New Alfaro Bimax result

thereallegend

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His face got narrower?
 
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Jon87

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Any idea why the recovery with Alfaro was so much easier? Was it because of his “minimally invasive” approach?

Can you share pics before your first bimax?

Also, do you think doing this staggered two surgeries approach was necessary to achieve your final result, or if you would’ve gone to Alfaro first do you think you could’ve had the same amount of total movement in one surgery?

I really appreciate you sharing your experience and answering questions, you look great.
Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,...

Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything.

My before bimaxs and my after Alfaro's one :
 

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epictroll

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Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,...

Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything.

My before bimaxs and my after Alfaro's one :
Holy shit!!! This is absolutely insane!

Thanks for sharing, congrats on your new life.
 
lasthope

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Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,...

Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything.

My before bimaxs and my after Alfaro's one :
Do you have any sensation loss?

Or does your mouth and so on feel completely normal after surgery
 
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Jon87

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Any idea why the recovery with Alfaro was so much easier? Was it because of his “minimally invasive” approach?

Can you share pics before your first bimax?

Also, do you think doing this staggered two surgeries approach was necessary to achieve your final result, or if you would’ve gone to Alfaro first do you think you could’ve had the same amount of total movement in one surgery?

I really appreciate you sharing your experience and answering questions, you look great.

Do you have any sensation loss?

Or does your mouth and so on feel completely normal after surgery
I am not even 3 months post op so no feeling in the lower lips and the top of the chin yet. After my first bimax 95% sensation came back.
 
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I am not even 3 months post op so no feeling in the lower lips and the top of the chin yet. After my first bimax 95% sensation came back.
How much does it bother you?

When I go to dentist, they sometimes numb my gums. It feels like they are super swollen, and the swollen feeling extends to my lips. Although it is supposed to feel like they are "numb" I definitely feel something and it is kind of annoying.

Is the numbness something you can actually feel or think about? Does it bother you at all?
 
6ft4

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dakchuh

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Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,...

Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything.

My before bimaxs and my after Alfaro's one :
imo you look slightly dogmaxxed in the after due to weak upper third, but still much better than before. how much movement did you get from the first bimax and how much movement from second bimax? got any pics of before both surgeries?
 
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6ft4

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So post 1st surgery to post 2nd surgery took you from an airway of 19 to an airway of 47
I will take a guess and say before your first bimax your airway was 10-12 because presumably the first bimax enhanced your airway
If so, that would mean surgery can increase someone's airway by 4x and your lower maxilla didn't even look recessed before your first surgery, your top lip appears in front of your browridge

It's crazy how goodlooking, properly facially developed people are naturally breathing 4x more effectively than people with facial issues.
Goodlooking people are literally 4x better at keeping themselves alive than non goodlooking people

I had SARPE and felt like it enhanced my breathing 2x, recovering from sprinting is much easier since then
Taking my maxilla from clinically recessed to hopsfully above average advancement will hopefully make me feel like I've unlocked god mode in terms of breathing capabilities
 
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How much does it bother you?

When I go to dentist, they sometimes numb my gums. It feels like they are super swollen, and the swollen feeling extends to my lips. Although it is supposed to feel like they are "numb" I definitely feel something and it is kind of annoying.

Is the numbness something you can actually feel or think about? Does it bother you at all?
It's anoying when you eat. But beside that I don't think about it. The nerves recovery is long and I am patient. I am confident it will come back step by step. Few weeks ago I was not feeling my chin at all.
 
Reckless Turtle

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Yes, minimal invasiv surgery makes a huge difference. Little incisions make less swelling, no blood in your stomach, shorter time under anesthesia,...

Indeed, the best would have been to go directly to Alfaro. He could have done 2cm advancement. But I thought that my surgeon in Paris could fix my sleep apnea. He didn't finally respect the plan from consultation and move the jaw so little it didn't change anything.

My before bimaxs and my after Alfaro's one :
Was rhinoplasty part of the procedure or are the changes in nasal appearance strictly from jaw surgery?
 
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imo you look slightly dogmaxxed in the after due to weak upper third, but still much better than before. how much movement did you get from the first bimax and how much movement from second bimax? got any pics of before both surgeries?
Yes I plan to have cheek infraorbital implants to balance the face now. You have a pic of the before in a post above. Total advancement were maxilla 6 + 4.5mm, mandibule 6 + 15.5mm
 
Reckless Turtle

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No rhinoplasty. Or it would have been a very badly one done haha.
The amount of forward movement of your anterior nasal spine is impressive.
 
dakchuh

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His face got narrower?
thats a good thing. his jaws were chubby, you can see how it bulges out a little. alfaro's bimax made his face leaner. lifefuel tbh i got the same chubby look around my jaws.
 
