My Consultation with Dr Zarrinbal

[mulattomaxxer]

Make sure to email Dr Z, his clinic will let you know the names of the orthodontists that he has worked with previously.

Ye, he has increased his price and is out of your budget if £30k still is your budget which you mentioned some time ago in a different thread.


Autograft - bone graft which is harvested from within the person itself, it is usually taken from the iliac crest (hip) for jaw osteotomies. If you have maxillary impaction done where bone from the maxilla is cut away, then this bone could also be reused as grafting material.

It makes sense that Dr Z is somewhat costly. His office is in Berlin (capitals are more expensive) and its 2022. Last time I saw his prices was from old jawsurgeryforums threads from 2015. Germany is a HCOL country with a higher GDP per capita then the UK.

If your from Germany he might be cheaper. He gave no metrics on the pricing reasoning. Regardless, I was expecting to pay alot. He is still at a simillar price to the other surgeons mentioned here.

 

[CursedOne]

Can't you just let them atrophy? Unless your jaw is comedically oversized having large massters should be good. Strong bite force is a masculine trait. Its why chad jawlines are considered attractive.

Botox can also help reduce the size of these muscles.

I am already on botox against gay masseter. The problem is that my masseter fuks my cheek bones up.

 

[Silver]

It makes sense that Dr Z is somewhat costly. His office is in Berlin (capitals are more expensive) and its 2022. Last time I saw his prices was from old jawsurgeryforums threads from 2015. Germany is a HCOL country with a higher GDP per capita then the UK.

If your from Germany he might be cheaper. He gave no metrics on the pricing reasoning. Regardless, I was expecting to pay alot. He is still at a simillar price to the other surgeons mentioned here.

Zarrinbals result just doesn't do it for me, especially when other surgeons around Dr Z's price point has produced better results in my opinion. I've also read on this forum that he doesn't do rotation and just goes for linear advancement, I don't know whether this is true or not but his results doesn't speak to me.

I also won't see him as I'm a ortho-first patient so I will have to go through the orthodontics phase prior to any surgery and I don't want to prolong the by consulting multiple surgeons before I bite the bullet and get started. My final task now is to set up a in-person consultation with Dr. R in Italy and then get a sleep study done to see if I need mandibular advancement too or not. If I see Dr. R I'll be content with having consulted two of the best OMFS's in the world before taking my decision. Luckily, I don't have to cut any corners as I have the funds for all the shit I need done.

 

[poopmaster22]

Main downside of Dr Z tbh. He doesn't like implants at all.

That sucks and is the main reason why I may end up picking Pagnoni for everything

 

[Chinlet Ascension]

This is an unusually informative and high-quality topic. Thanks OP.

 

[Pumanator]

How about chin shield? Is there more risk compared to sliding genioplasty?

Didn't ask about it. Didn't knew what it was till some time ago. He just recommended me a:
Rhino+ bimax + chin wing. Only know a little bit about that.

 

[Deleted member 2729]

I dont understand why you want to do shit chin wing JFL

 

[Deleted member 8869]

Introduction
I went for a consult with Dr Zarrinbal in April 2022. In this post I will recall what he said to me. For reference I have an anterior open bite, class 2 division one malocclusion with crossbite and moderate crowding in both jaws.

This post will cover:

1. SARPE/Upper Palate Expansion
2. Lower Jaw expansion
3. Bimax
4. Genioplasty/Chin Wing
5. High Cheekbones/Zgyomatic Osteotomy.
6. Eyelid Surgery
7. Cost
8. Dr Zarrinbals thoughts on 3D planning
9. Other noteworthy information.
10. Surgery Plan
11. Final Thoughts

My face and digital impression scans:
View attachment 1718069View attachment 1718072View attachment 1718076View attachment 1718078

Upper Palate Expansion
He said I needed SARPE. He also does a V shaped cut above the nasal spine to allow for more expansion of the maxilla whilst minimising the expansion of the alar base. However, he said I would need my wisdom teeth removing. There would be no change to my face after wisdom teeth extraction. Dr Zarrinbal can tell when somebody has had premolars extracted without needing to see their teeth. This is because the braces pull the face backwards.

