A tale of two Sailer proteges

[brock]

Some of you liked my previous consultation reviews, so here's two more.

Having consulted with the famous Italian docs, I was still a little dissatisfied. I wanted to get more opinions and a definitive answer on the best course of action. Now, the "best" maxfacs often talked about are LACOMS in the US, Coceanig in Australia, and Sailer in Switzerland. They all charge 100k+ and are out of the question. However, I found the next best thing; two of Sailer's proteges, Dr. Safi and Dr. Jacobsen. Jacobsen has been mentioned here before, but I was hoping to be the first with Safi. It seems @anticel beat me too it though. Anyway, I have consulted with them both extensively and have plans from both of them, so here are my thoughts:

Jacobsen

The first thing I noticed about her is that she's very caring and attentive. She listened to all my concerns without interruption. The second thing I noticed is that's she's very focused on function and very cautious. She asked my about any functional problems and was the first to suggest that my sleep issues were related. Now, I have diagnosed sleep issues, but nobody (including all the other maxfacs) ever told me that it could be related to breathing. But she strongly suggested that I might have a rare condition called UARS. Now, on my first consultation with her I only had xrays, and she refused to elaborate further or suggest any sort of treatment without a ct scan. We also spoke about implants, and I sort of got the sense that she didn't really focus on them. They were more of a finishing touch for her.

I came back to her with ct scans and got a more detailed plan. She actually surprised me with a powerpoint showing in depth analysis of my face and the face of a model I had told her I was aiming to look like. She took a very detailed look, down to comparing smiles. She told me I seem like a perfectionist, and if I wanted the absolute best results, her recommendation was to do palate expansion first (MSE/SARPE/whatever). She said my palate was quite narrow and it would make a huge difference for breathing and smiling. She said it can be surgically expanded during lefort 1, but only to a maximum of 4mm. Any more requires the expander device. She said my palate was more than 10mm narrower than the ideal. Afterwards I could get bimax and implants (she also said she couldn't do jaw implants at the same time as bimax). So her plan is:

1. Palate expansion and orthodontics (~9 months)
2. Bimax + cheek implants
4.6deg CCW
Maxilla: 4cm
Mandible: 13cm
Overall chin advancement: 20mm
She wanted to do significant rotation resulting in an advancement of a whopping 20mm. This surprised me, as she seemed kinda conservative at first.
3. Jaw angle implants (wait 6 months first)



Cost:
- Consultation: 0 (it was supposed to be 400, but even though I asked twice she never sent a payment request)
- Bimax + implants: ~35k (very rough estimate)

Pros:
- Very knowledeable about functional issues
- Explains things in detail and will even send studies to back up claims
- Very willing to listen and address any concerns
Cons:
- Seems less familiar with 3d planning and custom plates. She said she was "classically trained" and prefers to see and adjust during surgery.
- The clinic's communication and organization is poor. The staff never replies to emails and she ends up replying personally. But she seems super busy, so there is sometimes over a week's delay.

Safi

Safi is a very chill dude. He speaks to you like an old friend, and in a very relaxed manner. I immediately got the sense that he was confident and focused on aesthetics. He also spoke about sleep and breathing issues, but in a more broad manner than Jacobsen. However, he was quick to suggest a tentative plan from xrays. He was also quick to suggest implants and basically told me I needed them before I asked. So we were on the same page from the beginning. A word of warning though, he will keep talking for as long as you let him. I had to keep interrupting him and changing the topic, because the consultation time is limited and I had a lot of questions.

I brought him my ct scans later, and paid for a detailed simulation. One interesting thing was that he said he could do, and pretty much recommended, is putting in jaw angle implants at the same time as bimax. He also said wisdom teeth extractions were not necessary, and showed me an example of a bimax he did that preserved the teeth. From everything I saw, he seemed like a surgeon with excellent skills and also very blackpilled. He's not targetting looksmaxxers specifically, but he is aware of them and I have a feeling he will become very popular in the future.

