# New Alfaro Bimax result



## Deusmaximus (Jun 10, 2022)




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## LightSkinNoob (Jun 10, 2022)

+1.5 PSL great result.


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## russiancel (Jun 10, 2022)

tbh nothing changed. Only side profile changed slightly which is mostly cope. Bimax is redundant as usual if you are not recessed, imagine spending 20-30k euros for this ascension


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## Deusmaximus (Jun 10, 2022)

russiancel said:


> tbh nothing changed. Only side profile changed slightly which is mostly cope. Bimax is redundant as usual if you are not recessed, imagine spending 20-30k euros for this ascension


He would get a better resut with a wraparound jaw implant and leanmaxxing?


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## Wallenberg (Jun 10, 2022)

Good increaae in his airway volume.


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## Wallenberg (Jun 10, 2022)

Deusmaximus said:


> He would get a better resut with a wraparound jaw implant and leanmaxxing?


First bimax to fix airway then implants


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## russiancel (Jun 10, 2022)

Deusmaximus said:


> He would get a better resut with a wraparound jaw implant and leanmaxxing?


idk. I'm against wraparound jaw implant bc it looks like shit in most cases. Sometimes if patient is utterly recessed and need like 10-15mm bsso these cases with implant may look pretty good. And thus if you need big advancement IMO better stick with bimax and gonion implants/fillers. Personally I'm gonna cope with fillers into my gonions and if they'll look excellend, I consider gonion implants


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## HerpDerpson (Jun 10, 2022)

russiancel said:


> tbh nothing changed. Only side profile changed slightly which is mostly cope. Bimax is redundant as usual if you are not recessed, imagine spending 20-30k euros for this ascension


I dunno, his 3/4 looks much better too. Gave him some cheekbone definition. The front doesn't look like amorphous blob anymore either. 
It's just that, unfortunately, his other features are also bad.


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## fuckedupmanlet (Jun 10, 2022)

Deusmaximus said:


>



Great result. Too bad it costs like 40-50k to get this done.


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## buflek (Jun 10, 2022)

imagine paying 25k for this and not being able to eat and speak properly for weeks


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## KDA Player (Jun 10, 2022)

TBH it's conservative result but since every mm counts it's still better.


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## randomvanish (Jun 10, 2022)

Alfaro is overrated as fuck. I've only seen 1 legit good result.


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## Wallenberg (Jun 10, 2022)

This result should be good functionally. Now the airway volume is almost 2.5 times the volume before.


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## subhuman incel (Jun 10, 2022)

my bimax result is more impressive @Thompsonz and @MarkCorrigan can confirm


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## Deusmaximus (Jun 10, 2022)

Wallenberg said:


> This result should be good functionally. Now the airway volume is almost 2.5 times the volume before.


You think a guy with narrow airways can never be good in sports? Big airway important for endurance?


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## Deusmaximus (Jun 10, 2022)

subhuman incel said:


> my bimax result is more impressive @Thompsonz and @MarkCorrigan can confirm


Can i see the result? PM


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## russiancel (Jun 10, 2022)

buflek said:


> imagine paying 25k for this and not being able to eat and speak properly for weeks





randomvanish said:


> Alfaro is overrated as fuck. I've only seen 1 legit good result.


and he makes a PR on those results posted on his IG. So maybe there are more worse results which aren't there


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## Wallenberg (Jun 10, 2022)

Deusmaximus said:


> You think a guy with narrow airways can never be good in sports? Big airway important for endurance?


I don't know, but the difference in the airway volume is big. I think the guy should have an easier time breathing through the nose now.


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## Jon87 (Jun 10, 2022)

Wallenberg said:


> I don't know, but the difference in the airway volume is big. I think the guy should have an easier time breathing through the nose now.


I am the guy on the pics. Surgery has been done for sleeping apnea. I was not able to sleep anymore. Awaken many times during the night. Headacke the whole morning, exhausted the whole day, impossibilty to concentratre at work ,...


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## Deleted member 19551 (Jun 10, 2022)

Looks like every overbite cel before and after they learn what jutting is


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## Wallenberg (Jun 10, 2022)

Jon87 said:


> I am the guy on the pics. Surgery has been done for sleeping apnea. I was not able to sleep anymore. Awaken many times during the night. Headacke the whole morning, exhausted the whole day, impossibilty to concentratre at work ,...


I assume now you breath much better and your quality of life improved tremendously?


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## chigoha (Jun 10, 2022)

+0.1 PSL 

he would have ascended way more with rhino or jaw fillers


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## CursedOne (Jun 10, 2022)

Alfaro akbar


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## Jon87 (Jun 10, 2022)

Wallenberg said:


> I assume now you breath much better and your quality of life improved tremendously?


Completely. Much better morale and less anxiety now I can rest.


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## NOTCHADRIP (Jun 10, 2022)

buflek said:


> imagine paying 25k for this and not being able to eat and speak properly for weeks


Not true he does it in minimally invasive way


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## NOTCHADRIP (Jun 10, 2022)

I cannot wait to talk with alafaro


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## Jon87 (Jun 10, 2022)

NOTCHADRIP said:


> Not true he does it in minimally invasive way


Exactly. I was able to speak properly few hours after the op. Liquid diet one week. Soft food then. Recovery was pretty easy.


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## freeone12 (Jun 10, 2022)

@Jon87 short face syndrom before right?


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## Jon87 (Jun 10, 2022)

freeone12 said:


> @Jon87 short face syndrom before right?


Yes. And it used to be even worse than on these before pics. I already had a first bimax one year and half ago with 5mm down and 6mm forward before the one with Alfaro.


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## freeone12 (Jun 10, 2022)

yeah, you improved in this area a lot


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## HerpDerpson (Jun 10, 2022)

Deusmaximus said:


> You think a guy with narrow airways can never be good in sports? Big airway important for endurance?


Harry Kane is a literal mouthbreather.


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## stewiegriffin (Jun 10, 2022)

Jon87 said:


> Exactly. I was able to speak properly few hours after the op. Liquid diet one week. Soft food then. Recovery was pretty easy.


Can you give a full description of your recovery. This is mostly what makes me not want to get the surgery. I don’t want to be unable to function for too long


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## epictroll (Jun 10, 2022)

Just because you can’t afford jaw surgery doesn’t mean it isn’t effective.

This is a significant change, the face went from blobby to defined, lower third improved a lot.

Jaw surgery is the only surgery that could’ve had this aesthetic affect, how was he supposed to looksmax with a blobby face?


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## stewiegriffin (Jun 10, 2022)

epictroll said:


> Just because you can’t afford jaw surgery doesn’t mean it isn’t effective.
> 
> This is a significant change, the face went from blobby to defined, lower third improved a lot.
> 
> Jaw surgery is the only surgery that could’ve had this aesthetic affect, how was he supposed to looksmax with a blobby face?


This is exactly why I want it. I HATE being skinny with a undefined blobby face. @Jon87 did u also lose a lot of weight or is that mostly the surgery that makes ur face thinner


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## Deleted member 19551 (Jun 10, 2022)

🤣🤣🤣🤣🤣🤣🤣

This is the pipe dream of every serial mental masturbator here?

From invisible without x ray goggles to invisible without ultra violet goggls 🤣🤣🤣🤣


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## Jon87 (Jun 10, 2022)

stewiegriffin said:


> This is exactly why I want it. I HATE being skinny with a undefined blobby face. @Jon87 did u also lose a lot of weight or is that mostly the surgery that makes ur face thinner


Weight is almost the same. And the after pics were done one month after so there's still a bit of swelling.


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## stewiegriffin (Jun 10, 2022)

Jon87 said:


> Weight is almost the same. And the after pics were done one month after so there's still a bit of swelling.


Post a pic so I know it’s actually u. 😂


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## stewiegriffin (Jun 10, 2022)

Jon87 said:


> Weight is almost the same. And the after pics were done one month after so there's still a bit of swelling.


Also how much did u pay


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## Jon87 (Jun 10, 2022)

stewiegriffin said:


> Can you give a full description of your recovery. This is mostly what makes me not want to get the surgery. I don’t want to be unable to function for too long


Well with Alfaro the recovery was easy. When I left the hospital the day after I felt good enough to walk to my hotel one hour. Then the afternoon I had a two hours walk in Barcelona too. I was just a bit tired the next days. After ten days no one could have said I had surgery. And went back to work. Food is a bit anoying but you learn step by step to chew again. I had a first bimax last year with another surgeon. It was harder in a way it was much more unconfortable due to the swelling. The two first weeks very tiring. But at least in three-four weeks you go back to a normal life.


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## Jon87 (Jun 10, 2022)

stewiegriffin said:


> Also how much did u pay


40k


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## Hipcel (Jun 10, 2022)

Jon87 said:


> Well with Alfaro the recovery was easy. When I left the hospital the day after I felt good enough to walk to my hotel one hour. Then the afternoon I had a two hours walk in Barcelona too. I was just a bit tired the next days. After ten days no one could have said I had surgery. And went back to work. Food is a bit anoying but you learn step by step to chew again. I had a first bimax last year with another surgeon. It was harder in a way it was much more unconfortable due to the swelling. The two first weeks very tiring. But at least in three-four weeks you go back to a normal life.


