Pagnoni is not a botcher

[SurgeonsAreScammers]

Misinfo from surgery first Reddit cucks.

I had my consultation over my CT scan today and basically he told me I had to do orthodontic decompensation in order to do the surgery.

I asked him about surgery first. He said he does it, but only likes to do so with an orthodontist that he’s connected to and that otherwise there would be problems.

I asked if it were possible to advance both jaws forward at an even amount without decomp and he said that’s possible but risky, and that I would “be responsible” for anything that happens afterwards such as bite issues.

So reading between the lines it sounds to me like some incels wanted double jaw surgery ASAP and didn’t want to wait with braces. The botches were Americans who said they got surgery first lol which Pagnoni told me he only does with trusted Italian orthos. Pagnoni probably said “alright, your call but I’m not responsible”.

These guys were pushing a narrative of “bad BSSO cuts” and “no bone graft” when the reality was that they wanted surgery ASAP with no orthodontics. As I said, Pags said he does surgery first only with Italians orthos. If someone said they got surgery first with Pagnoni and that they’re American that’s a big red flag

 

[Ascension75]

It sounds more like he changed his strategy after botching several people and is playing it more safely now.

 

[ltn_looksminner]

Your name says otherwise

 

[ltn_looksminner]

I don't see how not including orthodontics increases botch rate

 

[SkeetNeet]

Respectfully, you have no idea what you’re talking about. Granted, I can see how you have come to your conclusions, but the BSSO cut is legitimately dog shit and sets up his patients to fail, and this has been confirmed by other surgeons and orthos.

There are more botched patients than the ones who have publicly posted.

Pagnoni has historically been much more liberal with surgery first than most other surgeons and it’s not a case of patients pushing him into it. He also doesn’t bone graft anywhere near enough and is relying on massive custom plates. The man loves to take a shortcut at the expense of his patients’ wellbeing.

He will impress you at first but he is a psycho and doesn’t have the surgical skills to make up it. He is a known liar and has no shame. This forum needs to stop dick riding him.

There is legitimately no good reason to go to him for jaw surgery in 2026.

 

[LEFORT17]

Respectfully, you have no idea what you’re talking about. Granted, I can see how you have come to your conclusions, but the BSSO cut is legitimately dog shit and sets up his patients to fail, and this has been confirmed by other surgeons and orthos.

There are more botched patients than the ones who have publicly posted.

Pagnoni has historically been much more liberal with surgery first than most other surgeons and it’s not a case of patients pushing him into it. He also doesn’t bone graft anywhere near enough and is relying on massive custom plates. The man loves to take a shortcut at the expense of his patients’ wellbeing.

He will impress you at first but he is a psycho and doesn’t have the surgical skills to make up it. He is a known liar and has no shame. This forum needs to stop dick riding him.

There is legitimately no good reason to go to him for jaw surgery in 2026.

respectfully get your 33k botch and commit

 

[tweaqo]

He told me I am a “no orthodontics” before or after surgery patient. Despite literally having a class 1 dental occlusion LOL

 

[LackEmpathyTherefor]

Misinfo from surgery first Reddit cucks.

I had my consultation over my CT scan today and basically he told me I had to do orthodontic decompensation in order to do the surgery.

I asked him about surgery first. He said he does it, but only likes to do so with an orthodontist that he’s connected to and that otherwise there would be problems.

I asked if it were possible to advance both jaws forward at an even amount without decomp and he said that’s possible but risky, and that I would “be responsible” for anything that happens afterwards such as bite issues.

So reading between the lines it sounds to me like some incels wanted double jaw surgery ASAP and didn’t want to wait with braces. The botches were Americans who said they got surgery first lol which Pagnoni told me he only does with trusted Italian orthos. Pagnoni probably said “alright, your call but I’m not responsible”.

