Author Topic: Seriously considering Modified Le Fort III  (Read 8847 times)

beyondconfusedtbh

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Seriously considering Modified Le Fort III
« on: June 12, 2018, 12:39:23 PM »
Hi everyone,

I've been lurking a while but this is my first post so go easy on me lol.

So not long after finding this forum I read earl's story about how he got modified lefort iii to advance his orbitals (and cheekbones?)

I though that the orbital area was a no go and that I should just leave it and focus on my jaw (i've been in touch with Dr. Z regarding chin wing and BSSO procedures) but after finding that post I felt like my prayers had been answered.

So now i'm seriously considering having a mlf3 with Dr. S, my only issue is that there is so little information (anecdotal or otherwise) about it.

My main questions are:

1) Is there chance of relapse? (stupid q maybe but im paranoid lmao)
2) Are there long term side effects?
3) Is it actually worth it lol (ie will it improve my orbitals)

If anyone has spoken to Earl or anyone that has had this procedure done, I'd be grateful if you could shed some light on the matter.

This site has helped me tremendously, so kudos to all of you.
 
« Last Edit: June 12, 2018, 01:22:27 PM by beyondconfusedtbh »

beyondconfusedtbh

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Re: Seriously considering Modified Le Fort III
« Reply #1 on: June 12, 2018, 01:23:57 PM »
also, in peoples opinions is Dr Ob. superior to Dr S. in this regard?

kavan

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Re: Seriously considering Modified Le Fort III
« Reply #2 on: June 12, 2018, 03:29:54 PM »
Ever since Earl's story, so many people come here wanting to be SPOON FED info about L3s and various permutations of 'modified' L3's.

Earl's real story is that he did research ON HIS OWN (medical journals), knew exactly what he wanted and WHY and had a very strong preference in favor of bone cuts over orbital rim implants and of course had the prominent eyes (bug eyes). I think he took a few years of lots of research into the medical papers and consulting around based on the knowledge he ACQUIRED on HIS OWN to cross reference with a good handful of doctors he traveled far to consult with and subsequently chose the doctor he chose.

So NONE of this stuff was handed to him on a platter (or spoon fed) on here as is the case of most of the people coming to JSF looking to be spoon fed info on L3s and various modifications thereof. In fact, a few people who just blindly fell into Earl's doctor's lap 'because Earl did it' could not have possibly been as well prepared as he was in terms of IDing themselves as ideal candidates for orbital rim area advancements this way because they didn't get the extent of improvement he got.

There is ample info out there on L3s and modifications thereof. But finding requires RESEARCH ABILITIES in addition to having the salient anatomy underbelt and ability to 'digest' medical articles and/or a long time to increase knowledge that way as to 'digest' conceptual material.

In essence Earl had the ability to FIND information on this (appropriate med journals) on HIS OWN and to PROCESS it in ACCORDANCE to his aesthetic situation and had all that UNDERBELT when he consulted with a variety of doctors. Also, he knew enought to pursue that surgery AFTER he got his jaw situation in balance.

Seriously, a LOT of the people flying in here wanting to know about L3s have acquired jacks**t info on their own, need to be spoon fed and demonstrate very little capacity to process information. Any doctor you consult with won't be spoon feeding it either and acquisition of knowledge, ON YOUR OWN (like Earl did) will be needed to increase the level of info you get from any consult you go on. That said, be careful about riding on someone else's coat tails for esoteric surgeries like chin wings and L3s . I find that people who are successful with the more esoteric surgeries are good researchers and good at processing complex information and don't need mother bird to chew up and spit out the worm for them.

That said, my policy on 'spoon feeding' is I will sometimes do it for people having a hard time with some of the JAW BALANCE relationships (Lefort1, BSSO and genio) but NOT for the L3s. This is because people coming to a JAW SURGERY forum demonstrate some to enough understanding of jaw to jaw relationships to fill in some of the blanks they have. But about 90-95% of those coming here wanting to know about L3s (or think they need them) are just TOO FULL of BLANKS to fill in for them.

