One year post-op Bimax and unhappy. Have consulted with many of the prominent surgeons in this forum for revision. Sharing my exp, requesting advice.

[savemefromthisfate]

The surgeon in California is Dr Bell of course

Was surprised you figured it out ngl, but then I remembered the location hint and other associations I mentioned probably gave it away

 

[Deleted member 64942]

I have to ask why you're unsatisfied with the outcome? If its from a cosmetic perspective, I think you're far better off getting a wrap around implant since you're most likely going to want jaw angles after BSSO anyways. I don't think going through the bimax over again is worth it unless you have functional issues.

 

[savemefromthisfate]

I have to ask why you're unsatisfied with the outcome? If its from a cosmetic perspective, I think you're far better off getting a wrap around implant since you're most likely going to want jaw angles after BSSO anyways. I don't think going through the bimax over again is worth it unless you have functional issues.

Implant results will almost always look uncanny. I don't really want bimax again either, but I'm fine with getting revision LJS or something

 

[Deleted member 64942]

Implant results will almost always look uncanny. I don't really want bimax again either, but I'm fine with getting revision LJS or something

That's untrue, poor implant designs almost always look uncanny. The trick is just to have a natural and conservative design.

 

[YoungWerther]

No consults with Gunson or LACOMS?

 

[savemefromthisfate]

No consults with Gunson or LACOMS?

LACOMS keeps asking me for documentation I don't have. Gunson (or at least a member of his staff) has questionable ethics. They were clearly doxxing someone who wrote a bad review about them on Reddit. Very unprofessional.

 

[YoungWerther]

LACOMS keeps asking me for documentation I don't have. Gunson (or at least a member of his staff) has questionable ethics. They were clearly doxxing someone who wrote a bad review about them on Reddit. Very unprofessional.

Interesting, what sort of documentation are they asking you for? I called without a reference from any sort of physician or insurance, had zero scans or pics, they didn't ask for so much as a selfie. I went in having told them I found their clinic through my own research and was interested for purely cosmetic purposes. Have you seen this from the r/jawsurgery sub, he says its their work:

Good to know about Gunson. I really want to consult with him, but the amount of negativity towards him seems to be only surpassed by Alfaro.

 

[savemefromthisfate]

yes inflation and also career advancement. If you get good at what you do you usually charge more that's how it works, once a surgeon is a "Safe" surgeon by proving themselves then yes they cost more than the ones youre taking a gamble with who haven't.

Yeah I just like doing it.

We've been in contact for a while on ig but we've only had scattered conversations. I've asked you for a consult a few times already.

Can I pay you for an initial zoom convo, and depending on how that goes, I can just pay your regular fee to design something for me?

 

[SLAY/NTs]

Hello All,

About one year ago, I had bimax surgery without genio in the U.S to correct a Class II Overbite. It was fully covered by insurance. I posted my results here, however many people roasted me, and I ended up deleting my account. The result is significantly better than my before, however, I am still unhappy with the outcome. Since I finally obtained a job, I have consulted with several well-known surgeons that are mentioned in this forum. I'll probably include some pictures of my current result as well. These are my experiences so far:

Pagnoni:
I consulted with him for Infraorbital Rim Implants and Potential LJS revision. After providing him with my 3D CT scan, he was very insistent that I do not need a revision surgery, and that genioplasty will be enough. I'm also not sure if the custom Infraorbital Rim Implants will be enough to satisfy my expectations, but I think I definitely need them. I've had two consultations with him so far.

Ramieri:
He took one look at my before/after ceph and suggested LJS revision after another round of braces and premolar extractions. He suggested that genioplasty would just be a "camouflage" option, but I'm not sure about his opinion since it was a very quick consultation, and I also made a very poor first impression since it was a 6 AM appointment, and I had forgotten to send him my surgical documentation until the day of. He's very unresponsive to my emails and I don't think I'll be able to proceed with him.

Raffaini:
Requested a consultation with him, with all relevant surgical documentation sent. His assistant told me that he is declining my case, because according to him "I don't need additional surgery". Honestly, I think the true reason he declined to allow me to consult with him is because in my initial email I may have offended him by jokingly referring to myself as "Spiritually Italian", due to the fact that I was aware he charges foreigners extra.

