Ramieri jaw implants

Wallenberg

Wallenberg

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Does Ramieri know how to design good-looking custom jaw implants that fit the patient's face? I ask because I don't really know how to design implants so I would have to trust the surgeon. He's pretty new to implants, right? Not very experienced yet? All other comments about Ramieri are welcome too.

@Gaia262 @TheLordMadness @politically correct
 
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He doesn't have a long history with implants, but I wouldn't write him off because of that. Eppley has been doing them his whole life, is called a "master", and is producing horrendous results.

Ramieri seems to have a good eye for aesthetics and seems quite ethical and careful. For example, he offered his beautiful chin procedure (a mini-chin wing) which did produce very nice results from the front. However, he quickly stopped offering it because it was creating a step off in the mandible. A lot of surgeons would just keep offering sub-par procedures if it is making them money, (like Zarrinbal and Brusco with the chin-wing which destroys your genial angle).

I think if a surgeon has a good aesthetic instinct they can produce good implant results. I tend to think the best implants are small ones.
 
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He doesn't have a long history with implants, but I wouldn't write him off because of that. Eppley has been doing them his whole life, is called a "master", and is producing horrendous results.

Ramieri seems to have a good eye for aesthetics and seems quite ethical and careful. For example, he offered his beautiful chin procedure (a mini-chin wing) which did produce very nice results from the front. However, he quickly stopped offering it because it was creating a step off in the mandible. A lot of surgeons would just keep offering sub-par procedures if it is making them money, (like Zarrinbal and Brusco with the chin-wing which destroys your genial angle).

I think if a surgeon has a good aesthetic instinct they can produce good implant results. I tend to think the best implants are small ones.
Yeah, I'm not writing him off because of his lack of experience. I just don't know much about him so I mentioned everything that I know about him.

I consider Yaremchuk and Ramieri. Dr. Y uses silicone I think, Ramieri uses PEEK. Dr. Y knows how to design implants, but he's a bit old - though he has younger assistant surgeons (or whatever those are called, fellows?).

What about the post-operation care with Ramieri? What if the implant gets infected, is the removal or revision free?
 
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Yeah from what I have read Dr. Y's jaw implants are well designed. Defrancq's ones seem average from a few reviews I saw.

Has Ramieri posted many implant results? I know he is doing infraorbital implants now which is interesting. Apparently Pagnoni is good at implants, at least infra, so you could always consult him too.

I have no idea about revision costs, however it's pretty standard for doctors to charge nothing for revision except for maybe anaesthetic cost (idk how it is in Italy, maybe they would just write that part off)
 
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Yeah from what I have read Dr. Y's jaw implants are well designed. Defrancq's ones seem average from a few reviews I saw.

Has Ramieri posted many implant results? I know he is doing infraorbital implants now which is interesting. Apparently Pagnoni is good at implants, at least infra, so you could always consult him too.

I have no idea about revision costs, however it's pretty standard for doctors to charge nothing for revision except for maybe anaesthetic cost (idk how it is in Italy, maybe they would just write that part off)
Defrancq isn't very experienced with implants. Also, he has some sketchy history according to some users here.

Ramieri hasn't posted many results. Here is one of his designs, I think it's @Gaia262 's implant.

 
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If you are just doing a jawline implant like that I cannot imagine he would fuck you up tbh. My ideal scenario would be to get a plan from Dr. Y and then say I am not doing it. Then I would have a good idea of what I wanted from a surgeon who uses peek.
 
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If you are just doing a jawline implant like that I cannot imagine he would fuck you up tbh. My ideal scenario would be to get a plan from Dr. Y and then say I am not doing it. Then I would have a good idea of what I wanted from a surgeon who uses peek.
I don't have a strong preference for implant material - implant design (shape and size) and surgeon's skill seem more important than whether it's silicone, medpor, or PEEK.

Yes, I only want a jaw implant. Actually not a jawline implant ("wraparound") but a jaw angle implant.

Also tagging experts @RealSurgerymax @Win200
 
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If you are just doing a jawline implant like that I cannot imagine he would fuck you up tbh. My ideal scenario would be to get a plan from Dr. Y and then say I am not doing it. Then I would have a good idea of what I wanted from a surgeon who uses peek.
Ramieri is only a lower third surgeon?
No orbital implants?
 
