Surgical Plan Review

[GJ]

Starting to get major cold feet though after reading so many people with permanent numbness and nerve damage.

Well it is a legitimate concern and risk. Only you can weigh that.

[eastcoastian1]

Well it is a legitimate concern and risk. Only you can weigh that.

Yeah….especially aesthetically I’m not that bad. Having a hard time deciding if it’s worth it or not.

[GJ]

Yeah….especially aesthetically I’m not that bad. Having a hard time deciding if it’s worth it or not.

Cases like this are only obvious in retrospect.

I mean, you are a bit recessed and could look quite a bit better if things go well, but I'm not sure the probability on that. It's a lot of things that have to go well. With a good surgeon probably 60/40 in your favor. But if things go badly, it will be, "what was I thinking, I was fine, etc"...

Some cases are very obvious and those people have easier decisions. I think class 2 with mild to moderate recession are some of the most difficult cases to figure out the risk/reward. It's why I usually tell people (opinion of course) not to do it for only aesthetics but you have to get some functional benefit from it.

[eastcoastian1]

Cases like this are only obvious in retrospect.

I mean, you are a bit recessed and could look quite a bit better if things go well, but I'm not sure the probability on that. It's a lot of things that have to go well. With a good surgeon probably 60/40 in your favor. But if things go badly, it will be, "what was I thinking, I was fine, etc"...

Some cases are very obvious and those people have easier decisions. I think class 2 with mild to moderate recession are some of the most difficult cases to figure out the risk/reward. It's why I usually tell people (opinion of course) not to do it for only aesthetics but you have to get some functional benefit from it.

Yep. I’m really struggling with it. Feels like for every one person that had a comparable treatment who thought it was worth it, there’s another person who says it was the biggest mistake of their life.

[ChinaBoy420]

Let me get this straight are you actually asking why the surgeon doesn't do something to DECREASE your facial height when your objective is to have the surgery get as close to what the implants did which was to INCREASE your facial height? I mean the OBVIOUS thing to observe in the low angle OP photo was the facial height was decreased.

I am very new to jaw surgery. But am I right to say that CCWr with posterior downgrafting (no impaction) will lengthen the face to a significant degree if the OP is very steep?

[kavan]

I am very new to jaw surgery. But am I right to say that CCWr with posterior downgrafting (no impaction) will lengthen the face to a significant degree if the OP is very steep?

It would tend towards decreasing the anterior facial height. Relationships in Jaw surgery relate to relationships in elementary geometry. So, prior familiarity with basic geometrical concepts is needed to have underbelt in order to relate to the relationships going on with such things as the rotation of a triangle on which the concept of CCW-r via posterior downgrafting is based.

[GJ]

I am very new to jaw surgery. But am I right to say that CCWr with posterior downgrafting (no impaction) will lengthen the face to a significant degree if the OP is very steep?

No that's not right. It's the opposite.

[eastcoastian1]

Small update here. I had a consult with Dr. Posnick (who’s retired) and he said I was basically bat s**t crazy for even considering jaw surgery and that I would almost assuredly regret it.

Ugh

[GJ]

Small update here. I had a consult with Dr. Posnick (who’s retired) and he said I was basically bat s**t crazy for even considering jaw surgery and that I would almost assuredly regret it.

Ugh

What was his reasoning?

[eastcoastian1]

What was his reasoning?

Aesthetically I will look way way worse taking out the implants I currently have (which he says looks great and are stable) in exchange for a proper bite. He said if I wood have had jaw surgery in the first place then did implants it would be a different story, but at this point, I would be making an “irreversible mistake” esthetically speaking if I were to do this and expect to look as good or better as now. 

Don’t know what to do. So much anxiety and I’m a month from surgery….

[kavan]

Assuming the maxfax surgery is CONTINGENT on removing the implants to do it, it's  only an 'irreversible mistake' IF the the maxfax surgery PRECLUDES putting in another set of implants down the line. Did you ask YOUR surgeon whether or not his surgery would actually preclude you from getting a new set of implants later down the line if yours need to be removed?

I would suggest discussing your apprehensions with the doctor you booked surgery with. That is preferable to gathering extraneous information from OTHER sources, especially since you have already gone through the decompensation process to prepare for a surgery.

[eastcoastian1]

Assuming the maxfax surgery is CONTINGENT on removing the implants to do it, it's  only an 'irreversible mistake' IF the the maxfax surgery PRECLUDES putting in another set of implants down the line. Did you ask YOUR surgeon whether or not his surgery would actually preclude you from getting a new set of implants later down the line if yours need to be removed?

I would suggest discussing your apprehensions with the doctor you booked surgery with. That is preferable to gathering extraneous information from OTHER sources, especially since you have already gone through the decompensation process to prepare for a surgery.

Hi Kavan.

Surgery is with Dr. Sullivan btw.

Yes decompensation has been a pain and would be for nothing if I abandon now.

Part of the surgery plan is not only remove my current implant but also REPLACE it when new custom gonial angle PEEK implants during surgery. Even he admits if I take my implant out and just do the BiMax, I’m gonna look pretty bad.

[kavan]

So, if Sullivan is REPLACING them and he knows you would look bad WITHOUT replacing them, then you should know Posnik's comments were EXTRANEOUS.

[ChinaBoy420]

No that's not right. It's the opposite.

Hmm that is interesting. In some videos I see like the ones I attached below the skull gets longer vertically (distance from chin to top of head) after CCWr.

https://www.instagram.com/p/CL7kp89giZx/?hl=en