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How much jaw bone can actually be removed?

Started by jayhey, June 16, 2015, 05:23:46 AM

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jayhey

I talked to Barry and after I said I'd like my entire jaw and chin shaved down: "It is not possible to reduce the overall jaw. The most practical reductions are in the vertical length and width of the chin, jaw angle width reduction and sine slight vertical reduction between the two."

What....?
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mmmmm

Talk to Facial team, dr. Capitan and dr. Simon do skype consultations quite often...
They do CT-3D-scans, pre-op and post-op... If I would need chin-jaw work I would look at them first.
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fluttershy1617

Don't worry, It is a piece of cake, there are girls thay have 3x bigger jaw than you and they really get nice results, Korea is very good in these procedures. They can also reduce maxilla ( between your eyes and lip "middle face area" )  and zygomatic + cheekbones they can reduce these bones .





Going to start HRT
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jayhey

Quote from: mmmmm on June 19, 2015, 02:07:50 PM
Talk to Facial team, dr. Capitan and dr. Simon do skype consultations quite often...
They do CT-3D-scans, pre-op and post-op... If I would need chin-jaw work I would look at them first.

Okay, thanks. I contacted them for a Skype consultation. Their work seems more aggressive which I like.
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mmmmm

Quote from: jayhey on June 19, 2015, 06:24:40 PM
Okay, thanks. I contacted them for a Skype consultation. Their work seems more aggressive which I like.

And they are overobsessive with pre-surgical analyzation and details, which is very important if you want aggressive chin & jaw work.
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myfairlady49

Quote from: fluttershy1617 on June 19, 2015, 02:24:01 PM
Don't worry, It is a piece of cake, there are girls thay have 3x bigger jaw than you and they really get nice results, Korea is very good in these procedures. They can also reduce maxilla ( between your eyes and lip "middle face area" )  and zygomatic + cheekbones they can reduce these bones .





Flutershy1617,

I do not know where the pictures from Korea came from - - but those are not the same people - -  or they are seriously photo shopped.

Not hard to figure that out - -.   If you just screen capture the pictures and put them into any picture editor,  you can easily measure the distance between the eyes - -  and then other facial landmarks.  When you scale the pictures so that the distance between the eyes is exactly the same - -  then the other facial landmarks (that cannot be surgically altered) do not match between the two pictures  (left and right ).

Whichever surgeon is sponsoring those pictures on some web site somewhere is putting up pictures that do not appear to even be physically possible to be what the sponsor of those pictures intend for the viewer to believe.

If those were used by some U.S. based surgeon for marketing in the U.S.,  then they would likely constitute fraud and deceptive marketing practices.  Somebody could lose their license.

One has to be really careful about this sort of thing.  It tends to happen rather more often with marketing efforts from outside the U.S.,  although it can happen in the U.S.
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Ever

like I said at beginning: there is only so much that can safely be done to reduce chin/jaw, but even a slight reduction might be better than none, and you might grow to appreciate the change as subtle but significant

I'd only go to one of the high level reputable ffs surgeons or comparable
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myfairlady49

Quote from: jayhey on June 19, 2015, 06:24:40 PM
Okay, thanks. I contacted them for a Skype consultation. Their work seems more aggressive which I like.

Jayhey,

Permission to be blunt ?

So, 
1) you ask a lot of good questions about trying to change your wide jaw. 
2) You post up pictures of your face.
3) In response to the good questions about which surgeon to find - -  you ultimately do exactly the right thing:
    You find a surgeon who is
             a) board certified by a real plastic surgery board:
             b) qualified in orthognathic or maxilla-facial surgery; and,
             c) has at least some training in craniofacial surgery.
4) This surgeon is not known for his FFS work - -  but he really does appear to be qualified to tell you what is medically possible to be done for you.
5) This surgeon reviews your requests and then politely refuses to take your money and do the surgery you are  seeking.  Further,  that surgeon who will not take your money  tells you that what you want cannot be accomplished with surgery.

And that isn't good enough.  You won't take that "no" for an answer.  So you start out to hunt another surgeon, based on further suggestions in this thread of messages.   And you will probably end up with someone, maybe someone in a foreign country, who is not nearly as well  qualified - -  and who will be willing to take your money.

If you were to now, again, go to one of the very few other surgeons that are trained in those three areas - - and are actually experienced in full FFS work - -  I suspect they might also  tell you the same thing that the surgeon has already told you.  But maybe not.  But if they did think what you want can be done,  then you would want a really good explanation as to why and how the changes you want can be done by them, and why the first surgeon said it could not be done.   And you would want to carefully consider the benefits you seek against the surgical risks that always exist even in the hands of the very best of the best surgeons.

There are very few  in the world with  training in those three critical areas and extensive real FFS experience. 