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Ohh if it's only a jaw implant and not a wrap around then don't even bother with Dr. Y

You will honestly be fine with Ramieri then. They simply recreate the angles and aesthetic from good skulls.
 
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Ohh if it's only a jaw implant and not a wrap around then don't even bother with Dr. Y

You will honestly be fine with Ramieri then. They simply recreate the angles and aesthetic from good skulls.
I will ask how much a jaw angle implant from Ramieri would cost. Dr. Y has a proven track record, although some people have had infections. Ramieri is a newcomer to implants.

Yep, it's only a jaw angle implant, not a wraparound.
 
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Yes, because silicone is more prone to infection. Avoid silicone.
 
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Yes, because silicone is more prone to infection. Avoid silicone.
Is this true? If I remember correctly some have claimed that infection risk is similar with all implant materials.
 
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Does Ramieri know how to design good-looking custom jaw implants that fit the patient's face? I ask because I don't really know how to design implants so I would have to trust the surgeon. He's pretty new to implants, right? Not very experienced yet? All other comments about Ramieri are welcome too.

@Gaia262 @TheLordMadness @politically correct
I had mine put in on monday so I'm currently 6 days post

General thesis is:
- Damn was I not prepared mentally for the extent of the swelling that occurs post jaw implants. Its probably triple what I was expecting which is a big mind game because you have no idea what the result is going to look like for at least a month probably
- Dr Ramieri is clearly a super genuine and smart guy, I have complete trust in him
- While I can't 100% tell you that I'm happy with my result as my face still looks like a balloon, I can tell that what's underneath is in line with expectation and early indications are good
- I don't think its true that he's new to implants. Bare in mind this is not a common surgery globally, its quite a niche thing so most surgeons save a select few dont do this often. But Dr R told me he has done 25-30 of these procedures which relatively is a lot.
- My general instinct is that if you are most likely to be happy if you are not going for an extreme result, as there is way more room for error. The more extreme your design and difference to your underlying bone structure, the more uncertain it is how it will look once your soft tissue is placed on top of the implants.
- He spends a lot of time asking you detailed questions about what you are going for. If you show him examples of jaws you like and jaws you dont like (would highly recommend spending as much time focusing on what you dont want) then he can work out what to do
- Dr R seems very balance and harmony focused which is re-assuring, he's not the kind of guy who would ever perform a surgery that he thinks would look bad
- No matter the doctor or amount of discussion, the result will never look identical to what's in your head, best to accept that
 
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I had mine put in on monday so I'm currently 6 days post

General thesis is:
- Damn was I not prepared mentally for the extent of the swelling that occurs post jaw implants. Its probably triple what I was expecting which is a big mind game because you have no idea what the result is going to look like for at least a month probably
- Dr Ramieri is clearly a super genuine and smart guy, I have complete trust in him
- While I can't 100% tell you that I'm happy with my result as my face still looks like a balloon, I can tell that what's underneath is in line with expectation and early indications are good
- I don't think its true that he's new to implants. Bare in mind this is not a common surgery globally, its quite a niche thing so most surgeons save a select few dont do this often. But Dr R told me he has done 25-30 of these procedures which relatively is a lot.
- My general instinct is that if you are most likely to be happy if you are not going for an extreme result, as there is way more room for error. The more extreme your design and difference to your underlying bone structure, the more uncertain it is how it will look once your soft tissue is placed on top of the implants.
- Dr R seems very balance and harmony focused which is re-assuring, he's not the kind of guy who would ever perform a surgery that he thinks would look bad
Thanks! You had a wraparound implant (from the left jaw angle to the right jaw angle via chin)? It was €10 000?
 
