Conflicting views

[CCW]

Do you live in the US? Get another opinion from Gunson.

[kavan]

Dr DF said it would make the face less round. I'm not expecting the soft tissue to be thinner but if the face is longer and more balanced it would make my face look better and would be a good compromise in my eye.
 The face may still have fat (mainly the result of dr g fat transfer) but my face may carry it better.

Can you explain to me what kind of 'down graft' he's proposing for you. Posterior downgraft or over all downgraft to give MORE tooth show.

[ITALIA]

Can you explain to me what kind of 'down graft' he's proposing for you. Posterior downgraft or over all downgraft to give MORE tooth show.

He did refer to lack of tooth show so I'm presuming anterior downgrafting as he said there would be some cw rotation.

I have pasted what he emailed me.

((The proposal is a bimax

—Lefort I canting and extrusion with some advancement. Eventually we will need a modest bone graft for this.

---Since there is a canting we need to adapt the lower jaw to it. BSSO slight advancement + canting.

PS : The canting will eliminate for a great deal the lower border asymmetry))

[kavan]

He did refer to lack of tooth show so I'm presuming anterior downgrafting as he said there would be some cw rotation.

I have pasted what he emailed me.

((The proposal is a bimax

—Lefort I canting and extrusion with some advancement. Eventually we will need a modest bone graft for this.

---Since there is a canting we need to adapt the lower jaw to it. BSSO slight advancement + canting.

PS : The canting will eliminate for a great deal the lower border asymmetry))

IDK. It doesn't sound like it's going to do much for you.

[Lazlo]

IDK. It doesn't sound like it's going to do much for you.

seriously what a waste of time. you really think this is gonna not only make you better looking but fix all your related problems too?

I'll tell you what, why don't you just pay the money you would spend on jaw surgery and hire me to teach you how to stop giving off weird vibes and talking to women.

[kavan]

Your presumption tells us it is NOT posterior downgrafting but rather a type of down grafting to show more upper teeth.

I will make some assumptions here too and draw my conclusions from them. In that way, YOU will know if my assumptions are correct in order to compare them to my conclusions.

ASSUMPTIONS:

I'm assuming your major complaint was NOT lack of tooth show and that you did NOT go in there saying something like: 'When I smile, NONE of my upper teeth show'.

I'm assuming your major complaint was NOT lower border asymmetry of the mandible NOR any canting of the maxilla. Basically that the asymmetry there was NOT a major issue for you.

I'm assuming BASICALLY, that lack of upper teeth show and canting of the maxilla and also canting of the mandible were NOT your MAJOR complaints when you consulted with him.

CONCLUSIONS:

The extent of a down graft to the maxilla whether it be an entire one to the whole of it or just an anterior down graft where BOTH could be used for MORE TOOTH SHOW, can only be as much as the LACK of tooth show. So if YOU did not go in there with major complaint of lack of tooth show and HE brought THAT to your attention, this 'lack of tooth show' would be MINOR and therefore MUCH LESS than that would be needed to distribute your soft tissue so your face looked MUCH LESS round to you. So, if the lack of tooth show was INSIGNIFICANT enough for YOU not to notice it or even have it as a complaint, the amount of 'extra face space' to distribute your soft tissues so all looks SIGNIFICANTLY LESS round to you will be as INSIGNIFICANT as the lack of tooth show you never noticed.

Usually, when a doc wants to cant the maxilla, it's because it's the maxilla cant that's responsible for some canting to the mandible. So canting of JUST ONE is all that is needed. So, his canting of the maxilla does NOT auto fix any cant to the mandible and just results in his needing to ALSO cant the mandible BECAUSE he cants the maxilla and all this is just going to result in some MINOR advancement of the lowerjaw.

Hence, I would conclude this surgery was being proposed to you based on HIS objectives where he may have found some 'employment opportunities' in your face that were NOT your MAJOR CONCERNS.
Therefore, IMO, you would be getting a surgery to address HIS findings which are MINOR and this surgery would tend to do very little for you with reference to YOUR reasons for getting it.


In terms of the major differences in opinion of Alfaro and him. They both see 'BACCALA'.
Alfaro, sets you straight and the other one looks for employment opportunities for himself.

[ITALIA]

^^^^

Your assumptions are correct up to a point. I should say I agree with some parts of what he says regarding my face being too short. Wouldn't a lack of tooth show be indicative of this?

Also, from reading an other email, he says my upper jaw is shifted  to the right and lower jaw to the left which would be corrected and also  one side of my face was longer  than the other.  My own surgeon said this and tried to mitigate it with all the surgeries.

But as I understand it you think I would be wasting my time?   I hope Dr DF isn't using me as an employee opportunity, I mean who would that, especially with the type of surgery involved.
I just know I need to do something.

Anyway.. thanks for all your help.



 

[ITALIA]

seriously what a waste of time. you really think this is gonna not only make you better looking but fix all your related problems too?

I'll tell you what, why don't you just pay the money you would spend on jaw surgery and hire me to teach you how to stop giving off weird vibes and talking to women.

I really don't know what to do !? 

