Treatment Planning with Dr. Gunson

[XXRyanXXL]

I've posted previously about my underlining LFS (Long Face Syndrome) diagnosis. I posted my medical records, cephs, and xrays, I have a high MP angle (45 deg), 13 OP. I had a previous surgery to address my 10 mm overbite, that surgery was unsucessful, the surgeon only made my condition worse. So I sought the help of A&G. At the time of this writing, a lot of people understand they are facing 3 civil lawsuits. 2 Years ago from this date I had a consult with Michael Gunson. I read all the reviews through this forum how good he is. He did measurements of my face, an iTooth analysis and bite wings were provided to him. He gave me a treatment plan to have a complete BSSO and LF-1 revision with genio reduction and advancement. I had questioned Dr. Gunson on this computer generated ceph with corrections made, and he indicated that he actually drew that line to match up with what I'm supposed to look like. I was in braces and when my final tooth placements were made by my Ortho, I was told to send updated models to him. I did that, and was getting ready for my surgery.
I then had a virtual consultation with Dr. Gunson via Zoom, and he put my previous surgery results on the screen and his intended plan. I was shocked what he had planned for me. He was not going to do ANYTHING. My exact results after my first surgery, was EXACTLY what he had planned for me, he wanted to charge me $86,000 for doing a revision surgery that addressed NOTHING but the chin. !
He told me he does not know how to do an inverted-L osteo, or 3d implants for my jaw angle, nor was he comfortable doing any type of CCW rotation or bone grafting.

I'm a little upset at this forum, he is overrated and expensive, but the fact he renigged on a partial plan 2 years ago and I went through 2 years of additional ortho when he could have came out and told me in advance he didn't wish to accomplish my goals. I have all the results to prove my point here. By the way, I got the money because my insurance would not pay for this surgery and i'm sure as hell not going to throw that down the toilet through another painful revision that is a complete waste of time.

[Lefortitude]

Not sure if i missed your previous posts or this is a standalone, but posting records of your prior surgery (pre and post) and dr gunsons plans would help assess the situation.

[kavan]

You say you are upset with this forum due to good reviews about Gunson and then go on to imply they left you with the expectation that he performed inverted L osteotomies and custom design 3-d jaw implants where, much to your chagrin, you found out directly from him that he actually does not do those things.

Although Gunson's name comes up on JSF, it's often in reference to CCW posterior downgrafting. However, I don't recall him being associated with inverted L osteos or custom 3d design jaw implants. I have no idea how the extrapolation came about that he did inverted L's and 3'd custom jaw implants based on what ever good reviews he may have had.

Can't validate on his plan being exactly the same as other surgery in absence of seeing both. But IF that is the case, it's certainly high cost for a surgery that is only the chin. If all the plan did was chart out a chin surgery, most likely, it could be used to have another do same/similar based on the plan for much less.

[GJ]

Sounds like you should be mad at him, not the forum.

I'd be curious to see his revision plan for you - hard to believe he'd just move a chin for 86k. Sorry. I just find that hard to believe.

[InvisalignOnly]

As far as I'm aware, people on this forum have been more critical of Gunson's work than anybody anywhere else online - there were discussions about his employees leaving reviews as well as botched surgeries etc. I feel that this forum has portrayed a very balanced picture of him and his work - people can make up their own minds based on what they read here.

[DRIVVEN]

I've posted previously about my underlining LFS (Long Face Syndrome) diagnosis. I posted my medical records, cephs, and xrays, I have a high MP angle (45 deg), 13 OP. I had a previous surgery to address my 10 mm overbite, that surgery was unsucessful, the surgeon only made my condition worse. So I sought the help of A&G. At the time of this writing, a lot of people understand they are facing 3 civil lawsuits. 2 Years ago from this date I had a consult with Michael Gunson. I read all the reviews through this forum how good he is. He did measurements of my face, an iTooth analysis and bite wings were provided to him. He gave me a treatment plan to have a complete BSSO and LF-1 revision with genio reduction and advancement. I had questioned Dr. Gunson on this computer generated ceph with corrections made, and he indicated that he actually drew that line to match up with what I'm supposed to look like. I was in braces and when my final tooth placements were made by my Ortho, I was told to send updated models to him. I did that, and was getting ready for my surgery.
I then had a virtual consultation with Dr. Gunson via Zoom, and he put my previous surgery results on the screen and his intended plan. I was shocked what he had planned for me. He was not going to do ANYTHING. My exact results after my first surgery, was EXACTLY what he had planned for me, he wanted to charge me $86,000 for doing a revision surgery that addressed NOTHING but the chin. !
He told me he does not know how to do an inverted-L osteo, or 3d implants for my jaw angle, nor was he comfortable doing any type of CCW rotation or bone grafting.

I'm a little upset at this forum, he is overrated and expensive, but the fact he renigged on a partial plan 2 years ago and I went through 2 years of additional ortho when he could have came out and told me in advance he didn't wish to accomplish my goals. I have all the results to prove my point here. By the way, I got the money because my insurance would not pay for this surgery and i'm sure as hell not going to throw that down the toilet through another painful revision that is a complete waste of time.

This is such an odd situation but similar to that of another patient.  I am really sorry this happened to you, but maybe you dodged a bullet. Think about that. There are some very positive supporters of Gunson in this forum but there are others with not so positive support in this forum, like me. Sometimes i feel that nobody wants to hear anything negative about gunson, but i would not say this is a pro-gunson forum.  I think back a few years before Arnett left the practice, there was much more positivity in many forums, but not now.  You also said in one of your earlier posts that Gunson promised you a lifetime of care, i dont think he told you the truth if he said that. WHo wants a lifetime of care anyway and multiple procedures as many gunson patients get??. For me, i would rather have a surgery, recover and get on with my life, but now i do need a lifetime of care from his surgery. Also do you think he was just not prepared, or he forgot you had an initial consult and what was discussed?  This must be most frustrating.

