Re: Dr Hernandez Alfaro

[jawsandsleep]

Jesus, so hard to make a decision. I went through the pictures of Alfaro and agree that most results just look okayish.
Gunsons pics look consistently great...

[Ramalito]

Gunson was at the top of my list but my insurance covers every country in the world except for the US, so in my case I would have to pay the cost of the surgery + the hospital stay which is supposed to be crazy expensive. I’m still meeting with him just in case.

I’ve been finding comments in Spanish on YouTube and blogs about Alfaro that worry me.
So here https://www.kukumiku.com/proyectos/ayuda-operacion-ortognatica-bimaxilar/#comment-187 the first comment says: “The only thing that I can tell you as advice is to look for another surgeon, I had surgery with him and after four years I have to get a revision to fix what he did. Besides my current surgeon told me after seeing me that he (Alfaro) didn’t need to touch even half of the things he touched. Seriously, ask for more opinions.”

This YouTube video has very negative comments talking about suing the doctor. https://m.youtube.com/watch?v=wWT7KioE56g

There are a lot of positive reviews as well and most surgeons are going to have unhappy patients, but can’t say this doesn’t scare me.




 

[Dogmatix]

Gunson was at the top of my list but my insurance covers every country in the world except for the US, so in my case I would have to pay the cost of the surgery + the hospital stay which is supposed to be crazy expensive. I’m still meeting with him just in case.

I’ve been finding comments in Spanish on YouTube and blogs about Alfaro that worry me.
So here https://www.kukumiku.com/proyectos/ayuda-operacion-ortognatica-bimaxilar/#comment-187 the first comment says: “The only thing that I can tell you as advice is to look for another surgeon, I had surgery with him and after four years I have to get a revision to fix what he did. Besides my current surgeon told me after seeing me that he (Alfaro) didn’t need to touch even half of the things he touched. Seriously, ask for more opinions.”

This YouTube video has very negative comments talking about suing the doctor. https://m.youtube.com/watch?v=wWT7KioE56g

There are a lot of positive reviews as well and most surgeons are going to have unhappy patients, but can’t say this doesn’t scare me.

Agree, it's scary to read such reviews. Unfortunately they're not too elaborate on what has actually happened. Would be interesting to know if they think the plan itself was bad, or that something else than the plan was executed etc.

It's probably true that he didn't have to touch half of what he did. The necessity of a jaw surgery is probably just a single jaw surgery in most cases to fix the bite. But for aesthetic best result a double jaw surgery may be done any way. I don't think Gunson "have" to mess with all the stuff he does either. It's also hard to know why the other surgeon says like he does, sometimes it can be like when you take in a handyman to your home, you can be d*mn sure they'll complain about the previous work.

But yes, I agree, this is something that makes you think twice. I've talked to a patient on the forum who wasn't happy with the procedure, but just as the cases above, there was no pictures so it was hard to evaluate objectively.

[Dogmatix]

most surgeons are going to have unhappy patients

This is somewhat true. Jaw surgery isn't magic, there is only so much you can do. The key to having happy patients is having them fully informed about what you are going to do, what you can achieve and how you handle if they're unhappy after. I think many cases of unhappy patient is due to lack of communication.

[Ramalito]

It's probably true that he didn't have to touch half of what he did. The necessity of a jaw surgery is probably just a single jaw surgery in most cases to fix the bite. But for aesthetic best result a double jaw surgery may be done any way

I thought the same thing when I read that part. He didn’t specify why he needed a revision either. Like you said, it’s hard to evaluate objectively without photos/info.

Why doesn’t Alfaro have a profile on Realself.com? He’s so good at marketing himself.

[beautyislife]

Do you guys think it's worth seeing Alfaro for a consultation?

[CCW]

Do you guys think it's worth seeing Alfaro for a consultation?

Sure if you're in Europe. Him and Raffaini are the ones I'd consider.

[jawsandsleep]

Sure if you're in Europe. Him and Raffaini are the ones I'd consider.

How about Birbe?
And is there anyone else that doesn't usually get mentioned?

The results of Raffaini are beyond believable, but there are some mixed opinions on this board and his website is not in English. Is it worth going with him, compared to Alfaro?

