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brock
Iron
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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
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
