SURGEONS NOTES: Video Update (HIGH IQ Looksmaxers Needed)

[Gaia262]

Hello Looksmaxxers,

So I had my consultation with my surgeon in London who sent me a letter please see extract below:

It was a pleasure to meet you in consultation today, regarding your interest in improving the proportions of your lower face and discussing lower facial contouring. Your concerns relate to a hereditary tendency for a receding chin with lack of central jawline definition and a tendency for soft tissue accumulation in the central lower portion of your face.On examination I noted a subtle craniofacial asymmetry affecting the lower two thirds of the left hemiface with the left side being slightly shorter and thinner than the right.

An overall symmetrical mandibular function and occlusion is noted. The length of the mandibular body is slightly longer on the right side. No pathology is evident within the oral cavity, craniofacial architecture, or facial soft tissues. From the side view the chin falls approximately 6-7mm behind the ideal lines created by the upper and mid facial structures. As such, the chin appears slightly deficient and out of balance. At the lower corners of the mouth, a light degree of buccal fat herniation is noted, most pronounced on the right side.

Based on our discussion, I recommend an anatomical chin implant to provide central chin augmentation with a masculine square profile. The selected implant will be a small to medium size providing conservative changes and adding approximately 6-7mm in side view. In addition, I recommend a conservative buccal fat reduction to slim the lower face and improve definition in your perioral area and jawline. The procedure can be performed in general anaesthesia as a day case at one of our surgical facilities located in central London.


he is happy for a chin implant and a slight buccal fat removal , he does not recommend a lip lift (due to risks for little benefit) nor does he recommend a chin osteonomy. What are you guys thoughts. PLEASE HIGH IQ. He essentially states no other surgeries will be needed after this as the benefit to risk ratio is not worth it so this would be my last surgery.


Here is an updated video of me.

 

[Deleted member 2527]

He sounds high IQ

Could you pm his name?

 

[Gebirgscel]

Custom ?

 

[eduardkoopman]

Why the fat removal in the face?
Can it not just be solved, by you losing weight and not being overweight?

 

[Rasputin]

like facemaxxed said above, he sounds high iq. Honestly I would not perform any surgery before be at least 12% BF at minimum. He’s trying to be conservative yet he sounds right. About no other surgeries needed I think he just don’t want you to look plastic.

 

[Andromeda88]

You look much better now, get the surgeries and ascend.

 

[Rasputin]

Why the fat removal in the face?
Can it not just be solved, by you losing weight and not being overweight?

It’s bucal fat removal. Not everyone lose fat in this region even at lower BF. It’s hereditary for some

 

[Deleted member 1862]

He sounds high IQ

like facemaxxed said above, he sounds high iq.

Not trying to roast you two (& you @Gaia262) but this is tragic. The surgeon used some big words & you're suddenly all impressed. He's no more 'high iq' than most other surgeons. @facemaxxed don't bother contacting him. He's in the UK & therefore should immediately be ruled out of your list of potential surgeons. It's not rash, it's the truth.

OP, you're trying to find an easy out and in doing so you're believing whatever bs this surgeon is saying as if he's the be all end all.
You're already aware of my stance on implants but if you're absolutely hell bent on pursuing one over an osteotomy I see no reason why you wouldn't seek help from one of the best in the field (ie Dr Y, eppley etc) instead of a nobody in (for the final time) one of the worst first world countries to get plastic/maxillofacial surgery in.

Your behaviour is exactly that of a typical surgery coper. I'm not talking about someone like @facemaxxed who has (as far as I can see & for better or worse) been relentless & reasonably meticulous in his pursuit.
You're trying to cut corners & clearly refusing to do your own research even though this seems to be of high importance to you.
Yours is not an easy problem to fix. All those people who told you your starting point is garbage are completely correct. You need to commit to this process if you want any remote chance of improving your looks in a substantial way.

Not trying to roast you two (& you @Gaia262) but this is tragic. The surgeon used some big words & you're suddenly all impressed. He's no more 'high iq' than most other surgeons. @facemaxxed don't bother contacting him. He's in the UK & therefore should immediately be ruled out of your list of potential surgeons. It's not rash, it's the truth.

