Is Ramieri the goat of Bimax?? Ramieri vs Raffaini

facebook, same day. idk if i trust him don t want to get dogmaxxed
For what it’s worth, I also consulted pagnoni and he actually proposed a fair bit less advancement than Ramieri surprisingly. But he did propose a little more downgrafting of the maxilla and chin than Ramieri’s original plan before I asked to amend it so the vertical movements were pretty similar in the end, I think even a little more than Pagnoni’s.

At the end of the day we can only go on what people say and results. Pagnoni is pretty renowned for implants and probably perfectly capable for bimax but ultimately I would still have more confidence in Ramieri for bimax as it’s his bread and butter and i’ve never seen an over-advanced patient from him. Pags is admittedly good value if having bimax and implants together.
 
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more people being overly impressed by good SFS result

compare that dude's starting point with this starting point:

123


people see that person's result and are like "meh, i've never seen an impressive result from so and so"

the funny thing is that people will see a Class III ascension and write it off like "oh well of course they ascended because they're Class III" but then be taken in by SFS result

but now that I've had bimax I do appreciate Ramieri's extractions and decomp approach
 
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For what it’s worth, I also consulted pagnoni and he actually proposed a fair bit less advancement than Ramieri surprisingly. But he did propose a little more downgrafting of the maxilla and chin than Ramieri’s original plan before I asked to amend it so the vertical movements were pretty similar in the end, I think even a little more than Pagnoni’s.

At the end of the day we can only go on what people say and results. Pagnoni is pretty renowned for implants and probably perfectly capable for bimax but ultimately I would still have more confidence in Ramieri for bimax as it’s his bread and butter and i’ve never seen an over-advanced patient from him. Pags is admittedly good value if having bimax and implants together.
thanks mate this is helpful
 
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did ramieri have your tc DICOM models + teeth scans also DICOM?
He had my CBCT scan file which I believe was DICOM, I just sent the ZIP from the scan place which had it bundled up in the viewer software:

1726316936462


He also needed my teeth/occlusion scans, which I got from my orthodontist who I'd previously done invisalign with (not intended as surgery preparation). They were .stl files.
 
He had my CBCT scan file which I believe was DICOM, I just sent the ZIP from the scan place which had it bundled up in the viewer software:

View attachment 3170165

He also needed my teeth/occlusion scans, which I got from my orthodontist who I'd previously done invisalign with (not intended as surgery preparation). They were .stl files.
How did you get a consultation with him? I sent a message a while ago but haven’t got a reply
 
He had my CBCT scan file which I believe was DICOM, I just sent the ZIP from the scan place which had it bundled up in the viewer software:

View attachment 3170165

He also needed my teeth/occlusion scans, which I got from my orthodontist who I'd previously done invisalign with (not intended as surgery preparation). They were .stl files.
and with that did he plan surgery directly after first consultation?
 
How did you get a consultation with him? I sent a message a while ago but haven’t got a reply
I just emailed and arranged it from there. His assistant should reply. They have like a summer break over august I think and maybe early september so that could be why you haven’t had a reply. No harm in sending another email.
 
and with that did he plan surgery directly after first consultation?
My first CBCT wasn’t perfect as apparently I had slightly opened my mouth or something. This meant he couldn’t make the surgical plan from it, but it was perfectly adequate to allow him to discuss my case with me and say what he could do.

So I got another CBCT and then he did the planning before the 2nd consultation, and then discussed it with me.

I later arranged a 3rd one to discuss some small changes to the plan (slightly more maxilla downgrafting and vertical genioplasty + slight ramus widening) Other than that, he did all the planning, I basically just said “got short face pls fix”.

The consultation fee was a one time thing, didn’t have to pay for the subsequent sessions. These were all online, I never travelled there prior to surgery.
 
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how much time from first consultation to surgery?
 
how much time from first consultation to surgery?
Like 6 months but only because I was saving money and wanted to do the surgery at a specific time. Otherwise it probably could’ve been within like a month or two.
 
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Like 6 months but only because I was saving money and wanted to do the surgery at a specific time. Otherwise it probably could’ve been within like a month or two.
thank you so much, dude i really doubt of your 13mm lower third increase, it has to be less. Can you contact them for the final plan with exact movements ?
 
thank you so much, dude i really doubt of your 13mm lower third increase, it has to be less. Can you contact them for the final plan with exact movements ?
Yeah I suppose I could just WhatsApp Ramieri and hopefully he should be able to provide it.

I am just going on memory but I really feel like he said something like 13mm. I could be mistaken. I think he was doing the measurements on the fly with the post-op CBCT overlayed on the pre-op one.

The maxilla downgraft was 4.5mm as I said, I think the genio downgraft was pretty big. And then I guess the mandible advancement also adds some height because its not parallel to tbe floor.

I mean my face was short af before and now it definitely isn't.
 
