Pagnoni have had some botches lately

[lurking truecel]

Apparently like 3 botches with some functional issues, i still think he is good but yea something has happend the last half a year. 3 anterior open bites formed after surgery. One girl from facebook, one from this forum, one from discord

 

[lurking truecel]

Apparently it could be due to some new teqnique, but i still think pagnoni is a good option. But he has been unlucky recently

 

[AryanSubhuman]

Link or show pics with proof of unstatisfied patiënts instead of making false claims

 

[Foreverbrad]

High volume of patients is probably the main issue here. There will naturally be more botches if there are more patients.

I’ve also spoken to one of the people who was botched.

Between this and his insane price increases since I had the first quotation (fucking infinite money Americans should stay in America)I’m seriously thinking about trying to change surgeon.

 

[lurking truecel]

Link or show pics with proof of unstatisfied patiënts instead of making false claims

1. I dont really know where this is from but yea

2. @Radiantmetal who got banned

3. She was on discord and had surgery with pag, then she upploaded on facebook

4 the last one is from discord who did a revision and also ended up with open bite and some issues

I only said 3 botches because the first one might be old

 

[lurking truecel]

High volume of patients is probably the main issue here. There will naturally be more botches if there are more patients.

I’ve also spoken to one of the people who was botched.

Between this and his insane price increases since I had the first quotation (fucking infinite money Americans should stay in America)I’m seriously thinking about trying to change surgeon.

High volume or not, having 3 failed surgeries with similar issues is not good in such a short amount of time.

 

[LEFORT17]

High volume of patients is probably the main issue here. There will naturally be more botches if there are more patients.

I’ve also spoken to one of the people who was botched.

Between this and his insane price increases since I had the first quotation (fucking infinite money Americans should stay in America)I’m seriously thinking about trying to change surgeon.

how much did you get quoted for trimax x infras

 

[AryanSubhuman]

1. I dont really know where this is from but yea
View attachment 3829017
2. @Radiantmetal who got banned

3. View attachment 3829020

4 the last one is from discord who did a revision and also ended up with open bite and some issues

Well fuck I was thinking to go between Ramieri or Pagnoni for revision but now I guess Ramieri would be the safer option.

 

[Foreverbrad]

how much did you get quoted for trimax x infras

It was 28k in late 2023 and obviously getting braces basically committed me to the process but now the price is 35k.

 

[lurking truecel]

Well fuck I was thinking to go between Ramieri or Pagnoni for revision but now I guess Ramieri would be the safer option.

I mean i also know of a guy who went to pag for third revision and it was succes it seems. And that was also this year. Like i said it might be new teqnique of some sort

 

[lurking truecel]

It was 28k in late 2023 and obviously getting braces basically committed me to the process but now the price is 35k.

Its because both pag and ram has been having many americans lately. and its 60k for bimax there so they raise the prices

 

[LEFORT17]

Its because both pag and ram has been having many americans lately. and its 60k for bimax there so they raise the prices

but do they raise the prices only for the americans or for anyone

 

[Foreverbrad]

but do they raise the prices only for the americans or for anyone

Everyone pays more, Europeans are being priced out of surgery rapidly.
This will only get worse as hardmaxxing goes fully mainstream.
And here I am stuck in braces watching my hereditary debt go up faster than I can make money.

 

[lurking truecel]

but do they raise the prices only for the americans or for anyone

Peobably everyone, even tho ramieri hasnt made the price so much higher yet

 

[lurking truecel]

Everyone pays more, Europeans are being priced out of surgery rapidly.
This will only get worse as hardmaxxing goes fully mainstream.
And here I am stuck in braces watching my hereditary debt go up faster than I can make money.

I mean considering most of these faield surgeries has been on americans and canadians. maybe they stop coming here as much for bimax, but yea overall its bad

 

[AryanSubhuman]

I mean i also know of a guy who went to pag for third revision and it was succes it seems. And that was also this year. Like i said it might be new teqnique of some sort

It's seriously such a gamble, when will someone master this shit procedure.