OP, you're trying to find an easy out and in doing so you're believing whatever bs this surgeon is saying as if he's the be all end all.
You're already aware of my stance on implants but if you're absolutely hell bent on pursuing one over an osteotomy I see no reason why you wouldn't seek help from one of the best in the field (ie Dr Y, eppley etc) instead of a nobody in (for the final time) one of the worst first world countries to get plastic/maxillofacial surgery in.

Your behaviour is exactly that of a typical surgery coper. I'm not talking about someone like @facemaxxed who has (as far as I can see & for better or worse) been relentless & reasonably meticulous in his pursuit.
You're trying to cut corners & clearly refusing to do your own research even though this seems to be of high importance to you.
Yours is not an easy problem to fix. All those people who told you your starting point is garbage are completely correct. You need to commit to this process if you want any remote chance of improving your looks in a substantial way.

Also you need to lose weight. Getting lipo was probably retarded bc now you've no accurate way to gauge how what you're actual BF % is. I have no doubt that your face would improve at least a bit should you lean down. More laziness. More reasons why it's over. You lack the (minimal) levels of mental fortitude required to looksmax.

 

[Gaia262]

It’s bucal fat removal. Not everyone lose fat in this region even at lower BF. It’s hereditary for some

Here is a video of my body, the fat on my face is hereditary If you feel I need to lose more weight let me know. Please note I had liposuction on my lower abs/flanks so I am actually thinner than this taking off the current swelling.

 

[Rasputin]

Not trying to roast you two (& you @Gaia262) but this is tragic. The surgeon used some big words & you're suddenly all impressed. He's no more 'high iq' than most other surgeons. @facemaxxed don't bother contacting him. He's in the UK & therefore should immediately be ruled out of your list of potential surgeons. It's not rash, it's the truth.

OP, you're trying to find an easy out and in doing so you're believing whatever bs this surgeon is saying as if he's the be all end all.
You're already aware of my stance on implants but if you're absolutely hell bent on pursuing one over an osteotomy I see no reason why you wouldn't seek help from one of the best in the field (ie Dr Y, eppley etc) instead of a nobody in (for the final time) one of the worst first world countries to get plastic/maxillofacial surgery in.

Your behaviour is exactly that of a typical surgery coper. I'm not talking about someone like @facemaxxed who has (as far as I can see & for better or worse) been relentless & reasonably meticulous in his pursuit.
You're trying to cut corners & clearly refusing to do your own research even though this seems to be of high importance to you.
Yours is not an easy problem to fix. All those people who told you your starting point is garbage are completely correct. You need to commit to this process if you want any remote chance of improving your looks in a substantial way.

True. I didn’t know he’s in the UK. Hmm, if he has all that money then why not move for a better country for a while then get top notch surgeons? @Gaia262

 

[Deleted member 2527]

Not trying to roast you two (& you @Gaia262) but this is tragic. The surgeon used some big words & you're suddenly all impressed. He's no more 'high iq' than most other surgeons. @facemaxxed don't bother contacting him. He's in the UK & therefore should immediately be ruled out of your list of potential surgeons. It's not rash, it's the truth.

OP, you're trying to find an easy out and in doing so you're believing whatever bs this surgeon is saying as if he's the be all end all.
You're already aware of my stance on implants but if you're absolutely hell bent on pursuing one over an osteotomy I see no reason why you wouldn't seek help from one of the best in the field (ie Dr Y, eppley etc) instead of a nobody in (for the final time) one of the worst first world countries to get plastic/maxillofacial surgery in.

Your behaviour is exactly that of a typical surgery coper. I'm not talking about someone like @facemaxxed who has (as far as I can see & for better or worse) been relentless & reasonably meticulous in his pursuit.
You're trying to cut corners & clearly refusing to do your own research even though this seems to be of high importance to you.
Yours is not an easy problem to fix. All those people who told you your starting point is garbage are completely correct. You need to commit to this process if you want any remote chance of improving your looks in a substantial way.

Also you need to lose weight. Getting lipo was probably retarded bc now you've no accurate way to gauge how what you're actual BF % is. I have no doubt that your face would improve at least a bit should you lean down. More laziness. More reasons why it's over. You lack the (minimal) levels of mental fortitude required to looksmax.

Why should UK surgeons be ruled out completely?

 

[Gaia262]

Not trying to roast you two (& you @Gaia262) but this is tragic. The surgeon used some big words & you're suddenly all impressed. He's no more 'high iq' than most other surgeons. @facemaxxed don't bother contacting him. He's in the UK & therefore should immediately be ruled out of your list of potential surgeons. It's not rash, it's the truth.

