Faavy
Iron
- Joined
- Sep 15, 2023
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Bimax is a complex procedure and many factors will affect its success. But here's one often overlooked on .org: orthodontics.
Have you ever wondered why in medical environments bimax is typically associated with orthodontics, while in .org most people get the surgery right away? Sure, surgery-first is a legit approach SOMETIMES, but why is it that almost every single user on .org follows the surgery-first protocol? What a coincidence!
In this recent study (by Alfaro's team), less than 10% of the patients are assigned to the surgery-first protocol: https://pubmed.ncbi.nlm.nih.gov/35643566/
My interpretation: surgery-first is a legit protocol if the patient adheres to the objective inclusion and exclusion criteria*. Essentially, you should go for surgery-first if both your jaws are equally recessed.
Otherwise, it will lead to sub-optimal results. Typically, in class 2 patients following surgery-first, the surgeon will overdo the maxilla advancement and CCW rotation to compensate for the poor orthodontics on the lower jaw. But the average .org user will have an urge to get the surgery, and no patience at all. The greedy surgeon will notice this urge and take advantage of the patient.
*Here's Alfaro's inclusion criteria and exclusion criteria:
Notice how Alfaro admits that the main reason for sugery-first are having an impatient incel as a patient.
This is the curve of Spee by the way:
Do you have a deep curve of Spee and the surgeons you consulted who were pushing you for surgery-first didn't even mention it? Guess why they didn't.
Imagine visiting a cheap Turkish surgeon asking for bimax, and the surgeon, instead of taking your money straightaway, saying: "You have a steep curve of Spee, do orthodontics for one year and come me see later"? The patient who goes to Turkey to get a cheap bimax won't accept that, he'll go to the first surgeon who does the surgery right away, and the surgeon won't be stupid to let the money escape. I'm not saying that Alfaro won't do the same by the way (he literally admits it in his inclusion criteria).
Have you ever wondered why in medical environments bimax is typically associated with orthodontics, while in .org most people get the surgery right away? Sure, surgery-first is a legit approach SOMETIMES, but why is it that almost every single user on .org follows the surgery-first protocol? What a coincidence!
In this recent study (by Alfaro's team), less than 10% of the patients are assigned to the surgery-first protocol: https://pubmed.ncbi.nlm.nih.gov/35643566/
My interpretation: surgery-first is a legit protocol if the patient adheres to the objective inclusion and exclusion criteria*. Essentially, you should go for surgery-first if both your jaws are equally recessed.
Otherwise, it will lead to sub-optimal results. Typically, in class 2 patients following surgery-first, the surgeon will overdo the maxilla advancement and CCW rotation to compensate for the poor orthodontics on the lower jaw. But the average .org user will have an urge to get the surgery, and no patience at all. The greedy surgeon will notice this urge and take advantage of the patient.
*Here's Alfaro's inclusion criteria and exclusion criteria:
Notice how Alfaro admits that the main reason for sugery-first are having an impatient incel as a patient.
This is the curve of Spee by the way:
Do you have a deep curve of Spee and the surgeons you consulted who were pushing you for surgery-first didn't even mention it? Guess why they didn't.
Imagine visiting a cheap Turkish surgeon asking for bimax, and the surgeon, instead of taking your money straightaway, saying: "You have a steep curve of Spee, do orthodontics for one year and come me see later"? The patient who goes to Turkey to get a cheap bimax won't accept that, he'll go to the first surgeon who does the surgery right away, and the surgeon won't be stupid to let the money escape. I'm not saying that Alfaro won't do the same by the way (he literally admits it in his inclusion criteria).