Zenturio

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he had that much ccw yet his nose wasnt cucked? Also upper lip barely changed despite this being 5-7 degrees of ccw rotation. Interesting
Also his smile looks wider?
my bimax result is more impressive @Thompsonz and @MarkCorrigan can confirm
please dm me your result
I am the guy on the pics. Surgery has been done for sleeping apnea. I was not able to sleep anymore. Awaken many times during the night. Headacke the whole morning, exhausted the whole day, impossibilty to concentratre at work ,...
can you tell me what movements you had?
 
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he had that much ccw yet his nose wasnt cucked? Also upper lip barely changed despite this being 5-7 degrees of ccw rotation. Interesting
Also his smile looks wider?

please dm me your result

can you tell me what movements you had?
I had 4.5mm maxilla advancement and 15.5 mandibule. 7-8° ccw
 
Zenturio

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I had 4.5mm maxilla advancement and 15.5 mandibule. 7-8° ccw
Did your nose get wider? Did your mouth get wider? What about lip changes?
 
lasthope

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Nose a little bit wider I noticed in comparing pictures. Mouth a bit wider. And upper lips definitly more fleshy.
Is 87 your birth age?

Is your feeling back again?
 
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@Jon87 Great result, good on you for taking action. When looking at the after pictures that Alfaro has published of your result it kinda looks like you have edge-to-edge bite now with posterior open bite, am I mistaken or do you have occlusal problems atm?
 
Zenturio

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Nose a little bit wider I noticed in comparing pictures. Mouth a bit wider. And upper lips definitly more fleshy.
any negative things you noticed?
 
chemosh

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Nose a little bit wider I noticed in comparing pictures. Mouth a bit wider. And upper lips definitly more fleshy.
How is this post op regarding eating foods? You said soft foods after one weeks? When did you got back to normal foods? How is eating with numbing lips?

Can you compare your post op with alfaro and the traditional one you got before?
 
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Is 87 your birth age?

Is your feeling back again?
Yes I am 35.

Feeling is back 80% in the chin. Sensations are coming back slowly in the lips. Like the first bimax the right side takes more time.
 
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@Jon87 Great result, good on you for taking action. When looking at the after pictures that Alfaro has published of your result it kinda looks like you have edge-to-edge bite now with posterior open bite, am I mistaken or do you have occlusal problems atm?
No edge to edge bite. I have open posterior bite yes. My ortho is working on pulling 8 molars and premolars and close the space. It's something common when you have big ccw.
 
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How is this post op regarding eating foods? You said soft foods after one weeks? When did you got back to normal foods? How is eating with numbing lips?

Can you compare your post op with alfaro and the traditional one you got before?
One week liquid diet. And soft food step by step. It's not that anoying because you can eat whatever you want as far as you mix or cut your food. Numb lower lips is anoying. I use my tongue to guide the glass, spoon,... Post op with mini invasiv surgery is way easier. Much less tiring. Much less inflammation. And you look normal after 10 days.
 
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No edge to edge bite. I have open posterior bite yes. My ortho is working on pulling 8 molars and premolars and close the space. It's something common when you have big ccw.
Was the posterior open bite prominent post surgery or did it come with time? Could be relapse if so.

Pulling 8 teeth seems rather excessive, wasn't your bite already fine after your 1st bimax? If you have the possibility to, try to get a 2nd opinion on the tooth extraction.
 
Zenturio

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Aestheticaly, a notch is visible in the mandibule now. I have no ogee curve anymore. I think that's it. But I plan to get infra and jaw angles implants at the end of the year to fix that.
With notch you mean the step off where the bsso cut was made?
 
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Was the posterior open bite prominent post surgery or did it come with time? Could be relapse if so.

Pulling 8 teeth seems rather excessive, wasn't your bite already fine after your 1st bimax? If you have the possibility to, try to get a 2nd opinion on the tooth extraction.
Well it's not really an open bite as the last molars are in contact. And by pulling I mean few mm to get the contact again. After one month ortho one side is almost closed. No extraction of course.
 
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His failos were eyes and eyebrows
 
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Maybe a 0.5/10 increase (not PSL autism points)
 
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I am thinking about getting jaw angles at the end of the year. I don't need that much width according to my scanns. It's more about lengthening the ramus which is very high (see 3D above). I don't find similar cases which don't look too bloated with implants. Also ramus lengthenings seem always conservative compare to widening. Any idea what could be done ? @Jade
 
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I am thinking about getting jaw angles at the end of the year. I don't need that much width according to my scanns. It's more about lengthening the ramus which is very high (see 3D above). I don't find similar cases which don't look too bloated with implants. Also ramus lengthenings seem always conservative compare to widening. Any idea what could be done ? @Jade
If you and your surgeon agree that you need or want a longer ramus (vertically speaking), then that's what you should get.

