Gonial/jaw implants is the shittiest surgery

[sir carti]

Filler for gonions for sure, just have enough money to routinely dissolve and replace

how often??

 

[svarddre]

how often??

Probably depends on the type of filler you get and your own metabolism

 

[svarddre]

This guy had a wraparound implant and the results were great

Dr. Karan Dhir in California

 

[it_will_begin]

Interesting.

I will talk with Ramieri about this

update? I'm a little bit scared bc i'm going to do implates w Ramieri too, i have no ramus

 

[it_will_begin]

All result i have seen from it and even irl experience when i did my surgery was extremly bad. It just never looks neither natural or good. I have seen like 10+ giant result, 4-5 ram result and 6 pag result. Also a few on the internet, and i have never seen one good or even half decent result thats even remotely close too an average jaw with decent width. Most of the times it litteraly descended them to the ground. And the ones i have seen irl looks absolutely awful and uncanny even because the jaw doesnt look normal. Most good looking jaws comes mostly from the muscle insertions and the size of it. Jaw implants litteraly destroys the muscle or it is attached not even remotely the same. In worst case you get dehiscence and get some weird bump and muscle slid up and shit.

Absolute scam surgery, never touch ever unless you have the worst jaw in human history or can grow a beard over it

I've done a research and asked Dr. Ramieri about this, and this is right if we're talking about bad designed cheap implants (many times in silicon) which are placed OVER the periosteum: meanwhile professional jaw angle implants are placed UNDER the periosteum, directly on the nude bone.
So the masseter is not detached, it is only lifted TOGETHER WITH THE PERIOSTEUM (since the masseter is attached to the periosteum).
Here is the reply of Dr. Ramieri to my question about this argument:

Excellent subperiosteal skeletonization
significantly limits any problems due to the proximity of the pterygo-masseteric sling. This type of prosthesis is never volumetrically enhanced as it is a refinement of the orthognathic surgery.

 

[lurking truecel]

I've done a research and asked Dr. Ramieri about this, and this is right if we're talking about bad designed cheap implants (many times in silicon) which are placed OVER the periosteum: meanwhile professional jaw angle implants are placed UNDER the periosteum, directly on the nude bone.
So the masseter is not detached, it is only lifted TOGETHER WITH THE PERIOSTEUM (since the masseter is attached to the periosteum).
Here is the reply of Dr. Ramieri to my question about this argument:

Excellent subperiosteal skeletonization
significantly limits any problems due to the proximity of the pterygo-masseteric sling. This type of prosthesis is never volumetrically enhanced as it is a refinement of the orthognathic surgery.

Nah thats the problem you place implant without detaching and reatching the muscle in a natural way on the augmented bone. Thats why people see the muscle above the bobe in the same place. Which is what people call dehiscence, some people do get problems with the muscle deatching involuntarily aswell

 

[Nahorscend]

I've done a research and asked Dr. Ramieri about this, and this is right if we're talking about bad designed cheap implants (many times in silicon) which are placed OVER the periosteum: meanwhile professional jaw angle implants are placed UNDER the periosteum, directly on the nude bone.
So the masseter is not detached, it is only lifted TOGETHER WITH THE PERIOSTEUM (since the masseter is attached to the periosteum).
Here is the reply of Dr. Ramieri to my question about this argument:

Excellent subperiosteal skeletonization
significantly limits any problems due to the proximity of the pterygo-masseteric sling. This type of prosthesis is never volumetrically enhanced as it is a refinement of the orthognathic surgery.