Zarrinbal:
Sent him my Surgical Documentation and a request for an initial consultation. He got back to me a few weeks later saying that revision isn't necessary, and that chin wing, or genio with a bone graft to fill in the labiomental fold would be enough. Told him I was seriously considering revision, but he confirmed that in his opinion it wasn't necessary.

Unnamed Doctor in California:
I want to gatekeep this Doctor, because he seems very genuine in my opinion, and it's not like any of you will ever be able to afford him. He even invited me into his own home. If you really want his name, then feel free to DM me. He trained under Dr. Sinn, and is close friends with Conceancig. He mentioned that only him and Conceancig can perform a 5 piece mandibular distraction. He provided me with a plan for genioplasty and a LJS revision, and IMO, there doesn't seem to be a huge difference. The only issue is, I'm not even sure if the soft-tissue changes in the genioplasty VTO he gave me are even feasible. I'm seriously considering working him, but he wants 15k for the genioplasty, so I'll have to wait a bit.


So that's it so far. I have a few more consults coming up. I have one with Taban for eye area in about a week. I'll try to attach a picture of my current post-op profile, infraorbital region, and the Genioplasty and LJS VTO provided to me by the doctor in California. Looking forward to hearing your constructive advice.

Btw, in the Genio model, the first row is genio only, second row is LJS + genio.

i believe that you need a blackpilled doctor who would do genio+gonion, infras, supras implants

 

[SLAY/NTs]

Hello All,

About one year ago, I had bimax surgery without genio in the U.S to correct a Class II Overbite. It was fully covered by insurance. I posted my results here, however many people roasted me, and I ended up deleting my account. The result is significantly better than my before, however, I am still unhappy with the outcome. Since I finally obtained a job, I have consulted with several well-known surgeons that are mentioned in this forum. I'll probably include some pictures of my current result as well. These are my experiences so far:

Pagnoni:
I consulted with him for Infraorbital Rim Implants and Potential LJS revision. After providing him with my 3D CT scan, he was very insistent that I do not need a revision surgery, and that genioplasty will be enough. I'm also not sure if the custom Infraorbital Rim Implants will be enough to satisfy my expectations, but I think I definitely need them. I've had two consultations with him so far.

Ramieri:
He took one look at my before/after ceph and suggested LJS revision after another round of braces and premolar extractions. He suggested that genioplasty would just be a "camouflage" option, but I'm not sure about his opinion since it was a very quick consultation, and I also made a very poor first impression since it was a 6 AM appointment, and I had forgotten to send him my surgical documentation until the day of. He's very unresponsive to my emails and I don't think I'll be able to proceed with him.

Raffaini:
Requested a consultation with him, with all relevant surgical documentation sent. His assistant told me that he is declining my case, because according to him "I don't need additional surgery". Honestly, I think the true reason he declined to allow me to consult with him is because in my initial email I may have offended him by jokingly referring to myself as "Spiritually Italian", due to the fact that I was aware he charges foreigners extra.

Zarrinbal:
Sent him my Surgical Documentation and a request for an initial consultation. He got back to me a few weeks later saying that revision isn't necessary, and that chin wing, or genio with a bone graft to fill in the labiomental fold would be enough. Told him I was seriously considering revision, but he confirmed that in his opinion it wasn't necessary.

Unnamed Doctor in California:
I want to gatekeep this Doctor, because he seems very genuine in my opinion, and it's not like any of you will ever be able to afford him. He even invited me into his own home. If you really want his name, then feel free to DM me. He trained under Dr. Sinn, and is close friends with Conceancig. He mentioned that only him and Conceancig can perform a 5 piece mandibular distraction. He provided me with a plan for genioplasty and a LJS revision, and IMO, there doesn't seem to be a huge difference. The only issue is, I'm not even sure if the soft-tissue changes in the genioplasty VTO he gave me are even feasible. I'm seriously considering working him, but he wants 15k for the genioplasty, so I'll have to wait a bit.


So that's it so far. I have a few more consults coming up. I have one with Taban for eye area in about a week. I'll try to attach a picture of my current post-op profile, infraorbital region, and the Genioplasty and LJS VTO provided to me by the doctor in California. Looking forward to hearing your constructive advice.

