Booked my first consultation with Ramieri. June 17.

[The Dire]

I turned 18 yesterday. Perfect timing. Now I need to get a 3D CBCT (Cone Beam, large FOV, full DICOM files) because they require it at least 15 days before the appointment. I still have to book it, but I’ll do it ASAP so they can properly analyze everything.

I trust Ramieri a lot. He’s one of the few surgeons here who actually thinks in terms of structure. But I also know he’s very conservative. For minor recessions he doesn’t push bimax. Ideally, I’d want a trimax + rhino because my main goal is to truly fix the side profile. That said, I’m open to whatever he recommends as long as it genuinely harmonizes the profile and hopefully improves the front a bit too.

My chin is definitely recessed. Realistically he might suggest genio + rhinoplasty. If that’s the direction, I’d at least want to consider adding zygo implants to improve midface projection, not just the lower third.

I’m attaching the X-ray I took a few weeks ago. Let me know what you guys think structurally and what approach you’d consider in my case.
Will update after the CBCT.

@lurking truecel

 

[brainregeneration]

@Denkaren

 

[Denkaren]

You have clearly been misled, especially since your tagging Lurkingcell for advice. That alone should raise serious red flags. Lurkingcell judgment can’t be trusted. His persistent hype around Ramieri is agenda-driven rather than objective. He is one of the reason Ramieri are regarded so high in this forum.

The only example we have here of someone whose appearance has been drastically changed is a patient he treated with trimax, implants, and rhinoplasty. That should be telling. Show me ONE just ONE result from him with trimax alone that has drastically changed ones appearance.

He is unable to properly assess fundamental structural needs such as maxillary expansion, and his overall diagnostic framework are incomplete. There’s little indication that he considers key functional factors like tongue posture or airway dynamics, which are critical in comprehensive craniofacial planning. His aesthetic sense is also questionable his work tends to create disproportion by failing to integrate the face as a whole rather than treating isolated regions.

His ethical posture is equally concerning. He presents himself as the moral surgeon who turns patients away when surgery isn’t justified, but that image doesn’t hold up. In practice, he is willing to take on any case. The driving motivation is solely . When things go wrong which, over the long term, often happens with implants there’s every indication the patient will be left without meaningful support.

I heard some absurd comment from Lurkingcell, he said Ramieri travel across countries if something goes wrong. I hope you realise that this is COMPLETELY false, quite frankly the exact opposite. If something goes wrong he basically lets you hanging or want you to pay full price for a new surgery.

Overall, the combination of questionable judgment, inconsistent ethics, and a distorted aesthetic framework makes reliance on Ramieri highly risky. Anyone considering Ramieri should proceed with extreme caution and seek independent, truly comprehensive evaluation before committing to irreversible procedures.

Hearing made-up cases on this forum obviously doesn’t mean a shit.

Your local surgeon has probably more knowledge in this area than Ramieri.

His followers on instagram are fake, his likes are fake. Which serious surgeons does this?

 

[tomahawk]

You have clearly been misled, especially since your tagging Lurkingcell for advice. That alone should raise serious red flags. Lurkingcell judgment can’t be trusted. His persistent hype around Ramieri is agenda-driven rather than objective. He is one of the reason Ramieri are regarded so high in this forum.

The only example we have here of someone whose appearance has been drastically changed is a patient he treated with trimax, implants, and rhinoplasty. That should be telling. Show me ONE just ONE result from him with trimax alone that has drastically changed ones appearance.

He is unable to properly assess fundamental structural needs such as maxillary expansion, and his overall diagnostic framework are incomplete. There’s little indication that he considers key functional factors like tongue posture or airway dynamics, which are critical in comprehensive craniofacial planning. His aesthetic sense is also questionable his work tends to create disproportion by failing to integrate the face as a whole rather than treating isolated regions.

His ethical posture is equally concerning. He presents himself as the moral surgeon who turns patients away when surgery isn’t justified, but that image doesn’t hold up. In practice, he is willing to take on any case. The driving motivation is solely . When things go wrong which, over the long term, often happens with implants there’s every indication the patient will be left without meaningful support.

I heard some absurd comment from Lurkingcell, he said Ramieri travel across countries if something goes wrong. I hope you realise that this is COMPLETELY false, quite frankly the exact opposite. If something goes wrong he basically lets you hanging or want you to pay full price for a new surgery.

Overall, the combination of questionable judgment, inconsistent ethics, and a distorted aesthetic framework makes reliance on Ramieri highly risky. Anyone considering Ramieri should proceed with extreme caution and seek independent, truly comprehensive evaluation before committing to irreversible procedures.

Hearing made-up cases on this forum obviously doesn’t mean a shit.

Your local surgeon has probably more knowledge in this area than Ramieri.

His followers on instagram are fake, his likes are fake. Which serious surgeons does this?

This

 

[The Dire]

You have clearly been misled, especially since your tagging Lurkingcell for advice. That alone should raise serious red flags. Lurkingcell judgment can’t be trusted. His persistent hype around Ramieri is agenda-driven rather than objective. He is one of the reason Ramieri are regarded so high in this forum.

