Don’t Get Implants with bimax!

[moltisantichincel]

If you think oh I can just get implants during bimax, no big deal, how convenient is it to just get everything at once
Especially looking at those jaw implant bsso plate hybrids (easily displaced, shitty design, shitty revision)

That’s how you speedrun shit fucking everything up

Infection rate goes up, because more swelling and longer surgery times

the design will most likely be shit

The surgeon is less likely to know what he’s doing

Like a certain i giant once said

You really think surgery is just like a retail store? You think you can just change you’re skin like this is fortnite

No!

Fuck no

Just be patient and wait a extra year after you’re bimax

And chances are you’re going to be happy with your bimax
And you might not need implants anyway


Stop being impatient I know your brain is completely fucked from scrolling tik tok

You’re greasy ass probably saw some shit called “xxx ultra terra mog HARDMAXX EDIT on tik tok and have adopted the identity of a “HARDMAXXER” and have been mentally masturbation everyday ever since

Like okay Mr XXXHARDMAXXXXXERXXX

Sure costs go up, but again this shit is real bro,

 

[prezz.dc]

timmothy literally just did this with giant lmao

 

[moltisantichincel]

timmothy literally just did this with giant lmao

Yeah but it’s stupid, high risk. Low reward, just wait bro

 

[prezz.dc]

Yeah but it’s stupid, high risk. Low reward, just wait bro

depends on the experience of the surgeon tbh

 

[lurking truecel]

You risk a lot more going in twice, muscle will be more likely to get dehisence. Scar tissue, nerve issues etc. You basically making it a revision surgery. Yes doing it at the same time has real risks but doing it later isnt really better.

Thats why its worth thinking about if you can get away with implants alone. Because that is a lot less risky. Eveb tough i know people who had 3 revisions just doing it alone also. So jsw implants overall has highest infection and its very hard to stay away from nerves too. Thats just the reality of jaw implants and why they kinda suck

Also the cost is a lot higher doing it seperate. We are talking double or triple the price most likely

 

[moltisantichincel]

You risk a lot more going in twice, muscle will be more likely to get dehisence. Scar tissue, nerve issues etc. You basically making it a revision surgery. Yes doing it at the same time has real risks but doing it later isnt really better.

Thats why its worth thinking about if you can get away with implants alone. Because that is a lot less risky. Eveb tough i know people who had 3 revisions just doing it alone also. So jsw implants overall has highest infection and its very hard to stay away from nerves too. Thats just the reality of jaw implants and why they kinda suck

Also the cost is a lot higher doing it seperate. We are talking double or triple the price most likely

Fuck god damn it. You’re right

 

[Nifty]

Fuck god damn it. You’re right

I would still do them separate. I personally didn't need implants after trimax.

Unless ur like the minority with good jaws yet bad gonials. I always think of Androgenic. Maybe I have a bad eye but he looks recessed with implants so his jaw looks so weird and off putting.

 

[jon_chase89]

You risk a lot more going in twice, muscle will be more likely to get dehisence. Scar tissue, nerve issues etc. You basically making it a revision surgery. Yes doing it at the same time has real risks but doing it later isnt really better.

Thats why its worth thinking about if you can get away with implants alone. Because that is a lot less risky. Eveb tough i know people who had 3 revisions just doing it alone also. So jsw implants overall has highest infection and its very hard to stay away from nerves too. Thats just the reality of jaw implants and why they kinda suck

Also the cost is a lot higher doing it seperate. We are talking double or triple the price most likely

I wish more surgeons knew how to place jaw implants endoscopically through a submental incision to eliminate the infection risk. Oscar Ramirez was doing it 30 years ago. As far as I know there's only 1 guy still doing it


Here's an interesting old video of Ramirez contouring off the shelf medpor implants using a skull model of the patient, then placing them all through the submental incision

 

[jaymog]

timmothy literally just did this with giant lmao

Yeah and he’s completely cooked? His bite is horrific. Look at this CT scan. his literal elastic screws that are supposed to be deep in your bone FELL OUT. lol. It took Gunson minutes to unscrew them from my jaw bone. That’s how deep they were and how long the screws are.