I believe the important thing here is understanding what looks best for you (according to your likes and expectations).

"I don't need that much width, according to my scans." - I would NOT make an opinion on the scans alone, but if you believe this when you look at your face in real life, then I can understand it.

If you are 100% sure that you need a "longer ramus" or vertical enhancing jaw implant, you should get vertical enhancing implants.

You mentioned that you had bimax surgery before. You also mentioned that you are planning to get jaw angles and "cheek/infra."

Where are you from, and what does "cheek/infra" mean to you exactly?

I believe cheek implants are specific to whatever effect you expect them to produce. So, when you say 'infra" I am assuming you have hollowness in the mid-face. If you had a bimax before, typically, people in your situation do have a sunken mid-face.
 
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Jade

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@Jon87 Is that you in the picture?

I just read some of your previous comments here, and I am still confused. I didn't know that was you.

First of all, why do so MANY OF YOU guys here pay so much money for these surgeries??? What is wrong with you?

You guys keep saying 25k- 40k. WHY?? Oh, God.

These surgeries were expensive 10 years ago, but NOT NOW!
 
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View attachment 1741694

@Jon87 Is that you in the picture?

I just read some of your previous comments here, and I am still confused. I didn't know that was you.

First of all, why do so MANY OF YOU guys here pay so much money for these surgeries??? What is wrong with you?

You guys keep saying 25k- 40k. WHY?? Oh, God.

These surgeries were expensive 10 years ago, but NOT NOW!
Well, about my surgery with Alfaro I went with him because I had sleeping apnea and I was a complicated case. I had already a first bimax which didn't cure me. And no other surgeon was able to do a revision with so much advancement and ccw. It's of course a lot of money but it really changed my everyday life. So spending one year saving for that was worth.


About implants I meant infraorbital rim. You can see on my ¾ pic I have no ogee curve anymore and the eye area needs more support. I am quite confident about Pagnoni's skills in this area, he shown me good results.


The jaw area is more tricky for me. I wonder how much is it possible to extend the ramus and how good does it look. I haven't found examples with more than 8-9mm. Is it because there is a risk of masseter deattachment ? Tbh I don't really see how is the muscle attachment in this area and what can be done.
 
lasthope

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Well, about my surgery with Alfaro I went with him because I had sleeping apnea and I was a complicated case. I had already a first bimax which didn't cure me. And no other surgeon was able to do a revision with so much advancement and ccw. It's of course a lot of money but it really changed my everyday life. So spending one year saving for that was worth.


About implants I meant infraorbital rim. You can see on my ¾ pic I have no ogee curve anymore and the eye area needs more support. I am quite confident about Pagnoni's skills in this area, he shown me good results.


The jaw area is more tricky for me. I wonder how much is it possible to extend the ramus and how good does it look. I haven't found examples with more than 8-9mm. Is it because there is a risk of masseter deattachment ? Tbh I don't really see how is the muscle attachment in this area and what can be done.
Did you had before bimax a ogre curve?

Would you personally say the recovery would be worth it “only” for aesthetic reasons?
 
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Did you had before bimax a ogre curve?

Would you personally say the recovery would be worth it “only” for aesthetic reasons?
The recovery for implants constists in swelling for few weeks. I can handle it.
 
Jade

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Well, about my surgery with Alfaro I went with him because I had sleeping apnea and I was a complicated case. I had already a first bimax which didn't cure me. And no other surgeon was able to do a revision with so much advancement and ccw. It's of course a lot of money but it really changed my everyday life. So spending one year saving for that was worth.


About implants I meant infraorbital rim. You can see on my ¾ pic I have no ogee curve anymore and the eye area needs more support. I am quite confident about Pagnoni's skills in this area, he shown me good results.


The jaw area is more tricky for me. I wonder how much is it possible to extend the ramus and how good does it look. I haven't found examples with more than 8-9mm. Is it because there is a risk of masseter deattachment ? Tbh I don't really see how is the muscle attachment in this area and what can be done.
You have some very good and specific questions. I'll respond in a bit. I think it will be useful for doctors and patients to learn from this.
 