 

[chadhamed]

It was 28k in late 2023 and obviously getting braces basically committed me to the process but now the price is 35k.

What about getting a beard

 

[lurking truecel]

It's seriously such a gamble, when will someone master this shit procedure.

Good question, almost every surgeon has a lot of botches when it comes to this. Maybe its just such a complex procedure that also depends so much on the anatomy of the patient

 

[Foreverbrad]

Good question, almost every surgeon has a lot of botches when it comes to this. Maybe its just such a complex procedure that also depends so much on the anatomy of the patient

Surgery-first is a common theme in some of these.

Impatient Americans with vast sums of easy money who want surgery now! The biggest movements you can do! I don’t want to wear no god damn braces!

 

[lurking truecel]

Surgery-first is a common theme in some of these.

Impatient Americans with vast sums of easy money who want surgery now! The biggest movements you can do! I don’t want to wear no god damn braces!

Yea very true, and yea doing big movements is allways a lot more risky. Apparently it could be that the cut is too close to the ramus which makes it more likely to create a open bite. But its also more aesthetically good if it succeds so i guess its to weight the pros and cons

 

[Foreverbrad]

Yea very true, and yea doing big movements is allways a lot more risky. Apparently it could be that the cut is too close to the ramus which makes it more likely to create a open bite. But its also more aesthetically good if it succeds so i guess its to weight the pros and cons

I don’t even really understand how or why you would develop an open bite 4 months after surgery like that girl, If the bite was good immediately post-surgery.

Fixation failure, non union, ICR, failure to wear appropriate retainer?

 

[key]

I’m seriously thinking about trying to change surgeon.

I thought you already had bimax? What else are you considering?

 

[lurking truecel]

I don’t even really understand how or why you would develop an open bite 4 months after surgery like that girl, If the bite was good immediately post-surgery.

Fixation failure, non union, ICR, failure to wear appropriate retainer?

Yea most of them had it directly after, so yea for her it must be something like that. Maybe tongue thrust aswell, but she is also a older woman so the bones take longer to heal also with more risk of icr as you said ä. Even tho i dont think its icr

 

[lurking truecel]

I don’t even really understand how or why you would develop an open bite 4 months after surgery like that girl, If the bite was good immediately post-surgery.

Fixation failure, non union, ICR, failure to wear appropriate retainer?

And yea she didnt have any Ortho after, she probably should have had elastics or bands

 

[tweaqo]

Do you know what Pagnoni‘a reaction was like after these botches?

Any free revision? Did he take accountability?

 

[lurking truecel]

Do you know what Pagnoni‘a reaction was like after these botches?

Any free revision? Did he take accountability?

I dont really know fully, but from what i heard one seem to be getting a revision. But he apparently tried to say it could be foxed with ortho for a long time untill the ortho said it was impossible

 

[Foreverbrad]

I thought you already had bimax? What else are you considering?

I haven’t had it yet, I’ve just been in braces for a long time decompensating.

Yea most of them had it directly after, so yea for her it must be something like that. Maybe tongue thrust aswell, but she is also a older woman so the bones take longer to heal also with more risk of icr as you said ä. Even tho i dont think its icr

I dont really know fully, but from what i heard one seem to be getting a revision. But he apparently tried to say it could be foxed with ortho for a long time untill the ortho said it was impossible

I dont understand why he’d put someone’s jaw back together with a 1 cm open bite and expect it to be fixable by ortho. Or how that even happens in the first place when the surgery is all 3D planned and guided (I would like to see an example of the surgery-first 3D planning)

 

[lurking truecel]

I haven’t had it yet, I’ve just been in braces for a long time decompensating.




