BiMax + Implants (Looking for Advice)

[lurking truecel]

@lurking truecel

This is what you meant with Jaw Widening (Condylar Torqueing), right?



Have you seen any examples of people that got that?

I think ive seen one Girl on Reddit that got her Jaw widened like that and she definitely looks better now, but i think most people shouldnt be doing it.

Yes it's condylar torquing, i don't have any result, but I think even in normal bimax they will torque some. It's like 5 mm max on both sides

 

[Vercel]

She looks very pretty from the side now and she had an Open Bite with Lip incompetence just like me which is gone now - i hope mine will will be gone too after Surgery.

@lurking truecel I feel like her posture slightly improved too immediately after surgery?

Do you think the body will naturally adjust / stop compensating with bad posture completely on itself after the surgery or will we still have to work on it because we are used to this bad posture / were walking around like that our whole life?

 

[lurking truecel]

She looks very pretty from the side now and she had an Open Bite with Lip incompetence just like me which is gone now - i hope mine will will be gone too after Surgery.

@lurking truecel I feel like her posture slightly improved too immediately after surgery?

Do you think the body will naturally adjust / stop compensating with bad posture completely on itself after the surgery or will we still have to work on it because we are used to this bad posture / were walking around like that our whole life?

I mean the normal human being today have kinda shit posture so after bimax it will probably be better than average at least. But yes practicing posturing with stretching and some muscle excersizes will help to make it better and sustainable even after

 

[Vercel]

I mean the normal human being today have kinda shit posture so after bimax it will probably be better than average at least. But yes practicing posturing with stretching and some muscle excersizes will help to make it better and sustainable even after

 

[Vercel]

in the post bimax results I have never seen an elongation of the philtrum

Don't understand, can you elaborate please?

You mean in Past BiMax Results you have never seen an elongation of the Philtrum?

 

[ectomorpher]

Don't understand, can you elaborate please?

You mean in Past BiMax Results you have never seen an elongation of the Philtrum?

I think i meant to say that in the results I've seen I rarely see lengthening of the philtrum

 

[Vercel]

@lurking truecel @iseeblue9 @NZb6Air

Do you guys know what the best Method of Capturing the NHP Position is currently?

In the Paper i read from Kühle it says this:

Digital treatment planning was performed using IPS CaseDesigner V. 2.4, a surgicalplanning and simulation software based on the individual patient datasets described below.The data included in the virtual planning were: (1) low-dose CT of the skull (DICOMdataset); (2) natural head position (NHP) standardized photos (*.jpeg); (3) intraoral scans(.stl); and (4) a digital model of the target occlusion (*.stl). These data were consecutivelyentered into IPS CaseDesigner V. 2.4 and merged to simulate the surgery based on the NHP.

https://www.researchgate.net/public...ually_Planned_Segmental_Le_Fort_I_Osteotomies

@lurking truecel Do you know how your Surgeon Captures and transfers the NHP?

The Paper above is from September 2023 tho, but i know someone took Photos of me most likely to Capture my NHP.

Capturing the NHP and transfering it to the CT or CBCT is very importent for the Surgicsl outcome and i know for a fact that Capturing the NHP with Photos isn't the best and most accurate Method.

https://www.sciencedirect.com/science/article/pii/S0278239122004128

 

[Vercel]

I think i meant to say that in the results I've seen I rarely see lengthening of the philtrum

Oh ok, verstood.

Yeah i mean based on the Simulation and pure logic it probably jusr Streches the Skin in the area which then might make the philtrum appear longer?

I have read many comments on Reddit of People who say that their philtrum lengthened after Surgery.

 

[Vercel]

Dr. Augusto Pary made a Instagram Post about this:

If I can say something after 15 years working with orthognathic and face surgery, it is that one of the most important factors of success is the oriented position of the head. That's point number 1 for a good result.
It sounds simple but it's not. Cl II and asymmetric patients are the ones with the most postural changes and only an attentive and experienced surgeon will know how to position them properly. This requires training and understanding what anatomical structures are the most reliable to use as a reference.
Wrong position changes the diagnosis and planning numbers, leading to suboptimal results.
And not only that, this clinical position has to be transferred identically to the CT scan.
In the following slides, I show some references that I use for this.

