WE need to TALK ABOUT CHEEKBONES

[kavan]

No if they synthesize jaw bone it will work perfectly. But whatever. I think right now only doing a double ZSO plust malar osteotomy/mfl3 is the best bet.

If it's synthesized, (bone matter with no blood supply in it) then I don't see how it would differ much from hydroxyappetite which is very close to human bone. Like why not just get an implant fabricated from hydroxyappatite.  What about using coral calcium (sea coral) that's very close to human bone for that matter. Anyway, what Wolf says is true. If it's your own bone, it's gotta be a bone sandwich; stuck between your own CUT bone. I realize the assumption with what Wolf said is that your own bone is that with a blood supply and can't just sit there on top of something without resorbing. But since your synthesized bone would also probably not have a blood supply and would probably be for all intents and purposes 'dead' (or not alive), why not consider fabrication with another bio-compatible material that's pretty close to bone.

[kavan]

OK back to this. Epibone says: [The technology at the heart of EpiBone is the bioreactor. Its task is essential and delicate: to mimic the finely calibrated conditions in the human body that enable bone to grow. Strong, living tissue can only form where the nourishment, temperature, movement, and pressure are just right. Our proprietary bioreactor technology is the product of 20 years of fundamental research and experience with orthopedic tissue engineering. Research has shown that cultivating human stem cells in an osteogenic scaffold in a bioreactor supports critical outcomes, including cell survival, differentiation, and maturation and deposition of bone matrix. This approach also restricts the development of unwanted cell lines. Bones that grow in a well designed bioreactor are ready to continue remodeling and vascularization once they’re transplanted into a patient. In the EpiBone bioreactor, we can grow a new, personalized bone in just three weeks.]

Now as far as VASCULARIZATION is concerned, vascularized bone does need to be between a bone cut as in a bone sandwich. Just not so sure these implants used as face bone overlays would stay there without resorbing....and what about the 'remodeling'. What if they remodel themselves to something you don't want on your face. Like what if they start growing bone spurs.

[Lazlo]

OK back to this. Epibone says: [The technology at the heart of EpiBone is the bioreactor. Its task is essential and delicate: to mimic the finely calibrated conditions in the human body that enable bone to grow. Strong, living tissue can only form where the nourishment, temperature, movement, and pressure are just right. Our proprietary bioreactor technology is the product of 20 years of fundamental research and experience with orthopedic tissue engineering. Research has shown that cultivating human stem cells in an osteogenic scaffold in a bioreactor supports critical outcomes, including cell survival, differentiation, and maturation and deposition of bone matrix. This approach also restricts the development of unwanted cell lines. Bones that grow in a well designed bioreactor are ready to continue remodeling and vascularization once they’re transplanted into a patient. In the EpiBone bioreactor, we can grow a new, personalized bone in just three weeks.]

Now as far as VASCULARIZATION is concerned, vascularized bone does need to be between a bone cut as in a bone sandwich. Just not so sure these implants used as face bone overlays would stay there without resorbing....and what about the 'remodeling'. What if they remodel themselves to something you don't want on your face. Like what if they start growing bone spurs.

Okay, I understand what we don't want. But it seems that if Epibone can do this that these would be the perfect graft. Hell they'd be fine even as Interpositional grafts.  I'm good with that. Coral and HA from what I can see look f**king artificial as hell. I mean what that freak Dr. Sailer does is slide in lypoholized cartilage (dead people's cartilage) into peoples faces by making an empty socket and slipping it in. That guy certainly creates some dramatic looking results but I don't think it really works.

Anyway, how can Epibone predict their product will produce bone like this in 3 weeks. I mean hvae they done it? Or are they just like, in our ideal world our bioreacter will do that? I'm assuming its the second, but then that just sounds like f**king wishful thinking.


I feel if Epibone can grow you a personalized bone graft (for interposition OR onlay) then it will work well for cosmetic surgery. Right? Am I right?

[kavan]

Okay, I understand what we don't want. But it seems that if Epibone can do this that these would be the perfect graft. Hell they'd be fine even as Interpositional grafts.  I'm good with that. Coral and HA from what I can see look f**king artificial as hell. I mean what that freak Dr. Sailer does is slide in lypoholized cartilage (dead people's cartilage) into peoples faces by making an empty socket and slipping it in. That guy certainly creates some dramatic looking results but I don't think it really works.

Anyway, how can Epibone predict their product will produce bone like this in 3 weeks. I mean hvae they done it? Or are they just like, in our ideal world our bioreacter will do that? I'm assuming its the second, but then that just sounds like f**king wishful thinking.


I feel if Epibone can grow you a personalized bone graft (for interposition OR onlay) then it will work well for cosmetic surgery. Right? Am I right?

