My experience with Alfaro, Pagnoni, Sailer and Safi

[aestheticmax]

I want to have a Bimax with genioplasty and face implants (jawangle, cheeks, temporalis).

My experience is the following:

1. Alfaro
He was interested in my case and makes very big advancements . But I think that with him it's a matter of luck whether you're good looking or overadvance.
Some of his results looks dogmaxxed and kinda asymmetrical.

2. Pagnoni
He seens to be a nice guy. I was also surprised that I get a rough planning of my case.
I liked his different types of genioplasties. But I don t like that he doesn`t fill the gaps of the lefort 1 and sagittal split. His results were ok.
I am a little bit afraied of his jawangle implants, I read that some people have problem with his jawangle design. The masseter doesnt aline with the implant and that it loosk strange while smiling.

3. Sailer
The Godfather of looksmaxxing.
His clinic looks more like a 5 star hotel. I would never say that he is already 80 years old. The consultation started with his wife, she was kinda annoying (and looks kinda spooky) after that I could talk with Prof Sailer about my case. He would create the anteface with 18mm advancement in my case and use cartillage to augment my midface and paransal area. Unfortunately is the price with 120 K CHF out of my budget and I am not sure, if he operates in his age or whether his assistant performs the surgery on his behalf.


4.
Safi
He is trained by Sailer and in my opinion blackpilled af.
He was also the only one who recommendet me temporalis implants beside jawangle and cheek implants. That was so helpfull for me coz I felt that something looks strange in the upper third of my face especially on the frontal camera.
The results he had shown me looked like they were from Sailer. He is convinced by the concept of the anteface and wants to create the male model look.
He also recommends me an advancement of 18mm in the lower jaw (Bsso and genio) and also 8 degrees CCW .

My next steps are the planning with Dr. Safi, I also thinks that he is the only one who can make a precise soft tissue simulation with facial implants.


Feel free to ask me

 

[Deleted member 46997]

I want to have a Bimax with genioplasty and face implants (jawangle, cheeks, temporalis).

My experience is the following:

1. Alfaro
He was interested in my case and makes very big advancements . But I think that with him it's a matter of luck whether you're good looking or overadvance.
Some of his results looks dogmaxxed and kinda asymmetrical.

2. Pagnoni
He seens to be a nice guy. I was also surprised that I get a rough planning of my case.
I liked his different types of genioplasties. But I don t like that he doesn`t fill the gaps of the lefort 1 and sagittal split. His results were ok.
I am a little bit afraied of his jawangle implants, I read that some people have

3. Sailer
The Godfather of looksmaxxing.
His clinic looks more like a 5 star hotel. I would never say that he is already 80 years old. The consultation started with his wife, she was kinda annoying (and looks kinda spooky) after that I could talk with Prof Sailer about my case. He would create the anteface with 18mm advancement in my case and use cartillage to augment my midface and paransal area. Unfortunately is the price with 120 K CHF out of my budget and I am not sure, if he operates in his age or whether his assistant performs the surgery on his behalf.


4.
Safi
He is trained by Sailer and in my opinion blackpilled af.
He was also the only one who recommendet me temporalis implants beside jawangle and cheek implants. That was so helpfull for me coz I felt that something looks strange in the upper third of my face especially on the frontal camera.
The results he had shown me looked like they were from Sailer. He is convinced by the concept of the anteface and wants to create the male model look.
He also recommends me an advancement of 18mm in the lower jaw (Bsso and genio) and also 8 degrees CCW .

My next steps are the planning with Dr. Safi, I also thinks that he is the only one who can make a precise soft tissue simulation with facial implants.


Feel free to ask me

wyll?

 

[Magnum Opus]

2. Pagnoni
He seens to be a nice guy. I was also surprised that I get a rough planning of my case.
I liked his different types of genioplasties. But I don t like that he doesn`t fill the gaps of the lefort 1 and sagittal split. His results were ok.
I am a little bit afraied of his jawangle implants, I read that some people have

You didn't finish the last sentence I quoted

 

[aestheticmax]

wyll?

I am recessed class 1 bite and skelletal class 2. with low cheek bones and only soft jawangles and temporal hollowing

 

[hansmoleman]

I’ve heard good things from Safi.

 

[bradpittshairline]

I like surgeons who are aestethically aligned but if they wanna change your jaw so much what if u get surergy and arent ok with what u look like post-op like real real body dysmoprhia then what, what if the male model look isn't meant for my face

 

[aestheticmax]

You didn't finish the last sentence I quoted

I read on this forum that Pagnosis jaw angle design cause masseter muscle dehiscence. I would call it muscular detachment because the muscle is detached from the lower border of the jawangle and that s why the implant is vertically to high and the masseter muscle cant aline the lower boarder. The muscle rises during movements, and it looks unnatural

 

[aestheticmax]

I like surgeons who are aestethically aligned but if they wanna change your jaw so much what if u get surergy and arent ok with what u look like post-op like real real body dysmoprhia then what

For that you get the precise hard and soft tissue simulation. You will know how you look like after the surgery and can discuss or change any detail during the planing phase.
For me it`s extremely important to know how I will look like after the surgery.

 

[depressionmaxxing]

3. Sailer
He would create the anteface with 18mm advancement in my case and use cartillage to augment my midface and paransal area. .

18mm is crazy tbh.
How exactly would using cartillate work to augment midface/paranasal? Did he explain it any further?