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Thanks! You had a wraparound implant (from the left jaw angle to the right jaw angle via chin)? It was €10 000?
not wraparound, just extended jaw/mandible, I have a seperate implantech chin implant in
 
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So left and right jaw angles and that was 10 000 euros?
Correct, but this doesnt include cost of medicines such as antibiotics etc

Also just FYI Ramieri does all revisions completely free of charge. He's also great and gives you his personal number post operation and will answer as many of your questions as you want, and if you prefer he will check on you multiple times per week in person, he's great at making time for his patients
 
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Correct, but this doesnt include cost of medicines such as antibiotics etc

Also just FYI Ramieri does all revisions completely free of charge. He's also great and gives you his personal number post operation and will answer as many of your questions as you want, and if you prefer he will check on you multiple times per week in person, he's great at making time for his patients
How much is the total cost all included except travel?
 
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Defrancq isn't very experienced with implants. Also, he has some sketchy history according to some users here.

Ramieri hasn't posted many results. Here is one of his designs, I think it's @Gaia262 's implant.



Yeah Dr Ramieri isn't the most experienced at iimplants but he is a hidden gem imo, he did an amazing job with my infraorbital malar implants and the other users who had them after look great.

I'm uploading my jaw implant video next month so you can see it's design and I will try to get him to show it on the surgical after table.

:feelsautistic:
 
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Yeah Dr Ramieri isn't the most experienced at iimplants but he is a hidden gem imo, he did an amazing job with my infraorbital malar implants and the other users who had them after look great.

I'm uploading my jaw implant video next month so you can see it's design and I will try to get him to show it on the surgical after table.

:feelsautistic:
Gaia after your extractions did you look noticeably worse while your ortho closed the gap?

And has Dr.Ramieri given you any info on the dimensions of the implant, you have thick skin so it would need to be relatively large and you should ask if he can do lipo of your Submental at the same time.
 
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I ask because I don't really know how to design implants so I would have to trust the surgeon.
Bring him a morph. That's the least amount of effort you can put it...
 
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Gaia after your extractions did you look noticeably worse while your ortho closed the gap?

And has Dr.Ramieri given you any info on the dimensions of the implant, you have thick skin so it would need to be relatively large and you should ask if he can do lipo of your Submental at the same time.

Yes the extractions and retraction before surgery made a significant difference on my face (old man gummy look) . You can see this on my main video when I'm talking. This is then fixed after the surgery and the jaws are moved forward.

He hasn't given me the dimensions of the implant yet. When I consulted with him I did discuss not to be overly large and masculine.

I will ask for the submental lipo but I don't think he does it.
 
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Also just FYI Ramieri does all revisions completely free of charge.
Do I understand correctly, that for example if the implant is too small (or big), Ramieri will free of charge replace it with a bigger (or smaller) implant?

The thing that worries me most is the design part. Dr. Y knows how to design implants. He doesn't take patient input in design process, but that's fine because I don't want to give input. I don't know if Ramieri knows how to design implants. I'm not saying he can't: I simply don't know. But some people have had good results with him.

Maybe I consult with Dr. Y and Ramieri and then compare their designs?
 
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well, what a return, went from promoting trans propaganda in offtopics everday to actually striving to achieve your aesthetic goals. nice to have you back
 
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Do I understand correctly, that for example if the implant is too small (or big), Ramieri will free of charge replace it with a bigger (or smaller) implant?

The thing that worries me most is the design part. Dr. Y knows how to design implants. He doesn't take patient input in design process, but that's fine because I don't want to give input. I don't know if Ramieri knows how to design implants. I'm not saying he can't: I simply don't know. But some people have had good results with him.

Maybe I consult with Dr. Y and Ramieri and then compare their designs?
If you give him the thumbs up on a design, and he implements your decision, then I believe that if you are not happy it will be your own expense to fix it as ultimately doing this type of surgery would be completely uneconomical for him otherwise. It's an art not a science and to an extent its impossible to know exactly what a given design will look like once your soft tissue is placed on top. This is why I caution you not to expect perfection and to have realistic expectations. When I designed mine I showed him my goal, he made the design and then I said to him 'now please make it 10-20% smaller just to be sure that I don't go too far with it'

He will pay for any revisions due to a complication for example

Knowing him though, I think if you were truly unhappy with your designs, he would probably give you a significant discount or charge it to you at cost to fix (although this is an assumption on my part based on my knowledge of him as a guy, he hasnt told me this). If this is the case I would guess that a revision would cost c.2000-3000 euros, because the hospital fee in rome is c.1000, and assume the implants are a couple of thousand to produce
 
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well, what a return, went from promoting trans propaganda in offtopics everday to actually striving to achieve your aesthetic goals. nice to have you back
If you would have a jaw implant, which surgeon would you choose? Aren't you interested in jaw implants too?
 
