2 Bimax questions

[lilhorizontal32]

1. Alfaro prefers a lefort 1 cut around the ANS point and this produces a different effect to doing CCW rotation like Arnett & Gunson, to avoid any unnecessary ANS advancement.

does anyone know the difference in the final aesthetic result with these 2 approaches and in which case would either be preferred?

Alfaro's lefort 1 cut for reference:

Normal lefort 1 cut:

Arnett and Gunson's CCW approach:

BIMAX - Monkey course

For people who are afraid to became Monkey with DJS i advise you this course of Dr.Arnett: At 11mn: -He compare straight BIMAX vs BIMAX CCW, and say that straight Bimax destroy ur face. He evend said the treatement plane (without CCW) is horrible At 35mn: -If you do straight advacenemt he...

looksmax.org

2. if excess advancement of the ANS point is what causes the so called "chimp lips" or "monkey face", why not just do as much lefort 1 advancement as needed for a mogger side profile and just shave the ANS point down as some surgeons do? what are the downsides of this?

 

[Rift]

nigger

 

[Deleted member 7725]

The point of cutting around the ANS is to avoid the nose upturning in cases where the nose is normal/upturned despite having a retruded maxilla. You're limited in movement since you're not moving your nose or paranasal area at all, so expanding past the orthognathic point will make you look even worse.

This is the first time I've seen this so I may be wrong and the effect on paranasal fullness is still present.

 

[one job away]

The point of cutting around the ANS is to avoid the nose upturning in cases where the nose is normal/upturned despite having a retruded maxilla. You're limited in movement since you're not moving your nose or paranasal area at all, so expanding past the orthognathic point will make you look even worse.

This is the first time I've seen this so I may be wrong and the effect on paranasal fullness is still present.

So for me cutting around the ans is a negative since I want an upturn

 

[StrangerDanger]

can you do CCW along with cutting around the ANS

 

[Deleted member 7725]

So for me cutting around the ans is a negative since I want an upturn

Yeah, I think you could benefit from a bit more fullness at the paranasal area and upturning of the nose.

Obviously I don't know the outcomes of this, but I'd assume the entire nasal structure is completely preserved, which isn't ideal for a lot of cases where the nose appears bigger/is downturned as a result of a recessed maxilla.

 

[dakchuh]

The point of cutting around the ANS is to avoid the nose upturning in cases where the nose is normal/upturned despite having a retruded maxilla. You're limited in movement since you're not moving your nose or paranasal area at all, so expanding past the orthognathic point will make you look even worse.

This is the first time I've seen this so I may be wrong and the effect on paranasal fullness is still present.

so those with a nose "buried" in their face with nasolabial folds should have the ANS moved with the lefort cut?

 

[lilhorizontal32]

can you do CCW along with cutting around the ANS

yeah pretty sure I have seen Alfaro do this for some of his patients

 

[Deleted member 7725]

so those with a nose "buried" in their face with nasolabial folds should have the ANS moved with the lefort cut?

Yes, I'd assume so. I have a droopy "buried" nose with folds so hopefully I'm right.