The only example we have here of someone whose appearance has been drastically changed is a patient he treated with trimax, implants, and rhinoplasty. That should be telling. Show me ONE just ONE result from him with trimax alone that has drastically changed ones appearance.

He is unable to properly assess fundamental structural needs such as maxillary expansion, and his overall diagnostic framework are incomplete. There’s little indication that he considers key functional factors like tongue posture or airway dynamics, which are critical in comprehensive craniofacial planning. His aesthetic sense is also questionable his work tends to create disproportion by failing to integrate the face as a whole rather than treating isolated regions.

His ethical posture is equally concerning. He presents himself as the moral surgeon who turns patients away when surgery isn’t justified, but that image doesn’t hold up. In practice, he is willing to take on any case. The driving motivation is solely . When things go wrong which, over the long term, often happens with implants there’s every indication the patient will be left without meaningful support.

I heard some absurd comment from Lurkingcell, he said Ramieri travel across countries if something goes wrong. I hope you realise that this is COMPLETELY false, quite frankly the exact opposite. If something goes wrong he basically lets you hanging or want you to pay full price for a new surgery.

Overall, the combination of questionable judgment, inconsistent ethics, and a distorted aesthetic framework makes reliance on Ramieri highly risky. Anyone considering Ramieri should proceed with extreme caution and seek independent, truly comprehensive evaluation before committing to irreversible procedures.

Hearing made-up cases on this forum obviously doesn’t mean a shit.

Your local surgeon has probably more knowledge in this area than Ramieri.

His followers on instagram are fake, his likes are fake. Which serious surgeons does this?

The truth is somewhere in the middle, and I’m fully aware of that.

I don’t think Ramieri is “100% the best surgeon in the world.” He’s definitely conservative. His movements are usually on the lighter side and he’s not someone who aggressively overcorrects. That’s a fact.

At the same time, you can’t say he doesn’t have good cases. Some of his results are objectively solid. For example, this one.

That’s not delusion, that’s just looking at outcomes. I’m not blindly following anyone, and I’m not taking Lurkingcell (or anyone else on this forum) as gospel. I read everything, I filter everything.

I’ll be very open during the consultation. I’ll listen to what he says, then I’ll analyze it myself based on the information I already have and what I keep studying. I’m not outsourcing my brain.

I’m Italian, so I’ll also consult Raffaini and Pagnoni. I’m not locking myself into one name. I want multiple opinions before even thinking about anything irreversible. If he suggests something too light, I’ll question it.

At the end of the day, this is my face. I’m not doing this because of hype or forum narratives. I’m doing it because I want structural harmony, especially in the side profile, and I’m willing to evaluate every serious option.

Extreme praise and extreme hate are both biased. I’m staying in the middle and making my own decision.

 

[yussimania]

dyor before you have your consult

too many people rely on surgeons advice and see them as institutional authority

it's your face so you should know what is being done to it and any side effects aesthetically and functionally

 

[blinemaxxer]

dyor before you have your consult

too many people rely on surgeons advice and see them as institutional authority

it's your face so you should know what is being done to it and any side effects aesthetically and functionally

this. you need at least a basic understanding of craniofacial structure and should be able to address your flaws, then come up with a "base" plan to further discuss with the doc, get their insight then proceed with the surgery.

 

[The Dire]

dyor before you have your consult

too many people rely on surgeons advice and see them as institutional authority

it's your face so you should know what is being done to it and any side effects aesthetically and functionally

ofc bro, i'm doing that

 

[The Dire]

this. you need at least a basic understanding of craniofacial structure and should be able to address your flaws, then come up with a "base" plan to further discuss with the doc, get their insight then proceed with the surgery.

I am studying at a medical high school and have spent months and months researching craniofacial structure and the ratios to be respected. I am open to your suggestions, but they must make sense.

 

[LackEmpathyTherefor]

@Denkaren

Bro

 

[lurking truecel]

You have clearly been misled, especially since your tagging Lurkingcell for advice. That alone should raise serious red flags. Lurkingcell judgment can’t be trusted. His persistent hype around Ramieri is agenda-driven rather than objective. He is one of the reason Ramieri are regarded so high in this forum.

The only example we have here of someone whose appearance has been drastically changed is a patient he treated with trimax, implants, and rhinoplasty. That should be telling. Show me ONE just ONE result from him with trimax alone that has drastically changed ones appearance.

He is unable to properly assess fundamental structural needs such as maxillary expansion, and his overall diagnostic framework are incomplete. There’s little indication that he considers key functional factors like tongue posture or airway dynamics, which are critical in comprehensive craniofacial planning. His aesthetic sense is also questionable his work tends to create disproportion by failing to integrate the face as a whole rather than treating isolated regions.

His ethical posture is equally concerning. He presents himself as the moral surgeon who turns patients away when surgery isn’t justified, but that image doesn’t hold up. In practice, he is willing to take on any case. The driving motivation is solely . When things go wrong which, over the long term, often happens with implants there’s every indication the patient will be left without meaningful support.

I heard some absurd comment from Lurkingcell, he said Ramieri travel across countries if something goes wrong. I hope you realise that this is COMPLETELY false, quite frankly the exact opposite. If something goes wrong he basically lets you hanging or want you to pay full price for a new surgery.