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Ramieri is the goat for sure
 
more people being overly impressed by good SFS result

compare that dude's starting point with this starting point:

View attachment 3161882

people see that person's result and are like "meh, i've never seen an impressive result from so and so"

the funny thing is that people will see a Class III ascension and write it off like "oh well of course they ascended because they're Class III" but then be taken in by SFS result

but now that I've had bimax I do appreciate Ramieri's extractions and decomp approach
I see where you're coming from.

SFS looks shit obviously but I feel like people who aren't facial aesthetics nerds generally wouldn't be able to pinpoint why an SFS-cel looks shit, whereas anybody can recognise a brutally recessed jaw, therefore with the SFS cases, it creates a bit more of an impression that something has been "created out of nothing".

I didn't actually do any decomp though although he gave me the option to.
 
I see where you're coming from.

SFS looks shit obviously but I feel like people who aren't facial aesthetics nerds generally wouldn't be able to pinpoint why an SFS-cel looks shit, whereas anybody can recognise a brutally recessed jaw, therefore with the SFS cases, it creates a bit more of an impression that something has been "created out of nothing".

I didn't actually do any decomp though although he gave me the option to.
It's not just that, although that is part of it. It's that SFS cels, or at least the really good ascensions, typically have great bone mass, just like Class III.

Check out this dude's mandible:

Screenshot 2024 09 18 184015

Screenshot 2024 09 18 183850


It's like a completely different surgery than trying to make a better face out of this:

4376709_123.png


There are issues like this that people don't think about even with something like rhinoplasty revision, like the quality of the person's rib cartilage and how much the surgeon is able to harvest, physical realities and limitations. But people act like surgeons are artists all starting with the same paints or blocks of marble.

This is a case my surgeon did (not me):

Screenshot 2024 09 18 185035


That's as good a result as I've ever seen. Does that make him one of the best in the world? No. It's mainly to do with the guy's potential. Of course Dr. Cansiz deserves credit for the planning and execution, but it's not like he created that guy's new face from scratch.
 
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It's not just that, although that is part of it. It's that SFS cels, or at least the really good ascensions, typically have great bone mass, just like Class III.

Check out this dude's mandible:

View attachment 3181026
View attachment 3181024

It's like a completely different surgery than trying to make a better face out of this:

4376709_123.png


There are issues like this that people don't think about even with something like rhinoplasty revision, like the quality of the person's rib cartilage and how much the surgeon is able to harvest, physical realities and limitations. But people act like surgeons are artists all starting with the same paints or blocks of marble.

This is a case my surgeon did (not me):

View attachment 3181049

That's as good a result as I've ever seen. Does that make him one of the best in the world? No. It's mainly to do with the guy's potential. Of course Dr. Cansiz deserves credit for the planning and execution, but it's not like he created that guy's new face from scratch.
I agree, good analysis
 
Yeah I suppose I could just WhatsApp Ramieri and hopefully he should be able to provide it.

I am just going on memory but I really feel like he said something like 13mm. I could be mistaken. I think he was doing the measurements on the fly with the post-op CBCT overlayed on the pre-op one.

The maxilla downgraft was 4.5mm as I said, I think the genio downgraft was pretty big. And then I guess the mandible advancement also adds some height because its not parallel to tbe floor.

I mean my face was short af before and now it definitely isn't.
Im having consultation in days and need to know how much vertical height i need. Thank you for helping
 
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Im going to be getting bimax soon and Im deciding between Raffaini and Ramieri.

-I can find many negative comments on raffaini where people say that they got botched and that he fucked up their life!

-I can’t find any on Ramieri though all the comments he has are positive And haven’t heard about any botches!

I feel like you can great results with raffaini or he can fuck you up.
I think Ramieri will give you fine results nothing crazy but there is minimal risk of messing you up.

Need some high Iq people to help with the decision
View attachment 3089358View attachment 3089360View attachment 3089359
View attachment 3089361View attachment 3089362View attachment 3089365
ramieri clears
 
Ramieri dont risk your face. Thinn abiut it you can unlock 90% of your facial asthetics with ramieri or either get a better result with pangnoni or get fucked like this guy and be made fun of by everybody and end up looking like monkey. Risk reward is not worth it think about itView attachment 3098035
Dude forgot to upswing his jaw
 
Yeah I suppose I could just WhatsApp Ramieri and hopefully he should be able to provide it.

I am just going on memory but I really feel like he said something like 13mm. I could be mistaken. I think he was doing the measurements on the fly with the post-op CBCT overlayed on the pre-op one.

The maxilla downgraft was 4.5mm as I said, I think the genio downgraft was pretty big. And then I guess the mandible advancement also adds some height because its not parallel to tbe floor.

I mean my face was short af before and now it definitely isn't.
have you find out mate?
 
have you find out mate?
Messaged him last week and he said he'll have to look into it.

I can try again on Monday and say "someone who wants to consult you wants to know" then maybe he'll be more inclined to do it immediately.
 
Messaged him last week and he said he'll have to look into it.

I can try
Messaged him last week and he said he'll have to look into it.