These guys were pushing a narrative of “bad BSSO cuts” and “no bone graft” when the reality was that they wanted surgery ASAP with no orthodontics. As I said, Pags said he does surgery first only with Italians orthos. If someone said they got surgery first with Pagnoni and that they’re American that’s a big red flag

Truth is we dnt know

 

[Foreverbrad]

He told me I am a “no orthodontics” before or after surgery patient. Despite literally having a class 1 dental occlusion LOL

despite having “ideal” occlusion? I don’t see the problem

 

[Nahorscend]

despite having “ideal” occlusion? I don’t see the problem

Unless he needed identical movements on both jaws how would he not need any orthodontics

 

[Foreverbrad]

Unless he needed identical movements on both jaws how would he not need any orthodontics

That’s exactly what a class 1 is though? The teeth fit together perfect already and thus it follows that movement would be identical for both jaws.

 

[SurgeonsAreScammers]

Respectfully, you have no idea what you’re talking about. Granted, I can see how you have come to your conclusions, but the BSSO cut is legitimately dog shit and sets up his patients to fail, and this has been confirmed by other surgeons and orthos.

There are more botched patients than the ones who have publicly posted.

Pagnoni has historically been much more liberal with surgery first than most other surgeons and it’s not a case of patients pushing him into it. He also doesn’t bone graft anywhere near enough and is relying on massive custom plates. The man loves to take a shortcut at the expense of his patients’ wellbeing.

He will impress you at first but he is a psycho and doesn’t have the surgical skills to make up it. He is a known liar and has no shame. This forum needs to stop dick riding him.

There is legitimately no good reason to go to him for jaw surgery in 2026.

What can you share with us?

I hear about the BSSO cut and bone grafting often, but with small or medium movements LeFort and BSSO don’t require bone grafting to my understanding.

And I hear about the shitty BSSO cut, but what is shitty about it exactly? Like I want to know specifically what sucks about it. Is it the ramps widening. I would agree that ramus widening is general is a shit idea because you’re torquing bones at your joints and the combination of lateral and saggital advancement probably really shits up the operation.

I’m not arguing with you. It seems you have better understanding than I do, but I would like to know my blind spots and hear what you know and I do not

 

[LEFORT17]

What can you share with us?

I hear about the BSSO cut and bone grafting often, but with small or medium movements LeFort and BSSO don’t require bone grafting to my understanding.

And I hear about the shitty BSSO cut, but what is shitty about it exactly? Like I want to know specifically what sucks about it. Is it the ramps widening. I would agree that ramus widening is general is a shit idea because you’re torquing bones at your joints and the combination of lateral and saggital advancement probably really shits up the operation.

I’m not arguing with you. It seems you have better understanding than I do, but I would like to know my blind spots and hear what you know and I do not

why would u even waste a second of thinking going to pagnoni in 2026 is a smart idea, both skill and financial wise

 

[SurgeonsAreScammers]

why would u even waste a second of thinking going to pagnoni in 2026 is a smart idea, both skill and financial wise

Don’t want ramus widening and I want infras

 

[LEFORT17]

Don’t want ramus widening and I want infras

sure bro get your infras which boost you up 0,1 on the scale for a bimax price with other great surgeons

 

[SurgeonsAreScammers]

sure bro get your infras which boost you up 0,1 on the scale for a bimax price with other great surgeons

Wait time is too long with ramieri

 

[SkeetNeet]

What can you share with us?

I hear about the BSSO cut and bone grafting often, but with small or medium movements LeFort and BSSO don’t require bone grafting to my understanding.

And I hear about the shitty BSSO cut, but what is shitty about it exactly? Like I want to know specifically what sucks about it. Is it the ramps widening. I would agree that ramus widening is general is a shit idea because you’re torquing bones at your joints and the combination of lateral and saggital advancement probably really shits up the operation.

I’m not arguing with you. It seems you have better understanding than I do, but I would like to know my blind spots and hear what you know and I do not

I’m not going to share info or pictures that people want to keep private for now. Boring, I know, but things aren’t good.

I’m sure you’ve seen these pics on Reddit. How on earth did Pagnoni expect this patient to heal?

Basically from what I remember, the BSSO cut is too posterior and the lack of bone contact (and grafting) makes it very difficult for the mandible to heal correctly. After a few weeks/months, the mandible can clockwise rotate and an open bite can form.