 

[bradpittshairline]

For that you get the precise hard and soft tissue simulation. You will know how you look like after the surgery and can discuss or change any detail during the planing phase.
For me it`s extremely important to know how I will look like after the surgery.

can sailer fix short face syndrome?

 

[aestheticmax]

18mm is crazy tbh.
How exactly would using cartillate work to augment midface/paranasal? Did he explain it any further?

Cartillage is like a natural implant. You can augment the midface and paranasal area with it.
It can be cut during and adjust during the surgery, it gives a natural looking result.

 

[aestheticmax]

can sailer fix short face syndrome?

I think he should be able to fix that, the problem is that you don t get a digital planning with sailer he is oldskool but good.

 

[depressionmaxxing]

Cartillage is like a natural implant. You can augment the midface and paranasal area with it.
It can be cut during and adjust during the surgery, it gives a natural looking result.

So he just thickens bone?

 

[aestheticmax]

So he just thickens bone?

It s a biological implant that you can modelate during the operation. You can see also before and afters on the sailerclinic.com site or at Dr Safis insta " craniologicum "

 

[PlagiocephalyTypeIV]

there is no accurate way of simulating surgery , especially implants

 

[aestheticmax]

there is no accurate way of simulating surgery , especially implants

I was skeptical too but made some research and found a lot of papers like this one https://pubmed.ncbi.nlm.nih.gov/33272289/

I think that dolphin and blender software are good at mapping out soft tissue, hitting near 95% accuracy.
Like in the case of @anticel I think he looks same like in the planning so in this field I trust Dr. Safi and his staff.
He is trained by Sailer and Sailer has a lot of implant pics and experience think around 30 years.

 

[Meister!]

I was skeptical too but made some research and found a lot of papers like this one https://pubmed.ncbi.nlm.nih.gov/33272289/

I think that dolphin and blender software are good at mapping out soft tissue, hitting near 95% accuracy.
Like in the case of @anticel I think he looks same like in the planning so in this field I trust Dr. Safi and his staff.
He is trained by Sailer and Sailer has a lot of implant pics and experience think around 30 years.

He didn't have great results though.

can sailer fix short face syndrome?

Of course he can, it's one of the most easy things to do for a maxfac and many SFS before and afters look insane.

I think he should be able to fix that, the problem is that you don t get a digital planning with sailer he is oldskool but good.

Back when Safi was at Sailerclinic I remember him offering me digital planning.

 

[bradpittshairline]

He didn't have great results though.

Of course he can, it's one of the most easy things to do for a maxfac and many SFS before and afters look insane.

Back when Safi was at Sailerclinic I remember him offering me digital planning.

If I perma jut will my SFS ascension look like my jut? I think jut gives a wrong ccw angle compared to the natural SFS angle

 

[Deleted member 19766]

I read on this forum that Pagnosis jaw angle design cause masseter muscle dehiscence. I would call it muscular detachment because the muscle is detached from the lower border of the jawangle and that s why the implant is vertically to high and the masseter muscle cant aline the lower boarder. The muscle rises during movements, and it looks unnatural

just get ur jaw angle implant designed by RSM then

"But I don t like that he doesn`t fill the gaps of the lefort 1 and sagittal split."
Could you elaborate on this?

 

[Meister!]

If I perma jut will my SFS ascension look like my jut? I think jut gives a wrong ccw angle compared to the natural SFS angle

The surgeon will most likely give you a maxillary downgraft and some rotation so a jut is still inacurrate, you should check out Gustavo's before and after on Alvaro's instagram he is a true SFS "ascension".

 

[bradpittshairline]

The surgeon will most likely give you a maxillary downgraft and some rotation so a jut is still inacurrate, you should check out Gustavo's before and after on Alvaro's instagram he is a true SFS "ascension".

Can u name the doctor so I can look it uo

 

[aestheticmax]

just get ur jaw angle implant designed by RSM then

"But I don t like that he doesn`t fill the gaps of the lefort 1 and sagittal split."
Could you elaborate on this

For me it s important that the gaps are filled with bone substitue it is much more stable after the surgery and it ossifies faster. This use Raffaini, Obwegeser or Sailer. This method is superior to other methods.

 

[Deleted member 19766]

For me it s important that the gaps are filled with bone substitue it is much more stable after the surgery and it ossifies faster. This use Raffaini, Obwegeser or Sailer. This method is superior to other methods.

Any aesthetic differences ?

 

[aestheticmax]

Any aesthetic differences ?

Yeh sure when they fill the sagittal split you don t get the step there

 

[Deleted member 19766]

can u show how it looks like with vs without filling?

 

[hansmoleman]

For me it s important that the gaps are filled with bone substitue it is much more stable after the surgery and it ossifies faster. This use Raffaini, Obwegeser or Sailer. This method is superior to other methods.

I agree, but why many surgeons don’t do it if it seems kinda obvious and easy? Are there any downsides?

 

[greycel]

Cartillage is like a natural implant. You can augment the midface and paranasal area with it.
It can be cut during and adjust during the surgery, it gives a natural looking result.

I heard that cartillage can cause bone absorption and is not permanent.
Also, I heard that if you smile/laugh or yawn/talk with paranasal implants/ cartillage it looks uncanny

 

[panfacemogger]

I heard that cartillage can cause bone absorption and is not permanent.
Also, I heard that if you smile/laugh or yawn/talk with paranasal implants/ cartillage it looks uncanny

First statement is only somewhat true, it is permanent, resorption is a real problem tho.
Second is also only somewhat true, you need to have properly set and well designed implant to minimize that risk, it's not always the case.