I brought up palate expansion and he did also agree that it was narrow, but told me he would surgically widen it. Then also rotate it so there was no gap, and also improve my occlusion. He loves 3d programs and the clinic uses several of them. He showed me the standard bone simulation, a soft tissue simulation, and also a cool heatmap of the occlusion of my teeth. He likes to design everything precisely and that's why he claims to be able to do jaw implants at the same time as bimax. He also mentioned a bunch of minor tweaks that he can do, such as: alar cinch to preserve nose width, turning the upper lip either in or out to make it larger or smaller appearing. His plan:

1. Surgery
- Cheek implants
- Jaw angle implants
- Bimax
?deg CCW
High cut segmental lefort 1: Maxilla advancement, widening, and rotation
Mandible: 10cm
Overall chin advancement: 15mm
Widening: 4mm each side
2. Orthodontics at home



Cost:
- Consultation: 1000 (first 30 min free, this is for the detailed simulation)
- Bimax + implants: 37k (detailed estimate w/italian implants, could go up depending on other factors)

Pros:
- Knowledgeable and confident with all the cutting edge surgery techniques
- Very focused on aesthetics.
- He and his team reply on whatsapp very quickly
Cons:
- Dismissed palate expansion devices
- A little too optimistic? Either he's a genius or he's overselling

Final thoughts

Things they had in common:
- Both trained under Sailer
- Both produce "anteface" results
- Both told me Sailer was old now and they wouldn't recommend him anymore (lmao)
- Both told me implants/custom plates in Switzerland were very expensive, but they were willing to work with other companies. Both ended up contacting the same Italian company that Pagnoni uses and said they could use them too.

Honestly, I was leaning towards Safi and still am. He was slightly more conservative with the advancement, but I don't want to be dogmaxxed, so not sure who to believe. But he also dismissed palatal expanders, while Jacobsen highly recommended them. People who have my sleep condition all rave about expansion being a must. They both seem highly skilled and studied under the best, but the real choice is whether I want optimal palate expansion or not.

Someone please tell me what to do lol

 

[Sens]

you are on the wrong forum, bro.

it's not 2020 anymore

 

[Reformed]

her

Stopped reading

choose the guy not even being sexist

 

[Foreverbrad]

Nice thread. Prices have really shot up though, faster than the majority of us can make money. Are ramieri/pagnoni still cheaper options than this near-40k when you consulted?

I wonder if it’s worth trying to find protégés of Alfaro/ramieri/raffaini/Pagnoni also?

 

[Zaq]

Some of you liked my previous consultation reviews, so here's two more.

Having consulted with the famous Italian docs, I was still a little dissatisfied. I wanted to get more opinions and a definitive answer on the best course of action. Now, the "best" maxfacs often talked about are LACOMS in the US, Coceanig in Australia, and Sailer in Switzerland. They all charge 100k+ and are out of the question. However, I found the next best thing; two of Sailer's proteges, Dr. Safi and Dr. Jacobsen. Jacobsen has been mentioned here before, but I was hoping to be the first with Safi. It seems @anticel beat me too it though. Anyway, I have consulted with them both extensively and have plans from both of them, so here are my thoughts:

Jacobsen

The first thing I noticed about her is that she's very caring and attentive. She listened to all my concerns without interruption. The second thing I noticed is that's she's very focused on function and very cautious. She asked my about any functional problems and was the first to suggest that my sleep issues were related. Now, I have diagnosed sleep issues, but nobody (including all the other maxfacs) ever told me that it could be related to breathing. But she strongly suggested that I might have a rare condition called UARS. Now, on my first consultation with her I only had xrays, and she refused to elaborate further or suggest any sort of treatment without a ct scan. We also spoke about implants, and I sort of got the sense that she didn't really focus on them. They were more of a finishing touch for her.

I came back to her with ct scans and got a more detailed plan. She actually surprised me with a powerpoint showing in depth analysis of my face and the face of a model I had told her I was aiming to look like. She took a very detailed look, down to comparing smiles. She told me I seem like a perfectionist, and if I wanted the absolute best results, her recommendation was to do palate expansion first (MSE/SARPE/whatever). She said my palate was quite narrow and it would make a huge difference for breathing and smiling. She said it can be surgically expanded during lefort 1, but only to a maximum of 4mm. Any more requires the expander device. She said my palate was more than 10mm narrower than the ideal. Afterwards I could get bimax and implants (she also said she couldn't do jaw implants at the same time as bimax). So her plan is:

1. Palate expansion and orthodontics (~9 months)
2. Bimax + cheek implants
4.6deg CCW
Maxilla: 4cm
Mandible: 13cm
Overall chin advancement: 20mm
She wanted to do significant rotation resulting in an advancement of a whopping 20mm. This surprised me, as she seemed kinda conservative at first.
3. Jaw angle implants (wait 6 months first)