Jade

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Well, about my surgery with Alfaro I went with him because I had sleeping apnea and I was a complicated case. I had already a first bimax which didn't cure me. And no other surgeon was able to do a revision with so much advancement and ccw. It's of course a lot of money but it really changed my everyday life. So spending one year saving for that was worth.
You have some clear asymmetry in the jaw area. It is extremely difficult to achieve perfection with a bimax, but I have seen better results than yours. (respectfully).
About implants I meant infraorbital rim. You can see on my ¾ pic I have no ogee curve anymore and the eye area needs more support. I am quite confident about Pagnoni's skills in this area, he shown me good results.
Could you "benefit" from having cheek implants? I guess you would. Of course, that is up to you, and I can see what you are referring to. (it would be helpful if you took your picture and drew on it to describe what you want )

You do have a nice amount of youthful fat in the mid-face, but I do agree with you, the ogee curve isn't there a whole lot.

"Pagnoni's skills in this area, he shown me good results." You are focusing on the wrong thing. Do NOT focus on the surgeon - any maxillofacial surgeon can do a good job with the right tools.

The jaw area is more tricky for me. I wonder how much is it possible to extend the ramus and how good does it look. I haven't found examples with more than 8-9mm. Is it because there is a risk of masseter deattachment ? Tbh I don't really see how is the muscle attachment in this area and what can be done.

Mine extends 10 mm vertically, and I know for a FACT that I should have gone longer. But I am happy for right now, though.

The problem here is understanding the materials used and the strength needed to hold them in place. Also, the approach taken by the doctor is important too.

What approach are you thinking of for the "infraorbital rim"?

Let's take this one question at a time so we can keep track of it all. Does that sound ok to you?
 
freeone12

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Maybe a 0.5/10 increase (not PSL autism points)
dude... look at his before first bimax in paris and after alfaro, day & night

who is surgeon you thinking about when it comes to getting jaw implants?
 
Jade

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LOL!! @NegativeNorwood What do you want to know?? Just ask, dude. It's ok!! Be specific, though.

I have not read your history, so tell me your situation.
 
NegativeNorwood

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"Pagnoni's skills in this area, he shown me good results." You are focusing on the wrong thing. Do NOT focus on the surgeon - any maxillofacial surgeon can do a good job with the right tools.

The problem here is understanding the materials used and the strength needed to hold them in place. Also, the approach taken by the doctor is important too.

This is very interesting. Let me know if I get this right or not. According to you, is it better to go to any maxfac that has "the right tools" (ie: does PEEK implants instead of silicone?) and not pay attention to the surgeon's previous experience or work. For example, if I find a taiwan/brazil/etc much cheaper surgeon that uses PEEK and I can communicate my aesthetic desires correctly, it would be the same outcome as going to an european surgeon with more experience and higher prices?

LOL!! @NegativeNorwood What do you want to know?? Just ask, dude. It's ok!! Be specific, though.

I have not read your history, so tell me your situation.

Not going to post pics in public, but I have a narrow palate, narrow jaw and undereye hollowness. I'm not recessed in side profile and have class 1 bite. Had 6 extractions (4 wisdom tooth and 2 molars) I will get SARPE and MSDO first, then 2 molar implants and after that I want to have jaw implants and custom infraorbital-malar implants. I'm 30 years old. Currently losing weight (already lost 30 pounds but have to lose another 20-30) and saving money. Will have SARPE, MSDO and tooth implants done where I live (Spain) but probably will travel to a different country for the implants (Pagnoni in Italy seems to have great results and is quite popular with users here).

My main questions are:
- What red flags should I be aware of when talking to a surgeon?
- If an implant goes wrong or I do not like the result, is the revision free or how much should I expect to pay for it?
- What surgeons work with custom PEEK implants in countries where surgery is much cheaper? I've only found Augusto Pary (Brazil) but do not like his infraorbital implants results too much (too feminine looking IMO and doesn't seem to do the ones that come with a saddle). I've also found Dr Adrian Hsieh (Taiwan) on Instagram who has great results but doesn't seem to use PEEK.
 
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materialistic

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Mouth clearly got wider. Lifefuel tbh.
 
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@NegativeNorwood

I don't have PEEK myself, but PEEK is fine. I could have chosen PEEK, but I didn't want to pay extra for the same outcome and benefit. I would never do silicone, though.

Of course, you'd want to go to a reputable surgeon with EXPERIENCE! I think that goes without saying. I can see how my comments can be confusing in that regard, though.

Implants are a cakewalk for most maxillofacial surgeons who do this for a living.


"My main questions are:"

- What red flags should I be aware of when talking to a surgeon?
Too many to mention here because they have to sell their services (which is normal)

- If an implant goes wrong or I do not like the result, is the revision free, or how much should I expect to pay for it? You will likely pay for the whole thing all over again. You have to come to a deal with your doctor first. Or find a company that will offer warranties to you or your doctor.


