New Alfaro Bimax result

NegativeNorwood

NegativeNorwood

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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.

Makes complete sense to me, thanks for explaining!
 
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Chinlet Ascension

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who is surgeon you thinking about when it comes to getting jaw implants?
Eppley or Yaremchuk. Not many options other than those guys, to be honest.
 
Jade

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@NegativeNorwood Hey, I just wrote a new post. Could you please chime in? I believe you have a good pulse on the subject, and I am trying to get to the bottom of these pricing concerns.

I would love you and others like @Wallenberg to help demystify this once and for all. I feel it is useful to talk about this. I hope you can help spread awareness to others on this forum. Can you invite others here? Who do you think are the knowledgeable guys here looksmax?

 
NegativeNorwood

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@NegativeNorwood Hey, I just wrote a new post. Could you please chime in? I believe you have a good pulse on the subject, and I am trying to get to the bottom of these pricing concerns.

I would love you and others like @Wallenberg to help demystify this once and for all. I feel it is useful to talk about this. I hope you can help spread awareness to others on this forum. Can you invite others here? Who do you think are the knowledgeable guys here looksmax?


Done bro :soy:
 
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Chinlet Ascension

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There are many options, actually. About 16 years ago, I used to look at it the same way you do. ✌️
OK. Who are the other doctors who offer custom implants?
 
Jade

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OK. Who are the other doctors who offer custom implants?
If you are serious ( I don't even get you guys anymore), but if you are serious about that, tell us where you live and I am sure I or someone here can find one in your country. 🤷‍♂️. Or near your country.
 
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Chinlet Ascension

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If you are serious ( I don't even get you guys anymore), but if you are serious about that, tell us where you live and I am sure I or someone here can find one in your country. 🤷‍♂️. Or near your country.
United States
 
Jade

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Well, you have lots of options. I am not even supposed to be here anymore!!!! I told a guy I was gonna leave this forum for good. Read this.

 
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Chinlet Ascension

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Well, you have lots of options. I am not even supposed to be here anymore!!!! I told a guy I was gonna leave this forum for good. Read this.

Honestly could you please just list the doctors? You have this spastic, verbose writing style that is painful to read.
 
Jade

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Honestly could you please just list the doctors? You have this spastic, verbose writing style that is painful to read.
No, I can't list doctors. I do not promote any doctors because I do not trust doctors. Besides, you are going about this the wrong way. Describe what you want to do and .... You know what? You are going about this the wrong way.
 
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Chinlet Ascension

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No, I can't list doctors. I do not promote any doctors because I do not trust doctors. Besides, you are going about this the wrong way. Describe what you want to do and .... You know what? You are going about this the wrong way.
WTF are you talking about
 
Jade

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@Chinlet Ascension

I think you are focusing on the doctor too much, and in my experience, that is not the best approach.

I went to the "best" doctors in the world, and some even stole money from me. That is correct, they charged me for things they didn't even do.

I know it sounds crazy, but I could tell you many similar stories. If you try to fight it in court, you will spend more than the procedure itself.

I don't mind "helping," but the mere fact that you are asking for a "list", tells me that you are not entirely ready, and I feel you will make many mistakes. Maybe not, I don't know, of course.

Describe your needs or point me to a thread where you have talked about your situation or what you want to have done.

A bit of context would help.
 
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Chinlet Ascension

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@Chinlet Ascension
I know it sounds crazy, but I could tell you many similar stories. If you try to fight it in court, you will spend more than the procedure itself.

I don't mind "helping," but the mere fact that you are asking for a "list", tells me that you are not entirely ready, and I feel you will make many mistakes. Maybe not, I don't know, of course.
You're either trolling or schizophrenic. This is all pretentious babble.
 
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Jon87

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No, I can't list doctors. I do not promote any doctors because I do not trust doctors. Besides, you are going about this the wrong way. Describe what you want to do and .... You know what? You are going about this the wrong way.
As the time you investigate in designing the implants matter more than the surgeon, could you explain us what could be a good design process ? What are the traps to avoid ? It's easy to see where you want to had volume on your face, but translating that on the bone is tricky because it's hard to anticipate the outcome.
 
Jade

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Yaremchuk, Eppley, Zhang, Diamond, Dhir, Ramieri, Defrancq.

