Gunson employees leaving positive reviews for Gunson

[PloskoPlus]

That's how it works with every business. Also, most surgeons let their assistant do the surgery and only supervise. They have too much demand to do the surgery themselves.

Pretty sure that's how I copped all my nerve damage.

[ben from UK]

Pretty sure that's how I copped all my nerve damage.

Sorry to hear.
How do you know that was caused by an assistant instead of the surgeon?

By the way, I wouldn't trust reviews online. I think these are more important 'cues':

- how may clients visit the surgeon? If the place is packed with clients, chances are there has been alot of good word of mouth. Still, there are exceptions when for example there is multiple surgeons working at the place. You won't know who came for who.

- how perfectionist is the surgeon? If he takes alot of time to look at your face and design the plan it's better than doing it fast. It often really really is a matter of millimeters.

- in office results of previous procedures

- experience with the specific procedure. The more mistakes the surgeon made, the better, cause we learn from mistakes.

All other things like: is the surgeon nice, does he have social skills, does the office looks good, are the assistants polite, does the surgeon react fast, etc. It doesn't say anything about the quality of the work.

 

[Post bimax]

- how perfectionist is the surgeon? If he takes alot of time to look at your face and design the plan it's better than doing it fast. It often really really is a matter of millimeters.

This is something I should’ve paid more attention to. I don’t know what sort of software Posnick uses, but during my ‘surgical planning appointment’ he was just eyeballing it.

He had me wear some head appliance and also put something between my teeth to see if I had a cant. He just sort of looked at it and then asked his fellow if he saw anything. He did this for a few different measures.

He also gave me a range of 8-12mm and asked me on the spot how far I wanted to be advanced. 8mm according to the clinical photos and 12mm according to the software. I just said 10mm because I didn’t know any better.

I don’t know how other surgeons do their planning, but in retrospect this seems a little off the cuff to me. Not necessarily wrong I guess, just haphazard from the patient perspective.

[PloskoPlus]

This is something I should’ve paid more attention to. I don’t know what sort of software Posnick uses, but during my ‘surgical planning appointment’ he was just eyeballing it.

He had me wear some head appliance and also put something between my teeth to see if I had a cant. He just sort of looked at it and then asked his fellow if he saw anything. He did this for a few different measures.

He also gave me a range of 8-12mm and asked me on the spot how far I wanted to be advanced. 8mm according to the clinical photos and 12mm according to the software. I just said 10mm because I didn’t know any better.

I don’t know how other surgeons do their planning, but in retrospect this seems a little off the cuff to me. Not necessarily wrong I guess, just haphazard from the patient perspective.

Most of them just eye ball things. Yet we have to wear it. Mine did not use "computers".

[kavan]

This is something I should’ve paid more attention to. I don’t know what sort of software Posnick uses, but during my ‘surgical planning appointment’ he was just eyeballing it.

He had me wear some head appliance and also put something between my teeth to see if I had a cant. He just sort of looked at it and then asked his fellow if he saw anything. He did this for a few different measures.

He also gave me a range of 8-12mm and asked me on the spot how far I wanted to be advanced. 8mm according to the clinical photos and 12mm according to the software. I just said 10mm because I didn’t know any better.

I don’t know how other surgeons do their planning, but in retrospect this seems a little off the cuff to me. Not necessarily wrong I guess, just haphazard from the patient perspective.

I don't know what kind of software Posnick  uses these days other than to say I know he used to do it the classic or 'old fashion' way which before the advent of VSP was a good way such as hand tracing of the cephs, hand drawn proposals and doing the surgery on model blocks. In fact a lot of articles by him on line show the plaster cast model blocks of the teeth.

I know (or have very good reason to believe) Gunson uses something called 'NemoFAB'.  The FAB part stands for Face Airway and Bite. It is software designed with and in accordance to the Arnett analysis. They are out of Madrid, Spain.  Nemo software even had a symposium named after Arnett. https://nemouniversity.nemotec.com/en/first-european-arnett-orthognathic-surgery-forum-symposium/
I think a good number of other Spanish and/or Euro docs use this software too.

Their 'Nemo' site used to have a video of Arnett explaining sleep apnea cases and how to maximize the aesthetics along with airway opening. But I can't find that on there anymore.

Doctors who use a high tech software program for planning will usually give you a ceph read out along with a 2D displacement diagram or sometimes a 3D VSP. It might not be the 'final' plan (because final plan is contingent on the braces getting you into the position they want). But it shows they are using very modern software for planning (as opposed to eyeballing or winging it on table).

[Post bimax]

I don't know what kind of software Posnick  uses these days other than to say I know he used to do it the classic or 'old fashion' way which before the advent of VSP was a good way such as hand tracing of the cephs, hand drawn proposals and doing the surgery on model blocks. In fact a lot of articles by him on line show the plaster cast model blocks of the teeth.

I know (or have very good reason to believe) Gunson uses something called 'NemoFAB'.  The FAB part stands for Face Airway and Bite. It is software designed with and in accordance to the Arnett analysis. They are out of Madrid, Spain.  Nemo software even had a symposium named after Arnett. https://nemouniversity.nemotec.com/en/first-european-arnett-orthognathic-surgery-forum-symposium/
I think a good number of other Spanish and/or Euro docs use this software too.

Their 'Nemo' site used to have a video of Arnett explaining sleep apnea cases and how to maximize the aesthetics along with airway opening. But I can't find that on there anymore.

