Advice for people wanting midface surgery

[earl25]

Earl25: I'm from Europe. And 50% of surgeons I ask can do this. But only one has documented this, and he can (probably) show me some examples.

and he is the most expensive as well.... (not including Swiss surgeons, too expensive for me)

did you ask them in person? I don't know much about Europe dr.'s but I wont be shocked if when you get there majority say it no for you/ too intense. Even in usa I had a lot of initial email responses from dr. saying yes they do them.

[MrFox]

Ok if you google image search "carmen dell'orefice ogee curve" Lol then it's on the first page and the picture where she's on a magazine that says, "Madame".

[PloskoPlus]

did you ask them in person? I don't know much about Europe dr.'s but I wont be shocked if when you get there majority say it no for you/ too intense. Even in usa I had a lot of initial email responses from dr. saying yes they do them.

Probably because Rico wants to fix a fracture that resulted from trauma.  You did yours for cosmetic reasons.  I just feel that most max facs equate "looks good" with "not obviously deformed".

[Lazlo]

I sent the image to earl, and he can respond here if he wants.

[terry947]

does the S shape come from zygo width or projection? Probably a bit of both I'd think. This picture that Rico posted looks like it'd create the S shape.

[PloskoPlus]

IMO, it's both plus tall vertical ramus.

[Lazlo]

can you achieve this with surgery with sinn earl?

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[Lazlo]

i mean look at that guys cheekbones they keep his face from aging even though he's old and there's a real positive vector under his eyes. he has the perfect S-curve.

[Rico]

Lazlo, answering to your qestions,

 at this time, mostly it's Prof. Iannetti but also I consider Prof Pelo. Both seems very professional
but interesting is fact that 50% of surgeons tell me to not do this surgery (enophthalmos, diploplia risk, not easy to set this bone properly)
I have to be careful. Probably I'm gonna choose the one who will show me before / after of such procedures.   and initially I know Iannetti is gonna show me, I'm waiting for his answer about last consultation before I make decision

I also bought his article about such surgeries. 77 cases (similar to mine) between 1977 - 1999 year. However it doesn't mean other surgeons do not perform it well, but how can I be sure if they are not able to show me such examples ? It's hard to trust without proof even if specific surgeon can be extremely good

I also think about Prof Goudot (France) and his new techniques of malar bone reposition, of course, if he will be able to show me before/ after photos.

[Lazlo]

Lazlo, answering to your qestions,

 at this time, mostly it's Prof. Iannetti but also I consider Prof Pelo. Both seems very professional
but interesting is fact that 50% of surgeons tell me to not do this surgery (enophthalmos, diploplia risk, not easy to set this bone properly)
I have to be careful. Probably I'm gonna choose the one who will show me before / after of such procedures.   and initially I know Iannetti is gonna show me, I'm waiting for his answer about last consultation before I make decision

I also bought his article about such surgeries. 77 cases (similar to mine) between 1977 - 1999 year. However it doesn't mean other surgeons do not perform it well, but how can I be sure if they are not able to show me such examples ? It's hard to trust without proof even if specific surgeon can be extremely good

I also think about Prof Goudot (France) and his new techniques of malar bone reposition, of course, if he will be able to show me before/ after photos.

Cool if he you can show pics here please post when you get them. If Ianetti has done it 77 times that's A LOT, means he has some real experience.

[Rico]

Nope . it has done by his team in university , do not know how much he done personally...you know by his hands
keep in mind that 77 cases  between 1977 and 1999 , now even more.  Overlooked malar fracture, or improperly set.

He cannot send me, he can show me during consultation. But I'm waiting for the answer. Since he is not cheap I was little picky in my last mail, so it is not obvious that invitation is still valid   we will see.  But I will give you very good description if he shows me.

[Rico]

Terry: I showed example of malar bone reposition. Where the bone must be cut to do this. When you mobilise the whole bone, then you can set it as you need, but having in mind, that enough significant changes in volume orbit will be catastrophic.  This is why most surgeon do not do this in mild cases like mine. Anywhay , this is osteotomy surgery typical for similar cases including mine...when malar fracture was overlooked or improperly set during first treatment. In more severe cases may rather be only improperly set. It is almost impossible to overlook , because big malar displacement may block the jaw (you can;t open mouth in full range or at all), you may have double vision, and post truama enopthalmos (sunken of the eye)

I think noone overlook that he can;t open his mouth or got double vision

[Rico]

Earl25:  Did your surgeon use any navigation system to put the zygomatic bone (after osteotomy) in the very right position ?  There are plenty of researches which show, that navigation system is very helpful because it decrease the risk of postop and late enopthalmos (sunken eye) and diploplia (double vision) . I wonder if this is really true

[PloskoPlus]

Earl25:  Did your surgeon use any navigation system to put the zygomatic bone (after osteotomy) in the very right position ?  There are plenty of researches which show, that navigation system is very helpful because it decrease the risk of postop and late enopthalmos (sunken eye) and diploplia (double vision) . I wonder if this is really true

You mean surgical guides?

[earl25]

Earl25:  Did your surgeon use any navigation system to put the zygomatic bone (after osteotomy) in the very right position ?  There are plenty of researches which show, that navigation system is very helpful because it decrease the risk of postop and late enopthalmos (sunken eye) and diploplia (double vision) . I wonder if this is really true

to my knowledge he didnt