 

[compost_]

You risk a lot more going in twice, muscle will be more likely to get dehisence. Scar tissue, nerve issues etc. You basically making it a revision surgery. Yes doing it at the same time has real risks but doing it later isnt really better.

Thats why its worth thinking about if you can get away with implants alone. Because that is a lot less risky. Eveb tough i know people who had 3 revisions just doing it alone also. So jsw implants overall has highest infection and its very hard to stay away from nerves too. Thats just the reality of jaw implants and why they kinda suck

Also the cost is a lot higher doing it seperate. We are talking double or triple the price most likely

W high iq input as usual love to see it

 

[RealSurgerymax]

1. Limiting Iatrogenic Harm / Getting the most benefit out of the iatrogenic harm
I think people imagine incisions, elevation and retraction as a neat and unproblematic thing. Surgery is a controlled 'necessary' injury.

Doing it after is still possible and you can get a good result, however scar tissue and a second (traumatic) elevation will cause more harm.

Every surgery causes some irreversible harm (External Scars, Internal Scar Tissue, Alter Blood Supply, Healthy Tissue Atrophy. Making incisions in the skin, mucosa, gingiva, through muscles, nerve fibers, venous and arterial branches, and scraping the periosteum off the bone has some negative effects, obviously. So the work we are doing needs to be well worth it so the outcome is still a net positive. Think we are causing 10% harm and 30-40% benefit. That's 20-30% better off than before the surgery. By combining we can cause maybe 12% harm and gain 50-70% benefit. Thats the first point.
- The incisions to access the Midface is the same for LF1 and same for infraorbital-malar-zygo implants, the periosteal elevation is almost the exact same but just slightly extended for the implants.
- The incisions are the same for bsso and jaw angles, the elevation is almost the same, but extended back a little further.
- The incision and elevation is the same for genioplasty and chin implant, and youre cutting through the mentalis muscle. Best to do that just once.

So combining surgeries can substantially increase the benefit while only barely increasing the iatrogenic harm.

2. Achieving the best result with virgin tissue
The best time to get implants is the first time the soft tissue is separated from the bone. That means during bimax.

2a. Scar Tissue.
A lot of people just give "scar tissue" as the answer and leave it at that. But most people dont understand the material impact scar tissue has. For one, it's tougher and less pliable than unscarred tissue. That means the soft tissue envelope will adapt to the implants with less soft tissue memory if it is fresh and doesnt have a tough layer of scar tissue already.

2b. Muscle Injury
Facial muscles are cut during these surgeries.
Eyelid Incision -> Orbicularis Oculi
LeFort/Infra-Malars Incision -> Zygomaticus Muscles
BSSO/Jaw Angles -> Bucicnators
Genio/Chin Implant -> Mentalis

We can hope for about 90% muscle recover one time. Two times.... less.

2c. Elevation and sagging
When you literally scrape the soft tissue off the bones, do you think it heals back tighter or in a lifted position? Of course not... Best case it heals back 95% how it was. But usually it heals in a descended position. At Giant we are anchoring the muscles back to the implants now (No where else is with peek implants and I have a patient pending Neo ligament) It helps a lot but doesnt totally cancel out the harm of surgery.

You might do bimax, heal okay maybe aged 1-2 years, then do impacts after and see you aged 5-10 years. Now you need a facelift at 20-something.

3. Harmonious Plans
The implants and the trimax are really 1 mega plan. Big Bimaxes often leaves behind the Midface and upper third leaving a dog like look.

While I acknowledge the center argument, which has merit, that sometimes it is better to re-assess and re-adjust at a half-way point (After Bimax) and then design the implants - and this is similar to my golf analogy I made years ago "You arent going to hit a hole in 1 from a mile away, you have to get closer and closer and readjust from the new position you gained."

Combined with the above 2 compelling reasons to combine if possible, it's best to look at all of this as one surgery - a total facial skeletal correction thats interrelated. You wouldn't make the argument that it's best to separate a trimax would you? Like Do LeFort 1, then BSSO, then Genioplasty. Sometimes people revise the genio after. But for the most part, it's obvious best to be planned and done together.