[PloskoPlus]

He probably wants easier cases, less demanding patients now.

[beautyislife]

Had surgery w/him. I wish the results were better, but he was always straight forward with his plan, has been good post-op with some minor issues that have come up, and has been nice enough to answer questions about further surgery. Most people I met in his office or around the area that had surgery with him had nothing but good things to say. Granted, my experience is ancedotal.

[Lefortitude]

Had surgery w/him. I wish the results were better, but he was always straight forward with his plan, has been good post-op with some minor issues that have come up, and has been nice enough to answer questions about further surgery. Most people I met in his office or around the area that had surgery with him had nothing but good things to say. Granted, my experience is ancedotal.

Anecdotes like yours or Drivens are the most valuable information we have regarding clinical practices.  There are no peer-reviewed studies on the satisfaction of Dr. Gunsons surgical patients as far as I know.

[InvisalignOnly]

Had surgery w/him. I wish the results were better, but he was always straight forward with his plan, has been good post-op with some minor issues that have come up, and has been nice enough to answer questions about further surgery. Most people I met in his office or around the area that had surgery with him had nothing but good things to say. Granted, my experience is ancedotal.

For the kind of money he charges the least he can do is be nice! I would be curious to know how he reacted when you told him you're not entirely happy with the result.

[kavan]

Anecdotes like yours or Drivens are the most valuable information we have regarding clinical practices.  There are no peer-reviewed studies on the satisfaction of Dr. Gunsons surgical patients as far as I know.

I'm not sure if there are peer review studies about patient satisfaction about any doctor. Have you ever come across peer review studies as to patient satisfaction of ANY doctor?

Peer reviewed studies are usually about a PROCEDURE and it's outcomes. If the study includes satisfaction about something, the something is usually a procedure or product and not a particular doctor or practice.

I've never come across a peer reviewed study where a Doctor 'X' says something like: '9 out 10 of my patients are delighted with my practice.' Something like that would resolve to an advertisement and not advance knowledge within the field.

[beautyislife]

Anecdotes like yours or Drivens are the most valuable information we have regarding clinical practices.  There are no peer-reviewed studies on the satisfaction of Dr. Gunsons surgical patients as far as I know.

That's fair I suppose. I guess I'm just stating the obvious that my opinion and experience should be taken with a grain of salt.

For the kind of money he charges the least he can do is be nice! I would be curious to know how he reacted when you told him you're not entirely happy with the result.

Yeah, it was expensive, but at the same time I don't think he's obligated to provide additional help or advice or even be kind if a patient is dissatisfied with their results. Before surgery I told him I'd be blunt about how I felt post-op and how I believed my results turned out. I think I told him at 2 months I was unhappy and he mentioned how much swelling I had left and to wait until the 6 month mark to be critical. I'm now about 6 months post op and not 100% satisfied, and I reached out to him to discuss my concerns. So far he hasn't reacted in a negative way, though I am waiting for his comments on my plans for an additional surgery.

[InvisalignOnly]

So far he hasn't reacted in a negative way, though I am waiting for his comments on my plans for an additional surgery.

Good luck with all that! My surgery came with a guarantee that they'll reoperate once at no additional cost except the cost of anesthesia in case I don't like the outcome - I'm so glad I didn't have to use that option though, jaw surgery is traumatic enough to do once in a lifetime.

[thedude]

I consulted with him and got a good overall impression.

[DRIVVEN]

I consulted with him and got a good overall impression. He is very nice and laid back. Frankly a very unusual personality for a surgeon. Compared to other surgeons where I felt like I was on my own dealing with insurance, finding orthodontists, and constantly following up to move things along, it was clear that all I had to do was say okay with Gunson's office and it would be easy and smooth sailing from start to finish. He has a good working relationship with a lot of orthodontists and they like working with him.

His surgical plan for me was on the conservative side. He wanted to do a moderate amount of jaw advancement and cheek augmentation. I'm pretty sure most of his patients have the cheek augmentation and I'm pretty sure it's why his results look so much better than other surgeons. It's not the jaw surgery but the cheek surgery that is catching your eye. It just looks great and he does that better than anyone and safely and routinely.

He will answer your questions and explain why he wants to do the surgery the way he does but he's not going to change his plan based on your input. If I were him I wouldn't either. If you study his work you'll see his patients have a consistent look and if you have him operate on you I think you can count on fitting pretty seamlessly into his portfolio. My personal observation is that he is  pretty conservative with enhancing masculine features in men such as the chin so that might disappoint some men that prize looking masculine over looking classically attractive.

He said they do several surgeries a week and based on all the employees he had at his office it was clear he liked to delegate work out so I have a hunch his surgical assistants are doing a lot of the cutting. He employs a PA and she's featured prominently on his webpage. Do the math. I'm sure she is well trained and that he's overseeing things in a professional and safe manner. Maybe though his reliance on others has something to do with why we're reading more reports of minor complications from that office. My feeling at the consultation was that if I wanted to get to know the person operating on me I should probably spend more time with the PA than Dr. Gunson.

If I decide to have surgery with him it will be because he makes the process simple, because I think the cheek implants would look great, and because I would feel safe knowing if there are any complications from the surgery they will probably not be life threatening.

I though in your pervious post your were disappointed that he offered no plan for your chin ptsosis caused by your chin implant, but you are comfortable now with the plan?