He also mentioned that the nose will increase in width after SARPE so I may need to consider rhinoplasty to reduce my alar width.
View attachment 1718414
Image demonstrating the different SARPE techniques:
View attachment 1718091

Lower Jaw Expansion
He suggested an anterior subapical osteotomy (see image below). This osteotomy will expand my lower jaw and help close my open bite. After the cut is made the orthodontist will bring back the segment using braces. This will prevent me from needing premolar extractions.

If I get an anterior subapical osteotomy, I predict I will need a genioplasty as bringing forward my lower teeth will make my chin appear more recessed. I will not be getting this until after both jaws have been expanded. It will be too hard to predict where my chin will need to be until my teeth are aligned.

Images of anterior subapical osteotomy:

View attachment 1718099View attachment 1718103
Bimax
Dr Zarrinbal told me that bimax would be considered during the next phase of my treatment. This would be after expansion of both jaws and 12-24 months in braces. What cuts he would give me (segmental or CW rotation) depends on where my jaws are before the operation. If he gives me a segmental cut it would probably be a 2 piece wassmund osteotomy. This would remove my gummy smile and make my midface shorter. Zarrinbal commented on my longish midface. Dr Z did not confirm any movements.

Image of wassmund osteotomy below:
View attachment 1718121

Dr Zarrinbal also performs high cut BSSO which reduces the risk of nerve damage. See low cut vs high cut BSSO below (high cut is second image):
View attachment 1718110


Genioplasty/Chin Wing
He suggested a Chin shield alongside a chin wing osteotomy. Chin shield would allow me to avoid getting a deep mentolabial crease in my chin. He also suggested a combined Chin shield and Lower jaw expansion to increase the length of my mandible body. He had some very good chin wing results on his computer. My only concern with chin wing is that it feels a bit crude. I also think it may have an adverse effect on the gonion. Dr Zarrinbals chin wing results looked great however its difficult to find good results online.

I also feel that chinwing is ineffective at giving you outward facing gonions to increase jaw width. Chin wing is good for decreasing the gonial angle and improving jawline definition. If you want outward facing gonions you need jaw angle implants. Outward facing gonions are are requirement for hollow cheekbones.

Examples of some moggers/foggers with great projection on both their gonions and cheekbones:
View attachment 1718405

High Cheekbones/Zygomatic Osteotomy
Mixed feelings about the Zygomatic Osteotomy. I think implants mog. He said that he can mobilise the bone in 3 dimensions. To complete a zgyomatic osteotomy a bone graft is required from your hip. He had some decent results on his computer, but I think implants are superior for cheekbone projection. I have also made some images explaining why I think implants are superior. See below:

View attachment 1718301
View attachment 1718303


Eyelid surgery
He didn’t like tampering with the eyes because they tend to look unnatural. He had one result on his computer. It was decent but I wouldn’t recommend you get eyelid surgery with him. Personally I am not a huge fan of cosmetic eyelid surgery because the results tend to look negilable or unnatrual. Due to having NCT I may consider this in the future. I think I will have to accept this flaw. I will never have hunter eyes .

Cost
He gave me a price range for these surgeries.

• Upper Jaw expansion - €6,000 to €7,000
• Lower Jaw Expansion - €6,000 to €7,000
• Chin Wing - €8000 to €10,000
• Lefort 1 - €8000 to €10,000
• BSSO - €8000 to €10,000
• Zgyomatic Osteotomy - €8000 to €10,000

I'm assuming getting multiple surgeries in a single operation will lower the price. However Zarrinbal did not give much information here. These prices may be lower if you live in Germany. I am overseas from the UK.

Dr Zarrinbals opinion on 3D planning
Not a huge fan of 3D planning. He does it however due to the issue that 3D plans will never look the same IRL he may choose to override the 3D planning. He then told me a story of a maxfac surgeon he knew who followed a 3D plan accurately and the final result left her with poor lip competence. He stressed the importance of having a good surgeon with an eye for aesthetics and good mechanical skill.