But that Post is also quite old ( 9. September 2022 )

What is the most accurate method of Capturing the NHP right now?

 

[Vercel]

@lurking truecel

Should be very Important for you too since you said we have the Same Issue regarding Shit Posture.

 

[Vercel]

@RealSurgerymax

How do you capture and Transfer the NHP into the VSP in your Cases if you don't mind saying?

 

[Vercel]

@lurking truecel @iseeblue9 @NZb6Air

Do you guys know what the best Method of Capturing the NHP Position is currently?

In the Paper i read from Kühle it says this:



https://www.researchgate.net/public...ually_Planned_Segmental_Le_Fort_I_Osteotomies

@lurking truecel Do you know how your Surgeon Captures and transfers the NHP?

The Paper above is from September 2023 tho, but i know someone took Photos of me most likely to Capture my NHP.

Capturing the NHP and transfering it to the CT or CBCT is very importent for the Surgicsl outcome and i know for a fact that Capturing the NHP with Photos isn't the best and most accurate Method.

https://www.sciencedirect.com/science/article/pii/S0278239122004128

The NHP is of importance in 3-dimensional virtual surgical planning (3D VSP) of orthognathic surgery. It provides the surgeon with a reference of the subjects' head orientation in space in relation to maxillary and mandibular movements. Generally, the NHP of the subject is obtained from frontal and lateral photographs and manually transferred to the 3D VSP with the aid of true horizontal and vertical lines.5 A previous study performed by Zhu et al investigated the reproducibility and accuracy of manually estimating the NHP, reporting a median reproducibility of −0.3° for the roll, −1.3° for the pitch, and 0.2° for the yaw.6


The influence of inaccuracies in the manual transfer of the clinical NHP to the 3D virtual planning environment on the hard tissue and soft tissue position in VSP has not been reported. This is, however, clinically relevant as an inaccurate transfer of the NHP to 3D VSP may influence the baseline jaw and soft tissue position and consequently lead to errors in the 3D VSP and the final surgical outcome. The aim of this study was to assess the reproducibility of manually transferring the clinical NHP to the 3D VSP and its subsequent influence on the soft tissue and maxillary hard tissue position.

Conclusions​

The present study demonstrated that the manual transfer of the NHP from the clinical situation to the virtual environment influenced the soft tissue and hard tissue position and that a more reproducible method of transferring the clinical NHP is recommended.

 

[Vercel]

Yeah guys, for anyone who is Interested in BiMax in the Future as you can see there's a lot of Knowledge needed for a good Result.

I really don't recommend rushing this Surgery, planning is Everything for BiMax.

I'm kind of forced to do all this shit research because I've been lied to from Doctors in the Past because most people simply Trust Doctors and think they are some Gods that know everything, but that couldn't be further from the Truth…

And some of them brutally exploit this to make more Money.

---

This forum isn't the Only Source for information btw, I'm just posting here because obviously (some) People here do have very very good knowledge. But I would also suggest reading Academical Papers from Surgeons.

---

If yore Uninformed and get pushed / or go to some Surgeon its a Gamble either you're going to get Fucked or you're lucky and got to someone that knows what he's doing.

I listended to my Bad Gut Feeling and said fuck that when i had my first Consultation with a Surgeon.

No CBCT or CT, he wanted to Operate me based on only X-Rrays and i bet it would have been a Straight Advancement without Rotation making me look like a Monkey...

Not even sure if he would have done BSSO, maybe he would have done HSSO osteotomy like some sother Surgeon i know which is outdated and rearly used these day for good reasons!

