Which surgeons do high cut le fort i/ii (version C, D or E in the pic)

[smallgromp123]

Which surgeons are qualified enough to do C, D or E? There is not much info on this, why do surgeons usually pussy out on going near the zygoma? Yet some say it is equivalent to implants in terms of safety. Why not choose the permanent solution, in a way of an osteotomy? Dr David Alfi said on Jawhacks that he can go near the zygoma because custom guides and plates allow him to, yet his results do not really show any improvements of zygomatic/eye area does anybody know anything about this? Is midface hypoplasia actually not solvable without implants? Also, there is no real studies on health improvements of enhancing thes areas of the face, I'm sure it does something for the person in terms of health. Maybe it solves sinus problems? (just theorizing)

Does anybody have any info on this? Would be appreciated, because I think most of us need this procedure instead of LF iii (which is too extreme)

 

[inwardgonionscel]

View attachment 2439451

Which surgeons are qualified enough to do C, D or E? There is not much info on this, why do surgeons usually pussy out on going near the zygoma? Yet some say it is equivalent to implants in terms of safety. Why not choose the permanent solution, in a way of an osteotomy? Dr David Alfi said on Jawhacks that he can go near the zygoma because custom guides and plates allow him to, yet his results do not really show any improvements of zygomatic/eye area does anybody know anything about this? Is midface hypoplasia actually not solvable without implants? Also, there is no real studies on health improvements of enhancing thes areas of the face, I'm sure it does something for the person in terms of health. Maybe it solves sinus problems? (just theorizing)

Does anybody have any info on this? Would be appreciated, because I think most of us need this procedure instead of LF iii (which is too extreme)

I never saw anything else than being done than a and b

 

[smallgromp123]

I never saw anything else than being done than a and b

Yeah, same. I found out that Ramieri does B sometimes, but no one really seems to be going further than that, there is literally no info on this whatsoever. I think C, D or E could be a great solution to most of the .org's users' problems in terms of midface deficiency. If Implants have the same risk value then why not go for an osteotomy if the surgeon is skilled enough to do it. I know fillers are dangerous, fat grafting is not sustainable and is also dangerous, so why not try the permanent solution?

 

[inwardgonionscel]

Yeah, same. I found out that Ramieri does B sometimes, but no one really seems to be going further than that, there is literally no info on this whatsoever. I think C, D or E could be a great solution to most of the .org's users' problems in terms of midface deficiency. If Implants have the same risk value then why not go for an osteotomy if the surgeon is skilled enough to do it. I know fillers are dangerous, fat grafting is not sustainable and is also dangerous, so why not try the permanent solution?

Fillers are dangerous in the infras area not the malar area, fat grafts are actually a better version of fillers and cheaper on the long term but both of those solutions are for foids cuz men need angularity.
So it's either well designed implants or an osteotomy like maybe Zso cut which i don't think gives forward advancement. But why get a weird ass osteotomy that no known surgeon does when you can go to pagnoni or giant to fix ur issue ?

 

[smallgromp123]

Fillers are dangerous in the infras area not the malar area, fat grafts are actually a better version of fillers and cheaper on the long term but both of those solutions are for foids cuz men need angularity.
So it's either well designed implants or an osteotomy like maybe Zso cut which i don't think gives forward advancement. But why get a weird ass osteotomy that no known surgeon does when you can go to pagnoni or giant to fix ur issue ?

Does it fix the issue tho? There is always a chance of an infection with implants + it looks unnatural most of the time, with an osteotomy you look more natural + I'm sure there must be a health benefit to having a well developed midface. Implants are just planted on top of the bone which is recessed, whereas an osteotomy moves the bone forward. Plus It's a permanent solution, worth the risk if done properly In my opinion, but I also see your point.

 

[inwardgonionscel]

Does it fix the issue tho? There is always a chance of an infection with implants + it looks unnatural most of the time, with an osteotomy you look more natural + I'm sure there must be a health benefit to having a well developed midface. Implants are just planted on top of the bone which is recessed, whereas an osteotomy moves the bone forward. Plus It's a permanent solution, worth the risk if done properly In my opinion, but I also see your point.

Yea that's because it's always some bs design of the malar implant as the ends are not tapered, shape is unnatural and they often come down too low. There are always risks that's not an argument against implant as the majority don't get infections. You're right, but except lefort 3 i'm not aware of any osteotomy that advance the whole infra malar area forward, maybe go to india and get a Lefort 3 mate

 

[smallgromp123]

Yea that's because it's always some bs design of the malar implant as the ends are not tapered, shape is unnatural and they often come down too low. There are always risks that's not an argument against implant as the majority don't get infections. You're right, but except lefort 3 i'm not aware of any osteotomy that advance the whole infra malar area forward, maybe go to india and get a Lefort 3 mate

naaw I'll pass

 

[WagedandReady]

Unfortunately unless you’re visually syndromic, your only available option as a non-deformed subhuman would be custom implants in combination with a regular lefort I for midface deficiencies, especially when addressing the area north of the ANS point (malar or submalar).

Another approach could be to get a maxfac to do your osteotomy then go to a seasoned implant specialist (ie Eppley or someone like that, idk the market super well) who’s known for manufacturing and designing custom fitted implants. This would obviously have to wait until after your post op swelling has completely subsided.

 

[Manfrommars]

View attachment 2439451

Which surgeons are qualified enough to do C, D or E? There is not much info on this, why do surgeons usually pussy out on going near the zygoma? Yet some say it is equivalent to implants in terms of safety. Why not choose the permanent solution, in a way of an osteotomy? Dr David Alfi said on Jawhacks that he can go near the zygoma because custom guides and plates allow him to, yet his results do not really show any improvements of zygomatic/eye area does anybody know anything about this? Is midface hypoplasia actually not solvable without implants? Also, there is no real studies on health improvements of enhancing thes areas of the face, I'm sure it does something for the person in terms of health. Maybe it solves sinus problems? (just theorizing)

Does anybody have any info on this? Would be appreciated, because I think most of us need this procedure instead of LF iii (which is too extreme)

I heard Safi is offering some quad lf1, but it seems he’s willing to do anything drastic for establishment atm