Alfaro is the Paley (LL) of maxfac surgeons. Top league but expensive


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## Hipcel (Jun 10, 2022)

russiancel said:


> tbh nothing changed. Only side profile changed slightly which is mostly cope. *Bimax is redundant as usual if you are not recessed*, imagine spending 20-30k euros for this ascension


Mostly side profile improvements for cases like the shared OP, but if you're truly recessed, probably your upper maxilla is too.

You gotta find that Russian fag that offers Lefort 2 for cosmetic reasons or 2 others that'll cost you a fortune or cope with midface implants and under eye BS that will try to mask the problem but won't fix it.


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## russiancel (Jun 10, 2022)

Hipcel said:


> Mostly side profile improvements for cases like the shared OP, but if you're truly recessed, probably your upper maxilla is too.
> 
> You gotta find that Russian fag that offers Lefort 2 for cosmetic reasons or 2 others that'll cost you a fortune or cope with midface implants and under eye BS that will try to mask the problem but won't fix it.


better go bonesmash your brain and go back when you gain some IQ points


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## Hipcel (Jun 10, 2022)

russiancel said:


> better go bonesmash your brain and go back when you gain some IQ points


What? You realize Lefort 2 affects the eye area or you're intellectually retarded?


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## russiancel (Jun 10, 2022)

Hipcel said:


> What? You realize Lefort 2 affects the eye area or you're intellectually retarded?


none does lf2 for cosmetical reasons jfl I have to text with larpcel


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## Hipcel (Jun 10, 2022)

russiancel said:


> none does lf2 for cosmetical reasons jfl I have to text with larpcel


Dr. Andreishchev. Do you actually think ANY surgeons that can perform Lf2, won't do it if you pay them *enough*?

Where are these morons coming from? Where do you live in a moneyless commie toilet or in the toilet that your username implies?

Because there they still use money.


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## russiancel (Jun 10, 2022)

Hipcel said:


> Dr. Andreishchev. Do you actually think ANY surgeons that can perform Lf2, won't do it if you pay them *enough*?
> 
> Where are these morons coming from? Where do you live in a moneyless commie toilet or in the toilet that your username implies?
> 
> Because there they still use money.


i live in lada


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## ROTTING (Jun 10, 2022)

Hipcel said:


> Dr. Andreishchev. Do you actually think ANY surgeons that can perform Lf2, won't do it if you pay them *enough*?
> 
> Where are these morons coming from? Where do you live in a moneyless commie toilet or in the toilet that your username implies?
> 
> Because there they still use money.


Lf2 is a little bit far fetche tbh.
I’m 100% sure not a single fucking looksmaxxer in the history of psl is gonna be able to get a lf2


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## LooksOverAll (Jun 10, 2022)

LightSkinNoob said:


> +1.5 PSL great result.


More like 0.25 PSL increase. Average .org user who thinks bimax will turn him into a slayer.


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## epictroll (Jun 10, 2022)

Jon87 said:


> Well with Alfaro the recovery was easy. When I left the hospital the day after I felt good enough to walk to my hotel one hour. Then the afternoon I had a two hours walk in Barcelona too. I was just a bit tired the next days. After ten days no one could have said I had surgery. And went back to work. Food is a bit anoying but you learn step by step to chew again. I had a first bimax last year with another surgeon. It was harder in a way it was much more unconfortable due to the swelling. The two first weeks very tiring. But at least in three-four weeks you go back to a normal life.



Any idea why the recovery with Alfaro was so much easier? Was it because of his “minimally invasive” approach?

Can you share pics before your first bimax?

Also, do you think doing this staggered two surgeries approach was necessary to achieve your final result, or if you would’ve gone to Alfaro first do you think you could’ve had the same amount of total movement in one surgery?

I really appreciate you sharing your experience and answering questions, you look great.


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## thereallegend (Jun 10, 2022)

His face got narrower?


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## Jon87 (Jun 10, 2022)

epictroll said:


> Any idea why the recovery with Alfaro was so much easier? Was it because of his “minimally invasive” approach?
> 
> Can you share pics before your first bimax?
> 
> ...


Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,... 

Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything. 

My before bimaxs and my after Alfaro's one :


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## epictroll (Jun 10, 2022)

Jon87 said:


> Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,...
> 
> Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything.
> 
> My before bimaxs and my after Alfaro's one :


Holy shit!!! This is absolutely insane!

Thanks for sharing, congrats on your new life.


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## lasthope (Jun 10, 2022)

Jon87 said:


> Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,...
> 
> Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything.
> 
> My before bimaxs and my after Alfaro's one :


Do you have any sensation loss?

Or does your mouth and so on feel completely normal after surgery


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## Jon87 (Jun 10, 2022)

epictroll said:


> Any idea why the recovery with Alfaro was so much easier? Was it because of his “minimally invasive” approach?
> 
> Can you share pics before your first bimax?
> 
> ...





lasthope said:


> Do you have any sensation loss?
> 
> Or does your mouth and so on feel completely normal after surgery


I am not even 3 months post op so no feeling in the lower lips and the top of the chin yet. After my first bimax 95% sensation came back.


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## epictroll (Jun 11, 2022)

Jon87 said:


> I am not even 3 months post op so no feeling in the lower lips and the top of the chin yet. After my first bimax 95% sensation came back.


How much does it bother you?

When I go to dentist, they sometimes numb my gums. It feels like they are super swollen, and the swollen feeling extends to my lips. Although it is supposed to feel like they are "numb" I definitely feel something and it is kind of annoying.

Is the numbness something you can actually feel or think about? Does it bother you at all?


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## 6ft4 (Jun 11, 2022)

...


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## dakchuh (Jun 11, 2022)

Jon87 said:


> Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,...
> 
> Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything.
> 
> My before bimaxs and my after Alfaro's one :


imo you look slightly dogmaxxed in the after due to weak upper third, but still much better than before. how much movement did you get from the first bimax and how much movement from second bimax? got any pics of before both surgeries?


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## 6ft4 (Jun 11, 2022)

So post 1st surgery to post 2nd surgery took you from an airway of 19 to an airway of 47
I will take a guess and say before your first bimax your airway was 10-12 because presumably the first bimax enhanced your airway
If so, that would mean surgery can increase someone's airway by 4x and your lower maxilla didn't even look recessed before your first surgery, your top lip appears in front of your browridge

It's crazy how goodlooking, properly facially developed people are naturally breathing 4x more effectively than people with facial issues. 
Goodlooking people are literally 4x better at keeping themselves alive than non goodlooking people 

I had SARPE and felt like it enhanced my breathing 2x, recovering from sprinting is much easier since then
Taking my maxilla from clinically recessed to hopsfully above average advancement will hopefully make me feel like I've unlocked god mode in terms of breathing capabilities


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## Jon87 (Jun 11, 2022)

epictroll said:


> How much does it bother you?
> 
> When I go to dentist, they sometimes numb my gums. It feels like they are super swollen, and the swollen feeling extends to my lips. Although it is supposed to feel like they are "numb" I definitely feel something and it is kind of annoying.
> 
> Is the numbness something you can actually feel or think about? Does it bother you at all?


It's anoying when you eat. But beside that I don't think about it. The nerves recovery is long and I am patient. I am confident it will come back step by step. Few weeks ago I was not feeling my chin at all.


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## Reckless Turtle (Jun 11, 2022)

Jon87 said:


> Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,...
> 
> Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything.
> 
> My before bimaxs and my after Alfaro's one :


Was rhinoplasty part of the procedure or are the changes in nasal appearance strictly from jaw surgery?


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## Jon87 (Jun 11, 2022)

dakchuh said:


> imo you look slightly dogmaxxed in the after due to weak upper third, but still much better than before. how much movement did you get from the first bimax and how much movement from second bimax? got any pics of before both surgeries?


Yes I plan to have cheek infraorbital implants to balance the face now. You have a pic of the before in a post above. Total advancement were maxilla 6 + 4.5mm, mandibule 6 + 15.5mm


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## Jon87 (Jun 11, 2022)

Reckless Turtle said:


> Was rhinoplasty part of the procedure or are the changes in nasal appearance strictly from jaw surgery?


No rhinoplasty. Or it would have been a very badly one done haha.


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## Reckless Turtle (Jun 11, 2022)

Jon87 said:


> No rhinoplasty. Or it would have been a very badly one done haha.


The amount of forward movement of your anterior nasal spine is impressive.


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## dakchuh (Jun 11, 2022)

thereallegend said:


> His face got narrower?


thats a good thing. his jaws were chubby, you can see how it bulges out a little. alfaro's bimax made his face leaner. lifefuel tbh i got the same chubby look around my jaws.


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## Zenturio (Jun 13, 2022)

Deusmaximus said:


>



he had that much ccw yet his nose wasnt cucked? Also upper lip barely changed despite this being 5-7 degrees of ccw rotation. Interesting
Also his smile looks wider?


subhuman incel said:


> my bimax result is more impressive @Thompsonz and @MarkCorrigan can confirm


please dm me your result


Jon87 said:


> I am the guy on the pics. Surgery has been done for sleeping apnea. I was not able to sleep anymore. Awaken many times during the night. Headacke the whole morning, exhausted the whole day, impossibilty to concentratre at work ,...


can you tell me what movements you had?