Finally,  when I look at your pictures - -  if you were my friend - - I would tell you to thank your lucky stars that you are stunningly beautiful with a "trade mark" facial structure that reminds me of  Muriel Hemingway's distinctive and  beautiful face. 

          **********

Why do I (and I would expect any number of others looking at this string of messages and your pictures )  get the feeling that what you are trying to do - -  is really not going to work out very well ?

So - -  thank you for allowing me to  to be blunt.  Please be very very careful.   

The enemy of  beautiful is often an attempt at "better".

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sh1982

Quote from: myfairlady49 on June 19, 2015, 09:16:14 PM
Flutershy1617,

I do not know where the pictures from Korea came from - - but those are not the same people - -  or they are seriously photo shopped.

Not hard to figure that out - -.   If you just screen capture the pictures and put them into any picture editor,  you can easily measure the distance between the eyes - -  and then other facial landmarks.  When you scale the pictures so that the distance between the eyes is exactly the same - -  then the other facial landmarks (that cannot be surgically altered) do not match between the two pictures  (left and right ).

Whichever surgeon is sponsoring those pictures on some web site somewhere is putting up pictures that do not appear to even be physically possible to be what the sponsor of those pictures intend for the viewer to believe.

If those were used by some U.S. based surgeon for marketing in the U.S.,  then they would likely constitute fraud and deceptive marketing practices.  Somebody could lose their license.

One has to be really careful about this sort of thing.  It tends to happen rather more often with marketing efforts from outside the U.S.,  although it can happen in the U.S.

These kind of resulrs can be achieved since besides pictures the also have clips on their website with people having similair results plus they do a make over show in Korea with sometimes stunning results.But these kind of results cannot be achieved with just shave these kind of results involve moving the lower jaw backward and the upper jaw forward which are very invasive surgeries.
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jayhey

Quote from: myfairlady49 on June 19, 2015, 09:48:41 PM
Jayhey,

Permission to be blunt ?

So, 
1) you ask a lot of good questions about trying to change your wide jaw. 
2) You post up pictures of your face.
3) In response to the good questions about which surgeon to find - -  you ultimately do exactly the right thing:
    You find a surgeon who is
             a) board certified by a real plastic surgery board:
             b) qualified in orthognathic or maxilla-facial surgery; and,
             c) has at least some training in craniofacial surgery.
4) This surgeon is not known for his FFS work - -  but he really does appear to be qualified to tell you what is medically possible to be done for you.
5) This surgeon reviews your requests and then politely refuses to take your money and do the surgery you are  seeking.  Further,  that surgeon who will not take your money  tells you that what you want cannot be accomplished with surgery.

And that isn't good enough.  You won't take that "no" for an answer.  So you start out to hunt another surgeon, based on further suggestions in this thread of messages.   And you will probably end up with someone, maybe someone in a foreign country, who is not nearly as well  qualified - -  and who will be willing to take your money.

If you were to now, again, go to one of the very few other surgeons that are trained in those three areas - - and are actually experienced in full FFS work - -  I suspect they might also  tell you the same thing that the surgeon has already told you.  But maybe not.  But if they did think what you want can be done,  then you would want a really good explanation as to why and how the changes you want can be done by them, and why the first surgeon said it could not be done.   And you would want to carefully consider the benefits you seek against the surgical risks that always exist even in the hands of the very best of the best surgeons.

There are very few  in the world with  training in those three critical areas and extensive real FFS experience. 


Finally,  when I look at your pictures - -  if you were my friend - - I would tell you to thank your lucky stars that you are stunningly beautiful with a "trade mark" facial structure that reminds me of  Muriel Hemingway's distinctive and  beautiful face. 

          **********

Why do I (and I would expect any number of others looking at this string of messages and your pictures )  get the feeling that what you are trying to do - -  is really not going to work out very well ?

So - -  thank you for allowing me to  to be blunt.  Please be very very careful.   

The enemy of  beautiful is often an attempt at "better".

It's just that I have had 2 consultations with 2 well-known FFS surgeons (one in person and one by Skype) and they said they could do what I asked, so to have a surgeon to say no in a confusing way, continues to make me wonder. I appreciate your concern though.

And like sh1982 said, the Asian photos actually are real (Although, I still think they edit them). I have watched way too many Asian plastic surgery shows to know it's real.  :o

If the Facial Team says no, then I'll reconsider the surgery. I have read on previous threads that they will not hesitate to deny surgeries they don't find necessary.
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myfairlady49

Quote from: sh1982 on June 19, 2015, 10:42:43 PM
These kind of resulrs can be achieved since besides pictures the also have clips on their website with people having similair results plus they do a make over show in Korea with sometimes stunning results.But these kind of results cannot be achieved with just shave these kind of results involve moving the lower jaw backward and the upper jaw forward which are very invasive surgeries.