Personally, I consider Yaremchuk and Ramieri.
I believe you limit yourself and other guys who have real needs when you only offer these relatively older surgeons as an option.

I do not believe you come from a place of malice, but I feel you haven't been exposed to more possibilities.

I am very much aware of people whose surgeons are the ones you mentioned, and these patients are not necessarily happy with their results.

Think about it, the doctors you mentioned still use silicone for these implants. Just thinking of describing the number of possible complications gives me a headache.

I have "worked" with guys and some ladies whose surgeons are the ones you mentioned above.

I do not think they are bad doctors, but there are many more surgeons who could do a fantastic job too.
 
Wallenberg

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I believe you limit yourself and other guys who have real needs when you only offer these relatively older surgeons as an option.

I do not believe you come from a place of malice, but I feel you haven't been exposed to more possibilities.

I am very much aware of people whose surgeons are the ones you mentioned, and these patients are not necessarily happy with their results.

Think about it, the doctors you mentioned still use silicone for these implants. Just thinking of describing the number of possible complications gives me a headache.

I have "worked" with guys and some ladies whose surgeons are the ones you mentioned above.

I do not think they are bad doctors, but there are many more surgeons who could do a fantastic job too.
Ramieri, Zhang, Diamond, and Dhir aren't old.

Ramieri and Defrancq use PEEK. Yaremchuk uses silicone and medpor.
 
Jade

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@Jon87

"Could you explain to us what could be a good design process?"

I have talked about this on other threads.

Although there are some good starting points in implant design like facial geometry ("the golden ratio"), muscles, bone structure functionality, and surgery methods, these are only starting points.

"It's easy to see where you want to had volume on your face, but translating that on the bone is tricky because it's hard to anticipate the outcome."

Yes. It is tricky, that is why most people who have had implants (even custom implants) have had more than two surgeries for the same purpose. There are specific technics to minimize possible unwanted results, but nothing is ever 100% perfect because we are talking about flesh and bones.

It would be helpful for us all to understand that it is impossible to design an implant without understanding the patient's perspective on what they feel good looks are. Also, not all surgeons have the same ideologies on how to go about designing or even surgery methods.

Look, I have a background in medical sales, and I have worked with doctors, patients and clinics.

Everything I say can get misconstrued and misinterpreted, and I am biased to a large degree, and this could be a problem.

I feel obligated to tell you about my background because I don't want you to take what I say as the "bible."

I know you are a real patient, and I truly feel for you.

If you have other more specific questions, we can discuss them here, but please keep in mind that I can be somewhat biased.
 
PURE ARYAN GENETICS

PURE ARYAN GENETICS

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wish somebody measured my airway like that :feelsbadman:
 
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Jon87

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@Jon87

"Could you explain to us what could be a good design process?"

I have talked about this on other threads.

Although there are some good starting points in implant design like facial geometry ("the golden ratio"), muscles, bone structure functionality, and surgery methods, these are only starting points.

"It's easy to see where you want to had volume on your face, but translating that on the bone is tricky because it's hard to anticipate the outcome."

Yes. It is tricky, that is why most people who have had implants (even custom implants) have had more than two surgeries for the same purpose. There are specific technics to minimize possible unwanted results, but nothing is ever 100% perfect because we are talking about flesh and bones.

It would be helpful for us all to understand that it is impossible to design an implant without understanding the patient's perspective on what they feel good looks are. Also, not all surgeons have the same ideologies on how to go about designing or even surgery methods.

Look, I have a background in medical sales, and I have worked with doctors, patients and clinics.

Everything I say can get misconstrued and misinterpreted, and I am biased to a large degree, and this could be a problem.

I feel obligated to tell you about my background because I don't want you to take what I say as the "bible."

I know you are a real patient, and I truly feel for you.

If you have other more specific questions, we can discuss them here, but please keep in mind that I can be somewhat biased.
I completely agree with you. You opinion is really important due to your experience and I appreciate it. But at least, it's one among others. What I try to do is collecting knowledge to optmize as much as possible the results of the surgery. At the end it's up to me to make my own opinion of what is good or not.


About the outcome, I am not looking for perfection. I know I'll never be the best looking ever, I just want a good improvement. As far as I am not messed up I can live with it and shouldn't be too disappointed.
 