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## Jon87 (Jun 13, 2022)

Zenturio said:


> he had that much ccw yet his nose wasnt cucked? Also upper lip barely changed despite this being 5-7 degrees of ccw rotation. Interesting
> Also his smile looks wider?
> 
> please dm me your result
> ...


I had 4.5mm maxilla advancement and 15.5 mandibule. 7-8° ccw


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## Zenturio (Jun 13, 2022)

Jon87 said:


> I had 4.5mm maxilla advancement and 15.5 mandibule. 7-8° ccw


Did your nose get wider? Did your mouth get wider? What about lip changes?


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## Jon87 (Jun 13, 2022)

Zenturio said:


> Did your nose get wider? Did your mouth get wider? What about lip changes?


Nose a little bit wider I noticed in comparing pictures. Mouth a bit wider. And upper lips definitly more fleshy.


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## lasthope (Jun 13, 2022)

Jon87 said:


> Nose a little bit wider I noticed in comparing pictures. Mouth a bit wider. And upper lips definitly more fleshy.


Is 87 your birth age? 

Is your feeling back again?


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## Silver (Jun 13, 2022)

@Jon87 Great result, good on you for taking action. When looking at the after pictures that Alfaro has published of your result it kinda looks like you have edge-to-edge bite now with posterior open bite, am I mistaken or do you have occlusal problems atm?


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## Zenturio (Jun 13, 2022)

Jon87 said:


> Nose a little bit wider I noticed in comparing pictures. Mouth a bit wider. And upper lips definitly more fleshy.


any negative things you noticed?


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## chemosh (Jun 13, 2022)

Jon87 said:


> Nose a little bit wider I noticed in comparing pictures. Mouth a bit wider. And upper lips definitly more fleshy.


How is this post op regarding eating foods? You said soft foods after one weeks? When did you got back to normal foods? How is eating with numbing lips?

Can you compare your post op with alfaro and the traditional one you got before?


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## Jon87 (Jun 13, 2022)

lasthope said:


> Is 87 your birth age?
> 
> Is your feeling back again?


Yes I am 35.

Feeling is back 80% in the chin. Sensations are coming back slowly in the lips. Like the first bimax the right side takes more time.


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## Jon87 (Jun 13, 2022)

Silver said:


> @Jon87 Great result, good on you for taking action. When looking at the after pictures that Alfaro has published of your result it kinda looks like you have edge-to-edge bite now with posterior open bite, am I mistaken or do you have occlusal problems atm?


No edge to edge bite. I have open posterior bite yes. My ortho is working on pulling 8 molars and premolars and close the space. It's something common when you have big ccw.


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## Jon87 (Jun 13, 2022)

Zenturio said:


> any negative things you noticed?


Aestheticaly, a notch is visible in the mandibule now. I have no ogee curve anymore. I think that's it. But I plan to get infra and jaw angles implants at the end of the year to fix that.


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## Jon87 (Jun 13, 2022)

chemosh said:


> How is this post op regarding eating foods? You said soft foods after one weeks? When did you got back to normal foods? How is eating with numbing lips?
> 
> Can you compare your post op with alfaro and the traditional one you got before?


One week liquid diet. And soft food step by step. It's not that anoying because you can eat whatever you want as far as you mix or cut your food. Numb lower lips is anoying. I use my tongue to guide the glass, spoon,... Post op with mini invasiv surgery is way easier. Much less tiring. Much less inflammation. And you look normal after 10 days.


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## Silver (Jun 13, 2022)

Jon87 said:


> No edge to edge bite. I have open posterior bite yes. My ortho is working on pulling 8 molars and premolars and close the space. It's something common when you have big ccw.


Was the posterior open bite prominent post surgery or did it come with time? Could be relapse if so.

Pulling 8 teeth seems rather excessive, wasn't your bite already fine after your 1st bimax? If you have the possibility to, try to get a 2nd opinion on the tooth extraction.


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## Zenturio (Jun 13, 2022)

Jon87 said:


> Aestheticaly, a notch is visible in the mandibule now. I have no ogee curve anymore. I think that's it. But I plan to get infra and jaw angles implants at the end of the year to fix that.


With notch you mean the step off where the bsso cut was made?


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## Jon87 (Jun 13, 2022)

Silver said:


> Was the posterior open bite prominent post surgery or did it come with time? Could be relapse if so.
> 
> Pulling 8 teeth seems rather excessive, wasn't your bite already fine after your 1st bimax? If you have the possibility to, try to get a 2nd opinion on the tooth extraction.


Well it's not really an open bite as the last molars are in contact. And by pulling I mean few mm to get the contact again. After one month ortho one side is almost closed. No extraction of course.


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## Jon87 (Jun 13, 2022)

Zenturio said:


> With notch you mean the step off where the bsso cut was made?


Yes


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## A23ghskung (Jun 13, 2022)

His failos were eyes and eyebrows


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## Zenturio (Jun 14, 2022)

Jon87 said:


> Yes


Not really noticeable


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## Chinlet Ascension (Jun 14, 2022)

Maybe a 0.5/10 increase (not PSL autism points)


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## Jon87 (Jun 19, 2022)

Deusmaximus said:


>




I am thinking about getting jaw angles at the end of the year. I don't need that much width according to my scanns. It's more about lengthening the ramus which is very high (see 3D above). I don't find similar cases which don't look too bloated with implants. Also ramus lengthenings seem always conservative compare to widening. Any idea what could be done ? @Jade


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## Jade (Jun 19, 2022)

Jon87 said:


> I am thinking about getting jaw angles at the end of the year. I don't need that much width according to my scanns. It's more about lengthening the ramus which is very high (see 3D above). I don't find similar cases which don't look too bloated with implants. Also ramus lengthenings seem always conservative compare to widening. Any idea what could be done ? @Jade


If you and your surgeon agree that you need or want a longer ramus (vertically speaking), then that's what you should get.

I believe the important thing here is understanding what looks best for you (according to your likes and expectations).

"I don't need that much width, according to my scans." - I would NOT make an opinion on the scans alone, but if you believe this when you look at your face in real life, then I can understand it.

If you are 100% sure that you need a "longer ramus" or vertical enhancing jaw implant, you should get vertical enhancing implants.

You mentioned that you had bimax surgery before. You also mentioned that you are planning to get jaw angles and "cheek/infra."

Where are you from, and what does "cheek/infra" mean to you exactly? 

I believe cheek implants are specific to whatever effect you expect them to produce. So, when you say 'infra" I am assuming you have hollowness in the mid-face. If you had a bimax before, typically, people in your situation do have a sunken mid-face.


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## Jade (Jun 19, 2022)

@Jon87 Is that you in the picture? 

I just read some of your previous comments here, and I am still confused. I didn't know that was you.

First of all, why do so MANY OF YOU guys here pay so much money for these surgeries??? What is wrong with you? 

You guys keep saying *25k- 40k.* WHY?? Oh, God. 

These surgeries were expensive 10 years ago, but NOT NOW!


----------



## Jon87 (Jun 20, 2022)

Jade said:


> View attachment 1741694
> 
> 
> @Jon87 Is that you in the picture?
> ...


Well, about my surgery with Alfaro I went with him because I had sleeping apnea and I was a complicated case. I had already a first bimax which didn't cure me. And no other surgeon was able to do a revision with so much advancement and ccw. It's of course a lot of money but it really changed my everyday life. So spending one year saving for that was worth. 


About implants I meant infraorbital rim. You can see on my ¾ pic I have no ogee curve anymore and the eye area needs more support. I am quite confident about Pagnoni's skills in this area, he shown me good results. 


The jaw area is more tricky for me. I wonder how much is it possible to extend the ramus and how good does it look. I haven't found examples with more than 8-9mm. Is it because there is a risk of masseter deattachment ? Tbh I don't really see how is the muscle attachment in this area and what can be done.


----------



## lasthope (Jun 20, 2022)

Jon87 said:


> Well, about my surgery with Alfaro I went with him because I had sleeping apnea and I was a complicated case. I had already a first bimax which didn't cure me. And no other surgeon was able to do a revision with so much advancement and ccw. It's of course a lot of money but it really changed my everyday life. So spending one year saving for that was worth.
> 
> 
> About implants I meant infraorbital rim. You can see on my ¾ pic I have no ogee curve anymore and the eye area needs more support. I am quite confident about Pagnoni's skills in this area, he shown me good results.
> ...


Did you had before bimax a ogre curve?

Would you personally say the recovery would be worth it “only” for aesthetic reasons?


----------



## Jon87 (Jun 20, 2022)

lasthope said:


> Did you had before bimax a ogre curve?
> 
> Would you personally say the recovery would be worth it “only” for aesthetic reasons?


The recovery for implants constists in swelling for few weeks. I can handle it.


----------



## Jade (Jun 20, 2022)

Jon87 said:


> Well, about my surgery with Alfaro I went with him because I had sleeping apnea and I was a complicated case. I had already a first bimax which didn't cure me. And no other surgeon was able to do a revision with so much advancement and ccw. It's of course a lot of money but it really changed my everyday life. So spending one year saving for that was worth.
> 
> 
> About implants I meant infraorbital rim. You can see on my ¾ pic I have no ogee curve anymore and the eye area needs more support. I am quite confident about Pagnoni's skills in this area, he shown me good results.
> ...


You have some very good and specific questions. I'll respond in a bit. I think it will be useful for doctors and patients to learn from this.