Cost:
- Consultation: 0 (it was supposed to be 400, but even though I asked twice she never sent a payment request)
- Bimax + implants: ~35k (very rough estimate)

Pros:
- Very knowledeable about functional issues
- Explains things in detail and will even send studies to back up claims
- Very willing to listen and address any concerns
Cons:
- Seems less familiar with 3d planning and custom plates. She said she was "classically trained" and prefers to see and adjust during surgery.
- The clinic's communication and organization is poor. The staff never replies to emails and she ends up replying personally. But she seems super busy, so there is sometimes over a week's delay.

Safi

Safi is a very chill dude. He speaks to you like an old friend, and in a very relaxed manner. I immediately got the sense that he was confident and focused on aesthetics. He also spoke about sleep and breathing issues, but in a more broad manner than Jacobsen. However, he was quick to suggest a tentative plan from xrays. He was also quick to suggest implants and basically told me I needed them before I asked. So we were on the same page from the beginning. A word of warning though, he will keep talking for as long as you let him. I had to keep interrupting him and changing the topic, because the consultation time is limited and I had a lot of questions.

I brought him my ct scans later, and paid for a detailed simulation. One interesting thing was that he said he could do, and pretty much recommended, is putting in jaw angle implants at the same time as bimax. He also said wisdom teeth extractions were not necessary, and showed me an example of a bimax he did that preserved the teeth. From everything I saw, he seemed like a surgeon with excellent skills and also very blackpilled. He's not targetting looksmaxxers specifically, but he is aware of them and I have a feeling he will become very popular in the future.

I brought up palate expansion and he did also agree that it was narrow, but told me he would surgically widen it. Then also rotate it so there was no gap, and also improve my occlusion. He loves 3d programs and the clinic uses several of them. He showed me the standard bone simulation, a soft tissue simulation, and also a cool heatmap of the occlusion of my teeth. He likes to design everything precisely and that's why he claims to be able to do jaw implants at the same time as bimax. He also mentioned a bunch of minor tweaks that he can do, such as: alar cinch to preserve nose width, turning the upper lip either in or out to make it larger or smaller appearing. His plan:

1. Surgery
- Cheek implants
- Jaw angle implants
- Bimax
?deg CCW
High cut segmental lefort 1: Maxilla advancement, widening, and rotation
Mandible: 10cm
Overall chin advancement: 15mm
Widening: 4mm each side
2. Orthodontics at home



Cost:
- Consultation: 1000 (first 30 min free, this is for the detailed simulation)
- Bimax + implants: 37k (detailed estimate w/italian implants, could go up depending on other factors)

Pros:
- Knowledgeable and confident with all the cutting edge surgery techniques
- Very focused on aesthetics.
- He and his team reply on whatsapp very quickly
Cons:
- Dismissed palate expansion devices
- A little too optimistic? Either he's a genius or he's overselling

Final thoughts

Things they had in common:
- Both trained under Sailer
- Both produce "anteface" results
- Both told me Sailer was old now and they wouldn't recommend him anymore (lmao)
- Both told me implants/custom plates in Switzerland were very expensive, but they were willing to work with other companies. Both ended up contacting the same Italian company that Pagnoni uses and said they could use them too.

Honestly, I was leaning towards Safi and still am. He was slightly more conservative with the advancement, but I don't want to be dogmaxxed, so not sure who to believe. But he also dismissed palatal expanders, while Jacobsen highly recommended them. People who have my sleep condition all rave about expansion being a must. They both seem highly skilled and studied under the best, but the real choice is whether I want optimal palate expansion or not.

Someone please tell me what to do lol

Don't pick the woman.

 

[brock]

Nice thread. Prices have really shot up though, faster than the majority of us can make money. Are ramieri/pagnoni still cheaper options than this near-40k when you consulted?

I wonder if it’s worth trying to find protégés of Alfaro/ramieri/raffaini/Pagnoni also?

Yes, they are cheaper. 24-28k. I also think they’re less skilled (but good enough for straightforward cases).

Mind you these quotes include jaw implants, while the ones from Pags, etc did not. Actually if you factor in jaw implants, it’s a pretty good deal.

 

[Meister!]

Some of you liked my previous consultation reviews, so here's two more.