Doesn’t like premade plates. This is because he may wish to adjust them after. This is because during 3D planning its primarily based on the skull base. This is good for a functional improvement however this cannot predict a good face. There are multiple ways that your jaws can meet, whilst giving you the correct bite. A good surgeon will give you the best aesthetic result.

He would use 3D planning for as a guideline then would personally review your face. Re-adjustments would be made based on both the client’s requests and Dr Zarrinbal’s aesthetic vision.

Other information on Dr Zarrinbal

• He is compliant (to an extent) with the patient’s requests. Dr Z admits that he has done patient requests which he didn’t agree with. However, the result was a lot better than Zarrinbal predicted.
• Doesn’t like Fillers because they look unnatrual and quickly lose definition due to filler migration.
• Doesn’t like fat grafts because they cause puffy eyes. Dr Z also says that they leave visible spots under the skin.
• Really likes Chin wing. He says it looks better than just getting a genioplasty.
• Doesn’t like facial implants and doesn’t offer them. (He does dental implants).
• Interesting case he showed me of a UKcel that “posts on online forums”. He wanted the low trust badboy look. He gave him a bheroplasty and a very aggressive chin wing. He went from looking nice to looking like a tough guy. Dr Z reluctantly did this and he didn’t like the result. His jawline was razor sharp. One of the sharpest jawlines I have ever seen. He did succeed and it looked natrual. I think looking medium trust mogs.
• Another patient got a revision chin wing. She liked the first result and wanted a more aggressive drop. Dr Z didn’t like the idea, but he did it anyway. She sent him an after picture and she was a fucking fogger. Madison Beer tier jawline.

Current Surgery Plan with Dr Zarrinbal

1. Phase 1 - Braces + Upper Jaw Expansion and Lower Jaw expansion. (Estimated cost £14800 to £16500)
2. Phase 2 - Chin Wing/Chin Shield Genioplasty (undecided) + Bimax. (Estimated cost £20600 to £25750
3. Phase 3 etc - Custom Infraorbital Malar Implants, Rhinoplasty (Pending) and Eyelid Surgery (Pending). I will be getting these elsewhere. (Estimated cost unknown)

Writing out these costs made me realise how expensive this is. Estimated cost £35,400-£42,250. I will need to increase my income and see if I can subsidise this as a medical expense. I am getting this for functional reasons along with aesthetic reasons.

Conclusion
Overall I was very impressed by Dr Zarrinbal at his consultation. We chatted for about 2 hours total. He gave me a large leaflet and his team was very friendly and proffesional. Their office was beautiful and his results on his computer was great. Dr Zarrinbal is quite friendly so he will listen to any concerns you have. I can tell why people speak highly of him and I would reccomend anyone considering bimax in europe to visit him. Most importantly I loved his surgery plan.

Unfortunately he doesn't offer any implants (except for dental implants). He is more expensive then I expected and you will have to meet him IRL because he doesn't offer online consultations. You can stay in a nearby hostel/hotel at a low cost.

Spoiler: BONUS: Some Travel Tips if you are planning on seeing Dr Z

Plan beforehand. I planned poorly and google maps was trying to get me on a bus which didn't exist. I ended up talking one of those E scooters out of range to get there. Luckily I left 2 hours early so I only arrived 15 minutes late but luckily maxfacs are usually like an hour late to appointments. I got fined €40 .

If your in the city centre get the U7, S3 or S9 Train to Berlin Spandeu Station. Then get the 134 bus directly to Dr Zarrinbals Office. Its a long straight road from the train station to his office. You can't miss it and there is a bus stop outside his place. His office is also up the elevator on the right
View attachment 1718203
View attachment 1718437
There is also a hotel nearby called the Boutique Hotel Sena which is very cheap. I chose to stay in a hostel because I wanted to stay a few days in the city centre and mingle. The hostel was cheaper but some of you antisocialcels may want a cheap room to yourself. This hotel offers this.

why do you think chin wing is crude?