[ditterbo]

seriously what a waste of time. you really think this is gonna not only make you better looking but fix all your related problems too?

I'll tell you what, why don't you just pay the money you would spend on jaw surgery and hire me to teach you how to stop giving off weird vibes and talking to women.

I hope life coaches, dating coaches etc. get an industry certification and become health insurance eligible some time in the next 5-10 years. I'd pay for one if they didn't cost a small fortune. Psychologists are pretty useless where practical experience is lacking. Healthy mind, healthy life, especially for the newest generation of kids who are most detached socially with all the technology distractions from face to face interaction. Kids that stay socially awkward in adulthood, not making babies because they can't form deep relationships hurts society in the long term kind of how physical ailments can kill people off before sexual maturity.   Hope we don't go the route of Japan and sell toy dolls and digi-girls for companionship.

[kavan]

^^^^

Your assumptions are correct up to a point. I should say I agree with some parts of what he says regarding my face being too short. Wouldn't a lack of tooth show be indicative of this?

Also, from reading an other email, he says my upper jaw is shifted  to the right and lower jaw to the left which would be corrected and also  one side of my face was longer  than the other.  My own surgeon said this and tried to mitigate it with all the surgeries.

But as I understand it you think I would be wasting my time?   I hope Dr DF isn't using me as an employee opportunity, I mean who would that, especially with the type of surgery involved.
I just know I need to do something.

Anyway.. thanks for all your help.

Well, of course you agree with your face too short. lol due to the roundness. But you are not going to have as much lack of tooth show as the increase in vertical dimension that you WANT for the 'face space'. There will be a LIMIT in how much he can drop down your upper jaw for that. That's what I'm saying. I'm also saying that IF it was not YOU, yourself who went in there with a complaint of asymmetry, but rather HIM who found some, this surgery is unlikely to give you the ALL the face space you want to distribute your roundness.

[ITALIA]

Well, of course you agree with your face too short. lol due to the roundness. But you are not going to have as much lack of tooth show as the increase in vertical dimension that you WANT for the 'face space'. There will be a LIMIT in how much he can drop down your upper jaw for that. That's what I'm saying. I'm also saying that IF it was not YOU, yourself who went in there with a complaint of asymmetry, but rather HIM who found some, this surgery is unlikely to give you the ALL the face space you want to distribute your roundness.

I see alot of asymmetry, some genetic but also down to fat transfer and cheek implants moving from Dr G.

With the maxfax I need to determine whether the pain is worth it or I may need to look at other options.

[ITALIA]

You say definitely no suicide, as your earnings can allow you to remain in an inertia-like state and continue to entertain "options" whilst you stall...

You know, I think your biggest issue is one of conviction. You can either decide to adjust whatever you see fit and commit to that, seeing it through until the bitter end, or you can make peace with your face and challenge yourself to move forward. The options you feel you're giving yourself are in fact barriers you've constructed to protect yourself from these hangups becoming realities. Thus, you are able to avoid doing things that might affirm your fears concerning women, etc.

Unfortunately shy people can sometimes come across as unfriendly. There will literally be no other reason for colleagues, who see you every day, to look at you strangely.

I understand your point regarding ' conviction' but I don't want to rush any decision. I did that with my fat transfer. Also surgery costs a ton of money. I've spent over 30k .   What ever I do next will be it.

[uj]

Both of their aesthetics can be really off sometimes. DF veers between recommending aggressive solutions when they're not needed, and minimal solutions when aggressive ones are needed. Alfaro's results can be overdone or neglect essential parts. He also seems to focus on the overbite/underbite market more than the downgrafting one, whereas that's DF's speciality.

The truth lies somewhere in between. You are very handsome with a very slightly short midface. Thus not "perfect" but still better looking than 90%>.

The real question is, how much does it eat away at you and are you absolutely dead set on doing this?

You're not the first handsome guy who's used jaw surgery to tweak their looks but the stakes are high when you aren't unattractive.

I would see a third doctor, perhaps someone who will be open to a more simple downgraft without adding on unneeded extras. Then at least you can make an informed decision. Raffaini might be your man as he offered similar to an attractive young woman here.

Does anyone know of any cases where he downgrafted? (Large enough movements to necessitate grafts)

It's also possible that he doesn't downgraft (though it's unclear where DF is proposing to do this), and therefore can't help you. Normally I think he is receptive to aesthetically-motivated patients. (You have asymmetry and canting, and he told me "models" with less asymmetry than I had have surgery with him.)

If I were you I'd consult with (an)other surgeon(s) who you know downgraft/have executed plans similar to what DF recommended. I'd be interested to hear what the other doctors say. Good luck ITALIA 

[ITALIA]

Do you live in the US? Get another opinion from Gunson.

I've been told you need a referral to get an appointment.

[haven]

I've been told you need a referral to get an appointment.

Yee. You need a referral from a doctor (ortho, dentist or something similar). I had an old referral letter for something and just changed the dates to something more recent since they told me it needs to be within the last 6 months. The question you have to ask yourself is what will you do if someone like him says he wont operate despite your self proclaimed "flaws'. Even with most people that post on here that have some form of recession don't look legit deformed or bad in my eyes.