Having consulted with the famous Italian docs, I was still a little dissatisfied. I wanted to get more opinions and a definitive answer on the best course of action. Now, the "best" maxfacs often talked about are LACOMS in the US, Coceanig in Australia, and Sailer in Switzerland. They all charge 100k+ and are out of the question. However, I found the next best thing; two of Sailer's proteges, Dr. Safi and Dr. Jacobsen. Jacobsen has been mentioned here before, but I was hoping to be the first with Safi. It seems @anticel beat me too it though. Anyway, I have consulted with them both extensively and have plans from both of them, so here are my thoughts:

Jacobsen

The first thing I noticed about her is that she's very caring and attentive. She listened to all my concerns without interruption. The second thing I noticed is that's she's very focused on function and very cautious. She asked my about any functional problems and was the first to suggest that my sleep issues were related. Now, I have diagnosed sleep issues, but nobody (including all the other maxfacs) ever told me that it could be related to breathing. But she strongly suggested that I might have a rare condition called UARS. Now, on my first consultation with her I only had xrays, and she refused to elaborate further or suggest any sort of treatment without a ct scan. We also spoke about implants, and I sort of got the sense that she didn't really focus on them. They were more of a finishing touch for her.

I came back to her with ct scans and got a more detailed plan. She actually surprised me with a powerpoint showing in depth analysis of my face and the face of a model I had told her I was aiming to look like. She took a very detailed look, down to comparing smiles. She told me I seem like a perfectionist, and if I wanted the absolute best results, her recommendation was to do palate expansion first (MSE/SARPE/whatever). She said my palate was quite narrow and it would make a huge difference for breathing and smiling. She said it can be surgically expanded during lefort 1, but only to a maximum of 4mm. Any more requires the expander device. She said my palate was more than 10mm narrower than the ideal. Afterwards I could get bimax and implants (she also said she couldn't do jaw implants at the same time as bimax). So her plan is:

1. Palate expansion and orthodontics (~9 months)
2. Bimax + cheek implants
4.6deg CCW
Maxilla: 4cm
Mandible: 13cm
Overall chin advancement: 20mm
She wanted to do significant rotation resulting in an advancement of a whopping 20mm. This surprised me, as she seemed kinda conservative at first.
3. Jaw angle implants (wait 6 months first)



Cost:
- Consultation: 0 (it was supposed to be 400, but even though I asked twice she never sent a payment request)
- Bimax + implants: ~35k (very rough estimate)

Pros:
- Very knowledeable about functional issues
- Explains things in detail and will even send studies to back up claims
- Very willing to listen and address any concerns
Cons:
- Seems less familiar with 3d planning and custom plates. She said she was "classically trained" and prefers to see and adjust during surgery.
- The clinic's communication and organization is poor. The staff never replies to emails and she ends up replying personally. But she seems super busy, so there is sometimes over a week's delay.

Safi

Safi is a very chill dude. He speaks to you like an old friend, and in a very relaxed manner. I immediately got the sense that he was confident and focused on aesthetics. He also spoke about sleep and breathing issues, but in a more broad manner than Jacobsen. However, he was quick to suggest a tentative plan from xrays. He was also quick to suggest implants and basically told me I needed them before I asked. So we were on the same page from the beginning. A word of warning though, he will keep talking for as long as you let him. I had to keep interrupting him and changing the topic, because the consultation time is limited and I had a lot of questions.

I brought him my ct scans later, and paid for a detailed simulation. One interesting thing was that he said he could do, and pretty much recommended, is putting in jaw angle implants at the same time as bimax. He also said wisdom teeth extractions were not necessary, and showed me an example of a bimax he did that preserved the teeth. From everything I saw, he seemed like a surgeon with excellent skills and also very blackpilled. He's not targetting looksmaxxers specifically, but he is aware of them and I have a feeling he will become very popular in the future.