Overall, the combination of questionable judgment, inconsistent ethics, and a distorted aesthetic framework makes reliance on Ramieri highly risky. Anyone considering Ramieri should proceed with extreme caution and seek independent, truly comprehensive evaluation before committing to irreversible procedures.

Hearing made-up cases on this forum obviously doesn’t mean a shit.

Your local surgeon has probably more knowledge in this area than Ramieri.

His followers on instagram are fake, his likes are fake. Which serious surgeons does this?

Coming from a guy who did bsso with ramieri, you basically dont even have experience with him then. Did you get tmj problem or something ?

Also i am not the reason ramieri is big on this forum, he was more hyped when i didnt comment on things. My threads on him overall has been of negative impact, not as much as yours but close.

And then plz explain what he should have done correctly in your case

 

[Denkaren]

Coming from a guy who did bsso with ramieri, you basically dont even have experience with him then. Did you get tmj problem or something ?

Also i am not the reason ramieri is big on this forum, he was more hyped when i didnt comment on things. My threads on him overall has been of negative impact, not as much as yours but close.

And then plz explain what he should have done correctly in your case

You’re genuinely slow. Are you on fentanyl or ragebaiting?

I’ve explained this several times already but you still can’t seem to grasp it? Amazing.
Ramieri himself said BSSO + genioplasty is all that’s needed in my case. His genioplasty totally threw all my lower third portions off.

He decided(without my consent) to cut my chin to reduce the vertical height. I would have never, NEVER agree of it. He does things to his liking and his aesthetic view are totally off

He set back the mandible to match the bite without having the tongue in mind at all. He just doesn’t understand the influence the tongue has on the mandible. My crossbite are now 3 mm of but to the LEFT side, not the right as prior to the surgery.

What he “should have done”?

Every surgeon I consulted before him rejected my case because I was Class I. I wasn’t chasing surgery at the time simply asked, in a normal way, whether I was even a jaw surgery candidate. Four surgeons said no. He was the only one who immediately took the case.

My dentist in Stockholm had previously worked with him, which reinforced my belief that he was a reputable surgeon who was seeing something the others didn’t.

His movements have since damaged my breathing, my quality of life, given me TMJ issues and tinnitus, because my tongue is no longer positioned inside the dental arch where it belongs. I now have a severe open bite on the left that did not exist pre-op.

My tongue chronically rests against my incisors rather than within the dental arch after the movement. The incisors and their periodontal ligaments are highly innervated sensory structures, and this persistent mechanical stimulation creates ringings in my left ear. This abnormal tongue posture is also the underlying cause of my unilateral open bite. He doesn’t understand how important it is to have the tongue inside of the dental arch, right now it rests ON the arch, not inside.

As I already described, the consultation after this was bizarre. He became visibly irritated when I reported breathing problems and said I could pay for another surgery to “fix” the open bite(full price of course) to correct something that did not exist before his intervention. Even if I had paid for that, the breathing problems would have remained, because he fundamentally does not understand that my functional issues stem from the tongue being displaced outside the arch after his movements. The genioglossus(place were the “main” position of the tongue basically rests) are attached on the mandible. Move it 2-3 mm left, the tongue are 2-3 mm more to the left.

My asymmetry was palatal. The tongue dictates mandibular posture. If the palate is asymmetric, the tongue rests asymmetrically, and the mandible follows. This is basic craniofacial functional anatomy.

That level of oversight is, in my view, extremely serious, serious enough that I feel that I have no other choice than to warn others. I have now spent two years living with these consequences, researching this field daily and consulting with over 50 airway-focused craniofacial specialists. That position is not one I would wish on anyone.

Yes, he may be able to advance a maxilla and mandible. That does not make someone a good surgeon. A good surgeon recognizes patterns, understands why the patient developed craniofacial issues in the first place, and plans surgery around that etiology.

A competent orthognathic surgeon understands that mandibular position is dependent on maxillary form via the tongue. You do not forcibly center a mandible when a crossbite exists for structural reasons. I had a crossbite for a reason. Forcing the mandible into that position without addressing the palate is profoundly incompetent. I get frustrated by hearing his name.

I have every right to call that thinking incompetent given the level of information I now possess. This is supposed to be a field expert, an expert YOU contributed to raising to the sky but he literally doesn’t understand the biology of the body.

“What he should have done” GTFO.
Your embarrassing. One day, he is the goat, another day, he is mediocre, another day again he is the goat. You have serious problems. You’ve fooled people by saying “I’ve done the surgery with him” but you can’t provide one single proof of it.

I don’t expect this text to register with you that would require you to actually process what you read.

I sincerely hope nobody takes you serious, your the definition of an incel.

 

[lurking truecel]

You’re genuinely slow. Are you on fentanyl or ragebaiting?

I’ve explained this several times already but you still can’t seem to grasp it? Amazing.
Ramieri himself said BSSO + genioplasty is all that’s needed in my case. His genioplasty totally threw all my lower third portions off.

He decided(without my consent) to cut my chin to reduce the vertical height. I would have never, NEVER agree of it. He does things to his liking and his aesthetic view are totally off

He set back the mandible to match the bite without having the tongue in mind at all. He just doesn’t understand the influence the tongue has on the mandible. My crossbite are now 3 mm of but to the LEFT side, not the right as prior to the surgery.