Unrelated but is that reply by his whatsapp AI or actually by him
And if it's by him, how did you contact him to get a personal reply

 

[it_will_begin]

Nah thats the problem you place implant without detaching and reatching the muscle in a natural way on the augmented bone. Thats why people see the muscle above the bobe in the same place. Which is what people call dehiscence, some people do get problems with the muscle deatching involuntarily aswell

bro it seems that u haven't read my explanation, do you know at least the anatomy of the human body? The implant is placed UNDER the periosteum (which mean under the muscle) and the muscle will readjust and stretch to match the new bone structure, and will remain attached to the periosteum as before

Unrelated but is that reply by his whatsapp AI or actually by him
And if it's by him, how did you contact him to get a personal reply

I actually asked that months ago on instagram under a video about implates

 

[Foreverbrad]

bro it seems that u haven't read my explanation, do you know at least the anatomy of the human body? The implant is placed UNDER the periosteum (which mean under the muscle) and the muscle will readjust and stretch to match the new bone structure, and will remain attached to the periosteum as before

Subperiosteal fillers are good too.

What did he mean that this type of prosthesis is never volumetrically enhanced?

 

[lurking truecel]

bro it seems that u haven't read my explanation, do you know at least the anatomy of the human body? The implant is placed UNDER the periosteum (which mean under the muscle) and the muscle will readjust and stretch to match the new bone structure, and will remain attached to the periosteum as before


I actually asked that months ago on instagram under a video about implates

I mean i have seen multiple results and know people irl and got vida etc. The muscle stays in the same spot and that is why it looks scuffed. And people have had problems with jaw implants from both ram and pag. Loosening with time and other shit issues. Pag even stopped doing it almost entirely. Its a shit surgery

 

[lurking truecel]

Subperiosteal fillers are good too.

What did he mean that this type of prosthesis is never volumetrically enhanced?

Fillers look 10 x better

 

[moltisantichincel]

D

I mean i have seen multiple results and know people irl and got vida etc. The muscle stays in the same spot and that is why it looks scuffed. And people have had problems with jaw implants from both ram and pag. Loosening with time and other shit issues. Pag even stopped doing it almost entirely. Its a shit surgery

Doesbt it only look bad when clenching? And would just doing masseter Botox help?, masseter hypertrophy looks shit anyways, you want to show the gonion

 

[lurking truecel]

D

Doesbt it only look bad when clenching? And would just doing masseter Botox help?, masseter hypertrophy looks shit anyways, you want to show the gonion

Test it and get back to me

 

[mrnut]

 

[mrnut]

wht abt jaw filler?

 

[moltisantichincel]

Test it and get back to me

I’m doing implate fuck it, too low inhib and too greedy to say no. I’ll post a thread explaining how it goes tho, worst case scenario I’ll do a couple rounds of masseter Botox and will stop clenching

 

[lurking truecel]

I’m doing implate with Ramieri fuck it, too low inhib and too greedy to say no. I’ll post a thread a year from now explaining how it goes

Good

 

[tweaqo]

Pag even stopped doing it almost entirely

Can confirm, he told me he hates them and they look retarded in his opinion

 

[it_will_begin]

Subperiosteal fillers are good too.

What did he mean that this type of prosthesis is never volumetrically enhanced?

He replied to me in italian (to my italian comment) and i used google translate which translated like shit, he means "this type of implant in never very big"

I'm still not convinced about implates i want to see a good natural result before doing on myself

I’m doing implate fuck it, too low inhib and too greedy to say no. I’ll post a thread explaining how it goes tho,

nice, when are u gonna do it? i'm gonna do it around summer 2026

 

[moltisantichincel]

He replied to me in italian (to my italian comment) and i used google translate which translated like shit, he means "this type of implant in never very big"

I'm still not convinced about implates i want to see a good natural result before doing on myself


nice, when are u gonna do it? i'm gonna do it around summer 2026

late 2026 probably, im still considering them aswell, I would like to see ramieris implate result portfolio before being sure, but from what I've heard and ramieris philosophy I don't think theres much of an issue, theres also added benefit to implate as it lowers the risk of relapse and condyles resorbing long term, at least that's what he said in his implate article (which btw none of the 7 patients got any dehiscence). but I will discuss it in my next appointment with ram once I am 6 months away from surgery with decomposition, and Im pretty sure the masseter only starts to look like shit ether when you are clenching or when you have masseter hypertrophy (who wants that shit anyway) so worst case scenario ill do a couple rounds of masseter botox, and stop clenching, also since ramieri is trying to capitalize off of implate since its kinda his invention,( giant will tell you otherwise lul). he's making sure that the design is as anatomical and has the best results, that's my theory tho im not sure. I feel safe with ram placing them tho