OP, you're trying to find an easy out and in doing so you're believing whatever bs this surgeon is saying as if he's the be all end all.
You're already aware of my stance on implants but if you're absolutely hell bent on pursuing one over an osteotomy I see no reason why you wouldn't seek help from one of the best in the field (ie Dr Y, eppley etc) instead of a nobody in (for the final time) one of the worst first world countries to get plastic/maxillofacial surgery in.

Your behaviour is exactly that of a typical surgery coper. I'm not talking about someone like @facemaxxed who has (as far as I can see & for better or worse) been relentless & reasonably meticulous in his pursuit.
You're trying to cut corners & clearly refusing to do your own research even though this seems to be of high importance to you.
Yours is not an easy problem to fix. All those people who told you your starting point is garbage are completely correct. You need to commit to this process if you want any remote chance of improving your looks in a substantial way.

Also you need to lose weight. Getting lipo was probably retarded bc now you've no accurate way to gauge how what you're actual BF % is. I have no doubt that your face would improve at least a bit should you lean down. More laziness. More reasons why it's over. You lack the (minimal) levels of mental fortitude required to looksmax.

Thanks for challenging me this is what this is all about. I did speak to my orthodontist yesterday funny enough ( for a retainer check), and he talked about my jaw about getting a BSSO and said that it approximately a few mm deficient and I would struggle to get a surgeon who would do this surgery for this level of deficiency and to factor in the recovery times/risks.

Regarding the chin osteotomy, I am trying my best to recall the consultation but he said I was not a candidate for this as my jaws functionality is perfectly fine, even though it is slightly asymmetric. I am struggling to recall correctly what was said on that.

 

[Deleted member 1862]

Why should UK surgeons be ruled out completely?

Standards are much lower in the UK. I can go into more detail later if you require but it's self evident if you try looking up surgeons in the uk

 

[Deleted member 2527]

Standards are much lower in the UK. I can go into more detail later if you require but it's self evident if you try looking up surgeons in the uk

Surely if he goes to a top Harley St surgeon then he is guaranteed a highly qualified surgeon is he not

 

[KEy21]

If you want an implant just do a Medpor custom wraparound

You around gonna slay shit with a few more mm of chin projection it’s not big enough of a chance

You need the angles lowered and widened of your jaw..you need more mass and the chin to be forward and thicker...

Plus medpor can simulate the real thing better than silicone

 

[Deleted member 1862]

Surely if he goes to a top Harley St surgeon then he is guaranteed a highly qualified surgeon is he not

in a word: no

harley street is well known because of it's history, the current residing businesses have nothing to do with this.

 

[Gaia262]

in a word: no

harley street is well known because of it's history, the current residing businesses have nothing to do with this.

He is an extremely high end surgeon.

 

[I'mme]

Thanks for challenging me this is what this is all about. I did speak to my orthodontist yesterday funny enough ( for a retainer check), and he talked about my jaw about getting a BSSO and said that it approximately a few mm deficient and I would struggle to get a surgeon who would do this surgery for this level of deficiency and to factor in the recovery times/risks.

Regarding the chin osteotomy, I am trying my best to recall the consultation but he said I was not a candidate for this as my jaws functionality is perfectly fine, even though it is slightly asymmetric. I am struggling to recall correctly what was said on that.

Lmao what!! Genioplasty/ chin osteotomy is often done for aesthetic purposes here in India. As Autophobic said, prefer osteotomy wherever possible. Implant are foreign materials. Even worse is that you'll get done silicone.

If you're little flexible, I would request you to at least consult this surgeon - facesurgeon.in

 

[Deleted member 2486]

He sounds high IQ

Could you pm his name?

DONT TELL HIM THE NAME, FOR HIS OWN SAKE

 

[Gaia262]

Custom ?

No, we discussed custom made and made with alternative materials, CT-scans etc, but he says there is no need that would be overkill and expensive, my case is quite straight forward.

 

[lookserumaxeru]

I would absolutely go for a surgeon that would do the chin osteotomy. Realize that doing this surgery, it is way more natural than an implant, because they are only cutting the bone and sometimes they don't even use screws to hold the new position in place. They may even use wires to hold a fixed position. Plus it's almost like you are just hiding your imperfection with an implant, rather than actually fixing it for real (osteotomy).

