Bimax with angle implants?

[politically correct]

So I've been planning a bimax with Dr Ramieri, and the original plan was to do bimax with genio and also infraorbital malar implants, and during the same surgery to put small jaw angle implants on my jaw angles to lengthen the ramus a bit and add some gonion flair. This could all be done in the same surgery so no need to wait months post bimax to put implants in. I dont want/need wraparound or implants that extend far along the mandible

About 6 months ago I paid for a consult with Eppley, so I spoke to him (mainly to get his views on design for infraorbital malar implants). I told him of my lntentions to have bimax with jaw implants all at once.

He didnt try and dissuade me from having bimax. In fact he said, based on what I'd told him he thinks I should go for it

But he basically said that he'd be nervous as a surgeon putting jaw implants in so close to an open saggital split site. He basically said jaw implants have the highest infection rate of any kind of facial implant, and the risk is amplified by the amount of hours that you are in surgery as obviously instruments are being re-used during the process etc. and that doing a whole bimax then putting jaw implants in at the end increases the risk a lot in his mind, and if you get an infection to the implants that spreads to the saggital split it could lead to osteomyelitis

He said any surgeon who says the risk is low hasnt done the procedure enough times to know

So now I'm in two minds, do I do the jaw implants after bimax recovery is complete? As I understand it Pagnoni and Sailer regularly combine implants and bimax in 1 procedure.

 

[Corleone]

He said any surgeon who says the risk is low hasnt done the procedure enough times to know

I think the most likely reason for Eppley to tell you that he wouldn't recommend doing both together is that he doesn't perform bimax surgeries and would miss out on business if he told you that it was possible (which you pointed out some other doctors that combine implants with bimax, no problem)

 

[Oberyn]

Ramieri designs implants according to bsso cut so your jaw implant won’t touch with open bone or surgical area whatever it’s called.

 

[politically correct]

Ramieri designs implants according to bsso cut so your jaw implant won’t touch with open bone or surgical area whatever it’s called.

true, but infections can travel

 

[politically correct]

I think the most likely reason for Eppley to tell you that he wouldn't recommend doing both together is that he doesn't perform bimax surgeries and would miss out on business if he told you that it was possible (which you pointed out some other doctors that combine implants with bimax, no problem)

true, but he literally encouraged me to get the bimax, he just said he thinks i should do both seperately ie. get my jaw implants done a few months post bimax not at same time

 

[HighClassMaxing]

Joined Apr 10, 2022 Posts 127 Reputation 192

already getting bimax mirin.
@Gaia262 thoughts on op ?

 

[Corleone]

true, but he literally encouraged me to get the bimax, he just said he thinks i should do both seperately ie. get my jaw implants done a few months post bimax not at same time

because he wants you to come back to him to get the implants, I'd assume. I don't know about your recession level, but could definitely true, that you need it.

 

[Gaia262]

Joined Apr 10, 2022 Posts 127 Reputation 192

already getting bimax mirin.
@Gaia262 thoughts on op ?

So I've been planning a bimax with Dr Ramieri, and the original plan was to do bimax with genio and also infraorbital malar implants, and during the same surgery to put small jaw angle implants on my jaw angles to lengthen the ramus a bit and add some gonion flair. This could all be done in the same surgery so no need to wait months post bimax to put implants in. I dont want/need wraparound or implants that extend far along the mandible

About 6 months ago I paid for a consult with Eppley, so I spoke to him (mainly to get his views on design for infraorbital malar implants). I told him of my lntentions to have bimax with jaw implants all at once.

He didnt try and dissuade me from having bimax. In fact he said, based on what I'd told him he thinks I should go for it

But he basically said that he'd be nervous as a surgeon putting jaw implants in so close to an open saggital split site. He basically said jaw implants have the highest infection rate of any kind of facial implant, and the risk is amplified by the amount of hours that you are in surgery as obviously instruments are being re-used during the process etc. and that doing a whole bimax then putting jaw implants in at the end increases the risk a lot in his mind, and if you get an infection to the implants that spreads to the saggital split it could lead to osteomyelitis

He said any surgeon who says the risk is low hasnt done the procedure enough times to know

So now I'm in two minds, do I do the jaw implants after bimax recovery is complete? As I understand it Pagnoni and Sailer regularly combine implants and bimax in 1 procedure.

I had my jaw implant as a second surgery. It allows you to plan for anything that goes wrong such as assymetries ect.

Dr Eppley raises a valid point, Its something I thought about aswell that if an infection did take place with the implant it would effect the osteotomy site of the bsso.

However, Dr Eppley is known for his trash ethics and he is a very well spoken salesman. Could be a tactic to go with his implants.

Overall Dr Sailer the pioneer, would commonly use jaw angle implants simultaneously in his bimax.