 

[it_will_begin]

late 2026 probably, im still considering them aswell, I would like to see ramieris implate result portfolio before being sure, but from what I've heard and ramieris philosophy I don't think theres much of an issue, theres also added benefit to implate as it lowers the risk of relapse and condyles resorbing long term, at least that's what he said in his implate article (which btw none of the 7 patients got any dehiscence). but I will discuss it in my next appointment with ram once I am 6 months away from surgery with decomposition, and Im pretty sure the masseter only starts to look like shit ether when you are clenching or when you have masseter hypertrophy (who wants that shit anyway) so worst case scenario ill do a couple rounds of masseter botox, and stop clenching, also since ramieri is trying to capitalize off of implate since its kinda his invention,( giant will tell you otherwise lul). he's making sure that the design is as anatomical and has the best results, that's my theory tho im not sure. I feel safe with ram placing them tho

shit maybe i'm doing it before you, i really hope Clavicular do that soon so we can see the results, but i'm losing the hope

 

[lurking truecel]

shit maybe i'm doing it before you, i really hope Clavicular do that soon so we can see the results, but i'm losing the hope

Good work guys being our forum own little test bunnies(it will prob look alright )

 

[moltisantichincel]

Good work guys being our forum own little test bunnies(it will prob look alright )

At least it’s with a licensed surgeon

 

[nishka]

why

I think jaw angles shouldnt be done unless you have no jaw. Like that its so severe that you basically need something to restore your humanity so its the best of the worst choice

not filler on the gonians?

 

[Lefor3Laser]

why

not filler on the gonians?

You can do that, i had my gonions invisible, did fillers and it looks natural so yes you can.

 

[bossman]

I would have to disagree with this

Yea 100%, jaw widening is worth a try and can be decently stable with custom plates. Def 1000% more worth then jaw implants

I had very in depth discussions with both Dr Paul Coceancig and Dr David Bell, who are the most experienced surgeons who use custom plates. These guys create widening not just through torquing the rami outwards but also doing a midline split in the maxilla and mandible and they flare these outwards too.

However, using your own bone to create width, which seems to be an obsession with users here, is not the holy grail. Most results were not a significant aesthetic improvement.

These are two highly skilled surgeons. I have heard stories of other surgeons who torque the rami outwards causing TMJ issues in patients. You don’t want that.

Dr Jorge Fernandes from Brazil seems to deliver decent jaw implants results without even using custom implants.

I know a maxfac who uses custom PEEK implants during bimax when indicated. None of his results look fake, they’re all very natural and have good harmony. But consequently, there is never the “chiselled” look that you might get from fillers. Just more facial development and more harmonious proportions, which is all one should hope for when doing facial implants.

 

[lurking truecel]

I would have to disagree with this


I had very in depth discussions with both Dr Paul Coceancig and Dr David Bell, who are the most experienced surgeons who use custom plates. These guys create widening not just through torquing the rami outwards but also doing a midline split in the maxilla and mandible and they flare these outwards too.

However, using your own bone to create width, which seems to be an obsession with users here, is not the holy grail. Most results were not a significant aesthetic improvement.

These are two highly skilled surgeons. I have heard stories of other surgeons who torque the rami outwards causing TMJ issues in patients. You don’t want that.

Dr Jorge Fernandes from Brazil seems to deliver decent jaw implants results without even using custom implants.