I brought up palate expansion and he did also agree that it was narrow, but told me he would surgically widen it. Then also rotate it so there was no gap, and also improve my occlusion. He loves 3d programs and the clinic uses several of them. He showed me the standard bone simulation, a soft tissue simulation, and also a cool heatmap of the occlusion of my teeth. He likes to design everything precisely and that's why he claims to be able to do jaw implants at the same time as bimax. He also mentioned a bunch of minor tweaks that he can do, such as: alar cinch to preserve nose width, turning the upper lip either in or out to make it larger or smaller appearing. His plan:

1. Surgery
- Cheek implants
- Jaw angle implants
- Bimax
?deg CCW
High cut segmental lefort 1: Maxilla advancement, widening, and rotation
Mandible: 10cm
Overall chin advancement: 15mm
Widening: 4mm each side
2. Orthodontics at home



Cost:
- Consultation: 1000 (first 30 min free, this is for the detailed simulation)
- Bimax + implants: 37k (detailed estimate w/italian implants, could go up depending on other factors)

Pros:
- Knowledgeable and confident with all the cutting edge surgery techniques
- Very focused on aesthetics.
- He and his team reply on whatsapp very quickly
Cons:
- Dismissed palate expansion devices
- A little too optimistic? Either he's a genius or he's overselling

Final thoughts

Things they had in common:
- Both trained under Sailer
- Both produce "anteface" results
- Both told me Sailer was old now and they wouldn't recommend him anymore (lmao)
- Both told me implants/custom plates in Switzerland were very expensive, but they were willing to work with other companies. Both ended up contacting the same Italian company that Pagnoni uses and said they could use them too.

Honestly, I was leaning towards Safi and still am. He was slightly more conservative with the advancement, but I don't want to be dogmaxxed, so not sure who to believe. But he also dismissed palatal expanders, while Jacobsen highly recommended them. People who have my sleep condition all rave about expansion being a must. They both seem highly skilled and studied under the best, but the real choice is whether I want optimal palate expansion or not.

Someone please tell me what to do lol

Safi isn't at sailerclinic anymore? He moved on fast then, because last time I visited him was like a year ago.

If I was in your shoes I would go with Safi, he has an impressive CV and has an eye for aesthetics.
Jacobsen? Never met her, never heard of her, never heard Prof. or Dr. Sailer talk about her but Safi was getting complimented by Dr. Sailer behind his back.

 

[brock]

Safi isn't at sailerclinic anymore? He moved on fast then, because last time I visited him was like a year ago.

If I was in your shoes I would go with Safi, he has an impressive CV and has an eye for aesthetics.
Jacobsen? Never met her, never heard of her, never heard Prof. or Dr. Sailer talk about her but Safi was getting complimented by Dr. Sailer behind his back.

He started his own clinic 6 months ago. Jacobsen worked with Sailer a while back.

 

[ItsOver999]

6 degrees person

 

[anticel]

It seems @anticel beat me too it though.

Based review, thanks for sharing and also thanks for the tag. Kind of a follow up to my post about Safi & confirms what I said about him. Also it was my case where he saved the wisdom teeth.
More than twice now I heard that Jacobsen is really forgetful about invoices for consultations.

Obviously I am biased towards Safi but I heard that Jacobsen is also really good. Even Safi talked highly about her. I was also debating MSE or sth too but Safi wasn't dismissive about it iirc. In the end I came to the conclusion that I am actually not narrow at all and aiming for the optimum would take to much time in my case so I just got Bimax. Overall its like this: MSE requires 80% of the work for 20% of the result while Bimax is 20% of the work but 80% of the result (for the airways). Probably should decide based on how badly your life is impacted by narrow airways and if you really want to wait 1 more year for a good result.
Also I think you could get MSE and then still do surgery with Safi, his wife is an orthodontist btw!

 

[brock]

Based review, thanks for sharing and also thanks for the tag. Kind of a follow up to my post about Safi & confirms what I said about him. Also it was my case where he saved the wisdom teeth.
More than twice now I heard that Jacobsen is really forgetful about invoices for consultations.

Obviously I am biased towards Safi but I heard that Jacobsen is also really good. Even Safi talked highly about her. I was also debating MSE or sth too but Safi wasn't dismissive about it iirc. In the end I came to the conclusion that I am actually not narrow at all and aiming for the optimum would take to much time in my case so I just got Bimax. Overall its like this: MSE requires 80% of the work for 20% of the result while Bimax is 20% of the work but 80% of the result (for the airways). Probably should decide based on how badly your life is impacted by narrow airways and if you really want to wait 1 more year for a good result.
Also I think you could get MSE and then still do surgery with Safi, his wife is an orthodontist btw!

Thanks bro. Yeah I like Safi better too, but the MSE thing has me torn. Mind if I PM you some questions?