What he “should have done”?

Every surgeon I consulted before him rejected my case because I was Class I. I wasn’t chasing surgery at the time simply asked, in a normal way, whether I was even a jaw surgery candidate. Four surgeons said no. He was the only one who immediately took the case.

My dentist in Stockholm had previously worked with him, which reinforced my belief that he was a reputable surgeon who was seeing something the others didn’t.

His movements have since damaged my breathing, my quality of life, given me TMJ issues and tinnitus, because my tongue is no longer positioned inside the dental arch where it belongs. I now have a severe open bite on the left that did not exist pre-op.

My tongue chronically rests against my incisors rather than within the dental arch after the movement. The incisors and their periodontal ligaments are highly innervated sensory structures, and this persistent mechanical stimulation creates ringings in my left ear. This abnormal tongue posture is also the underlying cause of my unilateral open bite. He doesn’t understand how important it is to have the tongue inside of the dental arch, right now it rests ON the arch, not inside.

As I already described, the consultation after this was bizarre. He became visibly irritated when I reported breathing problems and said I could pay for another surgery to “fix” the open bite(full price of course) to correct something that did not exist before his intervention. Even if I had paid for that, the breathing problems would have remained, because he fundamentally does not understand that my functional issues stem from the tongue being displaced outside the arch after his movements. The genioglossus(place were the “main” position of the tongue basically rests) are attached on the mandible. Move it 2-3 mm left, the tongue are 2-3 mm more to the left.

My asymmetry was palatal. The tongue dictates mandibular posture. If the palate is asymmetric, the tongue rests asymmetrically, and the mandible follows. This is basic craniofacial functional anatomy.

That level of oversight is, in my view, extremely serious, serious enough that I feel that I have no other choice than to warn others. I have now spent two years living with these consequences, researching this field daily and consulting with over 50 airway-focused craniofacial specialists. That position is not one I would wish on anyone.

Yes, he may be able to advance a maxilla and mandible. That does not make someone a good surgeon. A good surgeon recognizes patterns, understands why the patient developed craniofacial issues in the first place, and plans surgery around that etiology.

A competent orthognathic surgeon understands that mandibular position is dependent on maxillary form via the tongue. You do not forcibly center a mandible when a crossbite exists for structural reasons. I had a crossbite for a reason. Forcing the mandible into that position without addressing the palate is profoundly incompetent. I get frustrated by hearing his name.

I have every right to call that thinking incompetent given the level of information I now possess. This is supposed to be a field expert, an expert YOU contributed to raising to the sky but he literally doesn’t understand the biology of the body.

“What he should have done” GTFO.
Your embarrassing. One day, he is the goat, another day, he is mediocre, another day again he is the goat. You have serious problems. You’ve fooled people by saying “I’ve done the surgery with him” but you can’t provide one single proof of it.

I don’t expect this text to register with you that would require you to actually process what you read.

I sincerely hope nobody takes you serious, your the definition of an incel.

Couldnt the dentist fix the crossbite and openbite ? Can you open your mouth fully ? How many mm opening ?

Yea i mean its weird he made a crossbite, ngl my midline was also off with posterior openbite. But i am fixing it with ortho. I just rhink those things are common to have after.

But i dont get how the tongue space got influenced by only bsso, i get the tongue is attached to lower jaw and moving beackwards can make tongue collapse airway, but shouldnt be making it less space

 

[Denkaren]

No I can’t open my mouth fully.

I can open my mouth fully once I find my phonetic bite(you will find it by counting 66-79). At every “S” sound stop at first contact. There is your phonetic bite.

Once I force my mandible(proximal segment to be exact) back to its initial position I’m able to have my mouth open fully, my breathing are also normal there.

You haven’t verified that you’ve got surgery so I’m only going to give hypothetical guidelines to your “situation”. If he has moved your mandible laterally to correct some asymmetry, you’re basically cooked.

He has messed with structure he has no knowledge off. Sure your dentist might force your bite togheter(which by the way will lead to alveolar bone loss-> sunken cheekbones) you will never be able to open your mouth normally unless you move your mandible back to your phonetic bite.

Orthodontic attempts to force the teeth together in a non-physiologic position place chronic strain on the temporomandibular joints and masticatory muscles and are associated with alveolar bone loss over time, which will contributes to reduced midface support and sunken cheekbones. Your face will be cooked when the treatment is done, my personally guess, you will look at least 5-7 years older afterwards.

When occlusion deviates from the phonetic rest position, normal mouth opening will feel restricted or uncomfortable. My mandible has been forced to another position by an incompetent surgeon.

Your current open bite exists for a reason, it reflects the underlying jaw position and tongue–mandible relationship. If the mandible and genioglossus attachment are positioned unfavorably within the oral cavity, orthodontically closing the bite does not correct the cause. Your open bite will recur over time because the surrounding soft-tissue and functional forces remain unchanged.

I am not traveling to the U.S. and paying about $29,000 for revision surgery out of impulse, ive done two years of focused research and daily observation of how tongue posture and jaw position affect occlusion, breathing, and comfort.