----------



## Jade (Jun 20, 2022)

Jon87 said:


> Well, about my surgery with Alfaro I went with him because I had sleeping apnea and I was a complicated case. I had already a first bimax which didn't cure me. And no other surgeon was able to do a revision with so much advancement and ccw. It's of course a lot of money but it really changed my everyday life. So spending one year saving for that was worth.


You have some clear asymmetry in the jaw area. It is extremely difficult to achieve perfection with a bimax, but I have seen better results than yours. (respectfully).


Jon87 said:


> About implants I meant infraorbital rim. You can see on my ¾ pic I have no ogee curve anymore and the eye area needs more support. I am quite confident about Pagnoni's skills in this area, he shown me good results.


Could you "benefit" from having cheek implants? I guess you would. Of course, that is up to you, and I can see what you are referring to. (it would be helpful if you took your picture and drew on it to describe what you want ) 

You do have a nice amount of youthful fat in the mid-face, but I do agree with you, the ogee curve isn't there a whole lot. 

*"Pagnoni's skills in this area, he shown me good results." * You are focusing on the wrong thing. Do NOT focus on the surgeon - any maxillofacial surgeon can do a good job with the right tools. 



Jon87 said:


> The jaw area is more tricky for me. I wonder how much is it possible to extend the ramus and how good does it look. I haven't found examples with more than 8-9mm. Is it because there is a risk of masseter deattachment ? Tbh I don't really see how is the muscle attachment in this area and what can be done.



Mine extends 10 mm vertically, and I know for a FACT that I should have gone longer. But I am happy for right now, though. 

The problem here is understanding the materials used and the strength needed to hold them in place. Also, the approach taken by the doctor is important too. 

What approach are you thinking of for the "infraorbital rim"? 

Let's take this one question at a time so we can keep track of it all. Does that sound ok to you?


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## freeone12 (Jun 20, 2022)

Chinlet Ascension said:


> Maybe a 0.5/10 increase (not PSL autism points)


dude... look at his before first bimax in paris and after alfaro, day & night

who is surgeon you thinking about when it comes to getting jaw implants?


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## Jade (Jun 20, 2022)

LOL!! @NegativeNorwood What do you want to know?? Just ask, dude. It's ok!! Be specific, though. 

I have not read your history, so tell me your situation.


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## NegativeNorwood (Jun 20, 2022)

Jade said:


> *"Pagnoni's skills in this area, he shown me good results." * You are focusing on the wrong thing. Do NOT focus on the surgeon - any maxillofacial surgeon can do a good job with the right tools.
> 
> The problem here is understanding the materials used and the strength needed to hold them in place. Also, the approach taken by the doctor is important too.



This is very interesting. Let me know if I get this right or not. According to you, is it better to go to any maxfac that has "the right tools" (ie: does PEEK implants instead of silicone?) and not pay attention to the surgeon's previous experience or work. For example, if I find a taiwan/brazil/etc much cheaper surgeon that uses PEEK and I can communicate my aesthetic desires correctly, it would be the same outcome as going to an european surgeon with more experience and higher prices?



Jade said:


> LOL!! @NegativeNorwood What do you want to know?? Just ask, dude. It's ok!! Be specific, though.
> 
> I have not read your history, so tell me your situation.



Not going to post pics in public, but I have a narrow palate, narrow jaw and undereye hollowness. I'm not recessed in side profile and have class 1 bite. Had 6 extractions (4 wisdom tooth and 2 molars) I will get SARPE and MSDO first, then 2 molar implants and after that I want to have jaw implants and custom infraorbital-malar implants. I'm 30 years old. Currently losing weight (already lost 30 pounds but have to lose another 20-30) and saving money. Will have SARPE, MSDO and tooth implants done where I live (Spain) but probably will travel to a different country for the implants (Pagnoni in Italy seems to have great results and is quite popular with users here).

My main questions are:
- What red flags should I be aware of when talking to a surgeon?
- If an implant goes wrong or I do not like the result, is the revision free or how much should I expect to pay for it?
- What surgeons work with custom PEEK implants in countries where surgery is much cheaper? I've only found Augusto Pary (Brazil) but do not like his infraorbital implants results too much (too feminine looking IMO and doesn't seem to do the ones that come with a saddle). I've also found Dr Adrian Hsieh (Taiwan) on Instagram who has great results but doesn't seem to use PEEK.


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## materialistic (Jun 20, 2022)

Mouth clearly got wider. Lifefuel tbh.


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## Jade (Jun 20, 2022)

@NegativeNorwood 

I don't have PEEK myself, but PEEK is fine. I could have chosen PEEK, but I didn't want to pay extra for the same outcome and benefit. I would never do silicone, though. 

Of course, you'd want to go to a reputable surgeon with EXPERIENCE! I think that goes without saying. I can see how my comments can be confusing in that regard, though.

Implants are a cakewalk for most maxillofacial surgeons who do this for a living.


*"My main questions are:"

- What red flags should I be aware of when talking to a surgeon?* Too many to mention here because they have to sell their services (which is normal) 

*- If an implant goes wrong or I do not like the result, is the revision free, or how much should I expect to pay for it?* You will likely pay for the whole thing all over again. You have to come to a deal with your doctor first. Or find a company that will offer warranties to you or your doctor. 


*"- What surgeons work with custom PEEK implants in countries where surgery is much cheaper? I've only found Augusto Pary (brazil) but do not like his infraorbital implants results too much (too feminine looking IMO and doesn't seem to do the ones that come with a saddle)."*

Taiwan seems too far for me, and I don't know much about that. 

*Augusto Pary* has some nice results, however, his implants (the actual) implants seem to be made out of "bone cement," which is beyond pathetic, but like anything else, they could work too. I would not recommend that approach, though. However, from the things he shows, Augusto Pary seems to be a very good surgeon. 

If you do live in Spain, find someone near you. I personally traveled overseas for my last surgery. Ok, so I'm from the US, and I didn't have to travel too far. 

I don't blame you for not showing your face online. I guess you'd just have to talk to some surgeons and get quotes from them. 

Please, do not be a child and do not misinterpret what I am about to tell you: 

I recently accompanied two patients who underwent surgeries like you. A lady from Dallas Tx and a young guy too. 

You have to plan a lot, which is the main problem with these types of surgeries.


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## lasthope (Jun 20, 2022)

Jon87 said:


> The recovery for implants constists in swelling for few weeks. I can handle it.


I mean especially the bimax


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## NegativeNorwood (Jun 20, 2022)

Jade said:


> @NegativeNorwood
> 
> I don't have PEEK myself, but PEEK is fine. I could have chosen PEEK, but I didn't want to pay extra for the same outcome and benefit. I would never do silicone, though.
> 
> ...



Thanks for such a detailed response! Don't worry, 0 offense taken.
Just a couple of questions more if you don't mind:

- Which materials other than PEEK you consider good for implants? I've read you mentioning "UHMWPE" before but I don't know anything about it or any surgeon that uses it.
- By planning, yo mean taking into account down time after surgery, swelling and the amount of time needed to get "back to the normal everyday tasks", taking into account things could probably go wrong and take even more time? Will appreciate if you please can expand a bit more on this.

Again, thanks for the help!


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## Jade (Jun 20, 2022)

@NegativeNorwood 

*"- Which materials other than PEEK do you consider good for implants? "*

There is a variety of FDA (in the USA) approved materials that are class II or long-term implantables. 

Any of these materials could work for your doctor. The problem is not the material but making the implants themselves. Also, most doctors haven't used these materials. They are just not used to using them - that's all. 

Only a few companies in the world can make good implants, but they do not work with you necessarily. 

Some doctors use PMMA (bone cement), Silicone, Peek, Medpor, or Polyethylene (UHMWPE). There are other materials available, though. 

I went with Polyethylene (UHMWPE), the same material you've probably seen on a knee, shoulder, or hip replacements. 

*"- By planning, you mean taking into account downtime after surgery."*

No. I do not mean the post-op scenarios. I mean the pre-op planning. 
You see, you mentioned that you don't like *Augusto Pary's *cheek implants, but that is wrong. An aesthetic implant is what YOU want, not what the doctor wants only. Also, you'd have to be smart and understand that *NO DOCTOR* in the universe has complete control over your aesthetic outcome. 

Planning is everything, unfortunately, it is very expensive for most doctors to devote all of their time and efforts to you alone. Also, most surgeons don't know what good looks are.


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## NegativeNorwood (Jun 20, 2022)

Jade said:


> @NegativeNorwood
> 
> *"- Which materials other than PEEK do you consider good for implants? "*
> 
> ...



Makes complete sense to me, thanks for explaining!


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## Chinlet Ascension (Jun 20, 2022)

freeone12 said:


> who is surgeon you thinking about when it comes to getting jaw implants?


Eppley or Yaremchuk. Not many options other than those guys, to be honest.


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## Jade (Jun 21, 2022)

Chinlet Ascension said:


> Eppley or Yaremchuk. Not many options other than those guys, to be honest.


There are many options, actually. About 16 years ago, I used to look at it the same way you do. ✌️


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## Jade (Jun 21, 2022)

@NegativeNorwood Hey, I just wrote a new post. Could you please chime in? I believe you have a good pulse on the subject, and I am trying to get to the bottom of these pricing concerns. 