Well, I tend to think it would not work as an onlay, re what Wolfe said.  Interposition sandwich it could work like for one of those 'chin wings' where the mandible is sliced, dropped and the hip bone is sandwiched in there or a genio that needs a bone butress between the cut sections.

I don't keep tabs on Epibone. They are looking for venture capital investors.  Dead people's cartilage is standard use in plastic surgery coral ha looks OK but it's limited to about less than 3mm augmentation onlay. It can look bad when docs try to EXCEED that. Also good for filling in dents and dingies.

[Lazlo]

Well, I tend to think it would not work as an onlay, re what Wolfe said.  Interposition sandwich it could work like for one of those 'chin wings' where the mandible is sliced, dropped and the hip bone is sandwiched in there or a genio that needs a bone butress between the cut sections.

I don't keep tabs on Epibone. They are looking for venture capital investors.  Dead people's cartilage is standard use in plastic surgery coral ha looks OK but it's limited to about less than 3mm augmentation onlay. It can look bad when docs try to EXCEED that. Also good for filling in dents and dingies.

yeah so basiclaly nothing. I think good docs know how to augment cheekbones with zygomatic sandwich osteotomy but i wonder why results are so inconsistent.

guys the thing is maybe you may not have enough "bulk" that pic of the guy who got buolk to his mandible and stuff with implants looks amazing. I just don't want synthetic implants. So ho hum waiting for someone to give us some visibles on this s**t.

[Lazlo]

So you go to any f**king PS or max fac or realself sight and research cheekbone augmentation or zygoma, malar etc. (without implants) and all you get is f**king radio silence.

I've seen one mention of Dr. Anthony S Wolfe. Dr. Sinn was unheard of till what's his name found him and even then b*tches he was the first guy to ever get that surgery --it was the first one Dr. SInn did and just sort of made up how to do it.


So what I'm saying is, except for the dude who get ZSO in Berlin (which by the way do f**k all for your cheekbones or your orbital rims so basically are useless) --NO BODY DOES ANYTHING IN A REGULAR PREDICTIBLE FASHION FOR CHEEKBONES. SO WE"RE f**kED. NOBODY FIXES THIS s**t. What I mean to say is there's no expertise in it either and so nobody does anythign regularly. I doubt Wolfe has done more than a handful. And guess what, Sinn has done only 2.

So why the f**k are you haters still believing this procedure is something that is possible or done?

[Lestat]

I think we should be grateful for what is possible today, even if it is not optimal. Kavan mentioned the chin wing operation in one of his comments earlier. For example, the first chin wing was first introduced less than 10 years ago and has now become established. I am grateful for this new invention. As far as the cheekbones are concerned, I just wanted to point out that costal cartilage may have the lowest risk of resorption of all autologous bone materials. In order to get more facial width and more pronounced cheekbones I would recommend two zso, for the orbital rim fat is the best option. For my part, I will not wait what the future holds for me, because afterwards you are only disappointed. LIFE IS NOW.

[Lazlo]

I think we should be grateful for what is possible today, even if it is not optimal. Kavan mentioned the chin wing operation in one of his comments earlier. For example, the first chin wing was first introduced less than 10 years ago and has now become established. I am grateful for this new invention. As far as the cheekbones are concerned, I just wanted to point out that costal cartilage may have the lowest risk of resorption of all autologous bone materials. In order to get more facial width and more pronounced cheekbones I would recommend two zso, for the orbital rim fat is the best option. For my part, I will not wait what the future holds for me, because afterwards you are only disappointed. LIFE IS NOW.

Yeah life is totally s**t now.

Honestly, I don't think the ZSO does s**t for cheekbones. Maybe just augments the width a little but I don't know, haven't seen enough results. Every person I know who has looked at Zarrinibal's before and afters says they're s**t. Can't see any difference.

[kavan]

So you go to any f**king PS or max fac or realself sight and research cheekbone augmentation or zygoma, malar etc. (without implants) and all you get is f**king radio silence.

I've seen one mention of Dr. Anthony S Wolfe. Dr. Sinn was unheard of till what's his name found him and even then b*tches he was the first guy to ever get that surgery --it was the first one Dr. SInn did and just sort of made up how to do it.


So what I'm saying is, except for the dude who get ZSO in Berlin (which by the way do f**k all for your cheekbones or your orbital rims so basically are useless) --NO BODY DOES ANYTHING IN A REGULAR PREDICTIBLE FASHION FOR CHEEKBONES. SO WE"RE f**kED. NOBODY FIXES THIS s**t. What I mean to say is there's no expertise in it either and so nobody does anythign regularly. I doubt Wolfe has done more than a handful. And guess what, Sinn has done only 2.

