Dr Ramieri Second Online Consultation Debrief

Acquiescence

Acquiescence

MSTOWmaxxed
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Face and CT scan:


Procedures:

- Malar implants
: custom, saddled, PEEK, anterior projection focused, conservative sizing

- Indication: slight negative orbital vector


- Genioplasty: advancement, downgrafting, moderate movements

- Indication: slight recession / under representation in the lower third

- Widening: does NOT recommend a split widening cut due to observed frequent patient complications

- Instead, recommends either making the standard sliding genio osteotomy cut itself wider, and/or pairing the standard cut and movements with a custom PEEK chin implant to achieve the desired widening effect

- I personally elected to simply do the standard genio cut with advancement and downgrafting first, then reassess once fully recovered

- Why no bimax included?: class 1 bite already achieved with orthodontic work in early teen years, which corrected only a slight overbite. This, paired with only a mild lower third recession, does not make the ROI of a full trimax plan worth the additional time, cost, and risk


Cost: 16k euros for both procedures combined into one op


Recommended initial recovery time: 2 weeks in Rome


Next steps (for target surgery date of June 2027):
1. Reach out to his team in January 2027 for
- new full face 3D CT scan fax referral sent to local imaging clinic
- pay surgery downpayment
- scheduling of a specific June date

2. Obtain, submit, and confirm updated scan; book flights and hotel; request two weeks off work

3. I assume a month or two before the surgery date, final payment and more online meets to confirm specific implant design and osteotomy movements

3. Finally get to that operating table come next summer; post results here, let Ram’s team post to his socials, and inevitably get my LTN ass flayed alive by the community


And of course, all the meanwhile, tradeslave to pad savings and cope to not rope. Let’s ascend together lads :)
IMG 7509
 
Last edited:
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  • JFL
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do you have the full transcript or is this all of it
 
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blue eyed mogger
 
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U do need bimax, u have forward head posture
 
  • Hmm...
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U do need bimax, u have forward head posture
These any better? Idk this is just how I stand and hold myself normally
IMG 7516
IMG 7517


Either way it’s over I’m choosing to cope sorry
 
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Yeah u definitely have it , what’s the point in coping when u could do it for an extra 4k and just get malar in the future it’s defo not over
Way more than +4k bro

Perhaps you are right but even so I would have to find a different surgeon willing to perform the tri but I’m set on this, enough indecision, it’s time to act

There’s no end to hardmaxxing, maybe I will end up getting it done years later but for now this is round 1 let’s see what happens then reassess
 
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Way more than +4k bro

Perhaps you are right but even so I would have to find a different surgeon willing to perform the tri but I’m set on this, enough indecision, it’s time to act

There’s no end to hardmaxxing, maybe I will end up getting it done years later but for now this is round 1 let’s see what happens then reassess
Did rameiri say no? Eren pera would do it surgery first for us like 13.5k pounds
 
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Way more than +4k bro

Perhaps you are right but even so I would have to find a different surgeon willing to perform the tri but I’m set on this, enough indecision, it’s time to act

There’s no end to hardmaxxing, maybe I will end up getting it done years later but for now this is round 1 let’s see what happens then reassess
dont need a bimax. Vertical genio and you mog. How tall r u?
 
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I don't think bimax was for you. Have to consider the frontal bone for the overall harmony of ur porfile:rolleyes:
 
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Peak think I was the last patient ramieri did widening genio on
 
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U do need bimax, u have forward head posture
Forward head posture does not indicate that he needs bimax. Dr. Mew cope

He's also frankfurt in the photos shown

1781109770282


Head posture is completely irrelevant
 
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Forward head posture does not indicate that he needs bimax. Dr. Mew cope

He's also frankfurt in the photos shown

View attachment 5201212

Head posture is completely irrelevant
It’s not illrevelant plus that correct as u see from the other pics he’s sent
 
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It’s not illrevelant plus that correct as u see from the other pics he’s sent
It IS irrelevant. It would only matter if his head was tilted above the frankfurt plane in a significant manner, which people with forward head posture have a tendency to do (to fraud forward growth). That is what people refer to when they bring up forward head posture in this context. But that is not the case here, as his tragion is mostly collinear with his infraorbital rim from the photos.

The two may be correlated, although looking into it there's conflicting evidence on that even (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0276156). But one thing for sure is that forward head posture does not mean you have jaw recession, you can have forward head posture for many different reasons (rotting too much online is one of them).
 
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- Malar implants: custom, saddled, PEEK, anterior projection focused, conservative sizing
Your right cheekbone is more prominent than your left. Or your left is more prominent than your right (I don't know which of the photos are flipped). That's what I notice in the pictures, but the CT scan will describe it in millimeters. I could be wrong, but cheekbones don't have to be symmetrical. I don't mean to make you paranoid or anything. Ramieri didn't have your CT to measure stuff, right?

If it's true, that might change how the implants are designed or are implanted so to say.
 

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