 

[Preposterous]

Definitely try and find a surgeon who would be willing to do osteotomy over implants, especially in the chin area. Looks like you’d benefit mostly from getting your chin and jaw angles dropped down as well as projected forwards. Buccal fat pad removal could be done but I would get the chin work first and see if it’s even necessary after that. Like people have said already, UK surgeons are trash tier. I’ve consulted with a number of max fax surgeons across Europe, and the UK ones stood out as being the least aesthetically minded. If you want chin work done in Europe go to Germany or Switzerland.

 

[PubertyMaxxer]

Hello Looksmaxxers,

So I had my consultation with my surgeon in London who sent me a letter please see extract below:

It was a pleasure to meet you in consultation today, regarding your interest in improving the proportions of your lower face and discussing lower facial contouring. Your concerns relate to a hereditary tendency for a receding chin with lack of central jawline definition and a tendency for soft tissue accumulation in the central lower portion of your face.On examination I noted a subtle craniofacial asymmetry affecting the lower two thirds of the left hemiface with the left side being slightly shorter and thinner than the right.

An overall symmetrical mandibular function and occlusion is noted. The length of the mandibular body is slightly longer on the right side. No pathology is evident within the oral cavity, craniofacial architecture, or facial soft tissues. From the side view the chin falls approximately 6-7mm behind the ideal lines created by the upper and mid facial structures. As such, the chin appears slightly deficient and out of balance. At the lower corners of the mouth, a light degree of buccal fat herniation is noted, most pronounced on the right side.

Based on our discussion, I recommend an anatomical chin implant to provide central chin augmentation with a masculine square profile. The selected implant will be a small to medium size providing conservative changes and adding approximately 6-7mm in side view. In addition, I recommend a conservative buccal fat reduction to slim the lower face and improve definition in your perioral area and jawline. The procedure can be performed in general anaesthesia as a day case at one of our surgical facilities located in central London.


he is happy for a chin implant and a slight buccal fat removal , he does not recommend a lip lift (due to risks for little benefit) nor does he recommend a chin osteonomy. What are you guys thoughts. PLEASE HIGH IQ. He essentially states no other surgeries will be needed after this as the benefit to risk ratio is not worth it so this would be my last surgery.


Here is an updated video of me.

youre curry

save the money its over anyways

 

[crosshold]

If you want an implant just do a Medpor custom wraparound

You around gonna slay shit with a few more mm of chin projection it’s not big enough of a chance

You need the angles lowered and widened of your jaw..you need more mass and the chin to be forward and thicker...

Plus medpor can simulate the real thing better than silicone

why do you say medpor?

 

[KEy21]

why do you say medpor?

Saw a ton of results with medpor and it looks much more authentic and mocks bone better for the lower third

 

[crosshold]

Saw a ton of results with medpor and it looks much more authentic and mocks bone better for the lower third

i disagree, any form of "unrealness" is because the implant was probably too big. ask eppley or yaremchuk, they will tell you that there is no visual difference

 

[KEy21]

i disagree, any form of "unrealness" is because the implant was probably too big. ask eppley or yaremchuk, they will tell you that there is no visual difference

I know them both on a first name basis and have gotten 3 surgeries done with Eppley. The only excuse to not use medpor is being a poorcel and coping tbh.

All of the smartest PSLers got medpor in their jaws and the results look very good. The form of unrealness is due to the material and the fact that it can't possibly mimmic bone. Eppley will just tell you that because he likes to do silicone implants that he puts in 45 minutes. He has a great marketing scheme going. It takes extra work to put in Medpor and it's more entailed - Which means more precise result by the mm. Medpor has much higher tissue fixation which is important as well..

The thing with silicone is that it's probably easier to revise but you're more prone to revise with it since the material is shit. Silicone is a safer alternative and easier to do as a surgeon in countries here malpractice insurance is extremely expensive and pressure on doctors to perform at high levels is at an all-time high. Especially with all of the ambulance chasing lawyers in debt out of law school. Their practicality and simplicity for the cosmetic practice is why they're preferred by surgeons. Not because of their superiority as an implant.

It's the same reason they'll slap a silicone implant on a recessed jaw without second guessing it...Even if they know the patient needs double jaw. It's much less risky and they make their money. Cosmetic surgery is a business.