There are different BSSO cuts such as the Hunsuck-Dal Pont, but I can’t say I have good knowledge about this. All I know is that at least two quite famous surgeons have been shocked at the way Pagnoni is cutting the mandible. I have seen mandibles become deformed after surgery with him.

I appreciate your openness. I just can’t see any justification for anybody to continue to go with Pagnoni. There’s still some blurriness regarding what’s gone on, especially if you only have access to what’s publicly available on here and Reddit, but where there’s smoke there’s fire.

When you take a step back and research more, you will find better surgeons. Finances can be a problem, but Pagnoni for 30k euros plus isn’t worth the risk now, and it very well might cost you double that to correct any complications that you could end up having.

 

[Nahorscend]

That’s exactly what a class 1 is though? The teeth fit together perfect already and thus it follows that movement would be identical for both jaws.

But the movement needed for the two jaws is hardly ever identical, that's the point. The amount of movement most recessed people need on the mandible is much more than the amount of movement their maxilla can tolerate. If you need 4 mm maxilla and 10 mm mandible how are you gonna do that without orthodontics unless your lower arch is already lagging behind pre-op?

If you have a good bite before it's usually what stops you from getting surgery without orthodontics. Your occlusion class would be mismatched with your skeletal class. Maybe if you luck out and you need like 5 mm lf1 and 11 mm on pog you could get the 11 via 5 mm bsso + 6 mm genio. But that must be rare.

 

[Foreverbrad]

But the movement needed for the two jaws is hardly ever identical, that's the point. The amount of movement most recessed people need on the mandible is much more than the amount of movement their maxilla can tolerate. If you need 4 mm maxilla and 10 mm mandible how are you gonna do that without orthodontics unless your lower arch is already lagging behind pre-op?

If you have a good bite before it's usually what stops you from getting surgery without orthodontics. Your occlusion class would be mismatched with your skeletal class. Maybe if you luck out and you need like 5 mm lf1 and 11 mm on pog you could get the 11 via 5 mm bsso + 6 mm genio. But that must be rare.

Then you’d have to get extractions and fuck your class 1 bite up into a class 2. But why would you do that? Your example in your last sentence is what would normally be done.

Sure, you could pull some premolars and recess all the mandible teeth back but how exactly is that supposed to be better than just simply genioplasty the chin forward? The relative movement is the same.

 

[LackEmpathyTherefor]

Wait time is too long with ramieri

Bro doesn’t understand that surgeons other than Pagnoni and Ramieri can perform jaw surgery
Just with that information I can already tell you’re larping

 

[LEFORT17]

Then you’d have to get extractions and fuck your class 1 bite up into a class 2. But why would you do that? Your example in your last sentence is what would normally be done.

Sure, you could pull some premolars and recess all the mandible teeth back but how exactly is that supposed to be better than just simply genioplasty the chin forward? The relative movement is the same.

wouldnt look good on everyone/shouldnt be done in general especially if you got breathing problems

 

[Nahorscend]

Then you’d have to get extractions and fuck your class 1 bite up into a class 2. But why would you do that? Your example in your last sentence is what would normally be done.

Sure, you could pull some premolars and recess all the mandible teeth back but how exactly is that supposed to be better than just simply genioplasty the chin forward? The relative movement is the same.

Because some people have no room to do that much movement on their maxilla. Firstly if you need let's say 15 mm on pog, and genio can give 7-8 mm, if you don't decompensate you still need a 7-8 mm lf1 which to my knowledge is a massive maxillary movement that is risky and not all surgeons will even do (or prefer to do).

Even if it's doable what if you already have a decent maxilla, and moving it that much will completely wreck your philtrum and lip. Losing two premolars as an adult is nowhere near as bad aesthetically as over advancing a maxilla.

Unless you do a small lf1, identically small bsso, and massive genio. Then your nerves there will be at risk plus you can expect an inferior aesthetic result.

 

[LackEmpathyTherefor]

Then you’d have to get extractions and fuck your class 1 bite up into a class 2. But why would you do that? Your example in your last sentence is what would normally be done.