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If you give him the thumbs up on a design, and he implements your decision, then I believe that if you are not happy it will be your own expense to fix it as ultimately doing this type of surgery would be completely uneconomical for him otherwise. It's an art not a science and to an extent its impossible to know exactly what a given design will look like once your soft tissue is placed on top. This is why I caution you not to expect perfection and to have realistic expectations. When I designed mine I showed him my goal, he made the design and then I said to him 'now please make it 10-20% smaller just to be sure that I don't go too far with it'

He will pay for any revisions due to a complication for example

Knowing him though, I think if you were truly unhappy with your designs, he would probably give you a significant discount or charge it to you at cost to fix (although this is an assumption on my part based on my knowledge of him as a guy, he hasnt told me this). If this is the case I would guess that a revision would cost c.2000-3000 euros, because the hospital fee in rome is c.1000, and assume the implants are a couple of thousand to produce
I understand. Yes, I realize that implants have their limits, and predicting the exact outcome is impossible.

Is the implant making a positive difference in your looks?
 
If you would have a jaw implant, which surgeon would you choose? Aren't you interested in jaw implants too?
Ramieri is well up on my list as i trust his aesthetic eye. Only thing that concerns me with him is that he uses peek, which is a bitch to correct if he doesn't nail it first try, and the relative lack of experience compared to Eppley and Y. He's significantly cheaper than those two though + Eppley produced a bunch of hideous results, so long year experience doesn't necessarily equate to good results imo.

currently looking into a few turkish surgeons doing it, but they are all relatively new to it, but offer significantly lower prices
 
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I understand. Yes, I realize that implants have their limits, and predicting the exact outcome is impossible.

Is the implant making a positive difference in your looks?
Right now I look like a chipmunk, I've lost all definition in my face and I have huge puffy cheeks and a fat watery neck

But, I am 6 days post surgery and am totally swollen, type in 'eppley jaw implant swelling' into google, or watch Dr Dhirs implant video on youtube and they both explain that this procedure is a huge mind game as it makes you look a lot worse immediately after surgery and takes weeks/months to see the result

That said, I can feel my implant and see the edge of where the contours willbe once the swelling subsides, and indications are that it will look very good once done

I would like to emphasise that im a somewhat atypical case on this forum as I was good looking before surgery to be honest, and have done bits of modelling over the years (small ticket commercial stuff) so I really didn't need a big implant I just wanted to lower my gonions a little bit and add a few mm of width
 
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I understand. Yes, I realize that implants have their limits, and predicting the exact outcome is impossible.

Is the implant making a positive difference in your looks?
To be honest, I'm of the opinion that it's best to just pick a surgeon and go for it. Ultimately its a degree of luck because 1 surgeon might give 6/10 people a better result than other surgeons and a second surgeon might produce a better result for the other 4, but some people will spend forever deliberating and never actually get anything done.

Ramieri is 1) affordable and 2) has a good aesthetic eye and 3) couldn't be a nicer human being, so is a safe bet. Best to go conservative with him, and you almost definitely will look a lot better than you do now even if you dont look perfect

Then at least if you choose to replace the implants say in 2-3 years, you at least have a reference point now of 'here are my old designs, and I'd like a little more here and a little less here, to get me from X to Y'
 
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Ramieri is well up on my list as i trust his aesthetic eye. Only thing that concerns me with him is that he uses peek, which is a bitch to correct if he doesn't nail it first try, and the relative lack of experience compared to Eppley and Y. He's significantly cheaper than those two though + Eppley produced a bunch of hideous results, so long year experience doesn't necessarily equate to good results imo.

currently looking into a few turkish surgeons doing it, but they are all relatively new to it, but offer significantly lower prices
I consider Yaremchuk and Ramieri. Y has a proven track record and knows how to design implants. For example, @Win200 's implant done by Y is great. There have been some infections, but that's a risk with implants.

