Actual box osteotomy patient, as well as every other extreme surgery

[uranio]

Mirin your incredible dedication to surgerymaxing. Thank you for sharing your experience

 

[Gaia262]

Hello, I am an OG from puahate, and certainly the most surgically experienced person in PSL history. I will make threads in the future about other topics, but here I want to answer questions about the OBO I had.

I went from 65.5 mm IPD (on a 154 mm bizygo face) to a 72 mm IPD. I've attached a picture of my surgical plan. I also had my left eye raised relative to the right for symmetry, and my "boxes" rotated so that my cheekbones would be higher on a framework level, not just augmenting with implants, though I did have permanent filler in the area already, as well as infraorbital implants from Taban years ago (he sucks, actually worse than Douglas/Massry and Eppley, had cantho or lower lid retraction surgeries by all of them).

I was hoping the rotation would lead to more PCT but ultimately the canthal ligaments and whatnot resettle at their previous elevation. My canthos were not performed that great, but I did tons of research and got a follow-up drill-hole cantho with lower lid fat grafting by Eppley, and he gave me better results than any oculoplastic I tried previously (including 2 attempts by Taban).

My doc was Derek Steinbacher. I messaged a bunch of craniofacial/plastic combined specialty surgeons as found by google searching ("craniofacial plastic") and he was the one to respond.

Recovery was gnarly, not too painful, but I was functionally swollen blind the first few days. Months to regain eyebrow movement and general facial sensitivity. The right side of my upper lip extending upwards to encompass the buccal region is still experiencing numbness/parasthesia, but it's whatever. Overall I'm pretty happy with how it went. Attached a pic of my pre-surgical plan.

I'm sure this will attract a lot of interest, but I am quite busy so please don't dm me much, I'll answer various q's here. I'm not gonna show before/afters because I want to protect my identity.

Edit: May as well just use this thread to answer any questions about any surgeries at this point. I might make threads more specific to certain things (eye shape, LL, facial de-bloating, etc.) in the future.

Thanks for sharing your experience.

To go through with these kind of surgeries shows commitment beyond imagination.

 

[Titbot]

Hello, I am an OG from puahate, and certainly the most surgically experienced person in PSL history. I will make threads in the future about other topics, but here I want to answer questions about the OBO I had.

I went from 65.5 mm IPD (on a 154 mm bizygo face) to a 72 mm IPD. I've attached a picture of my surgical plan. I also had my left eye raised relative to the right for symmetry, and my "boxes" rotated so that my cheekbones would be higher on a framework level, not just augmenting with implants, though I did have permanent filler in the area already, as well as infraorbital implants from Taban years ago (he sucks, actually worse than Douglas/Massry and Eppley, had cantho or lower lid retraction surgeries by all of them).

I was hoping the rotation would lead to more PCT but ultimately the canthal ligaments and whatnot resettle at their previous elevation. My canthos were not performed that great, but I did tons of research and got a follow-up drill-hole cantho with lower lid fat grafting by Eppley, and he gave me better results than any oculoplastic I tried previously (including 2 attempts by Taban).

My doc was Derek Steinbacher. I messaged a bunch of craniofacial/plastic combined specialty surgeons as found by google searching ("craniofacial plastic") and he was the one to respond.

Recovery was gnarly, not too painful, but I was functionally swollen blind the first few days. Months to regain eyebrow movement and general facial sensitivity. The right side of my upper lip extending upwards to encompass the buccal region is still experiencing numbness/parasthesia, but it's whatever. Overall I'm pretty happy with how it went. Attached a pic of my pre-surgical plan.

I'm sure this will attract a lot of interest, but I am quite busy so please don't dm me much, I'll answer various q's here. I'm not gonna show before/afters because I want to protect my identity.

Edit: May as well just use this thread to answer any questions about any surgeries at this point. I might make threads more specific to certain things (eye shape, LL, facial de-bloating, etc.) in the future.

Regalar cantho are designed to relapse. Why not get bridge of bone cantho to get a wider pfl?

 

[CosmicMaxxer]

before and after mirror pics, as selfies make my canthal tilt look worse.

 

[CosmicMaxxer]

Regalar cantho are designed to relapse. Why not get bridge of bone cantho to get a wider pfl?

Steinbacher did a "bridge-of-bone" cantho, which is actually just a canthopexy. This actually does not even lengthen pfl. The only way to lengthen pfl (short of a later orbital osteotomy) is a "drill-hole canthoplasty", as only that can maintain canthus contact with the eyeball.