Doctors who use a high tech software program for planning will usually give you a ceph read out along with a 2D displacement diagram or sometimes a 3D VSP. It might not be the 'final' plan (because final plan is contingent on the braces getting you into the position they want). But it shows they are using very modern software for planning (as opposed to eyeballing or winging it on table).

Can confirm about the plaster models- he took moulds of my teeth pre-op

[PloskoPlus]

Can confirm about the plaster models- he took moulds of my teeth pre-op

This is normal. All surgeons do (or at least should) a practice surgery with models. At the end of the day it's all about the bite. If the bite splint fits, then "Grate Success!".

[april]

All surgeons are guided by a bite splint during surgery, they need to be. But the splint is representative of the plan. So the difference between a good and bad surgeon is in the design of that splint (i.e the plan) - good surgeons will make sure that bite fits in the most ideal position in the face, while bad surgeons don't give a f**k about your face. So for example, a splint for a 'linear DJS plan' and a splint for a 'CCW DJS plan' will both guide the bite to fit together, but the splints will be shaped differently.

[april]

- how perfectionist is the surgeon? If he takes alot of time to look at your face and design the plan it's better than doing it fast. It often really really is a matter of millimeters

I wish all surgeons were perfectionists with analysis/planning. Like you shouldn't even be allowed to operate on someone's face unless you're meticulous.

[ben from UK]

I wish all surgeons were perfectionists with analysis/planning. Like you shouldn't even be allowed to operate on someone's face unless you're meticulous.

Perfectionism = more costs. For example, alot of surgeons work with assistants. When you deal with a business, you can choose to hire a mediocre but cheap assistant or a high level but expensive assistant. Sometimes a surgeon lets his assistant do the surgery under his supervision. You can complain about this, but it's just how the business works. If an assistant never does the real work, he will never learn how to do it. Other problems are: if an assistant is really good, he will want to go set up his own office. How do you keep loyalty?

If a surgeon is very perfectionistic, he will hire a great assistant and supervise him tightly. Sometimes, assistants do have more skills than the supervisor. And I mean, with skills: natural talent/artistic eye. They still lack the experience of the supervisor, but a good assistant learns fast.

These things are way more important than: this surgeon is a nice guy and listens blabla. The fact that a surgeon is a nice guy or socially adept is of no importance when it comes to quality.

[DRIVVEN]

Perfectionism = more costs. For example, alot of surgeons work with assistants. When you deal with a business, you can choose to hire a mediocre but cheap assistant or a high level but expensive assistant. Sometimes a surgeon lets his assistant do the surgery under his supervision. You can complain about this, but it's just how the business works. If an assistant never does the real work, he will never learn how to do it. Other problems are: if an assistant is really good, he will want to go set up his own office. How do you keep loyalty?

If a surgeon is very perfectionistic, he will hire a great assistant and supervise him tightly. Sometimes, assistants do have more skills than the supervisor. And I mean, with skills: natural talent/artistic eye. They still lack the experience of the supervisor, but a good assistant learns fast.

These things are way more important than: this surgeon is a nice guy and listens blabla. The fact that a surgeon is a nice guy or socially adept is of no importance when it comes to quality.

Do you realize Gunson’s assistant is not a surgeon, she has no real surgical training and is pretty meek, never gives input, she works part time and has a background in aesthetic fillers. He used to have a surgical partner. I am also not sure of the software used since arnett retired.

[Lefortitude]

Do you realize Gunson’s assistant is not a surgeon, she has no real surgical training and is pretty meek, never gives input, she works part time and has a background in aesthetic fillers. He used to have a surgical partner. I am also not sure of the software used since arnett retired.

OK, Thats simply not true.  She has been a PA and Surgical Assistant since 1999 in orthopedic surgery, emergency care and dermatological surgery.

[kavan]

Do you realize Gunson’s assistant is not a surgeon, she has no real surgical training and is pretty meek, never gives input, she works part time and has a background in aesthetic fillers. He used to have a surgical partner. I am also not sure of the software used since arnett retired.

OK, Thats simply not true.  She has been a PA and Surgical Assistant since 1999 in orthopedic surgery, emergency care and dermatological surgery.

Physician assistants, although not surgeons themselves, have a type of training where they can assist in surgeries, and other aspects of med care.

Ref= https://www.learnhowtobecome.org/physician-assistant/

[Post bimax]

Surgical PAs are highly qualified.  PA school is essentially an abbreviated MD program and requires at least 2k hours of practical experience to graduate.  I believe they also require continuing education to maintain their certifications, similar to CPAs (my profession). My girlfriend is looking at PA programs right now and it's highly competitive.

[DRIVVEN]

Surgical PAs are highly qualified.  PA school is essentially an abbreviated MD program and requires at least 2k hours of practical experience to graduate.  I believe they also require continuing education to maintain their certifications, similar to CPAs (my profession). My girlfriend is looking at PA programs right now and it's highly competitive.

I must be missing someone, I called the California medical board and she is a PA, a member of the AAPA, not the AASPA—there is indeed a difference in training for a  straight PA and a surgical PA. I had probably more than 30 visits and had no diagnostic input on any occasion—Even on her own linkedin, she does not tout any real surgical experience. https://www.linkedin.com/in/lori-heinze-78642876/?locale=de_DE.  She works part time and teaches barre class at Barre3 in Santa Barbara, so its very different than a surgical partner. Is my information wrong?