Sure, you could pull some premolars and recess all the mandible teeth back but how exactly is that supposed to be better than just simply genioplasty the chin forward? The relative movement is the same.

Advancement genio won’t replace a longer BSSO.
Lip seal, and Lip appearance is one of the difference for example.

You can remove premolar teeth sometimes you don’t need to and make space for bigger BSSO from that with decomp. Then you get a class 1 with 6 months post op orthodontics

 

[LEFORT17]

Wait time is too long with ramieri

ig only these 2 exist

 

[Foreverbrad]

Because some people have no room to do that much movement on their maxilla. Firstly if you need let's say 15 mm on pog, and genio can give 7-8 mm, if you don't decompensate you still need a 7-8 mm lf1 which to my knowledge is a massive maxillary movement that is risky and not all surgeons will even do (or prefer to do).

Even if it's doable what if you already have a decent maxilla, and moving it that much will completely wreck your philtrum and lip. Losing two premolars as an adult is nowhere near as bad aesthetically as over advancing a maxilla.

Unless you do a small lf1, identically small bsso, and massive genio. Then your nerves there will be at risk plus you can expect an inferior aesthetic result.

Don’t forget about CCW as well, that’s one way to advance the mandible without moving the maxilla much. Normally these people who need huge movements are downswung so it suits them.

 

[SurgeonsAreScammers]

Bro doesn’t understand that surgeons other than Pagnoni and Ramieri can perform jaw surgery
Just with that information I can already tell you’re larping

Not with infras. I want to get as many surgeries as possible at once. Pagnoni is great with infras.

Also I live USA. Not spending 70k for a dogmaxx. I have a Pattinson type recession. Chin and jaw are good. Maxilla is hella flat. Knowing blue pilled docs they’d probably try and set my mandible back or give a chin reduction

 

[tweaqo]

despite having “ideal” occlusion? I don’t see the problem

lol what? That basically means u can have no mandibular movement unless u move the maxilla loads (which will chimpmaxx me). Also my maxilla only needs maybe 3-4mm at most. I am a clear case for decompensation in order to create an overbite and make a bigger BSSO

 

[yussimania]

good answers in this thread

we are .org

 

[nishka]

lol what? That basically means u can have no mandibular movement unless u move the maxilla loads (which will chimpmaxx me). Also my maxilla only needs maybe 3-4mm at most. I am a clear case for decompensation in order to create an overbite and make a bigger BSSO

Yeah, even if you do surgery first, I think you need braces later anyway to correct your bite. There's no way you can do it no braces.

 

[nishka]

@yussimania I'm lowkeyconcerned about Orion doing surgery first, but lowkey trust him. Do you think if I do decom I can get more BSSO? But do I even need that much BSSO?

 

[AustrianMogger]

Misinfo from surgery first Reddit cucks.

I had my consultation over my CT scan today and basically he told me I had to do orthodontic decompensation in order to do the surgery.

I asked him about surgery first. He said he does it, but only likes to do so with an orthodontist that he’s connected to and that otherwise there would be problems.

I asked if it were possible to advance both jaws forward at an even amount without decomp and he said that’s possible but risky, and that I would “be responsible” for anything that happens afterwards such as bite issues.

So reading between the lines it sounds to me like some incels wanted double jaw surgery ASAP and didn’t want to wait with braces. The botches were Americans who said they got surgery first lol which Pagnoni told me he only does with trusted Italian orthos. Pagnoni probably said “alright, your call but I’m not responsible”.

These guys were pushing a narrative of “bad BSSO cuts” and “no bone graft” when the reality was that they wanted surgery ASAP with no orthodontics. As I said, Pags said he does surgery first only with Italians orthos. If someone said they got surgery first with Pagnoni and that they’re American that’s a big red flag

Water

 

[AustrianMogger]

lol what? That basically means u can have no mandibular movement unless u move the maxilla loads (which will chimpmaxx me). Also my maxilla only needs maybe 3-4mm at most. I am a clear case for decompensation in order to create an overbite and make a bigger s

Solution to the Chip is USO