Surgical Plan for sleep apnea w/ Alfaro

[rafaaa]

Putting this as reference or help for others,

Here is the plan for my surgery that will be in two weeks (surgery first, using TADs and invisalign post-op), with Dr Alfaro.


https://imgur.com/a/NGacmJ2

Really happy with this, hoping for a cure of my sleep apnea / UARS.

[kavan]

Putting this as reference or help for others,

Here is the plan for my surgery that will be in two weeks (surgery first, using TADs and invisalign post-op), with Dr Alfaro.


https://imgur.com/a/NGacmJ2

Really happy with this, hoping for a cure of my sleep apnea / UARS.

It looks like a good plan. Would you happen to have a CEPH. There is something I would like to compare with the bone model.

[jawgraphy]

Good luck, my friend! Please keep us updated!

[kavan]

Putting this as reference or help for others,

Here is the plan for my surgery that will be in two weeks (surgery first, using TADs and invisalign post-op), with Dr Alfaro.


https://imgur.com/a/NGacmJ2

Really happy with this, hoping for a cure of my sleep apnea / UARS.

You have a very distinct ANS but your Alfaro bone scan does not show the distintion. It almost looks like he cut off the point of your ANS in the BEFORE photo.

It looks like he is cutting a V shaped notch beneath your ANS so he can bring the rest of your maxilla forward WITHOUT giving you a deformity. It is a GOOD thing. But did he mention this to you?

Illustration included with this post.

[rafaaa]

You have a very distinct ANS but your Alfaro bone scan does not show the distintion. It almost looks like he cut off the point of your ANS in the BEFORE photo.

It looks like he is cutting a V shaped notch beneath your ANS so he can bring the rest of your maxilla forward WITHOUT giving you a deformity. It is a GOOD thing. But did he mention this to you?

Illustration included with this post.

Thanks a lot for the work here Kavan !
He did NOT mention this to me. I finished MSE expansion a month ago, so maybe that notch is the result of the MPS being split and healing ? And the lack of ANS in the before, a CBCT imaging mistake ? I noted your observation and if I can, I will ask him, for the sake of information, if he did plan this.

 

[rafaaa]

Good luck, my friend! Please keep us updated!

Thank you !

[kavan]

Thanks a lot for the work here Kavan !
He did NOT mention this to me. I finished MSE expansion a month ago, so maybe that notch is the result of the MPS being split and healing ? And the lack of ANS in the before, a CBCT imaging mistake ? I noted your observation and if I can, I will ask him, for the sake of information, if he did plan this.

It looks like a notched  CUT to the area as to leave the ANS behind which isn't really a bad thing given the extent of the forward maxilla advancement. As CBCT imaging mistake, it would depend if the Alfaro bone model plan was based on the scan to the right. Thing is, his read out has the ANS going as much forward as the max advance. Yes, you should ask him and feel free to show him the diagram I made regarding this question.

[rafaaa]

It looks like a notched  CUT to the area as to leave the ANS behind which isn't really a bad thing given the extent of the forward maxilla advancement. As CBCT imaging mistake, it would depend if the Alfaro bone model plan was based on the scan to the right. Thing is, his read out has the ANS going as much forward as the max advance. Yes, you should ask him and feel free to show him the diagram I made regarding this question.

It's totally possible ! Your point makes a lot of sense and I can see it too. I will ask, I screenshotted the diagram as an help . Surgery next week so I might only be able to ask later.

[rafaaa]

It looks like a notched  CUT to the area as to leave the ANS behind which isn't really a bad thing given the extent of the forward maxilla advancement. As CBCT imaging mistake, it would depend if the Alfaro bone model plan was based on the scan to the right. Thing is, his read out has the ANS going as much forward as the max advance. Yes, you should ask him and feel free to show him the diagram I made regarding this question.

Hello Kavan.
Apparently Alfaro uses a subspinal lefort 1. He doesnt advance the ANS.

https://imgur.com/a/JN06zcO

[kavan]

Hello Kavan.
Apparently Alfaro uses a subspinal lefort 1. He doesnt advance the ANS.

https://imgur.com/a/JN06zcO

Well, that certainly confirms my observations regarding what I saw in your plan as to that notch below the ANS. I certainly think that's a GOOD thing when someone either has a prominent ANS or when the maxillary advancement is significant. But on the displacement read-out you showed,  it didn't reveal the non advancement of the ANS.

[rafaaa]

Well, that certainly confirms my observations regarding what I saw in your plan as to that notch below the ANS. I certainly think that's a GOOD thing when someone either has a prominent ANS or when the maxillary advancement is significant. But on the displacement read-out you showed,  it didn't reveal the non advancement of the ANS.

Yes exactly. Also just as a matter of fact, he always do alar cinch and vy closure, he told me.

[kavan]

Yes exactly. Also just as a matter of fact, he always do alar cinch and vy closure, he told me.

Those two things should also help cut down on unwanted changes to the base of the nose that could occur in the absence of those procedures.