Jade

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I completely agree with you. You opinion is really important due to your experience and I appreciate it. But at least, it's one among others. What I try to do is collecting knowledge to optmize as much as possible the results of the surgery. At the end it's up to me to make my own opinion of what is good or not.
I believe you are well informed, and I hope everything goes well. How much will you pay for your jaw implant procedure?

I feel it would help others and myself to know these things because they are essential. I compare prices based on location and type of surgery.

If you have any other questions or thoughts, please let me know.
 
Jade

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@Jon87
By the way, from your picture, I'd say you are a good-looking guy.

You said you'll never be the "best looking ever," but that is a subjective opinion. From your smile, you look like a charismatic guy with a great personality, and the ladies like that. You have nice eyes, and your overall face is NOT bad at all.

No, I am not a woman or "foid" or whatever other funny word guys use here, I am a man.

I just think that you are a good-looking dude who could do very well with the ladies and in life in general. 💪
 
tehVigilante

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This surgeries are legit if u have any sort of maloclusion, don't expect big improvements. It doesnt turn any normies in chads on itself.
 
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I believe you are well informed, and I hope everything goes well. How much will you pay for your jaw implant procedure?

I feel it would help others and myself to know these things because they are essential. I compare prices based on location and type of surgery.

If you have any other questions or thoughts, please let me know.
Dr. Pagnoni quoted 22k for PEEK infraorbital, jaw angle implants and widening genio and he is at the moment my choice number 1. Dr. Ramieri 18k but for PEEK malar implants instead of infraorbital and normal genio. In France I got quotations for jaw angles + genio for 6k with porous titanium. But now you mentioned you can get that for at least 15k, I gonna investigate who else can propose PEEK or non porous polyethylene implants. I am OK to travel and take few weeks off for recovery.
 
Wallenberg

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Dr. Pagnoni quoted 22k for PEEK infraorbital, jaw angle implants and widening genio and he is at the moment my choice number 1. Dr. Ramieri 18k but for PEEK malar implants instead of infraorbital and normal genio. In France I got quotations for jaw angles + genio for 6k with porous titanium. But now you mentioned you can get that for at least 15k, I gonna investigate who else can propose PEEK or non porous polyethylene implants. I am OK to travel and take few weeks off for recovery.
Who in France does jaw angle implants?
 
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Jon87

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@Jon87
By the way, from your picture, I'd say you are a good-looking guy.

You said you'll never be the "best looking ever," but that is a subjective opinion. From your smile, you look like a charismatic guy with a great personality, and the ladies like that. You have nice eyes, and your overall face is NOT bad at all.

No, I am not a woman or "foid" or whatever other funny word guys use here, I am a man.

I just think that you are a good-looking dude who could do very well with the ladies and in life in general. 💪
Thanks. Maybe also the pics from Alfaro, asking for special angles with the mouth open are not the best to judge. I think with few things I can now achieve a more balance face and I will be happy with that specially compared to my starting point. Before having these surgeries for medical reason I never really realized how uncomfortable I was due to my important retrognathism and now this problem is solved I feel much better. And as you say the rest is about your personality.
 
Jade

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@Jon87
Mmm, I don't think this 6k thing is a promising approach for the doctor or the patient. The numbers don't add up, and this makes me think that you will have to pay for other things in the back end.

With titanium, Medpore, or even with bone cement Polymethyl methacrylate (PMMA), I would think twice about this pricing thing in Paris.

I believe I have a good idea of how much these things cost in different parts of the world and how and why doctors charge what they charge, but 6k is not very doable no matter how I look at it, especially in France.

However, thinking of pricing alone could be a mistake. 22k is not necessarily better than 12k, and quality and safety in the medical field do not equal price simply.

The saying "you get what you pay for" does NOT apply here entirely.

In my opinion, ethics, norms, experience, process, and artistry are things you should consider primarily. Most of all, I believe you should consider yourself more than the doctor itself.

I have worked with guys who have paid over 30k in the US for their implants, and they are not happy with them.

Also, think about this for a second, please. If you are going to spend a similar amount to what a car costs, shouldn't that expense come with some guarantees of some sort?

Perhaps a deductable for the second try if you are not satisfied or other preventive measures?

How much would Alfaro charge you?
 