Also @RealSurgerymax I’ve been trying to consult with you for months… Safi mentioned you too lol. Do you mind giving your opinion on these two plans?

 

[anticel]

Thanks bro. Yeah I like Safi better too, but the MSE thing has me torn. Mind if I PM you some questions?


Also @RealSurgerymax I’ve been trying to consult with you for months… Safi mentioned you too lol. Do you mind giving your opinion on these two plans?

sure pm me!

 

[Foreverbrad]

One other question. How long was the wait list for a consult for each of these four surgeons you’ve consulted? And the wait time for surgery would be interesting too if provided.

 

[PURE ARYAN GENETICS]

never employ a hole for something as crucial as maxillofacial surgery. she can be ur delivery driver or waitress or something

 

[Deleted member 18582]

What made you feel dissatisfied with the Italian surgeons?
And how did the advancement these two recommended differ from theirs?

I am really interested in lyophilized cartilage implants, which Safi told me in an email he apparently does for every area of the face, and that especially for UEE they are better than fillers, bone graft, fat graft, and botox. I wonder if Jacobsen does those too since it was developed at Sailerklinik. It seems basically like PEEK 2.0

I really want to consult with him but my budget for trimax and inframalars is 30k and this is just too much.

 

[RandomGREY]

What didn’t u like about ramieri, Pagnoni etc. Also consulted w Safi and liked his vibe a lot. More blackpilled than any other I’ve talked to.

 

[brock]

What didn’t u like about ramieri, Pagnoni etc. Also consulted w Safi and liked his vibe a lot. More blackpilled than any other I’ve talked to.

Ramieri wanted orthodontics first. Also he didn’t really mention sleep issues, palate expansion, etc. Seems like he does the same linear advancement for everyone.

Pagnoni said orthodontics weren’t necessary, but his movements were too conservative. He only wanted to advance the jaw 5mm, 10 with genio. He also seems to offer a similar plan to everyone. I did like his implant work though.

Safi seems to take the entire face into consideration and come up with unique plan for each patient. He’s not just a maxfac, he looks at the entire face. Also, he can basically do anything. He even mentioned that he does lefort 3 and orbital box osteotomy, though he discouraged anyone who isn’t syndromatic from getting them.

He promised me major advancement, better airways and occlusion, and a surgery first approach.

 

[brock]

elaborate?

He mentioned he had a recent call with “that surgerymax guy.” I’m guessing they might work together in the future?

 

[RealSurgerymax]

Thanks bro. Yeah I like Safi better too, but the MSE thing has me torn. Mind if I PM you some questions?


Also @RealSurgerymax I’ve been trying to consult with you for months… Safi mentioned you too lol. Do you mind giving your opinion on these two plans?

Dm

 

[tomakine]

Ramieri wanted orthodontics first. Also he didn’t really mention sleep issues, palate expansion, etc. Seems like he does the same linear advancement for everyone.

Pagnoni said orthodontics weren’t necessary, but his movements were too conservative. He only wanted to advance the jaw 5mm, 10 with genio. He also seems to offer a similar plan to everyone. I did like his implant work though.

Safi seems to take the entire face into consideration and come up with unique plan for each patient. He’s not just a maxfac, he looks at the entire face. Also, he can basically do anything. He even mentioned that he does lefort 3 and orbital box osteotomy, though he discouraged anyone who isn’t syndromatic from getting them.

He promised me major advancement, better airways and occlusion, and a surgery first approach.

What about lefort 2 is he practicing it for aesthetic reason ?

I dont understand why you would want to project the middface without the nose, nose that is literally in the middface

 

[longjohnmong]

So Safi will do a 30 minute consult for free. Am I understanding correctly?

 

[Deleted member 18582]

So Safi will do a 30 minute consult for free. Am I understanding correctly?

Yes, i reached out and am having one

 

[Foreverbrad]

One other question. How long was the wait list for a consult for each of these four surgeons you’ve consulted? And the wait time for surgery would be interesting too if provided.

@brock guess you missed this question?

 

[tomakine]

Yes, i reached out and am having one

Can you ask him if he already did lefort 2 for aesthetic reason ?

 

[malicieusss]

Some of you liked my previous consultation reviews, so here's two more.