I would love you and others like @Wallenberg to help demystify this once and for all. I feel it is useful to talk about this. I hope you can help spread awareness to others on this forum. Can you invite others here? Who do you think are the knowledgeable guys here looksmax?









I bought my doctor a BMW for jaw, chin, and cheek implants.


Is it ok with y'all if we talk money? I believe many of us want to get jaw, chin, and cheek implants (wraparound), but many don't have money to pay for them. How much do you feel they should cost - how much do you think it would be reasonable to pay for them? I just saw a clinic in...




looksmax.org


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## NegativeNorwood (Jun 21, 2022)

Jade said:


> @NegativeNorwood Hey, I just wrote a new post. Could you please chime in? I believe you have a good pulse on the subject, and I am trying to get to the bottom of these pricing concerns.
> 
> I would love you and others like @Wallenberg to help demystify this once and for all. I feel it is useful to talk about this. I hope you can help spread awareness to others on this forum. Can you invite others here? Who do you think are the knowledgeable guys here looksmax?
> 
> ...



Done bro


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## Chinlet Ascension (Jun 21, 2022)

Jade said:


> There are many options, actually. About 16 years ago, I used to look at it the same way you do. ✌️


OK. Who are the other doctors who offer custom implants?


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## Jade (Jun 21, 2022)

Chinlet Ascension said:


> OK. Who are the other doctors who offer custom implants?


If you are serious ( I don't even get you guys anymore), but if you are serious about that, tell us where you live and I am sure I or someone here can find one in your country. 🤷‍♂️. Or near your country.


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## Chinlet Ascension (Jun 21, 2022)

Jade said:


> If you are serious ( I don't even get you guys anymore), but if you are serious about that, tell us where you live and I am sure I or someone here can find one in your country. 🤷‍♂️. Or near your country.


United States


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## Jade (Jun 21, 2022)

Chinlet Ascension said:


> United States


Well, you have lots of options. I am not even supposed to be here anymore!!!! I told a guy I was gonna leave this forum for good. Read this. 









I bought my doctor a BMW for jaw, chin, and cheek implants.


Is it ok with y'all if we talk money? I believe many of us want to get jaw, chin, and cheek implants (wraparound), but many don't have money to pay for them. How much do you feel they should cost - how much do you think it would be reasonable to pay for them? I just saw a clinic in...




looksmax.org


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## Chinlet Ascension (Jun 21, 2022)

Jade said:


> Well, you have lots of options. I am not even supposed to be here anymore!!!! I told a guy I was gonna leave this forum for good. Read this.
> 
> 
> 
> ...


Honestly could you please just list the doctors? You have this spastic, verbose writing style that is painful to read.


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## Jade (Jun 22, 2022)

Chinlet Ascension said:


> Honestly could you please just list the doctors? You have this spastic, verbose writing style that is painful to read.


No, I can't list doctors. I do not promote any doctors because I do not trust doctors. Besides, you are going about this the wrong way. Describe what you want to do and .... You know what? You are going about this the wrong way.


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## Chinlet Ascension (Jun 22, 2022)

Jade said:


> No, I can't list doctors. I do not promote any doctors because I do not trust doctors. Besides, you are going about this the wrong way. Describe what you want to do and .... You know what? You are going about this the wrong way.


WTF are you talking about


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## Jade (Jun 22, 2022)

Chinlet Ascension said:


> WTF are you talking about


I'll explain. Give me a bit of time.


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## Jade (Jun 22, 2022)

@Chinlet Ascension 

I think you are focusing on the doctor too much, and in my experience, that is not the best approach. 

I went to the "best" doctors in the world, and some even stole money from me. That is correct, they charged me for things they didn't even do. 

I know it sounds crazy, but I could tell you many similar stories. If you try to fight it in court, you will spend more than the procedure itself.

I don't mind "helping," but the mere fact that you are asking for a "list", tells me that you are not entirely ready, and I feel you will make many mistakes. Maybe not, I don't know, of course.

Describe your needs or point me to a thread where you have talked about your situation or what you want to have done. 

A bit of context would help.


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## Chinlet Ascension (Jun 22, 2022)

Jade said:


> @Chinlet Ascension
> I know it sounds crazy, but I could tell you many similar stories. If you try to fight it in court, you will spend more than the procedure itself.
> 
> I don't mind "helping," but the mere fact that you are asking for a "list", tells me that you are not entirely ready, and I feel you will make many mistakes. Maybe not, I don't know, of course.


You're either trolling or schizophrenic. This is all pretentious babble.


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## Wallenberg (Jun 23, 2022)

freeone12 said:


> who is surgeon you thinking about when it comes to getting jaw implants?





Chinlet Ascension said:


> Eppley or Yaremchuk. Not many options other than those guys, to be honest.


Yaremchuk, Eppley, Zhang, Diamond, Dhir, Ramieri, Defrancq.

Personally, I consider Yaremchuk and Ramieri.


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## Jon87 (Jun 23, 2022)

Jade said:


> No, I can't list doctors. I do not promote any doctors because I do not trust doctors. Besides, you are going about this the wrong way. Describe what you want to do and .... You know what? You are going about this the wrong way.


As the time you investigate in designing the implants matter more than the surgeon, could you explain us what could be a good design process ? What are the traps to avoid ? It's easy to see where you want to had volume on your face, but translating that on the bone is tricky because it's hard to anticipate the outcome.


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## Jade (Jun 23, 2022)

Chinlet Ascension said:


> You're either trolling or schizophrenic. This is all pretentious babble.


Ok, sure. Respectfully, please don't ask me anything else.


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## Jade (Jun 23, 2022)

Wallenberg said:


> Yaremchuk, Eppley, Zhang, Diamond, Dhir, Ramieri, Defrancq.
> 
> Personally, I consider Yaremchuk and Ramieri.


I believe you limit yourself and other guys who have real needs when you only offer these relatively older surgeons as an option. 

I do not believe you come from a place of malice, but I feel you haven't been exposed to more possibilities. 

I am very much aware of people whose surgeons are the ones you mentioned, and these patients are not necessarily happy with their results. 

Think about it, the doctors you mentioned still use silicone for these implants. Just thinking of describing the number of possible complications gives me a headache. 

I have "worked" with guys and some ladies whose surgeons are the ones you mentioned above. 

I do not think they are bad doctors, but there are many more surgeons who could do a fantastic job too.


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## Wallenberg (Jun 23, 2022)

Jade said:


> I believe you limit yourself and other guys who have real needs when you only offer these relatively older surgeons as an option.
> 
> I do not believe you come from a place of malice, but I feel you haven't been exposed to more possibilities.
> 
> ...


Ramieri, Zhang, Diamond, and Dhir aren't old. 

Ramieri and Defrancq use PEEK. Yaremchuk uses silicone and medpor.


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## Jade (Jun 23, 2022)

@Jon87 

*"Could you explain to us what could be a good design process?"*

I have talked about this on other threads. 

Although there are some good starting points in implant design like facial geometry ("the golden ratio"), muscles, bone structure functionality, and surgery methods, these are only starting points.

*"It's easy to see where you want to had volume on your face, but translating that on the bone is tricky because it's hard to anticipate the outcome."*

Yes. It is tricky, that is why most people who have had implants (even custom implants) have had more than two surgeries for the same purpose. There are specific technics to minimize possible unwanted results, but nothing is ever 100% perfect because we are talking about flesh and bones.

It would be helpful for us all to understand that it is impossible to design an implant without understanding the patient's perspective on what they feel good looks are. Also, not all surgeons have the same ideologies on how to go about designing or even surgery methods. 

Look, I have a background in medical sales, and I have worked with doctors, patients and clinics. 

Everything I say can get misconstrued and misinterpreted, and I am biased to a large degree, and this could be a problem. 

I feel obligated to tell you about my background because I don't want you to take what I say as the "bible." 

I know you are a real patient, and I truly feel for you. 

If you have other more specific questions, we can discuss them here, but please keep in mind that I can be somewhat biased.


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## Jade (Jun 23, 2022)

Wallenberg said:


> Ramieri, Zhang, Diamond, and Dhir aren't old.
> 
> Ramieri and Defrancq use PEEK. Yaremchuk uses silicone and medpor.


Yup.


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## PURE ARYAN GENETICS (Jun 23, 2022)

wish somebody measured my airway like that


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## Jon87 (Jun 24, 2022)

Jade said:


> @Jon87
> 
> *"Could you explain to us what could be a good design process?"*
> 
> ...


I completely agree with you. You opinion is really important due to your experience and I appreciate it. But at least, it's one among others. What I try to do is collecting knowledge to optmize as much as possible the results of the surgery. At the end it's up to me to make my own opinion of what is good or not. 


About the outcome, I am not looking for perfection. I know I'll never be the best looking ever, I just want a good improvement. As far as I am not messed up I can live with it and shouldn't be too disappointed.


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## Jade (Jun 24, 2022)

Jon87 said:


> I completely agree with you. You opinion is really important due to your experience and I appreciate it. But at least, it's one among others. What I try to do is collecting knowledge to optmize as much as possible the results of the surgery. At the end it's up to me to make my own opinion of what is good or not.


I believe you are well informed, and I hope everything goes well. How much will you pay for your jaw implant procedure?