[Ramalito]

I think Birbe is worth seeing too. He’s the president of the Maxillofacial and Oral surgery society in Catalonia (region in Northeastern Spain, includes Barcelona). From what I’ve read online (Spanish posters) well regarded orthodontists in Spain usually recommend Birbe or Alfaro.

[jawsandsleep]

I have been going through all pictures of R, A, Z and G. And honestly, I am starting to think that Alfaro might not be a good choice for me. He has many cases posted on his website and most of them end up somewhat mediocre. He does some incredible mandible movement, but his patients with retruded maxilla don't really get much movement. Many don't change in looks at all and one case actually ends up looking much worse. Lefort I advancement if done right can improve looks so much.

R pictures are outstanding, but I haven't seen a single user on here actually getting surgery with him. He focuses a lot on aesthetics and I am wondering what kind of techniques he uses to modify the jaw bones. I would place Z somewhat similar to R. Z also dares to advance the maxilla to a point where a rhinoplasty is obligatory. He cares a lot about looks. Also chin wing allows both shaving and expanding of the jaw.
I really like Alfaros marketing and everything, but there are only a few results that are outstanding. Z has changed trolls into princesses. But chickens out at CCW.

Hmm... I am getting really confused. Don't really want to settle with a surgeon who only gets the function right.

[Dogmatix]

I have been going through all pictures of R, A, Z and G. And honestly, I am starting to think that Alfaro might not be a good choice for me. He has many cases posted on his website and most of them end up somewhat mediocre. He does some incredible mandible movement, but his patients with retruded maxilla don't really get much movement. Many don't change in looks at all and one case actually ends up looking much worse.

Would you mind sharing some of the results you think is bad for discussion? In my opinion it's hard to know if a result is good or bad just by looking at the pictures and not get the full description of what was done and why. It's also hard to judge a surgeon by the pictures on their own website, as these are pictures they've elected to show. It does how ever give a hint on what the surgeon considers good.

[Ramalito]

I don’t like this result at all: https://www.institutomaxilofacial.com/es/caso-clinico/aicha/

Her jaw has a weird shape now, looks longer and steeper too.

[Dogmatix]

I don’t like this result at all: https://www.institutomaxilofacial.com/es/caso-clinico/aicha/

Her jaw has a weird shape now, looks longer and steeper too.

Hmm ok. I think that's a good result, meaning that I don't see how anything could be moved to make it better. The profile picture looks very balanced and natural, and there was also a gummy smile that had to be considered when doing the surgery. I don't know what you mean by weird jaw shape, but the shape of her jaw has probably not changed, only the position. Could it be that you just fancy another type of girls?

You talk about turning trolls into princesses, unfortunately that's not how it work. You work with bones and hard structure and you can never look like anyone else, just a better version of yourself.

There is however one case where I've wondered about the result. It's hard knowing without understanding the background, but to me this seems like a bit too much advancement. I see that it's surgery first, maybe it's harder to get best outcome then.

https://www.institutomaxilofacial.com/es/caso-clinico/estela/

[beautyislife]

Why do both results have noticeable asymmetry? The second one in particular has a good deal of asymmetry.

Is it just that bimax exposes this (meaning they had it prior to surgery) or is it movement via surgery first?

[kavan]

It's like anything else. OUTPUTS are a function of INPUTS. So results are to outputs as starting point is to inputs.

Every heard the adage: 'You can't make a silk purse out of a sow's ear.' ? It's like that and I DON'T mean this as insult to how the patients looked before. I mean it to convey the adage relates to outputs are a function of the inputs and results are a function of the start points.

For example, something like an extremely high mandibular plane angle can't be made much lower even with CCW and the person will still have a high MP after CCW and advancement BSSO. These surgeries are to balance bites and aesthetics so that both are improved.

IMO, I think the people who have significant problems with both the bite and aesthetic deviations from the norm will be the happy ones with their results and will like them despite some minor trade-offs that some of you MAGNIFY when looking at the results. . (Pretty obvious they are happy given they volunteer their photos to be used.). Others just looking at the RESULTS (and maybe judging from perspective of 'lack of perfection' or not being transformed into a model) or who just can't figure out, or worse yet, VOID of the concept that results depend on the start point, perhaps should not even be pursuing maxfax surgeries for 'aesthetics alone'.