Overall it's your choice, personally I would take things in stages. However I trust Dr Ramieri's ability to carry out both surgeries.

I have read some of your posts where you say you are struggling with the changes in your face from your first surgery (body dysmorphia). I would be hesitant to go full a full facial reconstruction especially in one surgery. This could be the thing that pushes you over.

People seem to be disregarding the mental health aspects of this.

Struggling mentally with having implants in my body

So I started my self-improvement journey around 15 months ago. I'd say I was a 7 out of 10 before any surgeries and never had problems getting women (in person, never been successful on apps) but I wanted to go from decent to top tier just because the market is so competitive now, and candidly I...

looksmax.org

 

[Chinlet Ascension]

But he basically said that he'd be nervous as a surgeon putting jaw implants in so close to an open saggital split site. He basically said jaw implants have the highest infection rate of any kind of facial implant, and the risk is amplified by the amount of hours that you are in surgery as obviously instruments are being re-used during the process etc. and that doing a whole bimax then putting jaw implants in at the end increases the risk a lot in his mind, and if you get an infection to the implants that spreads to the saggital split it could lead to osteomyelitis

This is actually really good, professional advice. There is an issue of cost here: If you are doing multiple procedures, it is cheaper to do them all at once (so you don't have to pay separate fees for anesthesia, etc.). But infection is always a risk with facial implants, and whatever you can do to mitigate that risk is probably worth it.

 

[Deleted member 12002]

So I've been planning a bimax with Dr Ramieri, and the original plan was to do bimax with genio and also infraorbital malar implants, and during the same surgery to put small jaw angle implants on my jaw angles to lengthen the ramus a bit and add some gonion flair. This could all be done in the same surgery so no need to wait months post bimax to put implants in. I dont want/need wraparound or implants that extend far along the mandible

About 6 months ago I paid for a consult with Eppley, so I spoke to him (mainly to get his views on design for infraorbital malar implants). I told him of my lntentions to have bimax with jaw implants all at once.

He didnt try and dissuade me from having bimax. In fact he said, based on what I'd told him he thinks I should go for it

But he basically said that he'd be nervous as a surgeon putting jaw implants in so close to an open saggital split site. He basically said jaw implants have the highest infection rate of any kind of facial implant, and the risk is amplified by the amount of hours that you are in surgery as obviously instruments are being re-used during the process etc. and that doing a whole bimax then putting jaw implants in at the end increases the risk a lot in his mind, and if you get an infection to the implants that spreads to the saggital split it could lead to osteomyelitis

He said any surgeon who says the risk is low hasnt done the procedure enough times to know

So now I'm in two minds, do I do the jaw implants after bimax recovery is complete? As I understand it Pagnoni and Sailer regularly combine implants and bimax in 1 procedure.

Why are you politically correct?

 

[zeek]

eppley gave you good advice

and ramieri's infras are unimpressive wouldn't do them with him

 

[politically correct]

I've seen that Sailer and Pagnoni also combine implants with bimax and ive never heard of single case of severe complications from it, so im in 2 minds

 

[politically correct]

eppley gave you good advice

and ramieri's infras are unimpressive wouldn't do them with him

eppley charges crazy money for them though, I have consulted with him though

 

[Chinlet Ascension]

I've seen that Sailer and Pagnoni also combine implants with bimax and ive never heard of single case of severe complications from it, so im in 2 minds

eppley charges crazy money for them though, I have consulted with him though

Eppley's prices are pretty standard compared to other USA surgeons who offer the same operations. Sailer, on the other hand, is outrageously expensive. He charges $100,000+ for a bimax+misc. operation (he likes to combine bimax with other things-jaw implants, rhino, etc.).

 

[politically correct]

How much are infras with eppley?

 

[Chinlet Ascension]

How much are infras with eppley?

I don't know if he might charge less, because they're smaller implants. Custom implants (a single cheekbone or jaw set) run around $16-19,000 for him, from what I've read online.

 

[zeek]

Eppley's prices are pretty standard compared to other USA surgeons who offer the same operations. Sailer, on the other hand, is outrageously expensive. He charges $100,000+ for a bimax+misc. operation (he likes to combine bimax with other things-jaw implants, rhino, etc.).

I disagree a bit.

Most surgeons in the US who do this kind of work would charge standard rate + $5-7k or so. Which is what eppley originally charged before he crept up due to demand.

Either way he should accept eppley’s advice even if he goes to someone else for implants.

 

[Chinlet Ascension]

Most surgeons in the US who do this kind of work would charge standard rate + $5-7k or so.

For standard implants, yes. Custom is much more expensive.

 

[zeek]

yeah I meant to say $5-7k in addition to The regular cost of cheek implants***

Bc they are paying a third party for the manufacturer and cad/cam plus more time planning.

So it would usually be around $9-12k for most surgeons who do this who aren’t eppley.