 

[Titbot]

I had two initial Taban surgeries spaced 4 years apart (I'm actually one of his b/a's from years ago). The first one was decent but kinda shortened my eyes and left residual outer lid droop, the 2nd did next to nothing. Then I had another lower lid/canthopexy with Raymond Douglas that went solid. Then the OBO which made them a bit worse, then a final Eppley attempt that's brought it to it's best state. Quite thin now, slight pct, but only averageish PSL (Eppley was able to extend them by like 1.5 mm per eye).

Scarring is slightly overstated. You can always release scar tissue in the lower lids, and stacking spacer grafts (i.e. one graft scars down, releasing its scar, placing another graft on top of it) is emerging as the most viable strategy according to the latest studies. When it comes to canthos, extra scar tissue may help to keep the canthus in place, though it does make webbing a bit more likely (less sharp/pointy canthuses).

My suggestion to those on a budget is Eppley's drill-hole cantho + lower eyelid fat grafting. It's only like 5k. If you want to be more thorough, get a lower lid retraction surgery with Douglas or Massry prior. Eppley may also be good for lower lids, but ideally you want someone who will do a free revision/graft-stacking should you need it (i.e. being prone to scar internally).i

i was able to widen my pfl by 1.5 mm on both eyes using Infraorbirtal rim implants and drill cantho

 

[Titbot]

Steinbacher did a "bridge-of-bone" cantho, which is actually just a canthopexy. This actually does not even lengthen pfl. The only way to lengthen pfl (short of a later orbital osteotomy) is a "drill-hole canthoplasty", as only that can maintain canthus contact with the eyeball.

Yes that’s what Pagnoni did for me. It mogs hard

 

[Deleted member 5786]

your eyes look like marlon brando's in the after

 

[Titbot]

Ok here is just the eye region. Please don't share or popularize over the net. I will likely delete the link tomorrow. Caveats are described in the link (swollen upper lids with the right one in the pic being worse, co2 laser done recently), so this is hardly representative of a final result, but to spare you the wait:

 

[Titbot]

Thanks for sharing your experience.

To go through with these kind of surgeries shows commitment beyond imagination.

Steinbacher did a "bridge-of-bone" cantho, which is actually just a canthopexy. This actually does not even lengthen pfl. The only way to lengthen pfl (short of a later orbital osteotomy) is a "drill-hole canthoplasty", as only that can maintain canthus contact with the eyeball.

The idea is to pin the lateral canthus to the lateral orbital wall instead of Weills tubercle.

 

[CosmicMaxxer]

Before my c02 laser:

 

[gamma]

You're white passing, why don't you locationmaxx instead of surgery?

 

[Titbot]

Before my c02 laser:

Whats your pfl now?

 

[CosmicMaxxer]

You're white passing, why don't you locationmaxx instead of surgery?

I'm already nearing the end of my surgery journey, and I didn't spend 600k so I'd have to move to Thailand lol.

 

[Blackgymmax]

Mirin the dedication. Keep up the good work

 

[CosmicMaxxer]

Whats your pfl now?

Pretty mediocre, I think like 28.5-29 mm. I'm not TOO bummed about it, I think it's masculine to have wide-set, thin, but only average pfl eyes. Though obv. I'd take a few more mm if I could.

 

[Titbot]

Pretty mediocre, I think like 28.5-29 mm. I'm not TOO bummed about it, I think it's masculine to have wide-set, thin, but only average pfl eyes. Though obv. I'd take a few more mm if I could.

I was in the same boat as you. I can tell you more about it when you are in the vanguard. My pfl after drill cantho and Infra orbitals rim implants mog. The importance of Infras are needed to achieve sn aesthetic eye shape

 

[CosmicMaxxer]

I was in the same boat as you. I can tell you more about it when you are in the vanguard. My pfl after drill cantho and Infra orbitals rim implants mog. The importance of Infras are needed to achieve sn aesthetic eye shape

I actually already have infraorbital implants from Taban, plus the OBO (unbeknownst to me initially) moved my orbitals forwards, so my ogee curve is actually over-pronounced now.

 

[Titbot]

I actually already have infraorbital implants from Taban, plus the OBO (unbeknownst to me initially) moved my orbitals forwards, so my ogee curve is actually over-pronounced now.

Taban implants suck. You should have gotten PEEK implants. Why not get eppley face mask post obo

 

[Titbot]

I do like the upper lid curvature op

 

[CosmicMaxxer]

Taban implants suck. You should have gotten PEEK implants. Why not get eppley face mask post obo

Ehh I'm pretty satisfied with the orbital and midfacial bones, my cheekbones are overly projected from 3/4. I don't think brow ridge is a high-value trait.

 

[Titbot]

Ehh I'm pretty satisfied with the orbital and midfacial bones, my cheekbones are overly projected from 3/4. I don't think brow ridge is a high-value trait.

