Just spoke with Pagnoni

tweaqo

tweaqo

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So I just had a consultation with Dr Pagnoni, with CBCT scans.

Before he had the CBCT scans, he recommended I just get genioplasty alone, but after he saw my skull, he changed the plan.

He said I have extremely mild maxillary recession (to the point it’s not noticeable due to my soft tissue covering it, so my maxilla still looks projected IRL).

He thinks that a genioplasty alone might give me a chin that looks unbalanced and protruded, so recommended I get a trimax, with ramus widening.

He said that the Lefort 1 would literally be less than 2mm, and I wouldn’t see a visible difference in the maxilla, and the only reason for doing the Lefort 1 is not to improve how my upper jaw looks, but to allow a bigger BSSO movement.

He wanted to be very conservative, recommending a 1-2mm Lefort 1 with maybe a small bit of downgrafting. A BSSO that would only be around 4-5mm and a 3 piece genioplasty which advances forward only about 4mm too, as well as heighten and widen. I was very surprised at how conservative he was.

For the BSSO cut, he said he could widen the ramus using custom plates, just by about 1-2mm per side, and also mentioned that he HATES jaw angle implants, but still does them. He was heavily against me getting jaw angle implants. He said I shouldn’t get jaw implants as my gonions aren’t too inward, so only need a small movement out.

I asked him about infras, and he said I probably don’t need them, but if I were to, he would use very small implants. So I’ll probably just stick to my original plan which is fat grafting and canthoplasty.
 
Last edited:
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He just wants to take most money btw
 
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1mm of maxilla advancement isn’t going to make your chin from unproportional to proportional
 
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@goo25 pagnoni keeps bluepilling lmao wtf is 1mm advancement 😂
 
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@goo25 pagnoni keeps bluepilling lmao wtf is 1mm advancement 😂
Did you read the thread bro…

My maxilla is hardly recessed, in fact he said it isn’t, and is only advancing it so we can actually do the BSSO.
 
Did you read the thread bro…

My maxilla is hardly recessed, in fact he said it isn’t, and is only advancing it so we can actually do the BSSO.
I didnt read rhe thread indeed i only read the reply above mine
 
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1mm of maxilla advancement isn’t going to make your chin from unproportional to proportional
I know, it was to allow enough space for BSSO to take place. A BSSO with genio will look more proportionate than genio alone.

Still, the movements on the pogonion seem quite small for my liking.
 
Doing bimax for anything less then 4 mm and 10 mm pog is stupid.
 
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And also why did he say he hates jaw implants ? Just in general or for your case ?
 
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Doing bimax for anything less then 4 mm and 10 mm pog is stupid.
Yeah don’t worry I’m not gonna go ahead straight away and do this lol.. gonna do extensive research on better options
And also why did he say he hates jaw implants ? Just in general or for your case ?
nope in general, he says he does them a lot but thinks the results look way less natural than ramus widening.
Yea 25k or even more for some authist to do 2 mm leforte :feelsyay:
he quoted me €33k for this btw
 
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Yeah don’t worry I’m not gonna go ahead straight away and do this lol.. gonna do extensive research on better options

nope in general, he says he does them a lot but thinks the results look way less natural than ramus widening.

he quoted me €33k for this btw
Yea i mean the msucle thingy woth jaw implants is bad, 33k holy fuckery
 
Now go to Ramieri and see what he says. I'll laugh if he proposes bigger movements because some clowns here argue with me he's too "blue pilled" :rolleyes:

Someone posted a while ago they visited both and got 2 completely different surgical plans, so it could be worth a second opinion.

Btw I've seen ramus widening where the outcome was underwhelming and on top of that he's proposing only 1-2mm (which could relapse to 0-1mm). Did he show you any before/afters with ramus widening?
 
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Yea i mean the msucle thingy woth jaw implants is bad, 33k holy fuckery
I’m gonna attach my scans in another thread

Now go to Ramieri and see what he says. I'll laugh if he proposes bigger movements because some clowns here argue with me he's too "blue pilled" :rolleyes:

Someone posted a while ago they visited both and got 2 completely different surgical plans, so it could be worth a second opinion.

Btw I've seen ramus widening where the outcome was underwhelming and on top of that he's proposing only 1-2mm (which could relapse to 0-1mm). Did he show you any before/afters with ramus widening?
Yes he showed me before and after of ramus widening and it was actually very impressive, it looked like they had implants but they were all osteotomies only.

I am going to ramieri to consult soon don’t worry. I expect their plans to be very different
 
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Yes he showed me before and after of ramus widening and it was actually very impressive, it looked like they had implants but they were all osteotomies only.

I am going to ramieri to consult soon don’t worry. I expect their plans to be very different
Very interesting, thanks for sharing. Was this in-person or virtual?
 