I know a maxfac who uses custom PEEK implants during bimax when indicated. None of his results look fake, they’re all very natural and have good harmony. But consequently, there is never the “chiselled” look that you might get from fillers. Just more facial development and more harmonious proportions, which is all one should hope for when doing facial implants.

I mean i know like 10+ people who did widening and yea it relapses to some degree but they have no issues. And like 5+ people who had jaw implants and like 3 had problems. All of them pag and ramieri patients. One even did it with both but it ended up shifting after a year from one of them. And another had infection after 6 months. And all of them have some kind of dehiscence and even jaw pain from the implant in some case. Its a shitty as surgery 100%

 

[nishka]

I would have to disagree with this


I had very in depth discussions with both Dr Paul Coceancig and Dr David Bell, who are the most experienced surgeons who use custom plates. These guys create widening not just through torquing the rami outwards but also doing a midline split in the maxilla and mandible and they flare these outwards too.

However, using your own bone to create width, which seems to be an obsession with users here, is not the holy grail. Most results were not a significant aesthetic improvement.

These are two highly skilled surgeons. I have heard stories of other surgeons who torque the rami outwards causing TMJ issues in patients. You don’t want that.

Dr Jorge Fernandes from Brazil seems to deliver decent jaw implants results without even using custom implants.

I know a maxfac who uses custom PEEK implants during bimax when indicated. None of his results look fake, they’re all very natural and have good harmony. But consequently, there is never the “chiselled” look that you might get from fillers. Just more facial development and more harmonious proportions, which is all one should hope for when doing facial implants.

you didnt talk abotu the masseter thing which is one of @lurking truecel main point

 

[nishka]

I mean i know like 10+ people who did widening and yea it relapses to some degree but they have no issues. And like 5+ people who had jaw implants and like 3 had problems. All of them pag and ramieri patients. One even did it with both but it ended up shifting after a year from one of them. And another had infection after 6 months. And all of them have some kind of dehiscence and even jaw pain from the implant in some case. Its a shitty as surgery 100%

i have consulation with burak tn i am going to tell him no gonian implants for me but do i ask about jaw widening thru osteotomy

 

[bossman]

I mean i know like 10+ people who did widening and yea it relapses to some degree but they have no issues. And like 5+ people who had jaw implants and like 3 had problems. All of them pag and ramieri patients. One even did it with both but it ended up shifting after a year from one of them. And another had infection after 6 months. And all of them have some kind of dehiscence and even jaw pain from the implant in some case. Its a shitty as surgery 100%

Pag and Ramieri are both surgeons who offer implants to have a commercial advantage. They don’t truly understand facial implants.

In America, Eppley is still stuck coping with Silicon. And players like Dhir have decided to start advertising implants despite being clueless about them.

Especially with Giant patients in Turkey and with Pagnoni, I have heard about infection, misplacement, dehiscence and revision after revision.

Someone I know was told by Giant that jaw implants is a meme surgery and almost every case seems to get dehiscence.

I agree it is more plausible that jaw implants as a procedure are to blame than to say all of the aforementioned people are clueless about implants. But that is what I genuinely think.

I would only trust two surgeons with jaw implants. You would not have heard of either. One told me dehiscence is almost never a problem among his patients. He explained to me how he avoids this from happening (which might involve detaching the masseter???) I’m not sure as I was too low IQ to understand.

Surgeons who don’t truly understand implants have accepted these complications as a fact of life, while there are other surgeons who have developed techniques for proper implant placement. Facial implants is not a massive academic sphere of interest so these techniques are less likely to spread through conferences and courses etc.

In general you are right that it is a shitty procedure if you go with 99% of surgeons. But there is that 1%.

Pagnoni and Ramieri are not popular because they are the best in the world. They are just capable surgeons who seemed to have spread by word of mouth on the internet. Capable at bimax, but certainly not implants

 

[tweaqo]

Pag and Ramieri are both surgeons who offer implants to have a commercial advantage. They don’t truly understand facial implants.