I dont understand why he’d put someone’s jaw back together with a 1 cm open bite and expect it to be fixable by ortho. Or how that even happens in the first place when the surgery is all 3D planned and guided (I would like to see an example of the surgery-first 3D planning)

He doesnt fo cusom plates for lower jaw.(Atleast most of the time) Their is varied opions on this but thats for sure makes it harder to follow exact plan. But yea the open bite on that guy was probably less then 5 mm

 

[LEFORT17]

He doesnt fo cusom plates for lower jaw.(Atleast most of the time) Their is varied opions on this but thats for sure makes it harder to follow exact plan. But yea the open bite on that guy was probably less then 5 mm

not fully custom for that price is crazy

 

[lurking truecel]

not fully custom for that price is crazy

Many people dont prefer custom on lower jaw for some reason

 

[LEFORT17]

Many people dont prefer custom on lower jaw for some reason

i mean gunson doesnt use them either, would really like to hear an explanation for that

 

[AryanSubhuman]

Good question, almost every surgeon has a lot of botches when it comes to this. Maybe its just such a complex procedure that also depends so much on the anatomy of the patient

Would you recommend Ramieri as someone with shortface? Í cant be taking risk when I'm already a revision case and from all the other Surgeons like Dr. Zarrinbal to raffaini i've read bad experiences (mostly through reddit/google reviews). The only bad ones I've seen with ramieri was an unnessesary setback and someone with CW rotation immediately relapsed because of condylar sac. Also read that he's more aggressive in his movements now if you ask him to.

 

[lurking truecel]

Would you recommend Ramieri as someone with shortface? Í cant be taking risk when I'm already a revision case and from all the other Surgeons like Dr. Zarrinbal to raffaini i've read bad experiences (mostly through reddit/google reviews). The only bad ones I've seen with ramieri was an unnessesary setback and someone with CW rotation immediately relapsed because of condylar sac. Also read that he's more aggressive in his movements now if you ask him to.

Yea i think both ramieri and pag works, but just do good Ortho before etc

 

[Going2KillMyself]

The issues are skeletal and very concerning because they are all similar to eachother. It’s not just orthodontic. It seems to be some issue with the lower jaw cut but I am not an expert.

Having a bunch of desperate people wanting surgery also doesn’t help. If a surgeon becomes popular, they have no real incentive to perform as well as they otherwise would’ve if they weren’t. Why? Because they have a backlog of desperate people wanting to get surgery, perhaps even unknowing of the risk. So, they’ll just move onto the next patient if you complain.

Either way, what it shows you is that even the “best” surgeons are a gamble - there is no ascension for many.

 

[Mr.Proper]

Liam Competitors put tremor-inducing drugs in his drink

 

[dough]

some foid also got botched by him on reddit make it 4

 

[lurking truecel]

some foid also got botched by him on reddit make it 4

Is it old tho ? Because this is within half a year

 

[dough]

Is it old tho ? Because this is within half a year

yeah its within a year she posted about on a reddit comment

 

[Snicket]

1. I dont really know where this is from but yea
View attachment 3829017
2. @Radiantmetal who got banned

3. She was on discord and had surgery with pag, then she upploaded on facebook View attachment 3829020

4 the last one is from discord who did a revision and also ended up with open bite and some issues

I only said 3 botches because the first one might be old

Why did @Radiantmetal get banned or was it a self ban?

 

[lurking truecel]

Why did @Radiantmetal get banned or was it a self ban?

Dont really know, bit not because pag thingy

 

[jaymog]

i mean gunson doesnt use them either, would really like to hear an explanation for that

I actually asked him this in my pre op surgical planning meeting that lasted 3 hours.

He said custom plates are OK in the maxilla, not great in the mandible due to the inaccuracy of seating the condyles in pre op measurements. With a patient awake, even if you deprogram the bite and seat the joint, it’s not reliably accurate to where their joint is when they are paralyzed with anesthesia and have zero muscle compensation.

Meaning you’d be planning custom movements based on multiple MM changes in position, thus ruins the integrity of your plan.

