Just had a consultation with another surgeon. Granted i let the cat out of the bag by mentioning my surgeon. Let's call this guy Z, by is admission he's more of a tmj specialist, but does orthognathic surgery as well.. But here's what he said. (X is my surgeon).
Z says he has no relation to X. Wasnt trained by him, isn't friends with him.
X is one of the best. You're in good hands.
People from all over the world to see him.
Your orthodontic preparation is excellent. Your orthodontist is very good.
X does absolutely everything including lefort iii.
If he doesn't suggest doing something, you don't need it.
Lefort iii is for severe cases. The precision is just not there compared with implants for standard cases. It may make your eyes look tiny. Implants can get infected, but so can jaw surgery plates. But their precision is far superior to the big leforts. In fact implants may be a bad idea in my case as well. Z once put a malar implant on a patient, and his eyes became "tiny dots".
X lives to operate. He's not in it for the money*. Registrars get paid by surgery item. They don't like assisting X because he often omits items, charging the patient less.
Trust X's aesthetic judgment.
X is right about leaving your lower jaw alone.
Higher lefort will kill the angles in your face. X is right again.
I told him X wanted to do the rhino at the same time as the jaw in the initial consultation, but changed his mind. Z said I spooked X. "It's probably because most orthognathic surgery is done in late teens, early 20s. They don't over think it". Suggested counseling. "You are a tough patient. I wouldn't take you. I would've sent you to X. Wait for 6, better 12 months after the lefort before doing anything else. You should benefit greatly from it alone"
Z said to puff up my upper lip and I'll know what I'll look like after surgery. (I don't like it). I asked him why Z charges so little for rhino. He asked what do PSs charge. I told him, and he nearly fell off his chair. "That's a one hour operation!" He said he's charging peanuts for TMJ joint replacement and should raise his prices then.
*X's price list is less than the guy he trained.
P.S.
Spent the train ride checking out people's philtrums, gonial angles, eye bags. Sat next to a poor mans blue eyed Javier Bardeem.