Author Topic: The limits of surgery  (Read 24609 times)

PloskoPlus

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Re: The limits of surgery
« Reply #30 on: June 23, 2014, 04:39:54 AM »
I still don't understand why she has no external scarring if a Lefort III was performed.

You can see the scews above her nose in the post-op X-ray.  Definitely Le Fort III.

PloskoPlus

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Re: The limits of surgery
« Reply #31 on: June 23, 2014, 04:47:52 AM »
Posko, from what I've read it does seem that the 'class 3' facial set up doesn't really show itself until the late teens, especially in guys.  I'd be cautious about reducing the chin/lower jaw too much because a) you're a guy and b) it's balancing your nose.

If anything I'd want a wider and slighter longer (vertically!) chng, though it's not so critical now that my face has thinned.  IMO, good looking faces have a projected upper face.  Reducing the lower jaw can make the upper look more projected.  Just jut your lower jaw and see how the cheekbones recede.  But I'm not keen on a BSSO at my age.  Even if retraction of the mandible is supposedly much easier on the nerve than advancement.

PloskoPlus

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Re: The limits of surgery
« Reply #32 on: June 23, 2014, 06:08:27 AM »
LeFort III requires a coronal incision, which is usually not visible especially with her hairstyle. If it is that visible, no one would do a rhytidectomy either.

And yes, there are intraoral approaches only but I thought only for LeFort II via piezoelectric devices (distraction osteogenesis).

To the thread: Yeah, you can't really fix ugly, there are some rare cases where it actually happens but you can't count on it. Worst thing is to be deluded and actually expect that it will change anything. It doesn't.

Lefort iii can be done without coronal incision.

earl25

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Re: The limits of surgery
« Reply #33 on: June 23, 2014, 07:19:51 AM »
LeFort III requires a coronal incision, which is usually not visible especially with her hairstyle. If it is that visible, no one would do a rhytidectomy either.

And yes, there are intraoral approaches only but I thought only for LeFort II via piezoelectric devices (distraction osteogenesis).

To the thread: Yeah, you can't really fix ugly, there are some rare cases where it actually happens but you can't count on it. Worst thing is to be deluded and actually expect that it will change anything. It doesn't.

its true unfortunately if your guys odds are with all the surgery in the world u wont be attractive BUT you can still improve yourself tremendously . an example is I was born naturally with a bird nose. wasn't really that big but very very curved beak life, huge drooping/goopy tip, wide alar etc. people used to call me pigeon,bird,penguin etc(on top of generic ugly also). now after my rhino no one ever calls me bird like anymore. so although im still ugly I do feel better shedding the bird label.

 you have a better chance of improvement (and risk also)with bone surgeries than implants and other ps fixes. when I first came onto cosmetic boards back in the early 2000's many ppl who had serious flaws mainly in jaw chin. so back then people would run off  to r. y ,r,t,r and get jaw,chin, cheek ,sometimes orbital rim, necklift etc. they would look a bit better but they would still look off. then it came out that they really needed maxfax but it was too late because they had medpor. on the flip side maxfax has really taken off since 2005 and the ppl getting it (assuming successful outcome) do look much better than the groupwho go with implants or fat etc.

earl25

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Re: The limits of surgery
« Reply #34 on: June 23, 2014, 08:14:13 AM »
the best all time results normally were maxfax followed by implant work

Tiny

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Re: The limits of surgery
« Reply #35 on: June 23, 2014, 12:14:31 PM »
the best all time results normally were maxfax followed by implant work

Agree.  It surprises me that more surgeons aren't doing custom titanium yet

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Gregor Samsa

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Re: The limits of surgery
« Reply #36 on: June 23, 2014, 12:16:16 PM »
Those are some good results. Which doctor performed the surgery?

Tiny

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Re: The limits of surgery
« Reply #37 on: June 23, 2014, 01:22:01 PM »
Those are some good results. Which doctor performed the surgery?

Dr Wittenberg

If you look on his site, the results are very hit and miss.  I'm not sure he is particularly clever wrt movements but he is one of the only docs who routinely combines jaw surgery with implants.  Some of the results are pretty 'meh' but the good ones are very good

A fair number of class 2s are deficient vertically in the ramus - the only way to get a vertical enlargement is implants or chin wing.  And hardly any surgeons are doing chin wing - and I think it can't be combined with a BSSO anyway?  I would think that a ramus osteotomy with a bone graft would provide a stable result but I've never seen it done.  For the people with the super steep lower jaws, like this woman, only an IVRO or an implant is going to improve it, yet you rarely see an IVRO done

Same with class 3 and the malar region.  How many surgeons actually do the zygomatic osteotomy?  If you look at this docs site though, the cheek implant results are really variable. Some look great but some look bad and just give a weird chubby cheek look rather than a high cheekbone

earl25

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Re: The limits of surgery
« Reply #38 on: June 23, 2014, 01:45:21 PM »
I have heard he has a lot of lawsuits against him

Gregor Samsa

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Re: The limits of surgery
« Reply #39 on: June 23, 2014, 01:56:41 PM »
I visited his website and it started playing some porno music in the background so that alone warrants a lawsuit.

earl25

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Re: The limits of surgery
« Reply #40 on: June 23, 2014, 02:17:39 PM »
Agree.  It surprises me that more surgeons aren't doing custom titanium yet

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I think custom titanium implants are expensive. I asked a dr. once and said it's too costly.   I know schendel has the option of using them

Modigliani

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Re: The limits of surgery
« Reply #41 on: June 23, 2014, 02:44:32 PM »
I visited his website and it started playing some porno music in the background so that alone warrants a lawsuit.

 ;D

PloskoPlus

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Re: The limits of surgery
« Reply #42 on: June 23, 2014, 02:59:03 PM »
Dr Wittenberg did Kristian - the YouTube poster boy for very large lefort I advancements  - 9 mm.

PloskoPlus

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Re: The limits of surgery
« Reply #43 on: June 23, 2014, 03:07:42 PM »
On the train ATM.  Bags under the eyes are... Quite common.  Is it just me or does like 30% of the population have recessed jaws?

Gregor Samsa

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Re: The limits of surgery
« Reply #44 on: June 23, 2014, 03:09:25 PM »
Dr Wittenberg did Kristian - the YouTube poster boy for very large lefort I advancements  - 9 mm.

Consistent results are much more important to me than the occasional exceptional result. Would you really gamble on a surgeon that produces average to bad results at least half of the time even though his best results are beyond fantastic?