 

[ectomorpher]

I have read many comments on Reddit of People who say that their philtrum lengthened after Surgery.

yes me too, do you think that bimax with impaction ccw rotation would reduce it ?

btw i have some questions to ask, can i pm you ?

 

[Vercel]

yes me too, do you think that bimax with impaction ccw rotation would reduce it ?

btw i have some questions to ask, can i pm you ?

Yeah, sure.

 

[Vercel]

yes me too, do you think that bimax with impaction ccw rotation would reduce it ?

btw i have some questions to ask, can i pm you ?

Ill go to bed soon tho, so i might not be able to give you a detailed anwser immediately if its something more complex.

 

[Vercel]

About the Airway:

This is pure speculation, but do you guys think UARS / SleepApnea could be the Cause for my ADHD?

Meaning, could it be possible that i sufficated in my Mothers Womb or as a small Child when my Brain Developed which then caused Brain Damage?

---

I actually took Benzodiazepines for Sleep once and Benzos relax your muscles.

My Brain Chemistry is fucked because of Stimulants which i desperately need to function normally / work / live a Normal Life (i tried it without for 20 Years because i didn't know i had ADHD) and it went miserable.

And i remember sleeping on my Back once (i took Benzos to Sleep that day), woke up in the Middle of the Night due to Sleep Paralysis and literally witnessed my Airwy Colpsing (i think) because i couldnt breathe trough my Nose. I legitimately thought im going to suffocate and die in that moment.

If that actually happens every night i wouldnt be surprised whatsoever that this Shit causes Brain Damage - you literally Stop Breathing for some time if you habe real Sleep Apnea.

---

Maybe my ADHD will be better Post OP (because i will be able to breathe better), because im literally taking 70mg Vyvanse/Elvanse (Lisdexamfetamine) + 300mg Elontrol (Bupropion) (off label for ADHD) because even 70mg Vyvanse isnt enough for me.

I will try Semax too as the other Guy Suggested.

 

[IHATETOUHOU]

wait did you have tmj?

 

[Vercel]

wait did you have tmj?

Nah, Doctor checked and said no TMJ.

But i do have Clicking / Popping on both Sides which is actually gone when i Jutt man lower Jaw forward.

 

[IHATETOUHOU]

Nah, Doctor checked and said no TMJ.

But i do have Clicking / Popping on both Sides which is actually gone when i Jutt man lower Jaw forward.

man my doctor recommanded me i get tmj disk thingy + bimax he talked about a new type of technologie that only one surgeon does it in north america only problem is i gotta wait month and wait until they remove my braces other than that my jaw is killing me

 

[Vercel]

man my doctor recommanded me i get tmj disk thingy + bimax he talked about a new type of technologie that only one surgeon does it in north america only problem is i gotta wait month and wait until they remove my braces other than that my jaw is killing me

We had this discussion above actually.

Which Doctor do you meean?

Alfi?

Alfi literally says he performs BiMax with Custom Guides & Plates (for the BSSO too) purely for people with TMJ and says the outcomes are consistently Positive.

 

[IHATETOUHOU]

We had this discussion above actually.

Which Doctor do you meean?

Alfi?

Alfi literally says he performs BiMax with Custom Guides & Plates (for the BSSO too) purely for people with TMJ and says the outcomes are consistently Positive.

no i dont remmeber his full name but i know it starts with K and the surgery is around 30-40 min for the tmj issue

 

[Vercel]

no i dont remmeber his full name but i know it starts with K and the surgery is around 30-40 min for the tmj issue

I don't have TMJ so i really never got into that but do you mind sharing if you find out who it is / what the procedure is exactly?

Or you go and trust Dr. David Alfi and go with him if you have TMJ



20:37 - 22:22

Instead, we're seeing an entire paradigm change shift and even philosophy where TMJs become healthier consistently and predictably after surgery so in fact a lot of my patients come to the office not for even thinking about jaw surgery but just complaining of their TMJs

Logically only one Person can be right.

There's no way Dr. David Alfi can just say those things? I mean he actually operates people?!