In America, Eppley is still stuck coping with Silicon. And players like Dhir have decided to start advertising implants despite being clueless about them.

Especially with Giant patients in Turkey and with Pagnoni, I have heard about infection, misplacement, dehiscence and revision after revision.

Someone I know was told by Giant that jaw implants is a meme surgery and almost every case seems to get dehiscence.

I agree it is more plausible that jaw implants as a procedure are to blame than to say all of the aforementioned people are clueless about implants. But that is what I genuinely think.

I would only trust two surgeons with jaw implants. You would not have heard of either. One told me dehiscence is almost never a problem among his patients. He explained to me how he avoids this from happening (which might involve detaching the masseter???) I’m not sure as I was too low IQ to understand.

Surgeons who don’t truly understand implants have accepted these complications as a fact of life, while there are other surgeons who have developed techniques for proper implant placement. Facial implants is not a massive academic sphere of interest so these techniques are less likely to spread through conferences and courses etc.

In general you are right that it is a shitty procedure if you go with 99% of surgeons. But there is that 1%.

Pagnoni and Ramieri are not popular because they are the best in the world. They are just capable surgeons who seemed to have spread by word of mouth on the internet. Capable at bimax, but certainly not implants

In cases where not much widening of the jaw is needed, I would say ramus widening is ideal. Even if the ramus widening relapses slightly, it isn’t that big of a deal. Only in people who have terrible jaw width should consider jaw angle implants imo

No point risking implants with most surgeons.

 

[Lefor3Laser]

In cases where not much widening of the jaw is needed, I would say ramus widening is ideal. Even if the ramus widening relapses slightly, it isn’t that big of a deal. Only in people who have terrible jaw width should consider jaw angle implants imo

No point risking implants with most surgeons.

Jaw widening via torque is very risky and unstable (even for small movement), many people whom got it developed tmj after years post op.

And what you also said, relapse could easily happen, basically surgery is like a russian roulette, but where there are 5 rounds loaded and one chamber empty.

Not impossible to get result, but definetely not easy.

 

[Lefor3Laser]

Pag and Ramieri are both surgeons who offer implants to have a commercial advantage. They don’t truly understand facial implants.

In America, Eppley is still stuck coping with Silicon. And players like Dhir have decided to start advertising implants despite being clueless about them.

Especially with Giant patients in Turkey and with Pagnoni, I have heard about infection, misplacement, dehiscence and revision after revision.

Someone I know was told by Giant that jaw implants is a meme surgery and almost every case seems to get dehiscence.

I agree it is more plausible that jaw implants as a procedure are to blame than to say all of the aforementioned people are clueless about implants. But that is what I genuinely think.

I would only trust two surgeons with jaw implants. You would not have heard of either. One told me dehiscence is almost never a problem among his patients. He explained to me how he avoids this from happening (which might involve detaching the masseter???) I’m not sure as I was too low IQ to understand.

Surgeons who don’t truly understand implants have accepted these complications as a fact of life, while there are other surgeons who have developed techniques for proper implant placement. Facial implants is not a massive academic sphere of interest so these techniques are less likely to spread through conferences and courses etc.

In general you are right that it is a shitty procedure if you go with 99% of surgeons. But there is that 1%.

Pagnoni and Ramieri are not popular because they are the best in the world. They are just capable surgeons who seemed to have spread by word of mouth on the internet. Capable at bimax, but certainly not implants

Even if there's 1%, it would still not be avoidable, if it happens it happens, even if there are techniques to it, surgery always has a risk, and sadly, risks are much higher than reward (for most of the surgeries).

 

[Nahorscend]

Jaw widening via torque is very risky and unstable (even for small movement), many people whom got it developed tmj after years post op.

Damn that is unfortunate to hear, I thought as long as you don't have tmj issues beforehand and the torque isn't too big, it will be fairly low risk.