Having consulted with the famous Italian docs, I was still a little dissatisfied. I wanted to get more opinions and a definitive answer on the best course of action. Now, the "best" maxfacs often talked about are LACOMS in the US, Coceanig in Australia, and Sailer in Switzerland. They all charge 100k+ and are out of the question. However, I found the next best thing; two of Sailer's proteges, Dr. Safi and Dr. Jacobsen. Jacobsen has been mentioned here before, but I was hoping to be the first with Safi. It seems @anticel beat me too it though. Anyway, I have consulted with them both extensively and have plans from both of them, so here are my thoughts:

Jacobsen

The first thing I noticed about her is that she's very caring and attentive. She listened to all my concerns without interruption. The second thing I noticed is that's she's very focused on function and very cautious. She asked my about any functional problems and was the first to suggest that my sleep issues were related. Now, I have diagnosed sleep issues, but nobody (including all the other maxfacs) ever told me that it could be related to breathing. But she strongly suggested that I might have a rare condition called UARS. Now, on my first consultation with her I only had xrays, and she refused to elaborate further or suggest any sort of treatment without a ct scan. We also spoke about implants, and I sort of got the sense that she didn't really focus on them. They were more of a finishing touch for her.

I came back to her with ct scans and got a more detailed plan. She actually surprised me with a powerpoint showing in depth analysis of my face and the face of a model I had told her I was aiming to look like. She took a very detailed look, down to comparing smiles. She told me I seem like a perfectionist, and if I wanted the absolute best results, her recommendation was to do palate expansion first (MSE/SARPE/whatever). She said my palate was quite narrow and it would make a huge difference for breathing and smiling. She said it can be surgically expanded during lefort 1, but only to a maximum of 4mm. Any more requires the expander device. She said my palate was more than 10mm narrower than the ideal. Afterwards I could get bimax and implants (she also said she couldn't do jaw implants at the same time as bimax). So her plan is:

1. Palate expansion and orthodontics (~9 months)
2. Bimax + cheek implants
4.6deg CCW
Maxilla: 4cm
Mandible: 13cm
Overall chin advancement: 20mm
She wanted to do significant rotation resulting in an advancement of a whopping 20mm. This surprised me, as she seemed kinda conservative at first.
3. Jaw angle implants (wait 6 months first)



Cost:
- Consultation: 0 (it was supposed to be 400, but even though I asked twice she never sent a payment request)
- Bimax + implants: ~35k (very rough estimate)

Pros:
- Very knowledeable about functional issues
- Explains things in detail and will even send studies to back up claims
- Very willing to listen and address any concerns
Cons:
- Seems less familiar with 3d planning and custom plates. She said she was "classically trained" and prefers to see and adjust during surgery.
- The clinic's communication and organization is poor. The staff never replies to emails and she ends up replying personally. But she seems super busy, so there is sometimes over a week's delay.

Safi

Safi is a very chill dude. He speaks to you like an old friend, and in a very relaxed manner. I immediately got the sense that he was confident and focused on aesthetics. He also spoke about sleep and breathing issues, but in a more broad manner than Jacobsen. However, he was quick to suggest a tentative plan from xrays. He was also quick to suggest implants and basically told me I needed them before I asked. So we were on the same page from the beginning. A word of warning though, he will keep talking for as long as you let him. I had to keep interrupting him and changing the topic, because the consultation time is limited and I had a lot of questions.

I brought him my ct scans later, and paid for a detailed simulation. One interesting thing was that he said he could do, and pretty much recommended, is putting in jaw angle implants at the same time as bimax. He also said wisdom teeth extractions were not necessary, and showed me an example of a bimax he did that preserved the teeth. From everything I saw, he seemed like a surgeon with excellent skills and also very blackpilled. He's not targetting looksmaxxers specifically, but he is aware of them and I have a feeling he will become very popular in the future.

I brought up palate expansion and he did also agree that it was narrow, but told me he would surgically widen it. Then also rotate it so there was no gap, and also improve my occlusion. He loves 3d programs and the clinic uses several of them. He showed me the standard bone simulation, a soft tissue simulation, and also a cool heatmap of the occlusion of my teeth. He likes to design everything precisely and that's why he claims to be able to do jaw implants at the same time as bimax. He also mentioned a bunch of minor tweaks that he can do, such as: alar cinch to preserve nose width, turning the upper lip either in or out to make it larger or smaller appearing. His plan:

1. Surgery
- Cheek implants
- Jaw angle implants
- Bimax
?deg CCW
High cut segmental lefort 1: Maxilla advancement, widening, and rotation
Mandible: 10cm
Overall chin advancement: 15mm
Widening: 4mm each side
2. Orthodontics at home



Cost:
- Consultation: 1000 (first 30 min free, this is for the detailed simulation)
- Bimax + implants: 37k (detailed estimate w/italian implants, could go up depending on other factors)

Pros:
- Knowledgeable and confident with all the cutting edge surgery techniques
- Very focused on aesthetics.
- He and his team reply on whatsapp very quickly
Cons:
- Dismissed palate expansion devices
- A little too optimistic? Either he's a genius or he's overselling

Final thoughts

Things they had in common:
- Both trained under Sailer
- Both produce "anteface" results
- Both told me Sailer was old now and they wouldn't recommend him anymore (lmao)
- Both told me implants/custom plates in Switzerland were very expensive, but they were willing to work with other companies. Both ended up contacting the same Italian company that Pagnoni uses and said they could use them too.

Honestly, I was leaning towards Safi and still am. He was slightly more conservative with the advancement, but I don't want to be dogmaxxed, so not sure who to believe. But he also dismissed palatal expanders, while Jacobsen highly recommended them. People who have my sleep condition all rave about expansion being a must. They both seem highly skilled and studied under the best, but the real choice is whether I want optimal palate expansion or not.

Someone please tell me what to do lol

I was the first one with dr Safi.

 

[Deleted member 6128]

Stopped reading

choose the guy not even being sexist

@brock ye bro choose the guy

The last guy I remember to have gotten jaw surgery from a woman ended up dying

 

[Deleted member 18582]

The last guy I remember to have gotten jaw surgery from a woman ended up dying

shockingly logical conclusion. homo habilis tier iq

 

[Deleted member 32196]

I was the first one with dr Safi.

you happy with him/the result?

 

[brock]

@RealSurgerymax I have my surgery booked with Safi in mid November. Would like to go through you for implant design, but didn’t get replies in DM.

 

[Going2KillMyself]

Wow great detailed content. @brock thank u. Is that CHF or euro cost? How are u coordinating the orthodontic work or is it done with someone from the same country?

 

[Deleted member 38639]

@RealSurgerymax I have my surgery booked with Safi in mid November. Would like to go through you for implant design, but didn’t get replies in DM.

How did the Virtual Surgical Planning work? Did you do it remotely, or did you visit his clinic in Zurich? Also, did you have to provide scans other than your CBCT?

 

[Deleted member 38639]

Ramieri wanted orthodontics first. Also he didn’t really mention sleep issues, palate expansion, etc. Seems like he does the same linear advancement for everyone.

Pagnoni said orthodontics weren’t necessary, but his movements were too conservative. He only wanted to advance the jaw 5mm, 10 with genio. He also seems to offer a similar plan to everyone. I did like his implant work though.

Safi seems to take the entire face into consideration and come up with unique plan for each patient. He’s not just a maxfac, he looks at the entire face. Also, he can basically do anything. He even mentioned that he does lefort 3 and orbital box osteotomy, though he discouraged anyone who isn’t syndromatic from getting them.

He promised me major advancement, better airways and occlusion, and a surgery first approach.

He said the same thing for me, too. I have a consult with Ramieri on the 27th, but I'm pretty dead set on Safi. Is it worth it to consult w/ him or should I get a refund?

 

[Deleted member 38639]

@RealSurgerymax Check your DMs. I'm one of Safi's patients.

 

[RealSurgerymax]

@RealSurgerymax Check your DMs. I'm one of Safi's patients.

I don’t see one from you

 

[brock]

@RealSurgerymax dude you promised me a consultation months ago. I had to postpone my surgery because the implant design was not good enough. I need a design asap and have 50k saved for surgery.

 

[RealSurgerymax]

@RealSurgerymax dude you promised me a consultation months ago. I had to postpone my surgery because the implant design was not good enough. I need a design asap and have 50k saved for surgery.

Dm me please. I am trying to put people ahead who have surgery scheduled.

 

[Mincilla]

Dm me please. I am trying to put people ahead who have surgery scheduled.

Please check giant implants instagram dms for the steinbacher case, ready now thanks

 

[Mincilla]

Dm me please. I am trying to put people ahead who have surgery scheduled.

Bump, please respond to Giant Implants IG dm for Steinbacher implants