Italian maxfac surgeons: Prof Pelo, Iannetti, Nocini, Sesenna, Clauser

[Rico]

But if you have bad feeling about Pelo why not consult some  alternatives surgeons like Nocini ?

I don't have bad feeling. thet are just  neutral. You know this is only talking but I'm kinda impressed
As I wrote in PM to You 2 hours before, Nocini has not responded to my mail which I sent 2 weeks ago. I will wait just one week more.
So what to do if he has not responded . I even asked receptionist a favor to turn his attention into checking spam folder. Sometimes message can go there, but it's rare. I've sent him only 2 messages. One with description of the problem and second request if he received my main message.
No response

[Rico]

Oh so now You started to see that they may botch my surgery.   You are telling me now , what I told You before

Don't worry I won't call police. You can write whatever You think might be helpful
Decision is only mine.

[Rico]

When I shave my brows they are visible but not much.

Who do this ?  I've seen some men with shaved brows only on German gay parade (only on TV)

Yes semi-coronal incision is possible. but jeesuss I prefer to have 2cm mild visible scar than this   to be scalped like in indians village

Incision on the eyebrow is necessart to cut the bone there including lateral wall . Whole complex has to bo moblilised. But on the side of eyebrow. He will be able to reach the upper part of the orbital rim...I don't how it is called





Lobotomy used to be made from the front of the head not of the side

By the way. After incision on the eyebrow i can loose hairs there ?


PS I'm waiting for some pictures pre / post similar to my case. Pelo said that he is gonna send me. We will see. I hope he will do that
How he is skilled we will see after surgery There is no final decision yet. I told him that I'm thinking seriously about surgery with him and I would like to make up my mind within 2 weeks. I asked him about pictures during consultation, but he told me that he couldn't show me - probably he had them on another comp. but he promised to send me. Generally I have only 2 small questions for him and waiting for these pictures. That's all . After that everything will be discussed well

[Rico]

Now its obvious that Pelo has the best approach from all surgeons that you have consulted. Forget endoscopic approach and others.
Its likely the same approach as in the medical manual that I have posted.

I think You missunderstood their approaches.
The same approach makes I.

All the same, with 2 differences:
P: 50% that augumentation of the orbital floor will be necessary
I: for 100% not necessary
Can't understand why I. told me, that he will just rotate the bone in the opposite way the bone moved after fracture, hence orbital volume won't change, and since the displacement is not big, the existing parts of orbitall wall should be enough to hold all orbital contents in the place. So do not know why P. is a little less sure about this part. Less experience? or Iannetti is too optimistic or P is more safe option. At this point I remind myself about prices differences , hmmm ??
I had only one  consultation for each of  them and hard to determine where is the problem - key point.  I asked P. again about this issue via mail. As I said I asked him only 2-3 questions ...which developed in my mind after I met I. and also I'm waiting for a few postop photos (examples). I hope he will be my good choice. But I have to wait for last data - information. I will see

P: needs to make incision on the lower eyelid to access orbital floor
I: does not need - he will get access there using endoscope

Both of them are gonna make incision on the side of the eyebrow to get access to upper part of the malar bone

So I think now it's more clear. What do you think ? about these differences

Is it good way to discuss with one surgeon about surgical approaches of the other surgeon ?
I have not acted in this way, but perhaps It is wrong.

Everyone, who reads this, give me some advice please

[Rico]

thx for info.

I developed numbness of the cheek following a maxilla fracture. Will the sensation return?
    Numbness following cheek fractures is relatively common. Cheek fractures often involve the bony channel through which the sensory nerve of the cheek travels. If the nerve is not severed due to trauma, the prognosis for return of sensation is quite good.

This is obvious only for fresh fractures not overlooked - older then 0.5 - 1 year. But generally my nerve is in good condition , and only minor dissfunction, which become better after cortisteroid injections, The chances now are low, but who knows. Only 3-6 months after surgery will show that

so the risk is here that with mobilization the eye can sink in the orbit so Pelo is very cautios to prevent this with bone grafts.

This is the key-point

This is not exactly how you think it is.
Iannetti told me that he will not move the bone horizontically/vertically, he just will only rotate it, without changing orbital volume. He emphasised, that this is crucial thing and needs great experience to not move the bone in wrong way.... I have not got dipoplia after fracture because the displacement of the bone was not big. It mailny only rotated but has not moved vertically / horrizontically.

Generally I think Pello is better option for me. but now I have to wait. I sent him info, that if he does not feel comfortabl with showing me those photos via mail I can meet with him again. OK I will write here again If i'm gonna have surgery / or will be after (I hope)

[Rico]

You dont mentioned that Ianetti will only rotate not move your zygoma-complex.....
Why you say this not before.....it seems that Ianetti had a lot of experience in this field..

I said.. but You did not read carefully.... but the rest on PM

[Rico]

Interesting... and in english

http://vimeo.com/101076866

[novakmali]

what is the best italian maxfac for lowering maxilla?? should i go with pelo or raffaini??

[Bobbit]

Interesting... and in english

http://vimeo.com/101076866

 . . . when this thread was bumped,  I noticed this older post.  Kind of neat stuff.  From that presentation, it appears those surgeons formally trained in craniofacial surgery are pretty much at the top of the pyramid in state of the art surgical skills involving the face and head structure.  It looks like most or all of the craniofacial surgeons came out of formal plastic surgery programs (see the slide from the presentation referencing  Arnaud and Marchac, for example).  A very few of the craniofacial /plastic surgeons also have training in orthognathic surgery.  That same distraction technique described in the video for craniofacial skull and face movements is also used for some jaw movements.  Would that technique automatically avoid or limit the risk of instability  when large moves are needed in the mandible?
 

[Rico]

and i didn't choose him. I'm a dork :/  and chose wrong surgeon