4. The risk of combining
Now with that said combining all this is a completely new concept. It wasnt even reliably possible pre-Giant and I invented a lot of new things to make it possible (Combined Jaw Implant/BSSO Plates, Combined Zygote Implant/LeFoRT Plates (Patent Pending), Combined Chin Implant Genio Plate (Patent Pending).

Only a few people in the world were ever combining stock implants, and less so custom Midface implants with bimax for the last 10ish years. They were flawed with imperfect fit or compromised design (for example Midface implants zone being limited by the lefort plate zone) But I fixed that...

With anything new, there were kinks to work out. The keys you cant go to just anyone and get a mega plan and expect it to go well.

No one else has any experience in designing or planning a full and true mega plan, and due to patents, they wouldn't even be allowed to. Even if they did, compare 6yrs experience with 0.

And from the surgeon standpoint, these cases take a lot of effort and stress. They are NOT easy. I am in the OR assisting regularly and I see the reality. Patients might imagine putting custom plates and custom implants on the bones as simple, but it's not as simple as it seems.

So I already know 100% that if I just designed a nice plan and just sent it to some random plastic or maxfac, gave no OR assistance it would NOT go well. I would know already 90% of surgeons would not be able to, I already know I would get some message about how things weren't fitting together, or some some other technical obstacles encountered.

Surgeons who are interested in doing these need to start slow & work their way up to this level of complexity. Will take years. Only a few are capable of delivering on a MegaPlan

So youre right to say, in general, dont combine implants and jaw surgery, if you mean going to a random OMFS/Plastic Surgeon using a random company-employee engineer/designer.

The engineering skill/effort, and the surgical skill/effort, to combine everything successfully without compromises is not something you will find anywhere else.

 

[Dr. Miami]

Yeah and he’s completely cooked? His bite is horrific. Look at this CT scan. his literal elastic screws that are supposed to be deep in your bone FELL OUT. lol. It took Gunson minutes to unscrew them from my jaw bone. That’s how deep they were and how long the screws are.

It took Gunson minutes

It would have literally took me 10 seconds in my clinic in Miami

You probably look like utter shit after going to that butcher Gunson

He has dozens of on going lawsuits for leaving people disabled after jaw surgery, you utterly retarded faggot

 

[it_will_begin]

If you think oh I can just get implants during bimax, no big deal, how convenient is it to just get everything at once
Especially looking at those jaw implant bsso plate hybrids (easily displaced, shitty design, shitty revision)

That’s how you speedrun shit fucking everything up

Infection rate goes up, because more swelling and longer surgery times

the design will most likely be shit

The surgeon is less likely to know what he’s doing

Like a certain i giant once said

You really think surgery is just like a retail store? You think you can just change you’re skin like this is fortnite

No!

Fuck no

Just be patient and wait a extra year after you’re bimax

And chances are you’re going to be happy with your bimax
And you might not need implants anyway


Stop being impatient I know your brain is completely fucked from scrolling tik tok

You’re greasy ass probably saw some shit called “xxx ultra terra mog HARDMAXX EDIT on tik tok and have adopted the identity of a “HARDMAXXER” and have been mentally masturbation everyday ever since

Like okay Mr XXXHARDMAXXXXXERXXX

Sure costs go up, but again this shit is real bro,

What about Ram's tecnique "implate"?
I'm having bimax with him in december and i'm thinking of having them for making my ramus a little bit longer, obv without exaggerating the size of the implant due to the associated risks...

 

[senram]

I wish more surgeons knew how to place jaw implants endoscopically through a submental incision to eliminate the infection risk. Oscar Ramirez was doing it 30 years ago. As far as I know there's only 1 guy still doing it


Here's an interesting old video of Ramirez contouring off the shelf medpor implants using a skull model of the patient, then placing them all through the submental incision

True adam Papi Oscar does it again

 

[moltisantichincel]

Yeah and he’s completely cooked? His bite is horrific. Look at this CT scan. his literal elastic screws that are supposed to be deep in your bone FELL OUT. lol. It took Gunson minutes to unscrew them from my jaw bone. That’s how deep they were and how long the screws are.

Yo bro. Could you dm me your results from HA implants?