Dr Defrancq

[UKMaxfac]

Hello everyone,

I wondered if anyone has had surgery with him in Belgium?
I consulted with him yesterday in London.
He seemed ok, but what surprised me most was he says firstly I wouldn't need braces
Secondly he said there are never problems with the upper jaw in terms of numbness post op in his practice
Thirdly you can be back to eating hamburgers within a week after bimax
Also most his patients can be back to work in 2 weeks.
Also downgrafting with bone and plates is very stable, dismissed my concerns on this (relapse)

Anyway I wondered if anyone had met or had surgery with him? Thoughts?

[UKMaxfac]

No one at all? Surprised by that, then again I guess everyone here is obsessed with Gunson apparently

[UKMaxfac]

Hello mate,
Also consulted with him recently and was told I wont need braces prior to jaw surgery. Seemed strange to me as the proposed plan included bimax, with palate expansion (device to be fitted at time of surgery). I'm not really sure how I feel about that. Obviously skipping orthodontics would be ideal but kinda goes against the norm. Did you discus anything about cheek augmentation with him?

Very interesting... personally I'm on his side, in the sense that when i look at my bite, I just can't understand why I'd need extensive preoperative braces..
http://imgur.com/w4sH01M

On the other hand surely there is a reason most surgeons say we need ortho work before?

He mentioned that my cheekbones were 'nice', but that if we do advancement and downgraft they might look  a bit flat and we could discuss some grafting at a later stage. He wants to have 3d x-rays done (at quite a large expense I might add)

Should we be very sceptical about it ?

[ditterbo]

He mentioned that my cheekbones were 'nice', but that if we do advancement and downgraft they might look  a bit flat and we could discuss some grafting at a later stage. He wants to have 3d x-rays done (at quite a large expense I might add)

Ok CCW was just saying how counter clockwise rotation with posterior downgraft would help fill in the midface.  Is Defrancq contradicting that or are you not talking about a posterior downgraft?

[UKMaxfac]

This forum is obsessed with ccw and Gunson.

I don't know anything about ccw all I know is CW is what I need desperately.

Defrancqs results seem good and he updates them quite often which is reassuring, just a shame no one here has taken the plunge yet

[PloskoPlus]

This forum is obsessed with ccw and Gunson.

I don't know anything about ccw all I know is CW is what I need desperately.

Defrancqs results seem good and he updates them quite often which is reassuring, just a shame no one here has taken the plunge yet

Make sure you see cases just like yours. CW is much easier to do,  but can lead to chimpville if overdone.

[ExtractionsRuinFaces]

Make sure you see cases just like yours. CW is much easier to do,  but can lead to chimpville if overdone.

Is there any way to improve tooth show on person with a flat occlusal plane without doing CW? I want to avoid the chimpface at all costs and Zarrinbal suggested CW to me.

[PloskoPlus]

Is there any way to improve tooth show on person with a flat occlusal plane without doing CW? I want to avoid the chimpface at all costs and Zarrinbal suggested CW to me.

If the lip is long, lip lift.

[ExtractionsRuinFaces]

If the lip is long, lip lift.

My philtrum is in the average range for males, somewhere between 15 and 16mm.

[boyo]

I got CW with substantial downgrafting for short face syndrom, and while i got the needed vertical length, my chin fell behind my lips in profile (because of the rotation) and i now need another bsso to bring it more forward. You correct one problem just to discover other shortcomings being revealed with increased bone projection.

If your zygos are weak pre-surgery, the chimplook in various degree is almost a given with forward lefort movement. You should then also plan for some kind of midface augmentation.

[deputy van halen]

I got CW with substantial downgrafting for short face syndrom, and while i got the needed vertical length, my chin fell behind my lips in profile (because of the rotation) and i now need another bsso to bring it more forward. You correct one problem just to discover other shortcomings being revealed with increased bone projection.

If your zygos are weak pre-surgery, the chimplook in various degree is almost a given with forward lefort movement. You should then also plan for some kind of midface augmentation.

Did you have surgery with him?  How much did your maxilla get moved down (that's what a downgraft is, right?) Did you need a bone graft? 

[deputy van halen]

Hello everyone,

I wondered if anyone has had surgery with him in Belgium?
I consulted with him yesterday in London.
He seemed ok, but what surprised me most was he says firstly I wouldn't need braces
Secondly he said there are never problems with the upper jaw in terms of numbness post op in his practice
Thirdly you can be back to eating hamburgers within a week after bimax
Also most his patients can be back to work in 2 weeks.
Also downgrafting with bone and plates is very stable, dismissed my concerns on this (relapse)

Anyway I wondered if anyone had met or had surgery with him? Thoughts?

I'm supposed to have surgery with him soon. 

He said I don't need braces either.  I just had mine off last year, but I still thought I would need them to decompensate the movements my orthodontist did to mask my malocclusion.  I think I need a bit of palate expansion because especially on the left side she had to flare out the top teeth/tip in the bottoms ones a bit and I'd rather have my teeth in a normal position.

With regards to the post op numbness, isn't that more of a lower jaw surgery thing? I'm not sure.

Hamburgers within a week--he didn't say that to me but yeah, I've never heard that before--don't most surgeons want you on liquids for like 4-6 weeks?

Back to work in two weeks--he actually told me I should take 3-4 weeks off but I can't; I plan on going back after 2 weeks.

Downgrafting is moving the maxilla down?  That's what I'm doing--he said it could be unstable and relapse but if I do a bone graft it should be okay.

[PloskoPlus]

I got CW with substantial downgrafting for short face syndrom, and while i got the needed vertical length, my chin fell behind my lips in profile (because of the rotation) and i now need another bsso to bring it more forward. You correct one problem just to discover other shortcomings being revealed with increased bone projection.

If your zygos are weak pre-surgery, the chimplook in various degree is almost a given with forward lefort movement. You should then also plan for some kind of midface augmentation.

Single jaw surgery for short face? First time I heard of this. How was your bite before and after surgery?

[UKMaxfac]

I'm supposed to have surgery with him soon. 

He said I don't need braces either.  I just had mine off last year, but I still thought I would need them to decompensate the movements my orthodontist did to mask my malocclusion.  I think I need a bit of palate expansion because especially on the left side she had to flare out the top teeth/tip in the bottoms ones a bit and I'd rather have my teeth in a normal position.

With regards to the post op numbness, isn't that more of a lower jaw surgery thing? I'm not sure.

Hamburgers within a week--he didn't say that to me but yeah, I've never heard that before--don't most surgeons want you on liquids for like 4-6 weeks?

Back to work in two weeks--he actually told me I should take 3-4 weeks off but I can't; I plan on going back after 2 weeks.

Downgrafting is moving the maxilla down?  That's what I'm doing--he said it could be unstable and relapse but if I do a bone graft it should be okay.

Maybe with me he was referring to just getting a lefort 1 by itself, hence why the recovery seemed easier. Or maybe it was lost in translation slightly...

So you are going ahead without the braces?

[kjohnt]

I got CW with substantial downgrafting for short face syndrom, and while i got the needed vertical length, my chin fell behind my lips in profile (because of the rotation) and i now need another bsso to bring it more forward. You correct one problem just to discover other shortcomings being revealed with increased bone projection...

Then it sounds like CW rotation was not indicated - you should have had an even downgraft resulting in no rotation.  That or less CW rotation than occurred.

Single jaw surgery for short face? First time I heard of this. How was your bite before and after surgery?

He said another BSSO so it sounds like it was bimax with bad planning.