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Jon87

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@Jon87
Mmm, I don't think this 6k thing is a promising approach for the doctor or the patient. The numbers don't add up, and this makes me think that you will have to pay for other things in the back end.

With titanium, Medpore, or even with bone cement Polymethyl methacrylate (PMMA), I would think twice about this pricing thing in Paris.

I believe I have a good idea of how much these things cost in different parts of the world and how and why doctors charge what they charge, but 6k is not very doable no matter how I look at it, especially in France.

However, thinking of pricing alone could be a mistake. 22k is not necessarily better than 12k, and quality and safety in the medical field do not equal price simply.

The saying "you get what you pay for" does NOT apply here entirely.

In my opinion, ethics, norms, experience, process, and artistry are things you should consider primarily. Most of all, I believe you should consider yourself more than the doctor itself.

I have worked with guys who have paid over 30k in the US for their implants, and they are not happy with them.

Also, think about this for a second, please. If you are going to spend a similar amount to what a car costs, shouldn't that expense come with some guarantees of some sort?

Perhaps a deductable for the second try if you are not satisfied or other preventive measures?

How much would Alfaro charge you?
I am not considering having this surgery in France because of the reasons you explain and many others. After consulting plenty surgeons for my revision I understood we are not good in maxillofacial.

As you say there are many parameters to care about. I just would like to consult other surgeons than the Italian ones to compare all the options.

The problem with Alfaro is that he doesn't provide a full package wraparound-infraorbital. He does only jaw angles.
 
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Jon87

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@Jon87
Mmm, I don't think this 6k thing is a promising approach for the doctor or the patient. The numbers don't add up, and this makes me think that you will have to pay for other things in the back end.

With titanium, Medpore, or even with bone cement Polymethyl methacrylate (PMMA), I would think twice about this pricing thing in Paris.

I believe I have a good idea of how much these things cost in different parts of the world and how and why doctors charge what they charge, but 6k is not very doable no matter how I look at it, especially in France.

However, thinking of pricing alone could be a mistake. 22k is not necessarily better than 12k, and quality and safety in the medical field do not equal price simply.

The saying "you get what you pay for" does NOT apply here entirely.

In my opinion, ethics, norms, experience, process, and artistry are things you should consider primarily. Most of all, I believe you should consider yourself more than the doctor itself.

I have worked with guys who have paid over 30k in the US for their implants, and they are not happy with them.

Also, think about this for a second, please. If you are going to spend a similar amount to what a car costs, shouldn't that expense come with some guarantees of some sort?

Perhaps a deductable for the second try if you are not satisfied or other preventive measures?

How much would Alfaro charge you?
Second try is a good point and is worth to negociate.
 
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Chinlet Ascension

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Yaremchuk, Eppley, Zhang, Diamond, Dhir, Ramieri, Defrancq.

Personally, I consider Yaremchuk and Ramieri.
Is it worth traveling abroad? How hard is it to get a Ramieri appointment as a foreigner?
 
Jade

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You deserve to get banned from the forum for your awful responses. This is just shitposting with a polite tone.
Bud, you are rude and disrespectful. I was trying to offer some well-intended comments, but you turned me off with your vocabulary.

What kind of a person expresses themselves as you did? I realize you don't know me in person. Nevertheless, we should all try to keep it respectful.
 
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Chinlet Ascension

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Bud, you are rude and disrespectful. I was trying to offer some well-intended comments, but you turned me off with your vocabulary.

What kind of a person expresses themselves as you did? I realize you don't know me in person. Nevertheless, we should all try to keep it respectful.
I engaged you, multiple times, trying to have a back-and-forth about the topic at hand. You insisted on speaking like a fortune cookie and responding with non-answers that don't mean anything. Comments like the one below are just spam that pollute the forum with non-information. (If you really need me to point this out, you sound incredibly pretentious.)
No, I can't list doctors. I do not promote any doctors because I do not trust doctors. Besides, you are going about this the wrong way. Describe what you want to do and .... You know what? You are going about this the wrong way.
 
E

epictroll

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I engaged you, multiple times, trying to have a back-and-forth about the topic at hand. You insisted on speaking like a fortune cookie and responding with non-answers that don't mean anything. Comments like the one below are just spam that pollute the forum with non-information. (If you really need me to point this out, you sound incredibly pretentious.)