"- What surgeons work with custom PEEK implants in countries where surgery is much cheaper? I've only found Augusto Pary (brazil) but do not like his infraorbital implants results too much (too feminine looking IMO and doesn't seem to do the ones that come with a saddle)."

Taiwan seems too far for me, and I don't know much about that.

Augusto Pary has some nice results, however, his implants (the actual) implants seem to be made out of "bone cement," which is beyond pathetic, but like anything else, they could work too. I would not recommend that approach, though. However, from the things he shows, Augusto Pary seems to be a very good surgeon.

If you do live in Spain, find someone near you. I personally traveled overseas for my last surgery. Ok, so I'm from the US, and I didn't have to travel too far.

I don't blame you for not showing your face online. I guess you'd just have to talk to some surgeons and get quotes from them.

Please, do not be a child and do not misinterpret what I am about to tell you:

I recently accompanied two patients who underwent surgeries like you. A lady from Dallas Tx and a young guy too.

You have to plan a lot, which is the main problem with these types of surgeries.
 
NegativeNorwood

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@NegativeNorwood

I don't have PEEK myself, but PEEK is fine. I could have chosen PEEK, but I didn't want to pay extra for the same outcome and benefit. I would never do silicone, though.

Of course, you'd want to go to a reputable surgeon with EXPERIENCE! I think that goes without saying. I can see how my comments can be confusing in that regard, though.

Implants are a cakewalk for most maxillofacial surgeons who do this for a living.


"My main questions are:"

- What red flags should I be aware of when talking to a surgeon?
Too many to mention here because they have to sell their services (which is normal)

- If an implant goes wrong or I do not like the result, is the revision free, or how much should I expect to pay for it? You will likely pay for the whole thing all over again. You have to come to a deal with your doctor first. Or find a company that will offer warranties to you or your doctor.


"- What surgeons work with custom PEEK implants in countries where surgery is much cheaper? I've only found Augusto Pary (brazil) but do not like his infraorbital implants results too much (too feminine looking IMO and doesn't seem to do the ones that come with a saddle)."

Taiwan seems too far for me, and I don't know much about that.

Augusto Pary has some nice results, however, his implants (the actual) implants seem to be made out of "bone cement," which is beyond pathetic, but like anything else, they could work too. I would not recommend that approach, though. However, from the things he shows, Augusto Pary seems to be a very good surgeon.

If you do live in Spain, find someone near you. I personally traveled overseas for my last surgery. Ok, so I'm from the US, and I didn't have to travel too far.

I don't blame you for not showing your face online. I guess you'd just have to talk to some surgeons and get quotes from them.

Please, do not be a child and do not misinterpret what I am about to tell you:

I recently accompanied two patients who underwent surgeries like you. A lady from Dallas Tx and a young guy too.

You have to plan a lot, which is the main problem with these types of surgeries.

Thanks for such a detailed response! Don't worry, 0 offense taken.
Just a couple of questions more if you don't mind:

- Which materials other than PEEK you consider good for implants? I've read you mentioning "UHMWPE" before but I don't know anything about it or any surgeon that uses it.
- By planning, yo mean taking into account down time after surgery, swelling and the amount of time needed to get "back to the normal everyday tasks", taking into account things could probably go wrong and take even more time? Will appreciate if you please can expand a bit more on this.

Again, thanks for the help!
 
Jade

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@NegativeNorwood

"- Which materials other than PEEK do you consider good for implants? "

There is a variety of FDA (in the USA) approved materials that are class II or long-term implantables.

Any of these materials could work for your doctor. The problem is not the material but making the implants themselves. Also, most doctors haven't used these materials. They are just not used to using them - that's all.

Only a few companies in the world can make good implants, but they do not work with you necessarily.

Some doctors use PMMA (bone cement), Silicone, Peek, Medpor, or Polyethylene (UHMWPE). There are other materials available, though.

I went with Polyethylene (UHMWPE), the same material you've probably seen on a knee, shoulder, or hip replacements.

"- By planning, you mean taking into account downtime after surgery."

No. I do not mean the post-op scenarios. I mean the pre-op planning.
You see, you mentioned that you don't like Augusto Pary's cheek implants, but that is wrong. An aesthetic implant is what YOU want, not what the doctor wants only. Also, you'd have to be smart and understand that NO DOCTOR in the universe has complete control over your aesthetic outcome.

Planning is everything, unfortunately, it is very expensive for most doctors to devote all of their time and efforts to you alone. Also, most surgeons don't know what good looks are.
 

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