he was very nice and didn't seem incompetent or anything, the approach he suggested for my jaw seemed very odd and was not in line with anything any other surgeon suggested. I need bi-max, he was suggesting just maxilla surgery. It was not going to achieve what I was asking, but I got the impression that he would prefer to do a lesser surgery regardless of whether that actually resolved the issue properly.
Of course he could just be the kind of surgeon that recommends doing less to avoid exposing the patient to risk/ complications - i.e. conservative with the interests of the patient in mind. But equally it could be about him not have confidence in his own experience/skills. I think in my case a conservative surgeon would have just suggested no surgery at all because what he suggested would not have resolved the issue and yet would still have exposed me to the risk of jaw surgery.
Would you be able to post a picture of your lower face so we can see the issue with your chin? You may not feel comfortable, and that's fine :)
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Here's a link to some photo bucket pictures.
I had a 4mm sliding genioplasty along with le fort 1 and bsso. The SG increased the length of my chin from the frontal view. I am unhappy with the dimpling of my chin, vertical length of my chin (especially from frontal view) and the curling/thinning of my lower lip. Before the le fort I had a pretty extensive open/over bite, that pushed against my upper lip giving it some body. When I had the le fort, my profile became much improved and I could close my lips easier at rest, but it did lengthen my philtrum and make my already small cupid bow upper lip appear smaller and thinner.
What I'm wondering is if perhaps the SG could be reversed or revised, or maybe just the plate removed to help the lower lip positioning. Or maybe something could be done about the dimpling - fat transfer or filler or ? maybe that's just wasted money? Either way, I'm going in for a consult soon.
I may go ahead and consult with gunson as well and hear what he has to say.
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Here's a link to some photo bucket pictures.
I had a 4mm sliding genioplasty along with le fort 1 and bsso. The SG increased the length of my chin from the frontal view. I am unhappy with the dimpling of my chin, vertical length of my chin (especially from frontal view) and the curling/thinning of my lower lip. Before the le fort I had a pretty extensive open/over bite, that pushed against my upper lip giving it some body. When I had the le fort, my profile became much improved and I could close my lips easier at rest, but it did lengthen my philtrum and make my already small cupid bow upper lip appear smaller and thinner.
What I'm wondering is if perhaps the SG could be reversed or revised, or maybe just the plate removed to help the lower lip positioning. Or maybe something could be done about the dimpling - fat transfer or filler or ? maybe that's just wasted money? Either way, I'm going in for a consult soon.
I may go ahead and consult with gunson as well and hear what he has to say.
i see no pics
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oops
http://s38.photobucket.com/user/RLC_85/library/?sort=3&page=1
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I think the dimpling is possibly caused by your mentalis muscle being strained. Did anyone you saw mention this? Maybe reversing the SG and reducing the vertical length would take the strain off and therefore resolve the dimpling, which happens when the chin muscle is hyperactive. Shortening the length of your chin would have a beneficial effect aesthetically, but not resolving the other issues you mentioned (philtrum length etc) would possibly mean you wouldn't be happy after having it done?
I think a full jaw revision would give you the best overall aesthetic outcome, but obviously it is not only expensive but a lot to go through again, so nothing anyone should recommend lightly. It really comes down to how much those other issues bother you? They are not really bad ones, so it isn't a case of a revision being essential.
If I were you I would still go and see yet more jaw surgeons (or try and get free opinions through email for those that will do that - possibly even with international surgeons). If almost all of them are saying no to a genio alone then I think you have to conclude there is good reason for this. One question to ask all of them is what they think the risk might be of any ptosis of the chin muscle following a reverse SG. It's a consideration. I have some sagging in my mentalis muscle (not from surgery though) and it really bothers me. There is a procedure that exists to excise the excess tissue, but it creates a scar under the chin and may not completely tighten things up (in my case).
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Thank you for your reply.
I just spent some time looking at other members jaw surgery results via blogs, etc. It does appear that my surgery results and bite are stable in comparison. My bite is closed, there's minimal - maybe 1mm horizontal movement, and minimal TMJ pain.
It's just the loss of self I think ---- I spent so much time worrying about my open bite and recessed chin through the years that I didn't realize how much I loved the other things about my face.
I'm not excited about going through another surgery... especially since there's no guarantee that it will make me happier.
I might try some less invasive things first - maybe lip filler to make the mouth seem less pinched and the philtrum length less glaring.
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some1,
You probably don't need a whole do-over of the maxfax surgery since your function is fine and the overly convex profile was improved. However, the CHIN is the main concern.
No idea why you got your chin done in a 2ncd surgery though. It would have best have been done in the first one where it could have been moved UPWARD along with outward so it did not look 'long' in frontal.
That said, I think you can isolate any revision to JUST the CHIN. To that regard, you want to look for docs who are open to revising just the chin. Not sure but some of the 'big names' might just want to take on cases where they can revise the whole thing and you don't need a total do-over.
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kavan,
that's exactly right. I have talked to two offices who said they wouldn't take on chin reversal/revision alone, only complete jaw surgery revision. they don't want to put their hands on someone elses work unless they are going to completely make it their own.
I am reluctant to undergo another double jaw surgery for many reasons, including cost and further blunting of my roots from another round of orthodontics. I have made it through my first round of DJS with no root damage or residual numbness and I have to consider myself lucky in that affect.
The chin was done as a secondary surgery at my request as my profile was still rather long and flat after DJS. It did look MUCH BETTER after the BSSO, I should've left things as they were. I am kicking myself now. I'm consulting with Deschamps-Braly soon about a chin reversal/revision. I think for the right $$$ he is willing to do an isolated chin surgery.
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kavan,
that's exactly right. I have talked to two offices who said they wouldn't take on chin reversal/revision alone, only complete jaw surgery revision. they don't want to put their hands on someone elses work unless they are going to completely make it their own.
I am reluctant to undergo another double jaw surgery for many reasons, including cost and further blunting of my roots from another round of orthodontics. I have made it through my first round of DJS with no root damage or residual numbness and I have to consider myself lucky in that affect.
The chin was done as a secondary surgery at my request as my profile was still rather long and flat after DJS. It did look MUCH BETTER after the BSSO, I should've left things as they were. I am kicking myself now. I'm consulting with Deschamps-Braly soon about a chin reversal/revision. I think for the right $$$ he is willing to do an isolated chin surgery.
Well, I'm usually right. You are too in this case to not get a total do over. There are probably maxfax docs who would do just the chin but the 'bigger' the name, the 'smaller' the likelihood. Options open for other PSs who have some cranio background to do just the chin also.
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Hi Jawsurgery forum goers - I had my consult with DSB and wanted to report back. Very professional and upscale office. Lots of imaging beforehand, X-rays from multiple views + CT + digital impressions. His recommendation is a genioplasty revision and while he's in there why not remove my BSSO hardware and smooth over some bone spurs.
His plan included removing 10mm vertical height + tapering the sides to create a more feminine, less boxy appearing chin. I think this is "V" line genioplasty? A "T" shaped piece of bone is removed then secured with plates. He recommended adding 2mm more of forward projection (currently it's 4mm so it would be 6mm).
Open to any comments from y'all....
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The only before and afters I've seen of his are gender reassignment feminization procedures, but they all looked AWESOME. Would you be willing to PM me the quote they gave you for a revision (including hospital fees, yada yada)?
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upscale office.
Just an FYI: this means nothing.