 

[Deusmaximus]

Get a wraparound jaw implant and veneers for your crooked teeth. The autistic surgery plan will take way to long and has to many downsides/risks. Also temporal muscle reduction with surgery or botox.
Colored contacts + lean maxxing.

 

[Blackgymmax]

Hmm what would you even theoretically look like after this?. I'm looking at this and I don't really see drastic improvements

 

[Blackgymmax]

Get a wraparound jaw implant and veneers for your crooked teeth. The autistic surgery plan will take way to long and has to many downsides/risks. Also temporal muscle reduction with surgery or botox.
Colored contacts + lean maxxing.

I can see a light canthoplasty + infra saddle and fixing the bite but beyond that just seems like.. eh

 

[omqwaider778]

what exactly is the issue?

masseters too prominent? - Ive seen some very nice results with botox on masseter reduction on women, nto so many on men

Need to have it re done every 4 months or so thouhg, my botox I had done in february has worn off already

Do you like the results can I pm you ?

 

[Deleted member 14166]

Introduction
I went for a consult with Dr Zarrinbal in April 2022. In this post I will recall what he said to me. For reference I have an anterior open bite, class 2 division one malocclusion with crossbite and moderate crowding in both jaws.

This post will cover:

1. SARPE/Upper Palate Expansion
2. Lower Jaw expansion
3. Bimax
4. Genioplasty/Chin Wing
5. High Cheekbones/Zgyomatic Osteotomy.
6. Eyelid Surgery
7. Cost
8. Dr Zarrinbals thoughts on 3D planning
9. Other noteworthy information.
10. Surgery Plan
11. Final Thoughts

My face and digital impression scans:
View attachment 1718069View attachment 1718072View attachment 1718076View attachment 1718078

Upper Palate Expansion
He said I needed SARPE. He also does a V shaped cut above the nasal spine to allow for more expansion of the maxilla whilst minimising the expansion of the alar base. However, he said I would need my wisdom teeth removing. There would be no change to my face after wisdom teeth extraction. Dr Zarrinbal can tell when somebody has had premolars extracted without needing to see their teeth. This is because the braces pull the face backwards.

He also mentioned that the nose will increase in width after SARPE so I may need to consider rhinoplasty to reduce my alar width.
View attachment 1718414
Image demonstrating the different SARPE techniques:
View attachment 1718091

Lower Jaw Expansion
He suggested an anterior subapical osteotomy (see image below). This osteotomy will expand my lower jaw and help close my open bite. After the cut is made the orthodontist will bring back the segment using braces. This will prevent me from needing premolar extractions.

If I get an anterior subapical osteotomy, I predict I will need a genioplasty as bringing forward my lower teeth will make my chin appear more recessed. I will not be getting this until after both jaws have been expanded. It will be too hard to predict where my chin will need to be until my teeth are aligned.

Images of anterior subapical osteotomy:

View attachment 1718099View attachment 1718103
Bimax
Dr Zarrinbal told me that bimax would be considered during the next phase of my treatment. This would be after expansion of both jaws and 12-24 months in braces. What cuts he would give me (segmental or CW rotation) depends on where my jaws are before the operation. If he gives me a segmental cut it would probably be a 2 piece wassmund osteotomy. This would remove my gummy smile and make my midface shorter. Zarrinbal commented on my longish midface. Dr Z did not confirm any movements.

Image of wassmund osteotomy below:
View attachment 1718121

Dr Zarrinbal also performs high cut BSSO which reduces the risk of nerve damage. See low cut vs high cut BSSO below (high cut is second image):
View attachment 1718110


Genioplasty/Chin Wing
He suggested a Chin shield alongside a chin wing osteotomy. Chin shield would allow me to avoid getting a deep mentolabial crease in my chin. He also suggested a combined Chin shield and Lower jaw expansion to increase the length of my mandible body. He had some very good chin wing results on his computer. My only concern with chin wing is that it feels a bit crude. I also think it may have an adverse effect on the gonion. Dr Zarrinbals chin wing results looked great however its difficult to find good results online.