I haven't really seen results from Ramieri's jaw implants. However, some people seem to like his results.

Then there is Zhang in California, who is a student of Y think. She has written a book on facial implants with Y and has done at least one jaw implant. Younger than Y. But doesn't seem very experienced with jaw implants.

At this point, I don't consider Eppley, at least not now. I trust Y's implant designing skills more. I don't trust Defranq.
 
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Ramieri is well up on my list as i trust his aesthetic eye. Only thing that concerns me with him is that he uses peek, which is a bitch to correct if he doesn't nail it first try, and the relative lack of experience compared to Eppley and Y. He's significantly cheaper than those two though + Eppley produced a bunch of hideous results, so long year experience doesn't necessarily equate to good results imo.

currently looking into a few turkish surgeons doing it, but they are all relatively new to it, but offer significantly lower prices
What do you mean by 'bitch to correct ifhe doesn't nail it the first try'

I only ask because my right-side implant when he placed it was placed perfectly on the corners but shifted 1-3mm (we can feel it through the swelling but not see it) off the mandible at the front. Dr R said he can fix it for me if I want but suggested I wait as he said it basically wont be visible or effect the result aesthetically at all, it just means that if I run my finger along my mandible I feel a little 'lump' or 'notch' where it transitions from bone to implant. He said the only person who will know will be me, but If I want he can go back in, unscrew the implant and tweak it. I decided against this as if it doesnt effect the look I dont care and more surgeries means more recovery and a risk of an infection
 
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What do you mean by 'bitch to correct ifhe doesn't nail it the first try'
due to it's structure, peek leads to a significant tissue and bone ingrowth once fully healed, which is not something that would happen with a silicone/titanium implant. The more your tissue grew into the implant the harder and more invasive will it be to remove it for what ever reason later on. Peek has two significant advantages though, it feels like bone and specifically due to the tissue ingrowth it will be more secured in place compared to one just held in place with screws, like silicone/titanium.
 
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due to it's structure, peek leads to a significant tissue and bone ingrowth once fully healed, which is not something that would happen with a silicone/titanium implant. The more your tissue grew into the implant the harder and more invasive will it be to remove it for what ever reason later on. Peek has two significant advantages though, it feels like bone and specifically due to the tissue ingrowth it will be more secured in place compared to one just held in place with screws, like silicone/titanium.
Isn't tissue in growth problem with medpor, not PEEK?
 
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Isn't tissue in growth problem with medpor, not PEEK?
it's a problem with both, but you're right, it's a bigger one with medpor compared to peek, but both have ingrowth.
medpor e.g. isn't meant to be removed, ever. gives you a hint of how much of a struggle it is to remove an implant that has tissue ingrowth.
 
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it's a problem with both, but you're right, it's a bigger one with medpor compared to peek, but both have ingrowth.
medpor e.g. isn't meant to be removed, ever. gives you a hint how much of a struggle it is to remove an implant that has tissue ingrowth
Some South Korean surgeons use bone mass, which isn't very common in the west. But they don't doo many jaw implants I think.

I think I will consult both Y and R and check what they think about my implants. Maybe compare their plans then.
 
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Some South Korean surgeons use bone mass, which isn't very common in the west. But they don't doo many jaw implants I think.
Most of the south koreans choose a jaw narrowing over an implant, retarded sense of aestethic. As they don‘t strive for masculinity
I think I will consult both Y and R and check what they think about my implants. Maybe compare their plans then.
Sounds like a plan. Keep us updated (y)
 
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it's a problem with both, but you're right, it's a bigger one with medpor compared to peek, but both have ingrowth.
medpor e.g. isn't meant to be removed, ever. gives you a hint of how much of a struggle it is to remove an implant that has tissue ingrowth.
I suspect this isn't a huge problem with PEEK, simply because PEEK is completely non-porous and nonreactive, also, whether the bone even has anywhere to 'grow into' depends a lot on how your implant is designed, I don't think mine wrap round the whole mandible so I would assume that they should come off pretty easily, but I may be wrong
 
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He doesn't have a long history with implants, but I wouldn't write him off because of that. Eppley has been doing them his whole life, is called a "master", and is producing horrendous results.