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Very interesting, thanks for sharing. Was this in-person or virtual?
Virtual- I live in the UK


He says almost every time he does a genio he widens at the same time, looking forward to having a squarer chin, would mog
 
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Ramus widening and jaw implants are not interchangeable surgeries. They address slightly different issues. Jaw implant is for decreasing gonial angle and increasing mandibular height and width in the back. Ramus widening “opens” out your jaws. That said the latter tends to look more natural. But again not interchangeable. Look at some of alfaros simulations in his YouTube b&as to see what I mean
 
@goo25 pagnoni keeps bluepilling lmao wtf is 1mm advancement 😂
he said the exact same thing to me but for downgrowth not recession, he said that i dont need bimax since he would only make my midface shorter by 1.5mm, and said i should only get BSSO. But how the fuck would he rotate my jaws with bsso as im clearly downgrown lmao
 
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bro,
So I just had a consultation with Dr Pagnoni, with CBCT scans.

Before he had the CBCT scans, he recommended I just get genioplasty alone, but after he saw my skull, he changed the plan.

He said I have extremely mild maxillary recession (to the point it’s not noticeable due to my soft tissue covering it, so my maxilla still looks projected IRL).

He thinks that a genioplasty alone might give me a chin that looks unbalanced and protruded, so recommended I get a trimax, with ramus widening.

He said that the Lefort 1 would literally be less than 2mm, and I wouldn’t see a visible difference in the maxilla, and the only reason for doing the Lefort 1 is not to improve how my upper jaw looks, but to allow a bigger BSSO movement.

He wanted to be very conservative, recommending a 1-2mm Lefort 1 with maybe a small bit of downgrafting. A BSSO that would only be around 4-5mm and a 3 piece genioplasty which advances forward only about 4mm too, as well as heighten and widen. I was very surprised at how conservative he was.

For the BSSO cut, he said he could widen the ramus using custom plates, just by about 1-2mm per side, and also mentioned that he HATES jaw angle implants, but still does them. He was heavily against me getting jaw angle implants. He said I shouldn’t get jaw implants as my gonions aren’t too inward, so only need a small movement out.

I asked him about infras, and he said I probably don’t need them, but if I were to, he would use very small implants. So I’ll probably just stick to my original plan which is fat grafting and canthoplasty.
can u send side profile please?? even in dms is fine
 
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So I just had a consultation with Dr Pagnoni, with CBCT scans.

Before he had the CBCT scans, he recommended I just get genioplasty alone, but after he saw my skull, he changed the plan.

He said I have extremely mild maxillary recession (to the point it’s not noticeable due to my soft tissue covering it, so my maxilla still looks projected IRL).

He thinks that a genioplasty alone might give me a chin that looks unbalanced and protruded, so recommended I get a trimax, with ramus widening.

He said that the Lefort 1 would literally be less than 2mm, and I wouldn’t see a visible difference in the maxilla, and the only reason for doing the Lefort 1 is not to improve how my upper jaw looks, but to allow a bigger BSSO movement.

He wanted to be very conservative, recommending a 1-2mm Lefort 1 with maybe a small bit of downgrafting. A BSSO that would only be around 4-5mm and a 3 piece genioplasty which advances forward only about 4mm too, as well as heighten and widen. I was very surprised at how conservative he was.

For the BSSO cut, he said he could widen the ramus using custom plates, just by about 1-2mm per side, and also mentioned that he HATES jaw angle implants, but still does them. He was heavily against me getting jaw angle implants. He said I shouldn’t get jaw implants as my gonions aren’t too inward, so only need a small movement out.

I asked him about infras, and he said I probably don’t need them, but if I were to, he would use very small implants. So I’ll probably just stick to my original plan which is fat grafting and canthoplasty.
can i see your scan
 
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How'd you go about setting up a consult?
 
I’m gonna attach my scans in another thread


Yes he showed me before and after of ramus widening and it was actually very impressive, it looked like they had implants but they were all osteotomies only.

I am going to ramieri to consult soon don’t worry. I expect their plans to be very different
Yea, tell me what ram says, but yea ramus widening is good if you need very little widening.
 
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Now go to Ramieri and see what he says. I'll laugh if he proposes bigger movements because some clowns here argue with me he's too "blue pilled" :rolleyes:

Someone posted a while ago they visited both and got 2 completely different surgical plans, so it could be worth a second opinion.

Btw I've seen ramus widening where the outcome was underwhelming and on top of that he's proposing only 1-2mm (which could relapse to 0-1mm). Did he show you any before/afters with ramus widening?
I mean to me pag first said no more then 3 mm and then after three consultation he says 6 mm. And ramieri said 5 mm directly, so i guess pag becomes big advacancer because he dont want to lose customer lol
 
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can i see your scan
Scans please am curious
I said I will later

How'd you go about setting up a consult?
He’s on holiday from today, will be back in September.

only for bimax or combined with implants?
Trimax only, no implants
I mean to me pag first said no more then 3 mm and then after three consultation he says 6 mm. And ramieri said 5 mm directly, so i guess pag becomes big advacancer because he dont want to lose customer lol
yeah I’m gonna see when he’s back from holiday if he changes his mind…
 
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33k for just trimax? what the fuck?
 
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