So why the f**k are you haters still believing this procedure is something that is possible or done?

Lazlo,

No consistency in an outcome ie. the OUTPUT can be expected when the INPUT varies greatly from individual to individual.

Think very very basic scientific high school chemistry experiment. For everyone to get the SAME result; such that the OUTCOMES of the experiment are CONSISTANT, the same chemicals, amount of them, mixture of them, time on bunson burner etc have to be used.

In terms of  very very basic scientific thought, one would not even EXPECT 'consistency' regarding the aesthetic outcomes of different individuals getting the same aesthetic procedure where the inputs had so much variance. The expectation would be INCONSISTENCY.

The output (results) would be 'inconsistent' because the input (start point) will vary from person to person. In terms of VARIANCE of facial bone structure, EXTERNAL facial bones that also make up part of the INTERNAL eye orbit vary the MOST and BECAUSE external facial structure is CONTINGENT on the growth direction going on in the INTERNAL orbit, one can't expect 'consistency' regarding an external aesthetic result. Since the zygomatic bone is part of the INTERNAL eye orbit, it's EXTERNAL orientation will be a FUNCTION of it's INTERNAL orientation. Not only that, it's connected to other facial bones in the internal orbit, eg. maxilla, frontal where the maxilla is is the most complex facial bone in terms of shape and also shape variance from person to person.

In a bone cutting cheek procedure or even one with implants the displacements will be made to the EXTERNAL part of the bone. So, the changes you see with the procedure will be relative to the INTERNAL eye socket; the bone orientation within. If the bone growth directions and orientation within the INTERNAL eye socket 'are what they are', the EXTERNAL outcome will be 'what it is'.

[Lazlo]

Lazlo,

No consistency in an outcome ie. the OUTPUT can be expected when the INPUT varies greatly from individual to individual.

Think very very basic scientific high school chemistry experiment. For everyone to get the SAME result; such that the OUTCOMES of the experiment are CONSISTANT, the same chemicals, amount of them, mixture of them, time on bunson burner etc have to be used.

In terms of  very very basic scientific thought, one would not even EXPECT 'consistency' regarding the aesthetic outcomes of different individuals getting the same aesthetic procedure where the inputs had so much variance. The expectation would be INCONSISTENCY.

The output (results) would be 'inconsistent' because the input (start point) will vary from person to person. In terms of VARIANCE of facial bone structure, EXTERNAL facial bones that also make up part of the INTERNAL eye orbit vary the MOST and BECAUSE external facial structure is CONTINGENT on the growth direction going on in the INTERNAL orbit, one can't expect 'consistency' regarding an external aesthetic result. Since the zygomatic bone is part of the INTERNAL eye orbit, it's EXTERNAL orientation will be a FUNCTION of it's INTERNAL orientation. Not only that, it's connected to other facial bones in the internal orbit, eg. maxilla, frontal where the maxilla is is the most complex facial bone in terms of shape and also shape variance from person to person.

In a bone cutting cheek procedure or even one with implants the displacements will be made to the EXTERNAL part of the bone. So, the changes you see with the procedure will be relative to the INTERNAL eye socket; the bone orientation within. If the bone growth directions and orientation within the INTERNAL eye socket 'are what they are', the EXTERNAL outcome will be 'what it is'.

Yes but even factoring for the inconsistency of the inputs the results of ZSO's are underwhelming. Every result I've seen and I've seen several now, have provided minimal change.

[Wheatsnax]

this chap got lateral growth all over from his MARPE

[kavan]

Yes but even factoring for the inconsistency of the inputs the results of ZSO's are underwhelming. Every result I've seen and I've seen several now, have provided minimal change.

It's hard to compensate for the bone growth orientation of the INTERNAL ORBIT when it's actually the orientation in THERE that people try to compensate for via surgeries to the outer orbit or peri-orbital area such as the cheek bones. So, no surprise to me that a lot of these types of surgeries don't give an impressive 'WOW!' factor.

[Lazlo]

this chap got lateral growth all over from his MARPE

This makes me want to break down and cry. This is what i should have gotten instead of bloody extractions. That's basically what ruined my life.

[Lazlo]

this chap got lateral growth all over from his MARPE

f**k it even caused amazing forward facial growth. I was supposed to have that f**king bastards.

[Lazlo]

It's hard to compensate for the bone growth orientation of the INTERNAL ORBIT when it's actually the orientation in THERE that people try to compensate for via surgeries to the outer orbit or peri-orbital area such as the cheek bones. So, no surprise to me that a lot of these types of surgeries don't give an impressive 'WOW!' factor.

Could you explain this a little further please. Are you basically saying that the problem is the distance between the orbits i.e. that the person needs to widen the orbits via something like orbital box surgery before they can really see a solid result?