Ramieri seems to have a good eye for aesthetics and seems quite ethical and careful. For example, he offered his beautiful chin procedure (a mini-chin wing) which did produce very nice results from the front. However, he quickly stopped offering it because it was creating a step off in the mandible. A lot of surgeons would just keep offering sub-par procedures if it is making them money, (like Zarrinbal and Brusco with the chin-wing which destroys your genial angle).

I think if a surgeon has a good aesthetic instinct they can produce good implant results. I tend to think the best implants are small ones.
what can you do to counter the gonial angle decrease with a chin wing? side wing?
 
He doesn't have a long history with implants, but I wouldn't write him off because of that. Eppley has been doing them his whole life, is called a "master", and is producing horrendous results.

Ramieri seems to have a good eye for aesthetics and seems quite ethical and careful. For example, he offered his beautiful chin procedure (a mini-chin wing) which did produce very nice results from the front. However, he quickly stopped offering it because it was creating a step off in the mandible. A lot of surgeons would just keep offering sub-par procedures if it is making them money, (like Zarrinbal and Brusco with the chin-wing which destroys your genial angle).

I think if a surgeon has a good aesthetic instinct they can produce good implant results. I tend to think the best implants are small ones.
what surgeon would you recommend for bimax and rhino? in europe?
 
Defrancq isn't very experienced with implants. Also, he has some sketchy history according to some users here.

Ramieri hasn't posted many results. Here is one of his designs, I think it's @Gaia262 's implant.


what is wrong with defranq?
 
what is wrong with defranq?
I don't trust his judgment. I haven't seen good results from him. Some people here have reported problems with him.
 
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I had mine put in on monday so I'm currently 6 days post

General thesis is:
- Damn was I not prepared mentally for the extent of the swelling that occurs post jaw implants. Its probably triple what I was expecting which is a big mind game because you have no idea what the result is going to look like for at least a month probably
- Dr Ramieri is clearly a super genuine and smart guy, I have complete trust in him
- While I can't 100% tell you that I'm happy with my result as my face still looks like a balloon, I can tell that what's underneath is in line with expectation and early indications are good
- I don't think its true that he's new to implants. Bare in mind this is not a common surgery globally, its quite a niche thing so most surgeons save a select few dont do this often. But Dr R told me he has done 25-30 of these procedures which relatively is a lot.
- My general instinct is that if you are most likely to be happy if you are not going for an extreme result, as there is way more room for error. The more extreme your design and difference to your underlying bone structure, the more uncertain it is how it will look once your soft tissue is placed on top of the implants.
- He spends a lot of time asking you detailed questions about what you are going for. If you show him examples of jaws you like and jaws you dont like (would highly recommend spending as much time focusing on what you dont want) then he can work out what to do
- Dr R seems very balance and harmony focused which is re-assuring, he's not the kind of guy who would ever perform a surgery that he thinks would look bad
- No matter the doctor or amount of discussion, the result will never look identical to what's in your head, best to accept that
Can you share your design?
 
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Does Ramieri know how to design good-looking custom jaw implants that fit the patient's face? I ask because I don't really know how to design implants so I would have to trust the surgeon. He's pretty new to implants, right? Not very experienced yet? All other comments about Ramieri are welcome too.

@Gaia262 @TheLordMadness @politically correct
For my case tbh i personally designed the implants. His first design wasn’t that good
Unfortunately he does not saddle infraorbital implants, i really like the zygo but the orbits aren’t that great tbh, jaw is ok but i had masseter dislocation (complication that happen sometimes while doing jaw implants).
Imo he isn’t that experienced with implants, but he is still an ok option, he hardly overdo and botch
 
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For my case tbh i personally designed the implants. His first design wasn’t that good
Unfortunately he does not saddle infraorbital implants, i really like the zygo but the orbits aren’t that great tbh, jaw is ok but i had masseter dislocation (complication that happen sometimes while doing jaw implants).
Imo he isn’t that experienced with implants, but he is still an ok option, he hardly overdo and botch
OK. I'm interested in a jaw angle implant. What were the problems with his first design?
 
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wackedchives
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