Btw, in the Genio model, the first row is genio only, second row is LJS + genio.

if u can then get rhino aswell, your nose fucks ur naso chin alignment

 

[savemefromthisfate]

i believe that you need a blackpilled doctor who would do genio+gonion, infras, supras implants

Why genio over Revision LJS. Pagnoni is the only doctor who will do this.

 

[SLAY/NTs]

Why genio over Revision LJS. Pagnoni is the only doctor who will do this.

its ur chin bro its not ur fucking maxilla

 

[ABCDEFGHIJKLMNOP]

Get some custom jaw surgery with custom implants.

The surgeon in California is Dr Bell of course. He’s good for jaw surgery, VERY good, but no experience in implants

@RealSurgerymax How are you gauging how good he is? I've always found Gunson, Li, LACOMS, etc to be odd when people note how good they are given that there aren't really any visual case evidence floating around. Or, at least none I've seen.

In comparison, surgeons like Ramieri, Raffaini, etc, etc have loads of Instagram and other posts showing their process, case studies, etc. But, no US surgeon (outside of Alfi) I know of does this.

Also, doesn't Bell kind of bite off of Coceancig's technique? From browsing around, this forum tends to roast Coceancig for bad aesthetics and over advancement similar to Alfaro and was recently banned from practicing apparently.

 

[savemefromthisfate]

@RealSurgerymax How are you gauging how good he is? I've always found Gunson, Li, LACOMS, etc to be odd when people note how good they are given that there aren't really any visual case evidence floating around. Or, at least none I've seen.

In comparison, surgeons like Ramieri, Raffaini, etc, etc have loads of Instagram and other posts showing their process, case studies, etc. But, no US surgeon (outside of Alfi) I know of does this.

Also, doesn't Bell kind of bite off of Coceancig's technique? From browsing around, this forum tends to roast Coceancig for bad aesthetics and over advancement similar to Alfaro and was recently banned from practicing apparently.

I think Bell is trustworthy. He won't do a 5 piece mandibular distraction unless the indication is very clear. I'm not sure what that even is, but I think that is the technique you are referring to. He was employed for a very long period of time by Kaiser Permanente, which is an HMO insurance company. Doubt they would have hired him if he didn't have solid credentials. And just personality wise, I've never met a surgeon who was courteous enough to invite me into their own home lol.

 

[savemefromthisfate]

And Bell was also very insistent on performing a genioplasty, but this is the part that i'm confused about, because in the genio VTO I posted, he's able to fill in the labiomental fold without a graft.

 

[ABCDEFGHIJKLMNOP]

I think Bell is trustworthy. He won't do a 5 piece mandibular distraction unless the indication is very clear. I'm not sure what that even is, but I think that is the technique you are referring to. He was employed for a very long period of time by Kaiser Permanente, which is an HMO insurance company. Doubt they would have hired him if he didn't have solid credentials. And just personality wise, I've never met a surgeon who was courteous enough to invite me into their own home lol.

Eh. I mean... Sure, but don't equate a trusting personality with surgical outcomes. Plenty of people have regretted that.

It's more so advancing the maxilla the same way coceancig does risking a doggish look. You can find a thread on reddit of a women that has this outcome in her case.

The 5 piece mandible as you noted, in sure it can be done stablely but it's not at all a common procedure likely for good reason.

And, doing huge segmental lefort beyond the 7mm limit considered to be stable. There are some posts on Reddit about how he can improve the nasal airway without palate expansion by cutting the segmental in a certain way, and coceancig has some videos of trimming the pyriform aperture, but that doesn't really hold up. Expansion with palatal devices results in a full mid face expansion not trimming the edges of the nasal bones

See what I'm getting at? There's a lot of .... Grey.

And Bell was also very insistent on performing a genioplasty, but this is the part that i'm confused about, because in the genio VTO I posted, he's able to fill in the labiomental fold without a graft.

As in he's going to fat graft it or...? I mean, yeah that's a standard approach. If not a fat graft I have no idea what this means or how that would even work

 

[Maalik]

 

[Maalik]

Implant results will almost always look uncanny. I don't really want bimax again either, but I'm fine with getting revision LJS or something

I believe Salludon got mandible implants based on his before and after pics.