He said for the maxilla, it depends on bone quality, density, thickness. For example if the bone is dog shit in his normal area of plating, he actually adjusts where he plates and screws or relapse risk is too high due to thin and low quality bone. If custom, he wouldn’t have the option. And he said it’s nearly impossible to tell bone quality until you open the patient up.

In addition to this, my assumption is that…if it ain’t broke don’t fix it. He seems to be very accurate in terms of plan to actual result, so relearning new things for almost no change in accuracy but a hell of a lot more risk and total overhaul of procedural operations is not worth it.

 

[lurking truecel]

I actually asked him this in my pre op surgical planning meeting that lasted 3 hours.

He said custom plates are OK in the maxilla, not great in the mandible due to the inaccuracy of seating the condyles in pre op measurements. With a patient awake, even if you deprogram the bite and seat the joint, it’s not reliably accurate to where their joint is when they are paralyzed with anesthesia and have zero muscle compensation.

Meaning you’d be planning custom movements based on multiple MM changes in position, thus ruins the integrity of your plan.

He said for the maxilla, it depends on bone quality, density, thickness. For example if the bone is dog shit in his normal area of plating, he actually adjusts where he plates and screws or relapse risk is too high due to thin and low quality bone. If custom, he wouldn’t have the option. And he said it’s nearly impossible to tell bone quality until you open the patient up.

In addition to this, my assumption is that…if it ain’t broke don’t fix it. He seems to be very accurate in terms of plan to actual result, so relearning new things for almost no change in accuracy but a hell of a lot more risk and total overhaul of procedural operations is not worth it.

Same thing gunson said basically, but i dont know if its 100% true still

 

[jaymog]

Same thing gunson said basically, but i dont know if its 100% true still

Yeah agreed. My last point, which is just my intuition and nothing he actually told me, I feel like might be true— he does fine without them and the overhaul of procedures and learning new plates probably isn’t worth the reward since he isn’t trying to be Alfi and do 3 surgeries per day.

 

[lurking truecel]

Same thing gunson said basically, but i dont know if its 100% true still

@RealSurgerymax what is your view on custom plates on the mandible or not ? You clearly do custom jaw implant with bimax so i guess you prefer custom in some way ?

 

[lurking truecel]

Yeah agreed. My last point, which is just my intuition and nothing he actually told me, I feel like might be true— he does fine without them and the overhaul of procedures and learning new plates probably isn’t worth the reward since he isn’t trying to be Alfi and do 3 surgeries per day.

Yea its hard to say, i guess theybwill need research in it, the bone thingy on ct scan doesnt make sense to me. And it feels more like laziness to learn a new method

 

[Foreverbrad]

Dont really know, bit not because pag thingy

Why did @Radiantmetal get banned or was it a self ban?

Yeah it’s not related to Pagnoni.

 

[Foreverbrad]

I actually asked him this in my pre op surgical planning meeting that lasted 3 hours.

He said custom plates are OK in the maxilla, not great in the mandible due to the inaccuracy of seating the condyles in pre op measurements. With a patient awake, even if you deprogram the bite and seat the joint, it’s not reliably accurate to where their joint is when they are paralyzed with anesthesia and have zero muscle compensation.

Meaning you’d be planning custom movements based on multiple MM changes in position, thus ruins the integrity of your plan.

He said for the maxilla, it depends on bone quality, density, thickness. For example if the bone is dog shit in his normal area of plating, he actually adjusts where he plates and screws or relapse risk is too high due to thin and low quality bone. If custom, he wouldn’t have the option. And he said it’s nearly impossible to tell bone quality until you open the patient up.

In addition to this, my assumption is that…if it ain’t broke don’t fix it. He seems to be very accurate in terms of plan to actual result, so relearning new things for almost no change in accuracy but a hell of a lot more risk and total overhaul of procedural operations is not worth it.

I guess for more complex movements you would need custom plating to have any chance of successfully achieving the 3D plan though? For example my maxilla movement will need:

- advancement
- downgraft
- CW rotation
- sideways movement to fix skeletal cross bite