Could I have surgery first any recommendations of doctors who use this approach

[Surgeryfirst]

I have had braces to correct a slight underbite when I was younger
I now have a edge to edge bite
However
My profile and bone structure looks like I have a underbite
Small and back maxillary
Larger mandilla
Flat cheeks and a droopy nose
I assume my nose drops more then it would if the maxillary was more forward to support it
I have had a consultation with Prof Raffini
He said to correct the bone structure
He would advice
A set of orthodontics to create a underbite in my teeth position
Then do surgery
My teeth are straight
However the top have been pushed forward to mask the underbite
That if he done surgery without orthodontics
I would have a my bone structure corrected then my bite of
I have read that it's possible to do surgery first
Then use orthodontics
Could anyone recommend a maxillofacial surgeon
In Europe that could do that
I have seen also paranasal implants
In what I feel could improve my bone structure 
Could anyone recommend some where in Europe that can do that
I have searched the uk
I spoke with mr Paul Johnsons secretary
She said if I come for a consultation
He could see if surgery first was an option
Has anyone else had or read someone who has a similar case
I have a online face to face consultation with prof sailer from Sweden this week
I have also contacted the maxillofacialinsitution Brussels
They have asked me to mail some moles over
Could anyone give me some reviews on these surgeons

[kavan]

Surgery first is good for people with underbite. But they still have to check whether you are a candidate for the braces to prep for it or if you can get them after the surgery.

Underbites are often associated with a retrusive upper jaw for which Lefort 1 to advance forward is needed. The forward advancement of the L1 also brings forward the PARANASAL area. So you would NOT need paranasal implants if you were getting a Lefort 1 which would be part of the maxfax surgery you would be getting, whether or not it was surgery first or surgery after braces.

[girl]

Your post is written in stanzas like a poem. I kind of read it as one.

Paul Johnson has varied feedback here i.e. largely not great. Do you have any photos? Did Sailer recommend anything specific?

[Dogmatix]

I can not in any way recommend any surgeon or know if you're a candidate. But I know that Hernandez-Alfaro advertise to be able to use SF where applicable.

[CCW]

Alfaro is good for surgery first, but I wouldn't recommend doing surgery first unless you have bad sleep apnea. You'll get a better result both aesthetically and functionally doing it the usual way.

[andyb]

I can advice you that you need braces before surgery for sure. they need them so you can fix the bands to and also keep the jaws in correct position post medical procedure.
I had braces on for about 7 weeks before the operation date, and it was fine.
Now I have a splint and bands for 2 months, then they will be removed 8 weeks after the operation.

I can fully recommend Dr Hernandez Alfaro at the Instituto maxillofacial,  Teknon hospital in Barcelona.

This is the guy, he can perform the best surgery in Europe for sure. maybe the best place in the world. 

He also does nasal adjustment / reconstruction part of the operation, but make sure you say at consultation that your not happy with it and you want it corrected and he will do the best possible adjustments required (within reason) I think from reading many threads and posts on this forum it sounds to me that people either don't say, forget or to scared to ask or tell what they want.


in my case I had a problem breathing all my life, and he do straighten the inside and clean out any obstruction so I can now breath through both nostrils for the first time in my life. 

I can only recommend from my own experience, I don't know this other guy or other doctors you list.
one thing I can say is forget the UK, they are time wasting and can't or wont do the surgery to the level of professionalism that Spain can offer.  I started out in the UK they wasted over 6 months of my life. I am so so glad I went to Barcelona,

and last thing never forget about the golden rule, you usually get what you pay for. therefore a cheap option is not always the best option.
 In Barcelona they basically do 2 operations in one. its not nice for the first week on liquid after but everyone has to go through the first week of recovery.


stay fit and strong, if your not already I recommend you eat / drink healthy and train in sports it will help your recovery.

[dvfan]

Alfaro is worth consulting with at least.

[underbite68]

I just got back from Colombia after having surgery by Dr. Carlos Villegas Bateman at Vibart Clinic in Medellin for my underbite. I'm 5 weeks post op after having a 2-piece Lefort 1 osteotomy with maxillary advancement and downgraft (8mm). No work done to my lower jaw.  I am happy to say I'm doing great and I am very pleased with the functional and aesthetic results.  I researched him quite a bit and actually traveled to Colombia back in August to meet him and see what he was all about.  The main reason I was attracted to him was because I wanted to do the Surgery First Approach as opposed to the conventional method here in the States.  I'm following up with my post op orthodontic care in Connecticut with an orthodontist referred to me by Dr. Villegas and just had my second visit. He thinks my braces may be able to come off in one year, which is fine by me.  I still have one more week to go before I can actually start chewing again, but my maxilla feels pretty solid and fused at this point.  I had very little pain and swelling, just a black and blue neck for about 2 weeks.