> You insisted on speaking like a fortune cookie and responding with non-answers that don't mean anything

:ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO::ROFLMAO:
 
NoPainNoChick

NoPainNoChick

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Literally 0 changes from the front.
If anything it made his face looks slightly longer.
 
Jade

Jade

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I engaged you, multiple times, trying to have a back-and-forth about the topic at hand. You insisted on speaking like a fortune cookie and responding with non-answers that don't mean anything. Comments like the one below are just spam that pollute the forum with non-information. (If you really need me to point this out, you sound incredibly pretentious.)
Ok, maybe I didn't understand your exact intentions. My apologies.

The thing is, when you ask for a "list," I see it as you playing roulette. A list won't do you much good if you don't have a well-studied plan before you contact any doctors. Even when you do, they don't have the tools to help you as well as you think they would.

Seeing people keep making the same mistakes I once made can be frustrating. I want you to have the perfect experience, but sometimes it is tough to see how some people go about their process.
 
Jade

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Hi, @Jon87

You make the distinction of mentioning infraorbital vs. malar implants. Can you explain why you think one is different than the other?

I believe you want "infraorbital," but are you merely referring to the method for implantation or the exact placement on the bony structure surface?

To me, in general terms, [cheek implants] refer to the mid-face area. Of course, there are different zones, i.e., zygomatic area, under the eye area, and more.

Why would one of your doctors offer one area but not the other one? Maybe, you guys are using different words for a relatively similar purpose?
 
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Jon87

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Hi, @Jon87

You make the distinction of mentioning infraorbital vs. malar implants. Can you explain why you think one is different than the other?

I believe you want "infraorbital," but are you merely referring to the method for implantation or the exact placement on the bony structure surface?

To me, in general terms, [cheek implants] refer to the mid-face area. Of course, there are different zones, i.e., zygomatic area, under the eye area, and more.

Why would one of your doctors offer one area but not the other one? Maybe, you guys are using different words for a relatively similar purpose?
Maybe my vocabulary is not accurate. For me an infraorbital rim has a saddle going to the base of the nose. When it doesn't have this extension, isn't it call malar implant ? From both consultations I had in Rome they propose to put it intraoral but Dr. Ramieri doesn't do any implant with saddle because he says it's too tricky to place without damaging the facial nerves.
 
Last edited:
Jade

Jade

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Maybe my vocabulary is not accurate. For me an infraorbital rim has a saddle going to the base of the nose. When it doesn't have this extension, isn't it call malar implant ? From both consultations I had in Rome they propose to put it intraoral but Dr. Ramieri doesn't do any implant with saddle because he says it's too tricky to place without damaging the facial nerves.
I am still confused about this all. Which one do you want?
 

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Chinlet Ascension

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The thing is, when you ask for a "list," I see it as you playing roulette. A list won't do you much good if you don't have a well-studied plan before you contact any doctors. Even when you do, they don't have the tools to help you as well as you think they would.
People make good decisions when they have access to the best information. When we ask for information, you just talk down to us like a parent talking down to a nosy child. You specify that you have the information, but you're just not going to share. It's insulting. If you don't have anything of substance to say, then shut up.
 
Jade

Jade

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People make good decisions when they have access to the best information. When we ask for information, you just talk down to us like a parent talking down to a nosy child. You specify that you have the information, but you're just not going to share. It's insulting. If you don't have anything of substance to say, then shut up.
Please, watch the vocabulary, friend. I am trying to do my best, and there is an ethical and real reason why I can't be more specific.

I will share more of my background and why things are the way they are. I don't mean to sound condescending or anything like that. I get these notifications via email and respond quickly.

Really, no need for insults or the whole "shut up" tone. I am sorry if I made you feel bad. Please help me out, and let's keep it civil.
 
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Chinlet Ascension

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Please, watch the vocabulary, friend. I am trying to do my best, and there is an ethical and real reason why I can't be more specific.

I will share more of my background and why things are the way they are. I don't mean to sound condescending or anything like that. I get these notifications via email and respond quickly.

Really, no need for insults or the whole "shut up" tone. I am sorry if I made you feel bad. Please help me out, and let's keep it civil.
You are not a clown you are the entire circus
 

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