ABOUT MALAR BONE OSTEOTOMY - DESIRED TOPIC FOR SOME 
Hello again
I'm after 2 consultation with Italian surgeons. Comparing to consultations in Poland, to MM, and Zarrinbal, i'm the most impressed with these ones from Italy
For some of You who does not know what I'm gonna do - I'm going to have malar bone osteotomy and infraorbital nerve decompression due to overlooked previous fracture
Some information may be helpful for You.
Prof Pelo and Ianetti generally told me almost the same and they both seem to be very skilled almost at the same level. Why almost? I will outline this...
At the same time I need your little help in choosing one of them
Both of them doesn't speak well in English. Iannetti enough good to communicate, Pelo needs assistant, probably even when someone write e-mail to him. But there is no problem with basic communication. However there is a very little problem with language barrier. My english is also not very good. I better write than speak, because I more use it in that way,
The consultation time was around 45-60 mins in both cases (I didn't check it exactly, but consultation with Pelo was at 4pm and when I was in the waiting room for a longer while I noticed it was about 5:45pm) , but Pelo also gave me extra time about 15-20minut. He had other patients, so after my scheduled consultation, I waited about one hour, when all patients was examined by doctor, and then I was able to ask some more questions.
Pelo performs all LeFort osteotomies from 1 to 4 (didn't know about 4th). Has got experience
I didn't ask Iannetti about this, but for sure the same experience.Pelo has got international patients (as he says) from time to time.Both of them don't see this surgery to be risky. just very low of risk. Iannetti even see lower then low
Pelo is a little more careful in saying that, but the same comment - this is the one of most simply from the most complicated surgeries they performs. Pelo informed me that there is more simplier method - just using implant, but osteotomy is more professional and only a little more risky.
Iannetti showed me 3 examples of his works, but for me weren't much heplful, because he showed me before / after in more serious cases, which after looks good, but not perfect (for example in one patient case, one of the eyelid was a bit lower and white part of the eye was more visible, but taking how it was before, quite good. However as I said it was not helpful in my case. He just showed that he is able to restore someone face quite good. He had a little troubles with showing me some more samples. He is not familiar with computers well.
Pelo couldn't show me pictures during consultation, but he told me that, he's gonna to send me via mail some of examples - I'm waiting
and now 2 little differences between them and one big..
First Ianetti is able to perform this surgery making only one barely visible incision, but Pelo needs two visible (and of course one inside mouth). In Pelo's approach, one will be on my lower eyelid (to get acces to orbital floor), the second almost invisible on eyebrow.
At first Iannetti also talked about two incisions, but I told him that once I got hypetropric scar, so he told me despite there is still extremely low risk that it will develope on the face, he can do most of the surgery making access from incision inside mouth. He will use endoscope to get to orbital floor
The second difference is Pelo told that during surgery turn out whether I need augumentation floor (by putting special biomaterial - very thin sheet, or piece of animal bone, or just nothing, perhaps it wil be not necessary) . By contrast, Iannetti claims that augumentation won't be necessary for sure in my case. Displacement is not big and he just will move the bone in the same way as it moved after fracture, but just in opposite way.
Additionally, Iannetti showed me on computer how big is my assymetry (only 4mm) and that he can make some calcultations to be sure how much this bone can be moved to be sure if he will not overdo which may cause too much orbital volume. When orbital volume is too big then eye has too much space and it starts to sunken a little. So he just now that it's 4 mm
Pelo didn't show me any calculations, but told me that he see how much this bone can be moved comparing to the other side.
So these are only minor difference - I think minor. One use some calculations on the computer, the other only his "instinct" and experience
The big one is the price. They prices vary much from them.
Druing surgery no nerve will be severly destroyd. I may have only slight loss of feeling after surgery which is good results...even zygomatic small ones, which MM wanted to destroy despite there are far away from the cut line - still wonder what the heck he wanted to do - this was major thing which made me to cancell surgery with him
Genrally You are not in this topic - I mean malar bones and orbitals
but perhaps You can tell me If for example I may ask Pelo about this endoscope solution, but If he could do that, he would have told me about this option. So probably it doesn't have any sense, and at the same I don't want to make him angry asking such qestions.
Scar on lower eyelid is not very visible (if it will not bocome hypotropic) but it's ..so Ianneti perhaps has better solution, but I don't want to wait
Perhaps decision will be more easy for me when Pelo send me his samples
That option with endoscope and one less scar is quite interesting
What You think ?