I feel it would help others and myself to know these things because they are essential. I compare prices based on location and type of surgery. 

If you have any other questions or thoughts, please let me know.


----------



## Jade (Jun 24, 2022)

@Jon87 
By the way, from your picture, I'd say you are a good-looking guy.

You said you'll never be the "best looking ever," but that is a subjective opinion. From your smile, you look like a charismatic guy with a great personality, and the ladies like that. You have nice eyes, and your overall face is NOT bad at all.

No, I am not a woman or "foid" or whatever other funny word guys use here, I am a man.

I just think that you are a good-looking dude who could do very well with the ladies and in life in general. 💪


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## tehVigilante (Jun 24, 2022)

This surgeries are legit if u have any sort of maloclusion, don't expect big improvements. It doesnt turn any normies in chads on itself.


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## Jon87 (Jun 24, 2022)

Jade said:


> I believe you are well informed, and I hope everything goes well. How much will you pay for your jaw implant procedure?
> 
> I feel it would help others and myself to know these things because they are essential. I compare prices based on location and type of surgery.
> 
> If you have any other questions or thoughts, please let me know.


Dr. Pagnoni quoted 22k for PEEK infraorbital, jaw angle implants and widening genio and he is at the moment my choice number 1. Dr. Ramieri 18k but for PEEK malar implants instead of infraorbital and normal genio. In France I got quotations for jaw angles + genio for 6k with porous titanium. But now you mentioned you can get that for at least 15k, I gonna investigate who else can propose PEEK or non porous polyethylene implants. I am OK to travel and take few weeks off for recovery.


----------



## Wallenberg (Jun 24, 2022)

Jon87 said:


> Dr. Pagnoni quoted 22k for PEEK infraorbital, jaw angle implants and widening genio and he is at the moment my choice number 1. Dr. Ramieri 18k but for PEEK malar implants instead of infraorbital and normal genio. In France I got quotations for jaw angles + genio for 6k with porous titanium. But now you mentioned you can get that for at least 15k, I gonna investigate who else can propose PEEK or non porous polyethylene implants. I am OK to travel and take few weeks off for recovery.


Who in France does jaw angle implants?


----------



## Jon87 (Jun 24, 2022)

Jade said:


> @Jon87
> By the way, from your picture, I'd say you are a good-looking guy.
> 
> You said you'll never be the "best looking ever," but that is a subjective opinion. From your smile, you look like a charismatic guy with a great personality, and the ladies like that. You have nice eyes, and your overall face is NOT bad at all.
> ...


Thanks. Maybe also the pics from Alfaro, asking for special angles with the mouth open are not the best to judge. I think with few things I can now achieve a more balance face and I will be happy with that specially compared to my starting point. Before having these surgeries for medical reason I never really realized how uncomfortable I was due to my important retrognathism and now this problem is solved I feel much better. And as you say the rest is about your personality.


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## Hueless (Jun 24, 2022)

No difference


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## Jon87 (Jun 24, 2022)

Wallenberg said:


> Who in France does jaw angle implants?


Dr Loncle in Paris. In Bordeaux, Dr Barere, Dr Verbrungen. But I have not been convinced by their aesthetics eyes and having a porous material in the body.


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## Jade (Jun 24, 2022)

@Jon87
Mmm, I don't think this 6k thing is a promising approach for the doctor or the patient. The numbers don't add up, and this makes me think that you will have to pay for other things in the back end.

With titanium, Medpore, or even with bone cement *Polymethyl methacrylate (PMMA)*, I would think twice about this pricing thing in Paris. 

I believe I have a good idea of how much these things cost in different parts of the world and how and why doctors charge what they charge, but 6k is not very doable no matter how I look at it, especially in France.

However, thinking of pricing alone could be a mistake. 22k is not necessarily better than 12k, and quality and safety in the medical field do not equal price simply.

The saying "you get what you pay for" does NOT apply here entirely.

In my opinion, ethics, norms, experience, process, and artistry are things you should consider primarily. Most of all, I believe you should consider yourself more than the doctor itself.

I have worked with guys who have paid over 30k in the US for their implants, and they are not happy with them.

Also, think about this for a second, please. If you are going to spend a similar amount to what a car costs, shouldn't that expense come with some guarantees of some sort?

Perhaps a deductable for the second try if you are not satisfied or other preventive measures?

How much would Alfaro charge you?


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## Jon87 (Jun 24, 2022)

Jade said:


> @Jon87
> Mmm, I don't think this 6k thing is a promising approach for the doctor or the patient. The numbers don't add up, and this makes me think that you will have to pay for other things in the back end.
> 
> With titanium, Medpore, or even with bone cement *Polymethyl methacrylate (PMMA)*, I would think twice about this pricing thing in Paris.
> ...


I am not considering having this surgery in France because of the reasons you explain and many others. After consulting plenty surgeons for my revision I understood we are not good in maxillofacial. 

As you say there are many parameters to care about. I just would like to consult other surgeons than the Italian ones to compare all the options. 

The problem with Alfaro is that he doesn't provide a full package wraparound-infraorbital. He does only jaw angles.


----------



## Jon87 (Jun 24, 2022)

Jade said:


> @Jon87
> Mmm, I don't think this 6k thing is a promising approach for the doctor or the patient. The numbers don't add up, and this makes me think that you will have to pay for other things in the back end.
> 
> With titanium, Medpore, or even with bone cement *Polymethyl methacrylate (PMMA)*, I would think twice about this pricing thing in Paris.
> ...


Second try is a good point and is worth to negociate.


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## Chinlet Ascension (Jun 25, 2022)

Wallenberg said:


> Yaremchuk, Eppley, Zhang, Diamond, Dhir, Ramieri, Defrancq.
> 
> Personally, I consider Yaremchuk and Ramieri.


Is it worth traveling abroad? How hard is it to get a Ramieri appointment as a foreigner?


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## Wallenberg (Jun 25, 2022)

Chinlet Ascension said:


> Is it worth traveling abroad? How hard is it to get a Ramieri appointment as a foreigner?


Yes. 

I don't think getting a Ramieri appointment as a foreigner is hard.


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## Chinlet Ascension (Jun 25, 2022)

Jade said:


> Ok, sure. Respectfully, please don't ask me anything else.


You deserve to get banned from the forum for your awful responses. This is just shitposting with a polite tone.


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## Jade (Jun 25, 2022)

Chinlet Ascension said:


> You deserve to get banned from the forum for your awful responses. This is just shitposting with a polite tone.


Bud, you are rude and disrespectful. I was trying to offer some well-intended comments, but you turned me off with your vocabulary. 

What kind of a person expresses themselves as you did? I realize you don't know me in person. Nevertheless, we should all try to keep it respectful.


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## Chinlet Ascension (Jun 26, 2022)

Jade said:


> Bud, you are rude and disrespectful. I was trying to offer some well-intended comments, but you turned me off with your vocabulary.
> 
> What kind of a person expresses themselves as you did? I realize you don't know me in person. Nevertheless, we should all try to keep it respectful.


I engaged you, multiple times, trying to have a back-and-forth about the topic at hand. You insisted on speaking like a fortune cookie and responding with non-answers that don't mean anything. Comments like the one below are just spam that pollute the forum with non-information. (If you really need me to point this out, you sound incredibly pretentious.)


Jade said:


> No, I can't list doctors. I do not promote any doctors because I do not trust doctors. Besides, you are going about this the wrong way. Describe what you want to do and .... You know what? You are going about this the wrong way.


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## epictroll (Jun 26, 2022)

Chinlet Ascension said:


> I engaged you, multiple times, trying to have a back-and-forth about the topic at hand. You insisted on speaking like a fortune cookie and responding with non-answers that don't mean anything. Comments like the one below are just spam that pollute the forum with non-information. (If you really need me to point this out, you sound incredibly pretentious.)



> *You insisted on speaking like a fortune cookie and responding with non-answers that don't mean anything


*


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## NoPainNoChick (Jun 26, 2022)

Literally 0 changes from the front.
If anything it made his face looks slightly longer.


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## Jade (Jun 26, 2022)

Chinlet Ascension said:


> I engaged you, multiple times, trying to have a back-and-forth about the topic at hand. You insisted on speaking like a fortune cookie and responding with non-answers that don't mean anything. Comments like the one below are just spam that pollute the forum with non-information. (If you really need me to point this out, you sound incredibly pretentious.)


Ok, maybe I didn't understand your exact intentions. My apologies.

The thing is, when you ask for a "list," I see it as you playing roulette. A list won't do you much good if you don't have a well-studied plan before you contact any doctors. Even when you do, they don't have the tools to help you as well as you think they would. 

Seeing people keep making the same mistakes I once made can be frustrating. I want you to have the perfect experience, but sometimes it is tough to see how some people go about their process.


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## Jade (Jun 26, 2022)

Hi, @Jon87 

You make the distinction of mentioning infraorbital vs. malar implants. Can you explain why you think one is different than the other?

I believe you want "infraorbital," but are you merely referring to the method for implantation or the exact placement on the bony structure surface? 

To me, in general terms, [cheek implants] refer to the mid-face area. Of course, there are different zones, i.e., zygomatic area, under the eye area, and more. 

Why would one of your doctors offer one area but not the other one? Maybe, you guys are using different words for a relatively similar purpose?