 

[yussimania]

Lol u 2 are always arguing bringing up the same shit just kiss already

 

[Denkaren]

Couldnt the dentist fix the crossbite and openbite ? Can you open your mouth fully ? How many mm opening ?

Yea i mean its weird he made a crossbite, ngl my midline was also off with posterior openbite. But i am fixing it with ortho. I just rhink those things are common to have after.

But i dont get how the tongue space got influenced by only bsso, i get the tongue is attached to lower jaw and moving beackwards can make tongue collapse airway, but shouldnt be making it less space

To answer your last question: I’ve explained this many times you need to read what I’m actually saying. Many people have a small crossbite, often only 0.5-1–2 mm. Surgeons routinely try to correct this while matching the bite, but they often miss the bigger picture why the jaw developed that way in the first place. Why your bite is compensated in that way. They attempt to “fix” it by moving the mandible sideways.
When the mandible is shifted laterally, the tongues skeletal base and its resting envelope move with the lower jaw BUT the maxilla palate and upper arch remain in their original position. You can’t move the maxilla the same as you can with the mandible sideways.

Tongue space is defined by the relationship between the tongue, the lower arch, and the palatal vault. If the lower arch is displaced sideways relative to the maxilla, the tongue no longer sits symmetrically within the palatal dome. One side becomes relatively compressed while the other is stretched, effectively reducing balanced functional tongue space even if TOTAL oral cavity volume hasn’t decreased.

So even with a BSSO alone, a lateral mandibular shift changes the tongue’s position and functional environment because the mandible, dentition, and genioglossus move as a unit against a fixed maxilla. That altered relationship not just posterior movement is what disturb tongue posture and occlusal stability.

My main theory for why some patients improve their sleep apnea with this surgery while others worsen is that surgeons sometimes move the mandible laterally, altering structures they don’t understand. You can see this on JawHacks YouTube channel, there are multiple cases of people advancing their jaws yet experiencing worse breathing afterward.

As I’ve said many times, most jaw surgeons are not specifically trained in tongue posture or functional tongue–jaw relationships, this is simply not a core part of maxillofacial surgical education. That gap in perspective explain why altering mandibular position unpredictably affect airway function and other issues.

 

[Denkaren]

Lol u 2 are always arguing bringing up the same shit just kiss already

He’s arguing with someone who has more expertise than he does. I genuinely think he’s procrastinating, which is why he keeps changing his opinion about Ramieri.

It’s unfortunate, I came here to warn others about him and be informative. I’m starting to realize I may have been too harsh on Lurkcell. Many in here are simply misguided and do not think rationally.

If I can help guide even a few people away from decisions that could seriously harm their lives, that’s enough for me.

 

[yussimania]

He’s arguing with someone who has more expertise than he does. I genuinely think he’s procrastinating, which is why he keeps changing his opinion about Ramieri.

It’s unfortunate, I came here to warn others about him and be informative. I’m starting to realize I may have been too harsh on him. Many in here are simply misguided and do not think rationally.

If I can help guide even a few people away from decisions that could seriously harm their lives, that’s enough for me.

I agree LT does flip flop alot - I value his contributions to the forum alot and they have helped me to be able to understand this for myself but he goes back on things he says a month prior

It's good that you warn about him as there is now a counteracting force that allows people to reconsider their options - your level of detail and knowledge on "myofunctionality" or whatever it's called despite being diluted with some orthotropic cope is great

I still think he is a good surgeon for the majority of people and I'm sorry to hear what happened to you, I hope this surgeon you're working with now can fix whatever mistakes he made

 

[Denkaren]

I agree LT does flip flop alot - I value his contributions to the forum alot and they have helped me to be able to understand this for myself but he goes back on things he says a month prior

It's good that you warn about him as there is now a counteracting force that allows people to reconsider their options - your level of detail and knowledge on "myofunctionality" or whatever it's called despite being diluted with some orthotropic cope is great

I still think he is a good surgeon for the majority of people and I'm sorry to hear what happened to you, I hope this surgeon you're working with now can fix whatever mistakes he made

Do you know why he keeps “flip-flopping”? It’s psychological. At first I wasn’t sure whether he had surgery with Ramieri, but now I suspect he did. The constant change in his stance reflects ambivalence, some days he feels satisfied, other days he’s frustrated by issues like a posterior open bite and limited mouth opening. To reduce that discomfort, he tries to normalize the outcome and reassure himself that Ramieri is good. Other days he can’t.

He’s also repeatedly exposed to Ramieri content, on Instagram and TikTok. The confidence and explanations sound convincing to him. He downplays the posterior open bite and trusts that a orthodontist will fix it because Ramieri and probably his orthodontist has said so. I understand the underlying mechanics far better and can explain why Ramieri’s approach leaves many patients with persistent open bites and unresolved breathing problems.

It’s hard for him to trust me, I’m just a random person online vs a surgeon he paid an HUGE amount and views as an authority. The further he goes in his journey, the more he’ll realize that what I’ve been saying is accurate.

He just need to do the deep deep research, to understand.

