What do you think of this trimax plan with Dr Safi?

[monkey.d.luffy]

Hey everyone, first post for me here, I've recently had a consult with Dr Safi, where he showed me the planned movements for my trimax. The results include the orthodontic decompression, which, based on what we have discussed, does not seem necessary, but would help achieve slightly more movement. What do you guys think of the results, and do you recommend that I still do the decompression?

Also, do you know if Raffaini or Ramieri also do zygo implants? Asking because I'd also like to get a plan from one of these two, but one of the reasons I'm going with Safi is he does these implants.

 

[adam_ross2549]

how much chin advancment is that?

 

[monkey.d.luffy]

I don't know to be honest, I will ask him on my next consult and post all the numbers here though!

 

[monkey.d.luffy]

how much chin advancment is that?

I can tell you there's some vertical movement as well though

 

[hansmoleman]

The 3 surgeons you mentioned do malar implants.

I’d strongly advocate for doing pre-op orthodontics.

 

[Deleted member 21048]

Cost?

 

[monkey.d.luffy]

Cost?

42K

 

[monkey.d.luffy]

The 3 surgeons you mentioned do malar implants.

I’d strongly advocate for doing pre-op orthodontics.

Good to hear! I'll probably consult with Ramieri then. Why do you strongly advocate for the pre-op decompression? Genuine question. Wouldn't it be possible to compensate after surgery as described here https://jkamprs.springeropen.com/articles/10.1186/s40902-019-0206-4?

 

[Deleted member 21048]

42K

For just a bimax + genio kinda steep

 

[monkey.d.luffy]

For just a bimax + genio kinda steep

Nono, trimax + zygo implants, but yeah, still steep

 

[Deleted member 21048]

Nono, trimax + zygo implants, but yeah, still steep

Yeah my case would probably be like 50k if i went with him, I can still afford just wondering if its worth the advancements, vs other surgeons im probably similar recession to you, i just have a shitty maxilla zygos would probably give move psl overall

 

[monkey.d.luffy]

Yeah my case would probably be like 50k if i went with him, I can still afford just wondering if its worth the advancements, vs other surgeons im probably similar recession to you, i just have a shitty maxilla zygos would probably give move psl overall

Have you consulted with anyone yet? And what do you think of these results?

 

[Deleted member 21048]

Have you consulted with anyone yet? And what do you think of these results?

Not anyone yet, just theoryizing rn, without going dead broke, not trying to spend 70k over various individual procedures, thats why i like doctors who do jaw and implant simultaneously, and should be a prerequisite anyways since most recessed people have bad maxillas

 

[hansmoleman]

Good to hear! I'll probably consult with Ramieri then. Why do you strongly advocate for the pre-op decompression? Genuine question. Wouldn't it be possible to compensate after surgery as described here https://jkamprs.springeropen.com/articles/10.1186/s40902-019-0206-4?

Surgery-first is a well-known and totally legit technique, but for patients with skeletal class 2 and dental class 1 it’s sub-optimal. When you opt for surgery-first in these cases, what the surgeon does is to keep your current bite. Doing decompensation after surgery, as you suggest, would be both risky and challenging. Basically, the surgeon would have to guess the exact amount of decompensation that it’s going to be done before it happens, which is impossible to do. Not to mention lack of stability of the new bite (you’d start off with a class 3 bite, and then pray God that orthodontics are indeed capable of fixing that).

 

[Deleted member 52566]

hope you get botched

 

[Deleted member 33030]

Does the 42k include the orthodontics or nah?

 

[Deleted member 23391]

Raffaini is hesitant to give people implants. He prefers fat grafting.

 

[monkey.d.luffy]

Does the 42k include the orthodontics or nah?

Nope, orthodontics excluded

 

[monkey.d.luffy]

Raffaini is hesitant to give people implants. He prefers fat grafting.

Yeah but fat, is fat, it adds volume sure but I wouldn't use for malar projection

 

[monkey.d.luffy]

hope you get botched

Sure champ

 

[IAMNOTANINCEL]

 

[monkey.d.luffy]

Surgery-first is a well-known and totally legit technique, but for patients with skeletal class 2 and dental class 1 it’s sub-optimal. When you opt for surgery-first in these cases, what the surgeon does is to keep your current bite. Doing decompensation after surgery, as you suggest, would be both risky and challenging. Basically, the surgeon would have to guess the exact amount of decompensation that it’s going to be done before it happens, which is impossible to do. Not to mention lack of stability of the new bite (you’d start off with a class 3 bite, and then pray God that orthodontics are indeed capable of fixing that).

Why is decomp after surgery risky? And why would you necessarily end up with a class 3 bite? Isn't it enough to slightly reduce advancement in the lower jaw?

 

[monkey.d.luffy]

View attachment 2591230

?

 

[hansmoleman]

Why is decomp after surgery risky? And why would you necessarily end up with a class 3 bite? Isn't it enough to slightly reduce advancement in the lower jaw?

i don't have the knowledge to say more than what i already said, but do you realize that even the article you cited does focus on class 3 patients right? i'll investigate further to be more precise in my explanation if i have time

 

[Deleted member 21048]

Why is decomp after surgery risky? And why would you necessarily end up with a class 3 bite? Isn't it enough to slightly reduce advancement in the lower jaw?

Dont ask retarded teenagers here

 

[Deleted member 38639]

Hey everyone, first post for me here, I've recently had a consult with Dr Safi, where he showed me the planned movements for my trimax. The results include the orthodontic decompression, which, based on what we have discussed, does not seem necessary, but would help achieve slightly more movement. What do you guys think of the results, and do you recommend that I still do the decompression?

Also, do you know if Raffaini or Ramieri also do zygo implants? Asking because I'd also like to get a plan from one of these two, but one of the reasons I'm going with Safi is he does these implants.

Is he planning to make your occlusal plane negative?!

 

[monkey.d.luffy]

Is he planning to make your occlusal plane negative?!

what do you mean?

 

[Deleted member 19957]

JFL just make one's occlusal plane -10 degrees theory. I'm less and less sure about that ante face shit tbh.

 

[Deleted member 38639]

what do you mean?

It looks like he's making your occlusal plane angle is negative. Usually it should be 8 degrees +/- 4 degrees. It'll make your look like it's tilted too upwards. Though, it's possible you were tilting your head upwards during your scan, idk

 

[Fairytale]

Since its safi it will be like 25-30mm
You will need really big forehead advancement after that.

 

[SixCRY]

Dont go to Dr Safi, or if you go with him do not consider his plan and do yours he will ajust

Dr Safi is all about CCW and super anteface

He's not taking harmony in consideration

I show you an example from his insta

Look at the chin abd lips, this is over advancement

Im not here to brag down safi, he surely is a good and skilled surgeon.

But dont follow the anteface cope, and ajust according to harmony not for max advancement

 

[PrinceofDarkness]

How much did you pay so far? Apparently he’s no good. Idk how the result is going to look thought.

 

[Deleted member 32196]

He wants to turn you into a dog