The Infra orbitals rims are needed to shape the lower lid in achieving an aesthetic eye shape

 

[CosmicMaxxer]

The Infra orbitals rims are needed to shape the lower lid in achieving an aesthetic eye shape

I guess you're referring to the kind that actually dips into the socket (saddle-style)? I guess if I could redo it I'd wait for Eppley to invent those and have gotten them at that point lol.

 

[Doggingercel]

facial de-bloating

Can you expand a bit on this? Surprised to see it mentioned along with all types of surgeries.

 

[Titbot]

I guess you're referring to the kind that actually dips into the socket (saddle-style)? I guess if I could redo it I'd wait for Eppley to invent those and have gotten them at that point lol.

Eppley already has those

 

[CosmicMaxxer]

Can you expand a bit on this? Surprised to see it mentioned along with all types of surgeries.

I went to this clinic in Korea: https://www.engfreshps.com/facial-liposuction
Did a decent job because they will suck out fat from literally anywhere in the face. But next, I'm gonna do Eppley's trifecta (buccal fat removal, perioral lipo, and buccinator muscle trimming). I also started Morpheus8 which can compact down subdermal fat.

 

[CosmicMaxxer]

Eppley already has those

Right I mean I would have waited until 2019 or whenever he "invented" them, instead of getting mediocre ones with Taban in 2015.

 

[Titbot]

Right I mean I would have waited until 2019 or whenever he "invented" them, instead of getting mediocre ones with Taban in 2015.

You in the vanguard discord server. I can tell you a surgeon who does it for 11 K

 

[Acromegaly_Chad]

Makes me wonder if a regular zygo reduction (15.4cm is 99th percentile and ogre tier to start with while 64.5mm IPD is a mere 2mm below average) bimax with quadrangular lefort 1, and zygo, under eye and jaw angle implants with focus on harmony and angularity wouldn't have produced a more natural, MUCH less risky and expensive result.

Because quite frankly to me it seems as if the OBO has impacted your eye area negatively apart from the IPD gain.

Still much respect for the dedication and courage to undergo all these procedures

 

[CosmicMaxxer]

Makes me wonder if a regular zygo reduction (15.4cm is 99th percentile and ogre tier to start with while 64.5mm IPD is a mere 2mm below average) bimax with quadrangular lefort 1, and zygo, under eye and jaw angle implants with focus on harmony and angularity wouldn't have produced a more natural, MUCH less risky and expensive result.

Because quite frankly to me it seems as if the OBO has impacted your eye area negatively apart from the IPD gain.

Still much respect for the dedication and courage to undergo all these procedures

The eyes look better when you see the entire head/face. It reduces the appearance of the flaw of somewhat low pfl:ipd ratio, and shows how the wide-set eyes harmonize with a massive skull. I’ve shown pics in the discord server. I can pm you if you’d like.

 

[Acromegaly_Chad]

The eyes look better when you see the entire head/face. It reduces the appearance of the flaw of somewhat low pfl:ipd ratio, and shows how the wide-set eyes harmonize with a massive skull. I’ve shown pics in the discord server. I can pm you if you’d like.

I'm in that server, saw the pics now.
Yes it's an improvement overall, indeed.

And damn you have almost the same pheno as me. Confirms my 23andme ancestry results JFL

 

[CosmicMaxxer]

I'm in that server, saw the pics now.
Yes it's an improvement overall, indeed.

And damn you have almost the same pheno as me. Confirms my 23andme ancestry results JFL

Jewish or Southern European or Armenian?

 

[Acromegaly_Chad]

Jewish or Southern European or Armenian?

half german
half eastern europe/ashkenazi.

What an irony actually lol

 

[ascentium]

Do I have to worry about lid retraction with transconjuctival incision for placing infraorbital implants?

 

[CosmicMaxxer]

Do I have to worry about lid retraction with transconjuctival incision for placing infraorbital implants?

Yes if doing it in isolation. Are you getting anything done with it? And which doc?

 

[ascentium]

Yes if doing it in isolation. Are you getting anything done with it? And which doc?

okay. Nothing planned for the lids, except the surgeon said the periosteal face lift and anchoring to the implant is sufficient to prevent retraction. In fact he suggest my pfh will decrease as a result of the lift and the saddle design.

 

[CosmicMaxxer]

okay. Nothing planned for the lids, except the surgeon said the periosteal face lift and anchoring to the implant is sufficient to prevent retraction. In fact he suggest my pfh will decrease as a result of the lift and the saddle design.

Ya that should work. You can always throw in a canthopexy or something so the eyes heal in an elevated position at least.