@lurking truecel

 

[lurking truecel]

Do you know why he keeps “flip-flopping”? It’s psychological. At first I wasn’t sure whether he had surgery with Ramieri, but now I suspect he did. The constant change in his stance reflects ambivalence, some days he feels satisfied, other days he’s frustrated by issues like a posterior open bite and limited mouth opening. To reduce that discomfort, he tries to normalize the outcome and reassure himself that Ramieri is good. Other days he can’t.

He’s also repeatedly exposed to Ramieri content, on Instagram and TikTok. The confidence and explanations sound convincing to him. He downplays the posterior open bite and trusts that a orthodontist will fix it because Ramieri and probably his orthodontist has said so. I understand the underlying mechanics far better and can explain why Ramieri’s approach leaves many patients with persistent open bites and unresolved breathing problems.

It’s hard for him to trust me, I’m just a random person online vs a surgeon he paid an HUGE amount and views as an authority. The further he goes in his journey, the more he’ll realize that what I’ve been saying is accurate.

He just need to do the deep deep research, to understand.

@lurking truecel

Maybe its just over for me. Do you have problem with mouth opening ? I dont really have it, but yea everything isnt perfect o agree. I could def feel that some things in the function could have been made better. But i am also still in braces and its kinda painful which makes my psyche up and down

 

[tyler1234]

Maybe its just over for me. Do you have problem with mouth opening ? I dont really have it, but yea everything isnt perfect o agree. I could def feel that some things in the function could have been made better. But i am also still in braces and its kinda painful which makes my psyche up and down

When did u have surgery with him

 

[lurking truecel]

When did u have surgery with him

Like 9 months ago

 

[tyler1234]

Ramieri is definitely overrated dr Sunil Richardson is better

 

[tyler1234]

Have

Like 9 months ago

Have u got functional issues ?

 

[lurking truecel]

Have

Have u got functional issues ?

Not good bite and kinda painful from braces. Hard to say how bad it is for function but it isnt perfect. But i have seen like every ram patient having decent bad bite after except for some. But i know its very common among all surgeons and often worse so its hard to say if its ram thats bad or my anatomy

 

[Denkaren]

Maybe its just over for me. Do you have problem with mouth opening ? I dont really have it, but yea everything isnt perfect o agree. I could def feel that some things in the function could have been made better. But i am also still in braces and its kinda painful which makes my psyche up and down

Once you stop living in denial, you can finally move forward. Why are you even arguing with me? Do you know how I can recognize the same flip-flopping in you now that I’m fairly sure you’ve had the surgery? Because I was in the exact same position. I tried to convince myself that he was the expert and knew best.

That self-deception didn’t last, because at the same time I was dealing with severe breathing problems. After isolating myself from friends and family, I realized I couldn’t stay in denial any longer, I had to act. I decided to learn everything I could about anatomy and function. At first I couldn’t understand how such a small movement could have such a major impact on breathing, but once I began to understand, everything became clear.

My first step was to remove the braces as soon as possible. I still had months left but chose to stop early. If you’re financially stable, I suggest you do the same and start paying attention to what I’m actually saying. Your open bite won’t truly be fixed they’ll camouflage it, at the cost of structural support, and over time your face will appear more sunken. Not only that but you will develope severe TMJ issues. Find your phonetic bite(count 66-79). At every S sound stop at first contact.
Your underjaw should be in that position.

Once I’ve heard all the details about your movements and surgical plan, I can guide you toward options that may actually help.

I’m honestly tired of repeating the same points when I’m confident in the facts. Choose wisely how you respond to this, I’ll be your last chance.

 

[LEFORT17]

Once you stop living in denial, you can finally move forward. Why are you even arguing with me? Do you know how I can recognize the same flip-flopping in you now that I’m fairly sure you’ve had the surgery? Because I was in the exact same position. I tried to convince myself that he was the expert and knew best.

That self-deception didn’t last, because at the same time I was dealing with severe breathing problems. After isolating myself from friends and family, I realized I couldn’t stay in denial any longer, I had to act. I decided to learn everything I could about anatomy and function. At first I couldn’t understand how such a small movement could have such a major impact on breathing, but once I began to understand, everything became clear.

My first step was to remove the braces as soon as possible. I still had months left but chose to stop early. If you’re financially stable, I suggest you do the same and start paying attention to what I’m actually saying. Your open bite won’t truly be fixed they’ll camouflage it, at the cost of structural support, and over time your face will appear more sunken. Not only that but you will develope severe TMJ issues. Find your phonetic bite(count 66-79). At every S sound stop at first contact.
Your underjaw should be in that position.

Once I’ve heard all the details about your movements and surgical plan, I can guide you toward options that may actually help.

I’m honestly tired of repeating the same points when I’m confident in the facts. Choose wisely how you respond to this, I’ll be your last chance.

whats your advise on jaw surgery in general for others, movement wise, how many jaws, rotation. since you only had lower jaw and the treatment plan was bad do you think ur a unique case where your breathing problems were cased by little movements

 

[lurking truecel]

Once you stop living in denial, you can finally move forward. Why are you even arguing with me? Do you know how I can recognize the same flip-flopping in you now that I’m fairly sure you’ve had the surgery? Because I was in the exact same position. I tried to convince myself that he was the expert and knew best.