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## Jon87 (Jun 26, 2022)

Jade said:


> Hi, @Jon87
> 
> You make the distinction of mentioning infraorbital vs. malar implants. Can you explain why you think one is different than the other?
> 
> ...


Maybe my vocabulary is not accurate. For me an infraorbital rim has a saddle going to the base of the nose. When it doesn't have this extension, isn't it call malar implant ? From both consultations I had in Rome they propose to put it intraoral but Dr. Ramieri doesn't do any implant with saddle because he says it's too tricky to place without damaging the facial nerves.


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## Jade (Jun 26, 2022)

Jon87 said:


> Maybe my vocabulary is not accurate. For me an infraorbital rim has a saddle going to the base of the nose. When it doesn't have this extension, isn't it call malar implant ? From both consultations I had in Rome they propose to put it intraoral but Dr. Ramieri doesn't do any implant with saddle because he says it's too tricky to place without damaging the facial nerves.


I am still confused about this all. Which one do you want?


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## Chinlet Ascension (Jun 26, 2022)

Jade said:


> The thing is, when you ask for a "list," I see it as you playing roulette. A list won't do you much good if you don't have a well-studied plan before you contact any doctors. Even when you do, they don't have the tools to help you as well as you think they would.


People make good decisions when they have access to the best information. When we ask for information, you just talk down to us like a parent talking down to a nosy child. You specify that you have the information, but you're just not going to share. It's insulting. If you don't have anything of substance to say, then shut up.


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## Jade (Jun 26, 2022)

Chinlet Ascension said:


> People make good decisions when they have access to the best information. When we ask for information, you just talk down to us like a parent talking down to a nosy child. You specify that you have the information, but you're just not going to share. It's insulting. If you don't have anything of substance to say, then shut up.


Please, watch the vocabulary, friend. I am trying to do my best, and there is an ethical and real reason why I can't be more specific. 

I will share more of my background and why things are the way they are. I don't mean to sound condescending or anything like that. I get these notifications via email and respond quickly. 

Really, no need for insults or the whole "shut up" tone. I am sorry if I made you feel bad. Please help me out, and let's keep it civil.


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## Chinlet Ascension (Jun 26, 2022)

Jade said:


> Please, watch the vocabulary, friend. I am trying to do my best, and there is an ethical and real reason why I can't be more specific.
> 
> I will share more of my background and why things are the way they are. I don't mean to sound condescending or anything like that. I get these notifications via email and respond quickly.
> 
> Really, no need for insults or the whole "shut up" tone. I am sorry if I made you feel bad. Please help me out, and let's keep it civil.


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## Jon87 (Jun 27, 2022)

Jade said:


> I am still confused about this all. Which one do you want?


First one !


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## Jade (Jun 27, 2022)

Jon87 said:


> First one !







Ok. I feared you would want the first one. Let me explain.

I know you have seen a lot of designs that have the red part like that, but personally, I have yet to see one single implant with those characteristics look natural.

When it is too close to the eye socket like that, you look (puffy), and strangely, it changes the "personality" of your eyes.

It could look unnatural or overdone when it's too close to the eye socket. It could look like you got punched in the eye.

I believe you feel you have hollowness under your eyes, right? You want the area under your eyes to be more lifted so that you don't look tired, right?

Also, you think that if you get something like #2 or #4, your eyes will look sunken in, right? You think you will have a deeper hollow, right?

So, I don't believe you will look bad with #2 or #4 because an intelligent design goes up towards the rim as far as possible to mimic your natural structure, but better.

In other words, you'd be correcting or improving your natural structure.

Now, if you think you will have a deep eye socket with #2 or #4, the answer is no. When you design an implant correctly, a natural slope makes the implant flow".

Also, there is a lot of eye movement that could be bad with #1, and I believe Dr. Ramieri was referring to this, and I agree with him. There are specific nerves that your doctor needs to protect, and there is no need to risk anything like that.

Push your cheeks up with your fingers and look at the effect you get. Push a little bit up, and you will see that your eyes will automatically look alive and less tired.

#2 and #4 will give you the lift you want, but for some bizarre reason, some surgeons want to give their patients that puffy/swollen look.

The yellow lines are a better approach; they look more harmonious and natural - and safer.

The green dot represents an important nerve.

Of course, if you want to go with #1, it is possible to do it safely, but I would not recommend it because you do not have a real deformity.

Please show me a model or celebrity you like and that you think looks like they have #1 implants naturally.

I hope this helps.


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## Jon87 (Jun 27, 2022)

Jade said:


> Ok. I feared you would want the first one. Let me explain.
> 
> I know you have seen a lot of designs that have the red part like that, but personally, I have yet to see one single implant with those characteristics look natural.


Thanks for taking time to explain that in detail.

Indeed since very young I have this hollowness under the eyes making me look tired and I was thinking that the way to bring more support in the area was to bring height on the implant.

Eriksen is the model I had in mind with this kind of eye area. Now I observe it, I understand that the lower eyelid has to be flat to give a nice effect.






I gonna try to find before/after examples to see how bad it is when the infraorbital rim is too high and horizontal and integrate this info when I start my design face. 

About Ramieri’s implant I was talking about this kind of implant where the saddle doesn’t go to the nose and I am afraid in this case it doesn’t bring the effect we are talking about :


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## Jade (Jun 27, 2022)

Jon87 said:


> Thanks for taking time to explain that in detail.
> 
> Indeed since very young I have this hollowness under the eyes making me look tired and I was thinking that the way to bring more support in the area was to bring height on the implant.
> 
> ...



Let's do the obvious first.

*1- The jaw. *
By looking at your face and by seeing the jaw implant design, my intuition tells me that the jaw implant will NOT give you the effect you want.
Jaw implants are the hardest to design.

*2- The cheeks.*
Eriksen has large cheeks (high cheekbones). These are considered old-timey styles. The Hollywood actors of today have softer, more volume in the middle style cheeks (not like Eriksen).

Eriksen's style of cheeks will make you look hard and perhaps older than you are now. However, if you want this style, then this is what you should get.

This style will NOT get rid of the tired look because you will still look droopy under the eyes.

*The good*
The beauty of custom implants is that you can design them and get the exact benefits you need. You will get the high-cheekbone look, and you can also get balance under the eyes too!!

*The problem.*
Right now, there is a massive error in your cheeks design, mechanically speaking. We can talk more about this in private if you want.

*No guessing.*
There is no need for you to guess how you will look. You can do some concrete things to know exactly how you will look. 

Let's try it, and then we can show the guys here how you could look. Nothing is 100%, but if you do what you are supposed to, you can get pretty close to how you envision yourself.

Do you have more pictures of the design? Side view, maybe?


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## Jade (Jun 27, 2022)

@Jon87 His cheeks are so big that you are not noticing the effect under the eye. Like I said, if you are willing to put in the time, I am willing to help you look like a fricking God.


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## Jon87 (Jun 28, 2022)

Jade said:


> @Jon87 His cheeks are so big that you are not noticing the effect under the eye. Like I said, if you are willing to put in the time, I am willing to help you look like a fricking God.



Cool. I really want to invest time in the process to get the best result as possible.

I am waiting two months more to have a better healing of my bimax before doing a 3D scann and start the design phase. What would be the best, waiting the 3D model to do a first draft or could some morphs + drawings on the scanns be a good starting point for discussion ?

About your points :

*1- The jaw.*
_By looking at your face and by seeing the jaw implant design, my intuition tells me that the jaw implant will NOT give you the effect you want. Jaw implants are the hardest to design._

It gonna be tricky yes specially because I have asymetry. 


*2- The cheeks.*
_Eriksen has large cheeks (high cheekbones). These are considered old-timey styles. The Hollywood actors of today have softer, more volume in the middle style cheeks (not like Eriksen).
Eriksen's style of cheeks will make you look hard and perhaps older than you are now. However, if you want this style, then this is what you should get.
This style will NOT get rid of the tired look because you will still look droopy under the eyes._

I am thinking about Eriksen because I am wondering if the best wouldn’t be to emphasize the cheeks and the chin (a bit higher, wider and square) more that having a too wide jaw as I have a quite long face. About the droopy eyes, do you mean because this kind of design will increase the contrast between big cheeks and the hollowness of the lower eyelid ?


*No guessing.*
_There is no need for you to guess how you will look. You can do some concrete things to know exactly how you will look._

I will try to get a .stl file of my skull to manipulate it. I have a good 3D comprehension due to my work and that will help me to understand better the volumes and get, I hope, something close to what I have in mind.


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## Jade (Jun 28, 2022)

Jon87 said:


> Cool. I really want to invest time in the process to get the best result as possible.
> 
> I am waiting two months more to have a better healing of my bimax before doing a 3D scann and start the design phase. What would be the best, waiting the 3D model to do a first draft or could some morphs + drawings on the scanns be a good starting point for discussion ?
> 
> ...


Since you'd only be dealing with your bones, the CT scan is good now or anytime. Try to do a CT scan and not a CBCT. In Spain is called a (TAC).

Morphs are nice for playing around with but can be deceiving. Everyone looks good in morphs. First, get the (TAC).

*The Jaw.*
The asymmetry is rather easy to fix. The concern is making sure your face has the perfect silhouette and balance after the implants. 

