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
 
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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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anything u plan to do about your lips?
 
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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.
He does already and will get an updated one closer to surgery
 
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He does already and will get an updated one closer to surgery
Was it like active during the zoom call? Readily did he have 3d measurements? And do you think your cheekbones are symmetric?

A lot of blackpillers drone on about "symmetry" this and that.
 
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Was it like active during the zoom call? Readily did he have 3d measurements? And do you think your cheekbones are symmetric?

A lot of blackpillers drone on about "symmetry" this and that.
Yes he pulls it up as a 3d render that can be rotated and morphed

I don’t know I will cross that bridge when we get to the design stage
 
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and morphed
What?! Morphed? Did he show anything brutal or exciting in that way? There was this cocky guy Elim on the forum in prior months who said he was the only one in the world who morphed in 3D. He like Facemetrics charged scared sub5s and normies for advice with filler JFL. I wonder what he's up to.

@vnw[oggwg
 
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lol this nigga got you in june 2027 jfl. Price is not bad but ram isn't that great for implants. you need lid work done spacers and cantho. keep wageslaving bro surgerys not for another year jfl when you could go to a great surgeon and be on the table in under 1-2 months
 
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lol this nigga got you in june 2027 jfl. Price is not bad but ram isn't that great for implants. you need lid work done spacers and cantho. keep wageslaving bro surgerys not for another year jfl when you could go to a great surgeon and be on the table in under 1-2 months
June was an intentional choice on my part

My work situation is such that for the next 3 years I only have the summer months available to take adequate time off for surgeryceling

Ram did not know this until I told him and was ready to get me booked for September of this year

I am going to Ram because I do not know anyone else who does infras with a saddle (aka Pags and Giant) that I would trust to operate on me

The initial sliding genio could be done with any half competent maxfac yes, but I might as well pair it up w the infras and save time and money that way. Especially since it’s likely I’ll go for that widening chin implant afterwards, it makes sense to have the same team do it all for aesthetic planning continuity

Everything else I intend to get with certainty - lip lift and periorbital fat transfer - will be done locally at a clinic that’s a 10 minute drive from my house, vs going on an overseas odyssey to Europe. I don’t want to massively inconvenience myself when avoidable, but I see this specific situation as precisely the opposite - unavoidable

Cantho is indeed on the “maybe” list, but the order of operations is always getting the underlying bone work done first to see how the soft tissues adapt and change, before going in to directly tweak them, so yes that negative vector needs addressed first

And yes I will indeed keep wageslaving, because it’s necessary. I had just barely enough in the bank to get this done when I initially consulted last year in May, but guess what? I refuse to be one of those impatient IQlets who blows every last penny on surgery only to have fuck all left over if something goes wrong. And things can go very, very wrong, both surgically and just in general. I’m not rich, smart, talented, or lucky. This is the only way
 
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June was an intentional choice on my part

My work situation is such that for the next 3 years I only have the summer months available to take adequate time off for surgeryceling

Ram did not know this until I told him and was ready to get me booked for September of this year

I am going to Ram because I do not know anyone else who does infras with a saddle (aka Pags and Giant) that I would trust to operate on me

The initial sliding genio could be done with any half competent maxfac yes, but I might as well pair it up w the infras and save time and money that way. Especially since it’s likely I’ll go for that widening chin implant afterwards, it makes sense to have the same team do it all for aesthetic planning continuity

Everything else I intend to get with certainty - lip lift and periorbital fat transfer - will be done locally at a clinic that’s a 10 minute drive from my house, vs going on an overseas odyssey to Europe. I don’t want to massively inconvenience myself when avoidable, but I see this specific situation as precisely the opposite - unavoidable

Cantho is indeed on the “maybe” list, but the order of operations is always getting the underlying bone work done first to see how the soft tissues adapt and change, before going in to directly tweak them, so yes that negative vector needs addressed first

And yes I will indeed keep wageslaving, because it’s necessary. I had just barely enough in the bank to get this done when I initially consulted last year in May, but guess what? I refuse to be one of those impatient IQlets who blows every last penny on surgery only to have fuck all left over if something goes wrong. And things can go very, very wrong, both surgically and just in general. I’m not rich, smart, talented, or lucky. This is the only way
saddled infras are not it anymore even giant doesnt use saddles infras w a spacer grafts are a much better alternative which can be combined with lid work like cantho and have it all done in one procedure by an occuplastic surgeon.
 
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What?! Morphed? Did he show anything brutal or exciting in that way? There was this cocky guy Elim on the forum in prior months who said he was the only one in the world who morphed in 3D. He like Facemetrics charged scared sub5s and normies for advice with filler JFL. I wonder what he's up to.

@vnw[oggwg
Okay morphed was perhaps the wrong word but in my initial consult he was able to click and drag out my chin to show a ballpark estimate of what a genio with perhaps 6mm advancement and 3mm downgrafting would look like (in 2d though; I’m sure he probably could’ve done it w the 3d render too if I had asked. I’ll post what that looked like too below):
IMG 7520
IMG 7522


IMG 7523

IMG 7524
 
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saddled infras are not it anymore even giant doesnt use saddles infras w a spacer grafts are a much better alternative which can be combined with lid work like cantho and have it all done in one procedure by an occuplastic surgeon.
Maybe but I will have to explore that in summer 2028 when my next surgery window opens up and I’ve replenished my savings :forcedsmile:
 
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Maybe but I will have to explore that in summer 2028 when my next surgery window opens up and I’ve replenished my savings :forcedsmile:
you can do custom infra implants w spacers to fix scleral show and cantho by an occuplastic in one guy and get genio from a diff surgeon
 
My only good eye area feature :Sadge: Everything else is DOG
View attachment 5200744
View attachment 5200748
Damn if THESE are considered dogshit eyes then I need to rope immediately :feelswhy: Feel lucky for what you have bro

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).
Yeah this has always been the most frustrating blackpill myth for me, I see all sorts of people with FHP, smartphone/computer overuse seems a much bigger part of it then recession. Very few people are actually recessed enough to be forced in forwards head posture to breathe, that type tends to only show up in severe cases. Even seen threads where people will say "don't try to fix your posture, you need bimax since you have the posture, you can only fix it by getting bimax" :lul:
 
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i swear you will be unsatisfied without the bimax bro please get it
 
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too low roi for this nigger
i can visualize him with a genio only and see how itd suck
he will stay just as brachy with an out of place chin
 
i can visualize him with a genio only and see how itd suck
he will stay just as brachy with an out of place chin
He wouldn’t get much advancement with bimax anyway
 
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it's not how it works
no shit that's not how the movements go exactly through those lines on the table
very clear that im depicting a downgraft with cw vs ccw in the picture
 
no shit that's not how the movements go exactly through those lines on the table
very clear that im depicting a downgraft with cw vs ccw in the picture
hes not a downgraft candidate
 
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Charlie Kirk looking ass
 
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