 

[Gaia262]

Thanks so much, these replies are really helpful believe me.

 

[crosshold]

I know them both on a first name basis and have gotten 3 surgeries done with Eppley. The only excuse to not use medpor is being a poorcel and coping tbh.

All of the smartest PSLers got medpor in their jaws and the results look very good. The form of unrealness is due to the material and the fact that it can't possibly mimmic bone. Eppley will just tell you that because he likes to do silicone implants that he puts in 45 minutes. He has a great marketing scheme going. It takes extra work to put in Medpor and it's more entailed - Which means more precise result by the mm. Medpor has much higher tissue fixation which is important as well..

The thing with silicone is that it's probably easier to revise but you're more prone to revise with it since the material is shit. Silicone is a safer alternative and easier to do as a surgeon in countries here malpractice insurance is extremely expensive and pressure on doctors to perform at high levels is at an all-time high. Especially with all of the ambulance chasing lawyers in debt out of law school. Their practicality and simplicity for the cosmetic practice is why they're preferred by surgeons. Not because of their superiority as an implant.

It's the same reason they'll slap a silicone implant on a recessed jaw without second guessing it...Even if they know the patient needs double jaw. It's much less risky and they make their money. Cosmetic surgery is a business.

Fair enough, I guess I have more research to do

 

[Gaia262]

in a word: no

harley street is well known because of it's history, the current residing businesses have nothing to do with this.

RESPONSE FROM SURGEON


Would a BSSO or Chin osteotomy be a better option for me as opposed to a chin implant? if not why?
As discussed during consultation, genioplasty and osteotomy are more invasive procedures - not indicated in your case.

- I should of asked if I needed vertical projection of the lower third, if yes, would the chin implant offer this? Essentially if all I need for my lower third is this chin implant, where everything else Is not necessary.

The surggested chin implant will provide anterior chin augmentation with a moderately square profile. Although the implant is located along the lower mandibular border, it usually provides a slight improvement in vertical chin height.

- Would there be a significant impact on my appearance or would it be more or less unnoticeable at 6mm?

We will have an implant size available with both 6mm and 7mm projection, and use the most appropriate.

- Is my buccal fat hereditary/genetic or is it due to excess weight ? I feel as though I have lost a lot of weight and am only 144lb (want to be 150lb lean) but what do you think? Will this get worse as I age?

Your buccal fat is most likely hereditary


Essentially I just want to know if this is the best option I am doing for my lower third and why not the alternatives i.e. chin osteotomy/mandibular implant and would provide an optimal outcome of my lower third. Do you truly feel this is the most optimal out of everything? Do he feel from his perspective that I need this? Forgive me I take everything seriously.

In your situation, there is no benefit in performing an osteotomy or genioplasty, as compared to an implant.

As we discussed during consultation, there are several options for implants, including custom implants manufactured from CT scans. However, as the occlusion is normal, and the underlying mandibular asymmetry minor - a standard silicone implant will provide very similar improvement for you as with a custom implant.

 

[Sweboy]

You are an inspiration OP

 

[wellthatsucks]

First of all what is your goal? Trying to reach looks threshold for relationships? Fixing your self image?

 

[Gaia262]

First of all what is your goal? Trying to reach looks threshold for relationships? Fixing your self image?

just being an acceptable person when conducting business going on holiday etc just enjoying /progressing in life without being held back by looks. Yes meeting the relationship threshold even though not wanting a relationship.

 

[Linoob]

Small to medium sized chin implant?

The surgeon is a fucking idiot.

You need the largest available shelf size (XL) or most likely a custom implant as your lower third is fucking ridiculously small / recessed

 

[BNCcel]

You need to lose all the fat first, or else you'll never see your true face

 

[Gaia262]

Any recommendations for surgeons uk based that specialize in what I need that I can research ?

 

[I'mme]

Any recommendations for surgeons uk based that specialize in what I need that I can research ?

Don't go with that surgeon bro. Either eppley or Dr Y or that Indian surgeon.

Don't ever get silicone - prefer PEEK, titanium, and medpor instead.

 

[Sweboy]

I would focus on harmony. I think it would be easier to pull of and you wont be feeling as self consiouc as with a gigantic implant. 90 % of the people commenting would never had surgeries done themselvs.

As for topic, I'm thinking about this also but I Will try and focus on my facila symmetry/harmony rather than having the biggest jaw/chin size.