Hence, my policy is for people wanting what Earl had is to BE LIKE EARL and do their own research as he did. Then come back with some demonstration of knowledge in that regard and only a FEW blanks needed to be filled in. Of course, my policy on this does not preclude others who want to tell you all about L3s in the absence of even seeing what you look like.
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Lazlo

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Re: Seriously considering Modified Le Fort III
« Reply #3 on: June 12, 2018, 04:47:33 PM »
Listen Dr. Sinn does something for the under orbitals. It just is a "meh" like I'd say its an improvement, but not as much as you'd think. I'm more interested in knowing what Dr. Anthony S Wolfe might be able to do with his "malar osteotomy"

beyondconfusedtbh

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Re: Seriously considering Modified Le Fort III
« Reply #4 on: June 12, 2018, 04:59:38 PM »
Ever since Earl's story, so many people come here wanting to be SPOON FED info about L3s and various permutations of 'modified' L3's.

Earl's real story is that he did research ON HIS OWN (medical journals), knew exactly what he wanted and WHY and had a very strong preference in favor of bone cuts over orbital rim implants and of course had the prominent eyes (bug eyes). I think he took a few years of lots of research into the medical papers and consulting around based on the knowledge he ACQUIRED on HIS OWN to cross reference with a good handful of doctors he traveled far to consult with and subsequently chose the doctor he chose.

So NONE of this stuff was handed to him on a platter (or spoon fed) on here as is the case of most of the people coming to JSF looking to be spoon fed info on L3s and various modifications thereof. In fact, a few people who just blindly fell into Earl's doctor's lap 'because Earl did it' could not have possibly been as well prepared as he was in terms of IDing themselves as ideal candidates for orbital rim area advancements this way because they didn't get the extent of improvement he got.

There is ample info out there on L3s and modifications thereof. But finding requires RESEARCH ABILITIES in addition to having the salient anatomy underbelt and ability to 'digest' medical articles and/or a long time to increase knowledge that way as to 'digest' conceptual material.

In essence Earl had the ability to FIND information on this (appropriate med journals) on HIS OWN and to PROCESS it in ACCORDANCE to his aesthetic situation and had all that UNDERBELT when he consulted with a variety of doctors. Also, he knew enought to pursue that surgery AFTER he got his jaw situation in balance.

Seriously, a LOT of the people flying in here wanting to know about L3s have acquired jacks**t info on their own, need to be spoon fed and demonstrate very little capacity to process information. Any doctor you consult with won't be spoon feeding it either and acquisition of knowledge, ON YOUR OWN (like Earl did) will be needed to increase the level of info you get from any consult you go on. That said, be careful about riding on someone else's coat tails for esoteric surgeries like chin wings and L3s . I find that people who are successful with the more esoteric surgeries are good researchers and good at processing complex information and don't need mother bird to chew up and spit out the worm for them.

That said, my policy on 'spoon feeding' is I will sometimes do it for people having a hard time with some of the JAW BALANCE relationships (Lefort1, BSSO and genio) but NOT for the L3s. This is because people coming to a JAW SURGERY forum demonstrate some to enough understanding of jaw to jaw relationships to fill in some of the blanks they have. But about 90-95% of those coming here wanting to know about L3s (or think they need them) are just TOO FULL of BLANKS to fill in for them.

Hence, my policy is for people wanting what Earl had is to BE LIKE EARL and do their own research as he did. Then come back with some demonstration of knowledge in that regard and only a FEW blanks needed to be filled in. Of course, my policy on this does not preclude others who want to tell you all about L3s in the absence of even seeing what you look like.

I was reading your replies to some other similar posts and realised that you'd respond with something like this.

To be honest I don't have a smart rebuttal or anything. Earl's story definitely had me excited so perhaps I rushed in. Apologies.

That said, thanks for taking the time to formulate such an apt response.

beyondconfusedtbh

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Re: Seriously considering Modified Le Fort III
« Reply #5 on: June 12, 2018, 05:37:25 PM »
Listen Dr. Sinn does something for the under orbitals. It just is a "meh" like I'd say its an improvement, but not as much as you'd think. I'm more interested in knowing what Dr. Anthony S Wolfe might be able to do with his "malar osteotomy"

Interesting, his website gives very little information regarding it though.

edit: yeah a 'meh' result was pretty much my primary concern considering how scary the procedure sounded

kavan

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Re: Seriously considering Modified Le Fort III
« Reply #6 on: June 12, 2018, 08:52:53 PM »
I was reading your replies to some other similar posts and realised that you'd respond with something like this.