I also feel that chinwing is ineffective at giving you outward facing gonions to increase jaw width. Chin wing is good for decreasing the gonial angle and improving jawline definition. If you want outward facing gonions you need jaw angle implants. Outward facing gonions are are requirement for hollow cheekbones.

Examples of some moggers/foggers with great projection on both their gonions and cheekbones:
View attachment 1718405

High Cheekbones/Zygomatic Osteotomy
Mixed feelings about the Zygomatic Osteotomy. I think implants mog. He said that he can mobilise the bone in 3 dimensions. To complete a zgyomatic osteotomy a bone graft is required from your hip. He had some decent results on his computer, but I think implants are superior for cheekbone projection. I have also made some images explaining why I think implants are superior. See below:

View attachment 1718301
View attachment 1718303


Eyelid surgery
He didn’t like tampering with the eyes because they tend to look unnatural. He had one result on his computer. It was decent but I wouldn’t recommend you get eyelid surgery with him. Personally I am not a huge fan of cosmetic eyelid surgery because the results tend to look negilable or unnatrual. Due to having NCT I may consider this in the future. I think I will have to accept this flaw. I will never have hunter eyes .

Cost
He gave me a price range for these surgeries.

• Upper Jaw expansion - €6,000 to €7,000
• Lower Jaw Expansion - €6,000 to €7,000
• Chin Wing - €8000 to €10,000
• Lefort 1 - €8000 to €10,000
• BSSO - €8000 to €10,000
• Zgyomatic Osteotomy - €8000 to €10,000

I'm assuming getting multiple surgeries in a single operation will lower the price. However Zarrinbal did not give much information here. These prices may be lower if you live in Germany. I am overseas from the UK.

Dr Zarrinbals opinion on 3D planning
Not a huge fan of 3D planning. He does it however due to the issue that 3D plans will never look the same IRL he may choose to override the 3D planning. He then told me a story of a maxfac surgeon he knew who followed a 3D plan accurately and the final result left her with poor lip competence. He stressed the importance of having a good surgeon with an eye for aesthetics and good mechanical skill.

Doesn’t like premade plates. This is because he may wish to adjust them after. This is because during 3D planning its primarily based on the skull base. This is good for a functional improvement however this cannot predict a good face. There are multiple ways that your jaws can meet, whilst giving you the correct bite. A good surgeon will give you the best aesthetic result.

He would use 3D planning for as a guideline then would personally review your face. Re-adjustments would be made based on both the client’s requests and Dr Zarrinbal’s aesthetic vision.

Other information on Dr Zarrinbal

• He is compliant (to an extent) with the patient’s requests. Dr Z admits that he has done patient requests which he didn’t agree with. However, the result was a lot better than Zarrinbal predicted.
• Doesn’t like Fillers because they look unnatrual and quickly lose definition due to filler migration.
• Doesn’t like fat grafts because they cause puffy eyes. Dr Z also says that they leave visible spots under the skin.
• Really likes Chin wing. He says it looks better than just getting a genioplasty.
• Doesn’t like facial implants and doesn’t offer them. (He does dental implants).
• Interesting case he showed me of a UKcel that “posts on online forums”. He wanted the low trust badboy look. He gave him a bheroplasty and a very aggressive chin wing. He went from looking nice to looking like a tough guy. Dr Z reluctantly did this and he didn’t like the result. His jawline was razor sharp. One of the sharpest jawlines I have ever seen. He did succeed and it looked natrual. I think looking medium trust mogs.
• Another patient got a revision chin wing. She liked the first result and wanted a more aggressive drop. Dr Z didn’t like the idea, but he did it anyway. She sent him an after picture and she was a fucking fogger. Madison Beer tier jawline.