I can try again on Monday and say "someone who wants to consult you wants to know" then maybe he'll be more inclined to do it immediately.

again on Monday and say "someone who wants to consult you wants to know" then maybe he'll be more inclined to do iti
 
@BlackpilledPlatypus would it be retarded to go with whatever plan ramieri has devised for you without getting other opinions? does he have a good eye for aesthetics?
 
@BlackpilledPlatypus would it be retarded to go with whatever plan ramieri has devised for you without getting other opinions? does he have a good eye for aesthetics?
I don’t think it would be retarded exactly, I think his aesthetic eye is good and my final plan was only slightly different to his original proposal, and perhaps not actually any better. I do think it’s true that he generally errs on the conservative side, you can push him for more but obviously when you go for as big advancements as possible, you run the risk of starting to look uncanny. The simulations can’t accurately predict how your soft tissue will react.

But consulting other surgeons is easy, cheap (compared to the procedure cost) or sometimes free so I would always recommend it.
 
Yeah, I don’t think the ramus widening made a noticeable difference as it was a very small amount, but assuming you’re referring to the recent pictures on Ramieri’s IG, I honestly don’t think they’re a great representation of the result because I was giga-bloated on that day from being a tourist and eating some big-ass salty pizzas.
Does ramus widening also affect gonion projection?
 
Does ramus widening also affect gonion projection?
Yes, but idk if it’s very likely to turn inward gonions into outward ones. That probably needs implants.
 
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You gotta look on this forum. But he took money from some idiot guy which didnt need bimax and performed it anyways took the 15k and chipmunked himView attachment 3091613

I also heard he left some chick with crazy nerve damage
This is what happens when some goon looksmaxxer asks for crazy ass advancements to "become a slayer"
 
Ramieri and Pagnoni had different ideas for me unfortunately.

Ramieri was saying no rotation, Pagnoni saying CCW. I tend to agree with Ramieri - CCW doesn’t make sense with occlusal plane that I have.
 
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no such thing as inward and outward gonions
Perhaps it's technically incorrect to talk about "inward and outward gonions" but they can still vary in shape/eversion, no? And I suppose this is the kind of thing people are generally referring to with that terminology.

1000001153
 
Perhaps it's technically incorrect to talk about "inward and outward gonions" but they can still vary in shape/eversion, no? And I suppose this is the kind of thing people are generally referring to with that terminology.

View attachment 3237593
yeah, but when you look at the appearance that people call "outward gonions" it probably isn't due to the gonions at all. for instance:

3631775784348908191


I seriously doubt her gonia flare out like that. It's probably due to soft tissue.

Like, look at all the differences in people's calves or even just their ankles. So many different shapes, and very little of it is because of the shape of the femur.

or:

outward-2542910_1631902582863-jpeg.2253777


If you shaved off the sides of his chin so he had a pointy chin, he'd no longer have the appearance of "outward gonia."

my guess is people would have better luck getting the look they want with a widening genio or chin implant than with jaw implants
 
Im going to be getting bimax soon and Im deciding between Raffaini and Ramieri.

-I can find many negative comments on raffaini where people say that they got botched and that he fucked up their life!

-I can’t find any on Ramieri though all the comments he has are positive And haven’t heard about any botches!

I feel like you can great results with raffaini or he can fuck you up.
I think Ramieri will give you fine results nothing crazy but there is minimal risk of messing you up.

Need some high Iq people to help with the decision
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It will sound very paradoxical, but won't there be a halo effect on raffaini's patients? He is quite old and looks bad, while ramieri is a htn old, mog a raffaini.
 
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Ramieri and Pagnoni had different ideas for me unfortunately.

Ramieri was saying no rotation, Pagnoni saying CCW. I tend to agree with Ramieri - CCW doesn’t make sense with occlusal plane that I have.
can you share your plan in private please?
 
What is the current consensus on this as of 2024?
 
Ramieri and Pagnoni had different ideas for me unfortunately.

Ramieri was saying no rotation, Pagnoni saying CCW. I tend to agree with Ramieri - CCW doesn’t make sense with occlusal plane that I have.
Which surgeon did you go with?
 
Leaning toward Pagnoni but I could probably still change if I wanted to.
Can you add me, I want to discuss this in pms. It's one of those pivotal moments when you can either win big and create a beautiful future or fuck everything up and destroy your life completely, so choosing the right surgeon is a hard decision.
 
Ramieri and Pagnoni had different ideas for me unfortunately.

Ramieri was saying no rotation, Pagnoni saying CCW. I tend to agree with Ramieri - CCW doesn’t make sense with occlusal plane that I have.
I had a similar issue. Ramieri said I need extractions and decompensation. Pagnoni said I can have surgery first. Both said I could have some rotation but Ramieri said it would be quite minimal, I guess Pagnoni would be doing more as that is what would allow for advancement without decomp.

My problem is that due to personal circumstances surgery first is WAY more convenient for me so I will probably have to go with Pagnoni regardless. What would some issues be with too much CCW?
 

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