 

[CosmicMaxxer]

You in the vanguard discord server. I can tell you a surgeon who does it for 11 K

I'll prob ask Eppley whether a saddle-shaped replacement infra-orbital could help me get even straighter lower lids. I'm guessing that it's more risk than reward given the amount of scar tissue I have down there and the risk of things scarring down worse than before.

 

[nastynas]

mirin your dedication man, congratulations

would you be okay to rate me and give some suggestions surgery wise? would be a great opportunity for me as you have years of cumulative both theory and practical knowledge

 

[CosmicMaxxer]

mirin your dedication man, congratulations

would you be okay to rate me and give some suggestions surgery wise? would be a great opportunity for me as you have years of cumulative both theory and practical knowledge

sure shoot me a pm

 

[Tobias Fünke]

I started as roughly a 3.75/10 on the PSL scale before any surgery, and will likely end up around 6.5/10 (top 10%) after the swelling from my final surgery resolves, as rated by several PSL friends of mine. The box osteotomy specifically did not boost me much in and of itself, but set up the stage for a wraparound jaw implant and skull implant to complete my robust spacious face (tall and very broad skull), which contributes to my presence (skull-mog).

I should also mention, I've had 2 LL's, started at 5'7.5 and ending up at 6'1.67. I'll make another thread about that eventually.

How long did you have to wait between the 2 LL surgeries? Were there any complications and how much do you feel your athletic ability has diminished since getting them?

Also how supportive have friends/family been on your surgical journey?

 

[CosmicMaxxer]

How long did you have to wait between the 2 LL surgeries? Were there any complications and how much do you feel your athletic ability has diminished since getting them?

Also how supportive have friends/family been on your surgical journey?

6 years between. I mostly recovered from the first one, maybe 85% of athleticism. Still recovering from tibias, walking all hobbled for now but it steadily improves every week.

My family thinks I'm a nut case and have tried to get me to stop throughout the journey, though they will admit I look better at times. Many of my friends are from psl so ofc they are supportive lol.

 

[deepweb1298]

I went to this clinic in Korea: https://www.engfreshps.com/facial-liposuction
Did a decent job because they will suck out fat from literally anywhere in the face. But next, I'm gonna do Eppley's trifecta (buccal fat removal, perioral lipo, and buccinator muscle trimming). I also started Morpheus8 which can compact down subdermal fat.

Absolute based my dude. I recently done Buccal fat Removal + FaceTite + Morpheus8 for facial fat. Will defos look into this

 

[Tobias Fünke]

6 years between. I mostly recovered from the first one, maybe 85% of athleticism. Still recovering from tibias, walking all hobbled for now but it steadily improves every week.

My family thinks I'm a nut case and have tried to get me to stop throughout the journey, though they will admit I look better at times. Many of my friends are from psl so ofc they are supportive lol.

Thanks for the response. Best of luck with your final push toward the looksmaxing summit!

 

[deepweb1298]

Why are you going to Eppeley after going to Korea for lipo? Were you not satisfied with the result?

 

[CosmicMaxxer]

Why are you going to Eppeley after going to Korea for lipo? Were you not satisfied with the result?

I think they lied that their method removes buccal fat, because I still have heaviness in the buccal region. I think they did a decent job, but these days I'd recommend the Eppley trifecta + accutite/facetite, and Morpheus8. What they did in Korea was basically the equivalent of accutite. Though I was not aware of that at the time I went.

 

[deepweb1298]

I think they lied that their method removes buccal fat, because I still have heaviness in the buccal region. I think they did a decent job, but these days I'd recommend the Eppley trifecta + accutite/facetite, and Morpheus8. What they did in Korea was basically the equivalent of accutite. Though I was not aware of that at the time I went.

I can tell you work for FAANG. I'm a SWE as well but dont work for them. Really mirin' the dedication and you're very lucky that us SWE's can just do remote work and do surgeries at the same time.

 

[CosmicMaxxer]

I can tell you work for FAANG. I'm a SWE as well but dont work for them. Really mirin' the dedication and you're very lucky that us SWE's can just do remote work and do surgeries at the same time.

Ya covid is one hell of a blessing tbh. To get into faang I quit my job and did 6 months of leetcode a few years ago lol. Had to leetcode to ascend my L.

 

[deepweb1298]

Ya covid is one hell of a blessing tbh. To get into faang I quit my job and did 6 months of leetcode a few years ago lol. Had to leetcode to ascend my L.

im currently leetcoding as well hard its a fucking pain in the ass but yeah gotta do it for the big bucks

 

[Lihito]

I'll send them via some instant disappearing platform like snapchat (with pics disabled or something) in late January. That is when all my swelling will be gone, and I'll be doing a pro photo shoot then.

Why you do afraid of doxxing bratha