could custom jaw angle implants be placed at same time as bimax?

[MD_Hopeful69]

@RealSurgerymax

dont want to have to fly to italy twice

 

[Deleted member 10172]

@RealSurgerymax

dont want to have to fly to italy twice

no

 

[RealSurgerymax]

@RealSurgerymax

dont want to have to fly to italy twice

Yes but it depends on the design and will raise chances of complications during the recovery period.

It is not a straight-forward answers but here are some general considerations

• Silicone, PEEK, and PPE implants can and have been placed at the time of orthognathic surgeries including midface and jaw angle implants
• They have been placed successfully near the osteotomy through the same incision at the time of the osteotomy
• They have been placed successfully bordering and over the osteotomy as well, but I dont know of any studies that show if healing is slower or impaired in such a case. You could reasonably assume the ideal situation is to let the periosteum connect back down to the bone to aid in its healing post surgery.
• Whether this raises the degree of relapse deserves further investigation.
• Jaw angle implants may be able to be designed in a way that does not completely cover the planned or actual osteotomy line to be placed at the time of BSSO.
• In a 2 stage approach (Jaw Surgery then custom implants) you have 2 advantages one being the ability to re-assess and plan the implant design from the post-jaw surgery starting point.
• The second advantage of a 2-stage approach is the ability for the implant to correct any minor contour deformity caused by jaw surgery - filling in and smoothing the irregularities at the healed osteotomy site. You can read about this application in a 2018 issue of PRS by Yaremchuk.
  
  

 

[aphelios]

@DatGuyYouLike would you have ever done jaw angles in conjunction with Bimax or would you have opted for 2 stage approach?

Ramieri will tell you to do it later, when i asked him he told me to do bimax+cheek implant and then jaw angles (wait atleast 6 months)

 

[aphelios]

He told me the same but he is willing to do it at the same time from what I’ve heard from others.

Maybe cuz you are not italian, but its more riskier to do it that way

 

[aphelios]

I’m referring to a foreigner. But I feel like the stage 2 approach is the most sensible because it’ll be more precise I feel. But you obviously save a shit ton making them a package.

Yeah you save for the flight aswell, if i was non-italian i would maybe consider it.

 

[aphelios]

Do you plan on getting surgery with Ramieri? If so, when?

Yeah already talked to him in person, i will get teeth removed soon and then i have to wait 3 months to get bimax + cheek implants and gonial angle later

 

[Deleted member 4797]

@DatGuyYouLike would you have ever done jaw angles in conjunction with Bimax or would you have opted for 2 stage approach?

2 stage since i wanted rhino and cheek implants after my bimax head healed only, to see what movements i need. So may as well not rush the ramus which can be done in same surgery as rhino zygo implants