That self-deception didn’t last, because at the same time I was dealing with severe breathing problems. After isolating myself from friends and family, I realized I couldn’t stay in denial any longer, I had to act. I decided to learn everything I could about anatomy and function. At first I couldn’t understand how such a small movement could have such a major impact on breathing, but once I began to understand, everything became clear.

My first step was to remove the braces as soon as possible. I still had months left but chose to stop early. If you’re financially stable, I suggest you do the same and start paying attention to what I’m actually saying. Your open bite won’t truly be fixed they’ll camouflage it, at the cost of structural support, and over time your face will appear more sunken. Not only that but you will develope severe TMJ issues. Find your phonetic bite(count 66-79). At every S sound stop at first contact.
Your underjaw should be in that position.

Once I’ve heard all the details about your movements and surgical plan, I can guide you toward options that may actually help.

I’m honestly tired of repeating the same points when I’m confident in the facts. Choose wisely how you respond to this, I’ll be your last chance.

I will not be able to do revision so i got to live with the problems atleast for now. Whether it takes me down or not. It is what it is, i just need to cope and hope.

 

[LEFORT17]

I will not be able to do revision so i got to live with the problems atleast for now. Whether it takes me down or not. It is what it is, i just need to cope and hope.

edge on edge bite or something else

 

[Animepilled]

CCW until horizontal, a minor advancement, no genio.

 

[lurking truecel]

edge on edge bite or something else

Nah posterior openbite, but my bite will prob be camouflaged but yea

 

[tyler1234]

Not good bite and kinda painful from braces. Hard to say how bad it is for function but it isnt perfect. But i have seen like every ram patient having decent bad bite after except for some. But i know its very common among all surgeons and often worse so its hard to say if its ram thats bad or my anatomy

Why do u always recommend him then
who’s ur Orthadontist

 

[lurking truecel]

Why do u always recommend him then

My post is him being good and moral when i was there which is true. And how many jaw surgeons do i know ? Not many lol. He is the only surgeo. Recommended here. Sure i could say some random name i find but i dont know

 

[tyler1234]

My post is him being good and moral when i was there which is true. And how many jaw surgeons do i know ? Not many lol. He is the only surgeo. Recommended here. Sure i could say some random name i find but i dont know

where did u travel from, would u say ur happy with results or na

 

[lurking truecel]

where did u travel from, would u say ur happy with results or na

 

[brainregeneration]

Bro

 

[bimaxmaxxer]

He’s arguing with someone who has more expertise than he does. I genuinely think he’s procrastinating, which is why he keeps changing his opinion about Ramieri.

It’s unfortunate, I came here to warn others about him and be informative. I’m starting to realize I may have been too harsh on Lurkcell. Many in here are simply misguided and do not think rationally.

If I can help guide even a few people away from decisions that could seriously harm their lives, that’s enough for me.

what do you think about brazilian surgeons?

 

[Animepilled]

you dont need bimax. But if you do it, do ccw only and a little advancement

 

[brainregeneration]

K

it

Once you stop living in denial, you can finally move forward. Why are you even arguing with me? Do you know how I can recognize the same flip-flopping in you now that I’m fairly sure you’ve had the surgery? Because I was in the exact same position. I tried to convince myself that he was the expert and knew best.

That self-deception didn’t last, because at the same time I was dealing with severe breathing problems. After isolating myself from friends and family, I realized I couldn’t stay in denial any longer, I had to act. I decided to learn everything I could about anatomy and function. At first I couldn’t understand how such a small movement could have such a major impact on breathing, but once I began to understand, everything became clear.

My first step was to remove the braces as soon as possible. I still had months left but chose to stop early. If you’re financially stable, I suggest you do the same and start paying attention to what I’m actually saying. Your open bite won’t truly be fixed they’ll camouflage it, at the cost of structural support, and over time your face will appear more sunken. Not only that but you will develope severe TMJ issues. Find your phonetic bite(count 66-79). At every S sound stop at first contact.
Your underjaw should be in that position.

Once I’ve heard all the details about your movements and surgical plan, I can guide you toward options that may actually help.

I’m honestly tired of repeating the same points when I’m confident in the facts. Choose wisely how you respond to this, I’ll be your last chance.

Who are you doing your revision with?

 

[Denkaren]

what do you think about brazilian surgeons?

I don’t know anything about them other than the famous botch-surgeon, Jonathas Claus

 

[Denkaren]

K



Who are you doing your revision with?

A NY surgeon, I will reveal after I’ve done the surgery.

I’m traveling to NY for cbct and surgical planning in a month.

 

[snowslayer]

A NY surgeon, I will reveal after I’ve done the surgery.

I’m traveling to NY for cbct and surgical planning in a month.

you seem quite intellectual on all of this but i'm confused why you got jaw surgery in the first place. There's so many better ways to improve the lower 3rd and midface w out jaw surgery, more the lower 3rd but still

 

[snowslayer]

also how much is your revision will it just be bsso or are you doing a revision genio?

 

[brainregeneration]

A NY surgeon, I will reveal after I’ve done the surgery.

I’m traveling to NY for cbct and surgical planning in a month.

Hope all goes well for you. I read over your posts and it’s absolutely been a wake up call in the case of me wanting to originally do BiMax with Ramieri.