To be honest I don't have a smart rebuttal or anything. Earl's story definitely had me excited so perhaps I rushed in. Apologies.

That said, thanks for taking the time to formulate such an apt response.

LOL. Glad to hear you were braced for it.
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beyondconfusedtbh

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Re: Seriously considering Modified Le Fort III
« Reply #7 on: June 14, 2018, 11:51:11 AM »
Listen Dr. Sinn does something for the under orbitals. It just is a "meh" like I'd say its an improvement, but not as much as you'd think. I'm more interested in knowing what Dr. Anthony S Wolfe might be able to do with his "malar osteotomy"

what are your thoughts on Pelo? He does malar osteotomies too & seems experienced from the videos & B/A i've seen. Theres a thread on here with some i think.

PloskoPlus

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Re: Seriously considering Modified Le Fort III
« Reply #8 on: June 15, 2018, 03:59:11 AM »
what are your thoughts on Pelo? He does malar osteotomies too & seems experienced from the videos & B/A i've seen. Theres a thread on here with some i think.
No, he's s**t.

jawguy123

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Re: Seriously considering Modified Le Fort III
« Reply #9 on: June 15, 2018, 06:32:54 PM »
Why wouldn't you just get implants? I don't know much about the mLF3, but I really don't understand its appeal...

PloskoPlus

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Re: Seriously considering Modified Le Fort III
« Reply #10 on: June 15, 2018, 06:49:19 PM »
Why wouldn't you just get implants? I don't know much about the mLF3, but I really don't understand its appeal...
Because a terrible end is better than terror without end.  Implants can get infected decades after surgery and medpor can be impossible to remove.

jawguy123

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Re: Seriously considering Modified Le Fort III
« Reply #11 on: June 15, 2018, 07:23:58 PM »
According to https://www.dryaremchuk.com/blog/complications-and-toxicities-of-implantable-biomaterials-used-in-facial-reconstructive-and-aesthetic-surgery-a-comprehensive-review-of-the-literature/, in a study of 617 patients, malar implant infection rate was around 2.4%.

Because a terrible end is better than terror without end. Implants can get infected decades after surgery

In which case they'll have to be removed? I really don't think the fear of infection (requiring implant removal), which is a pretty low rate anyway, should constitute "terror without end."

On the other hand, mLF3 risks include blindness (or other vision problems), a much higher rate of other major complications, etc. Not to mention it is very difficult (if even possible) to revise. Not to mention that relapse could still be an issue.

Also, it seems hypocritical to criticize implants because of the very low risk of infection decades later when we don't even know the long term risks / complications of mLF3 due to the severe paucity of data (since there are very few non-syndromic patients who would opt for this procedure). I don't even know if there's enough data to study the complication rates of mLF3 short term.

ditterbo

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Re: Seriously considering Modified Le Fort III
« Reply #12 on: June 15, 2018, 07:58:52 PM »
With an infection, you remove the implant, wait a year or however many months for healing, and then you can go back in with another implant if you so choose. if it happens decades later, then maybe something less risky will be out by then as a better substitute than what you had in before. meh.

PloskoPlus

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Re: Seriously considering Modified Le Fort III
« Reply #13 on: June 15, 2018, 08:05:46 PM »
With an infection, you remove the implant, wait a year or however many months for healing, and then you can go back in with another implant if you so choose. if it happens decades later, then maybe something less risky will be out by then as a better substitute than what you had in before. meh.
I've heard horror stories about medpor being impossible to remove. Although maxillofacial surgeons said it was a piece of cake.

jawguy123

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Re: Seriously considering Modified Le Fort III
« Reply #14 on: June 15, 2018, 08:29:44 PM »
With an infection, you remove the implant, wait a year or however many months for healing, and then you can go back in with another implant if you so choose. if it happens decades later, then maybe something less risky will be out by then as a better substitute than what you had in before. meh.

It is meh, but IMO the complication of having to remove the implant pales in comparison to the complications of mLF3.

I've heard horror stories about medpor being impossible to remove. Although maxillofacial surgeons said it was a piece of cake.

Same here. What's wrong with silicone, especially in the malar/infraorbital area (where bone resorption -- barring extremely rare cases -- shouldn't really cause any issues)?