*The cheeks.*
_"Do you mean because this kind of design will increase the contrast between big cheeks and the hollowness of the lower eyelid?"_

Correct. This is why you have to find a balance for your cheeks. If you go too wide and high like Andreas Eriksen, you could have an "Asian effect." 

The "problem" is that you are a good-looking guy as you are now. You have a rather fine and soft face. Your skin isn't super thick, and your neck isn't massive. 

The face is magic, and when you don't have something really wrong with you, the magic of the face could disappear as you introduce a foreign shape. 

I'd be more worried about the jaw than the cheeks. The jaw is a lot more complicated to get right.

I am going to connect you with my special effects person. She is a make-up artist who will "morph" you in real life, not on the screen. 

What do you do for work that can help you understand volumes?


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## Jon87 (Jun 28, 2022)

Jade said:


> Since you'd only be dealing with your bones, the CT scan is good now or anytime. Try to do a CT scan and not a CBCT. In Spain is called a (TAC).
> 
> Morphs are nice for playing around with but can be deceiving. Everyone looks good in morphs. First, get the (TAC).
> 
> ...


Why not a CBCT ? All the surgeons I consulted for implants asked for a cone beam. It's more precise if you are only interested in the skull. Concerning healing I mean I wanted to wait 6 months after the bimax to have a good calcification in the osteotomy area. As the implants will cover this part, wouldn't it make sense ?

Curious to know how can you morph someone irl.

I am an automotive designer. I spend my days switching between Photoshop, 3D models and clay models.


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## Jade (Jun 28, 2022)

Jon87 said:


> Why not a CBCT ? All the surgeons I consulted for implants asked for a cone beam. It's more precise if you are only interested in the skull. Concerning healing I mean I wanted to wait 6 months after the bimax to have a good calcification in the osteotomy area. As the implants will cover this part, wouldn't it make sense ?
> 
> Curious to know how can you morph someone irl.
> 
> I am an automotive designer. I spend my days switching between Photoshop, 3D models and clay models.


This would be a CT scan for the skull only - not for the body.

CBCT is a series of photos, bu it usually leaves empty wholes around the cheek area. It can work fine sometimes, but the CT scan is more precise and presents fewer artifacts. If you can only get a CBCT, then that's fine. 

The implants do not calcify with the bones. The screws are placed strategically. But yes, waiting is always best. 

You morph someone like in a movie character with special make-up. 

Maybe go in for the scan so you can plan everything and wait for surgery. 

*"I am an automotive designer. I spend my days switching between Photoshop, 3D models, and clay models."*

I like you!👌 Did you design your implants in blue with red dots?


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## Jon87 (Jun 29, 2022)

Jade said:


> This would be a CT scan for the skull only - not for the body.
> 
> CBCT is a series of photos, bu it usually leaves empty wholes around the cheek area. It can work fine sometimes, but the CT scan is more precise and presents fewer artifacts. If you can only get a CBCT, then that's fine.
> 
> ...


No, the pic with the implants is not mine it's the one Ramieri shows as an example of what he proposes. 


But that's what I wanna do. Model my implants if I can get the CT scann converted in stl. Turning around the volumes will help a lot understanding what I need. I also will be able to give more precise inputs to the surgeon than drawing on screenshots. 


I will do my scann this summer, 5-6months post bimax. I am looking forward to see what can be done.


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## eyebagcel (Jul 8, 2022)

Jade said:


> Well, you have lots of options. I am not even supposed to be here anymore!!!! I told a guy I was gonna leave this forum for good. Read this.
> 
> 
> 
> ...


what’s your opinion on infraorbitals without malar extension like these two









shouldn’t these result in an unnatural look because the infraorbitals are being pushed way further ahead of the cheekbones than they’re supposed to? especially from the 3/4 like in the circled area, the peak of the ogee curve is almost right next to the eye


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## Jade (Jul 8, 2022)

@eyebagcel 
*"What’s your opinion on infraorbital without malar extension like these two"*

Giving an intelligent opinion based on designs alone is impossible without seeing the patient's face. Still, more importantly, it is even more impossible without knowing what the patient *likes or wants.* 

*"Shouldn’t these result in an unnatural look because the infraorbitals are being pushed way further ahead of the cheekbones than they’re supposed to?" *

"Unnatural or natural" are relative terms. You might like something, but someone else might hate it. 

If you are here wondering about this, more than likely, your gut feeling is telling you that something is wrong. 

Although I can't see your face, and even though giving an opinion based on bones and designs is wrong, personally, from experience, I would be inclined to say that this design usually does not suit most patients. 

Why? Because if you want cheek implants, the problem is usually in the mid-face and not on the corner of your cheeks.

Eppley's has good results now and then, but these are from repeated patients who get them twice or even three times with him. 

Is this an Eppley design by chance?


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## eyebagcel (Jul 8, 2022)

Jade said:


> @eyebagcel
> *"What’s your opinion on infraorbital without malar extension like these two"*
> 
> Giving an intelligent opinion based on designs alone is impossible without seeing the patient's face. Still, more importantly, it is even more impossible without knowing what the patient *likes or wants.*
> ...


first one is from mario pagnoni in italy(who’s the main guy im considering), second one is dr. apostolakis from texas

can i dm u some pics of me real quick? i know for a fact my infraorbitals are recessed, probably the most recessed on this forum, but idk what implant design suits me the most


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## Jade (Jul 8, 2022)

eyebagcel said:


> first one is from mario pagnoni in italy(who’s the main guy im considering), second one is dr. apostolakis from texas
> 
> can i dm u some pics of me real quick? i know for a fact my infraorbitals are recessed, probably the most recessed on this forum, but idk what implant design suits me the most


Go ahead. Sure thing.


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## one job away (Jul 16, 2022)

Jon87 said:


> Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,...
> 
> Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything.
> 
> My before bimaxs and my after Alfaro's one :


Bro. Alfaro is just the goat. But I don’t have the money. What should I do. 

I have money for ramieri. I just wrote Alfaro an email asking for online consultation


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## Jon87 (Jul 16, 2022)

one job away said:


> Bro. Alfaro is just the goat. But I don’t have the money. What should I do.
> 
> I have money for ramieri. I just wrote Alfaro an email asking for online consultation


Going to Alfaro has sense if you are really recessed and if you need big ccw. With a radio or a CT scan you can estimate how much he will advance you to be on the Barcelona line. And then compare with what Ramieri proposes you and see if it's worth.


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## one job away (Jul 16, 2022)

Jon87 said:


> Going to Alfaro has sense if you are really recessed and if you need big ccw. With a radio or a CT scan you can estimate how much he will advance you to be on the Barcelona line. And then compare with what Ramieri proposes you and see if it's worth.


Do you have a clue about this? I tried measuring the Barcelona line but couldn’t find it.

Can I dm yöu ?


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## Eduardo DOV (Jul 16, 2022)

Zenturio said:


> Also his smile looks wider?
> 
> please dm me your result
> 
> can you tell me what movements you had?


subespinal cut does not affect the nose


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## Eduardo DOV (Jul 16, 2022)

Zenturio said:


> Also his smile looks wider?
> 
> please dm me your result
> 
> can you tell me what movements you had?


subespinal cut does not affect the nose




@Jade what if I look better when I wake up, with the eyes knda puffy. can I mimic that effect with infra implants?


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## Zenturio (Jul 16, 2022)

Eduardo DOV said:


> subespinal cut does not affect the nose


Can you tell me if I need subspinal bimax?


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## Eduardo DOV (Jul 16, 2022)

Zenturio said:


> Can you tell me if I need subspinal bimax?


no, never seen your face


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## Eduardo DOV (Jul 16, 2022)

@Jade i was being serious


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## Jade (Jul 16, 2022)

Eduardo DOV said:


> @Jade i was being serious


I don't know how to even answer that! Implants can make you look puffy, I guess. Have you ever looked into fillers? 

I don't usually get questions like that. ✌️


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## Zenturio (Jul 16, 2022)

Eduardo DOV said:


> no, never seen your face


I would DM


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## Eduardo DOV (Jul 16, 2022)

Zenturio said:


> I would DM


dm then


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## Eduardo DOV (Jul 16, 2022)

Jade said:


> I don't know how to even answer that! Implants can make you look puffy, I guess. Have you ever looked into fillers?
> 
> I don't usually get questions like that. ✌️


would it reduces uee or eyes height? because I already have no uee, but wanted that puffy effect. Like you said, I fear it could somehow change the faces "personality"


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## Jade (Jul 17, 2022)

Eduardo DOV said:


> would it reduces uee or eyes height? because I already have no uee, but wanted that puffy effect. Like you said, I fear it could somehow change the faces "personality"


I am not sure. Maybe, try fillers and see how you like the effect you get. It is difficult to offer an intelligent opinion without seeing your face. 

Maybe upload your picture here and let these guys suggest something for you. I would go to a professional first for any important decisions.


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## kriz44 (Oct 28, 2022)

Jon87 said:


> One week liquid diet. And soft food step by step. It's not that anoying because you can eat whatever you want as far as you mix or cut your food. Numb lower lips is anoying. I use my tongue to guide the glass, spoon,... Post op with mini invasiv surgery is way easier. Much less tiring. Much less inflammation. And you look normal after 10 days.


Please respond to my DM if you don't mind. Thanks!


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