Current Surgery Plan with Dr Zarrinbal

1. Phase 1 - Braces + Upper Jaw Expansion and Lower Jaw expansion. (Estimated cost £14800 to £16500)
2. Phase 2 - Chin Wing/Chin Shield Genioplasty (undecided) + Bimax. (Estimated cost £20600 to £25750
3. Phase 3 etc - Custom Infraorbital Malar Implants, Rhinoplasty (Pending) and Eyelid Surgery (Pending). I will be getting these elsewhere. (Estimated cost unknown)

Writing out these costs made me realise how expensive this is. Estimated cost £35,400-£42,250. I will need to increase my income and see if I can subsidise this as a medical expense. I am getting this for functional reasons along with aesthetic reasons.

Conclusion
Overall I was very impressed by Dr Zarrinbal at his consultation. We chatted for about 2 hours total. He gave me a large leaflet and his team was very friendly and proffesional. Their office was beautiful and his results on his computer was great. Dr Zarrinbal is quite friendly so he will listen to any concerns you have. I can tell why people speak highly of him and I would reccomend anyone considering bimax in europe to visit him. Most importantly I loved his surgery plan.

Unfortunately he doesn't offer any implants (except for dental implants). He is more expensive then I expected and you will have to meet him IRL because he doesn't offer online consultations. You can stay in a nearby hostel/hotel at a low cost.

Spoiler: BONUS: Some Travel Tips if you are planning on seeing Dr Z

Plan beforehand. I planned poorly and google maps was trying to get me on a bus which didn't exist. I ended up talking one of those E scooters out of range to get there. Luckily I left 2 hours early so I only arrived 15 minutes late but luckily maxfacs are usually like an hour late to appointments. I got fined €40 .

If your in the city centre get the U7, S3 or S9 Train to Berlin Spandeu Station. Then get the 134 bus directly to Dr Zarrinbals Office. Its a long straight road from the train station to his office. You can't miss it and there is a bus stop outside his place. His office is also up the elevator on the right
View attachment 1718203
View attachment 1718437
There is also a hotel nearby called the Boutique Hotel Sena which is very cheap. I chose to stay in a hostel because I wanted to stay a few days in the city centre and mingle. The hostel was cheaper but some of you antisocialcels may want a cheap room to yourself. This hotel offers this.

good luck man have a safe surgery bro

 

[Deleted member 16133]

Well I need to contact both Ramieri and Zarrinbal. I prefered Zarrinbal but Ramieri was cheaper. However Ramieri couldn't give me alot of insight until I got my digital impressions scan. They were a fucking nightmare to get.

damn nigga if u can actual get at least half of these surgeries done in theory you could be a chadlite
if you GOT THEM ALL youd be a fucking certified chad nigga i cant wait to see you become this tyrone fr

 

[deepweb1298]

Very nice thread OP I remember travelling to Z from the UK as well. Pain in the ass since it was during Covid times. I took a taxi there from one of the hotels near the airport. Expensive af.

My plan was just a chin wing he wouldnt do bimax on me, didnt go for him in the end

 

[Pakicel]

You don't need all these surgeries.

 

[Deleted member 13588]

How does this black dude have the $$ for this?

Drug dealing

 

[Deleted member 13588]

I asked dr. Z. for surgically masster removal, he said he doesnt recommand it because of assymetry, functional problems etc. He was my only hope for masseter removal done in germany. over for my ass tbh

Inject Botox

 

[Timelessbrah]

Impressive resume, but how are you gonna pay for that bro ?

 

[BugeyeBigNoseCurry]

Only side profile will improve ngl

when he spends +50k, and sees that nothing has changed

 

[Deleted member 3679]

Damn! That is a lot of work but it looks like it might mog... based on your pics you do lack forward growth but mainly your jaws look too narrow. Get some consults from more Italian surgeons but I think the jaw expansion would definitely help you ascend.

 

[Prinz Eugen]

dude is the consultation free?

 

[chinpilled69]

You need lots of time with orthodontics before you even begin with any surgery.
Look at the state of your teeth.
Your last molar are wide but then there are teeth with gums that are pulled very inwards.
There is potential for expansion with braces like Damon.

You need a cut in your lower jaw and bring it forward and give you normal occlusion.
Expansion is hardly gonna make any difference cosmetic wise.

This fucking doctor is trying to scam you.