 

[Denkaren]

you seem quite intellectual on all of this but i'm confused why you got jaw surgery in the first place. There's so many better ways to improve the lower 3rd and midface w out jaw surgery, more the lower 3rd but still

I didn’t want to “improve” my lower third. I liked my face. I only wanted to correct the asymmetry. My lower jaw had shifted toward the right side. With the knowledge I have now, I understand that the vast majority of asymmetrical cases are due to an asymmetrical palate. This is an intraoral scan of my palate. Beside is a post showing how my tongue naturally rests. As you can see, my tongue habits during childhood weren’t ideal (probably because I always slept on my right side and always chewed on my left side).

When your sutures are loose (when you’re young), constant pressure will bend the side(alveolar bone) that has continuous pressure inward. When you’re an adult, it doesn’t matter as much because the sutures are fused (some believe they aren’t fully fused until age 70–80, I haven’t decided what’s true about that yet and need to investigate more and see proof. In any case, there can be multiple factors. Your mandible follows your tongue. As you can see, the front tongue is bent to the right → my mandible was therefore forced to the right. That was my asymmetry. It had nothing to do with the mandible itself.

Ramieri couldn’t see that, he didn’t even look at my palate. When I came to him to confront him about my breathing problem, he immediately became defensive and angry, gaslighting me, as I’ve said. It was bizarre. This was about a year ago. By that time, I had already done a lot of independent research and knew how important the palate and arch are. I told him my palate was asymmetrical.

This was basically our conversation about it. I don’t remember the exact words, but it went something like this

Me: My palate is asymmetrical. I’ve seen and measured it.
Ramieri: No, it isn’t.
Me: I’ve sent you my CBCT. Bring it up on the screen and we can measure it together.
For some reason, he brought a colleague to the discussion. The colleague was silent the entire conversation. Ramieri put the measurements on the screen.
Me: You see?! My left palate is 2 mm wider than my right.
Ramieri and his colleague looked surprised and realized I was right based on the measurements.
Ramieri: Just tell your orthodontist to expand.
Me: My asymmetry was in the palate, not the mandible.
Ramieri: (talking to himself) saying something about me having blue eyes(I have no idea about what he meant by that but I remember it very well). Maybe he implied that people with blue eyes lie, I have no idea.
Me: I have an open bite, but only on the left. I know it’s because my tongue now rests on the dental arch rather than inside it. It’s forced to push against the incisors, and since you moved my mandible and my genioglossus to the left, the force is directed toward the left incisors. Can’t you see the pattern?
Ramieri made a lot of excuses and said, “If I were to operate on you again, I would only close your open bite and bring your maxilla down. You would pay full price.”
The tension in the room was at its highest. He wrote some notes. I thought it was bizarre and left. I removed my braces one week later and started my search for a new surgeon to continue with my revision.

After studying his eyes and overall demeanor during that consultation, I realized he was a narcissist. However, I still needed to obtain all the information for the surgeon who would perform my revision, so I played along.

I received almost no answers when I brought up all my breathing issues, so I resorted to reverse psychology.

I told him I had been delusional and that I loved my results. I gave him five stars on Google (which I of course removed once I had obtained all the information I needed).
I needed to secure my complete surgical plan, the brand of the bicortical screws he used for fixation, and details about how much he flared my ramus. (This was some month after the confrontation incident).

I got everything. He could pay me, I still wouldn’t do surgery with him.

Hope all goes well for you. I read over your posts and it’s absolutely been a wake up call in the case of me wanting to originally do BiMax with Ramieri.

Thank you, yes it is indeed fascinating how much error there is in this field.

Very important to be cautious and do Independent research.

 

[Denkaren]

also how much is your revision will it just be bsso or are you doing a revision genio?

29k.
Only underjaw, maxillary surgery carries to much risks, even though my maxilla are recessed to some degree from prior braces use.
When I say carries risk I’m not speaking about swelling or something going wrong during- or after the surgery.

I’m basing this on my knowledge of the tongue.

I’m from Sweden, I won’t pay 100 k to stay one night at the hospital so I will leave the same day.

 

[snowslayer]

do you think your asymmetry could be traced down to other parts of body?

 

[Denkaren]

do you think your asymmetry could be traced down to other parts of body?

Of course.
Everything starts from your feet. Inward toes equals narrow palate.

Palate/tongue-> hyoid->cervical fascia-> diaphragm-> psoas->pelvis->pelvic floor.
They all are connected.

If you’ve got asymmetry in your mandible, you should mainly evaluate the feet, pelvis, psoas, spine and palate.

Posture correction are essential.

 

[Denkaren]

Nah posterior openbite, but my bite will prob be camouflaged but yea

I’ve already told you what will happened.

It’s not only about camouflaging, it’s about camouflaging a jaw relationship that is wrong. This can lead to condylar resorption.

The consequences will be severe in the long run, get your shit together. Stop procrastinating, it’s pathetic.

Remove your braces.

 

[Denkaren]

whats your advise on jaw surgery in general for others, movement wise, how many jaws, rotation. since you only had lower jaw and the treatment plan was bad do you think ur a unique case where your breathing problems were cased by little movements

My advice is to not trust anyone in here.

Genuinely impossible to discuss movement and degree of rotation without seeing your jaw relation.