Sh1982

The types of surgeries you are describing were first developed in Switzerland by Hugo Obwegeser during the 1950s and 1960s at about the same time that Paul Tessier was developing craniofacial surgery in Paris.   All of the procedures you described were invented and perfected by Obwegeser, almost single handedly.  He often collaborated with Tessier.  Dr. Obwegeser  has trained a very few Americans.  And still fewer of those that he has trained are also plastic surgeons.  Maybe only one.

Ultimately, whatever is being done in Korea - - was not invented nor even developed there.

None of that changes the fact that the pictures that are posted in this thread and other places on this forum to represent the typical capabilities of jaw surgery in Korea do not appear to be  honest depictions.   You don't have to be a CSI geek to figure out that they are photo-shopped and they are deceptive.

It is true that in the hands of a good orthognathic surgeon,  movement of the lower jaw or the upper jaw and sometimes both can give dramatic or even stunning improvement to the face of many males and females that have over bites or under bites,  or even more complicated problems.  In almost all cases the best results come from those surgeries  done by a real plastic surgeon who is also trained in orthognathic surgery. 

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myfairlady49

Quote from: jayhey on June 19, 2015, 11:14:12 PM
It's just that I have had 2 consultations with 2 well-known FFS surgeons (one in person and one by Skype) and they said they could do what I asked, so to have a surgeon to say no in a confusing way, continues to make me wonder. I appreciate your concern though.

And like sh1982 said, the Asian photos actually are real (Although, I still think they edit them). I have watched way too many Asian plastic surgery shows to know it's real.  :o

If the Facial Team says no, then I'll reconsider the surgery. I have read on previous threads that they will not hesitate to deny surgeries they don't find necessary.

Looking back at your first post, you consulted with Dr. Z and he said he could do what you wanted.   Dr. S said - -  ? "No" , or only with subtle results ?

Did Dr. Z say he could substantially reduce your jaw ? 

According to www.certificationmatters.org,  Dr. Spiegel is not a board certified plastic surgeon.  He advertises board certificationn in a "plastic surgery board" that is not recognized as one of the 24 member boards approved by the american board of medical specialties.  That board is not the "real" plastic surgery board.  However, he is board certified in otolaryngology which is one of the ABMS recognized boards.  But there is no evidence of training in orthognathic surgery or oral maxillofacial surgery (jaw surgery).  But maybe that is there somewhere.   Clearly, he is not trained in craniofacial surgery.

Dr. Z is a board certified plastic surgeon,  but he is not  trained in either jaw surgery or craniofacial surgery.

The last person you talked with is, apparently, trained in all three.  Board Certified in plastic surgery and also trained in oralmaxillofacial surgery and with some experience in craniofacial surgery.   

There are some other FFS surgeons that are fully trained in all three of those areas.   You might keep investigating until you are really sure of the capabilities of the science and art to get the results you are seeking.





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Amy1988

Quote from: jayhey on June 16, 2015, 05:23:46 AM
Hi, everyone. I have been researching jaw reduction surgery for over a year now. I had my first in-person consult with Dr. Z and he agreed to do the surgery along with a neck lift. He did not think any other work would be needed (like cheek implants or brow lift).

My biggest concern (other than losing the feeling in my face or dying..) is how much mandible they can actually shave off.
I think I have only seen MY desired amount of bone removed on patients in Asia, but who knows if they Photoshop or not. Otherwise, it has been subtle for American patients, no? Any photos of that would be appreciated.

I am deciding between Dr. Z and Dr. Spiegal. I worry Dr. S would be too subtle, but I feel more comfortable with him due to the fact he demands x-rays for safety and does the surgery in a hospital (Dr. Z does not provide either). Dr. Z is local to me though. Dr. Z said Dr. S is unable to shave the chin vertically due to the "inside the mouth" technique, but who knows if it is true. I can't find pictures where Dr. S actually shaved the chin.

I should add, I am a genetic woman, but my jaw is large and masculine.

http://i.imgur.com/zILSqbJ.png

http://i.imgur.com/6SEVtWu.png

The shadow actually shaves off some of my jaw..
http://i.imgur.com/ZyhAPeS.png

http://i.imgur.com/9RloyuK.png

There is nothing wrong with your jaw.  You have a beautiful face but apparently you are not happy with your jaw so my opinion doesn't matter. 
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possessed

You are a beautiful woman already. My only advice is to go to a doctor trained in maxillofacial surgery. I think that dr rossi and di maggio are both experienced maxillofacial surgeons worth of considering. Good luck

Sent from my LG-H220 using Tapatalk

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SamSparks

I'm also interested in this.  It seems impossible to figure out if they can change jaws enough to actually make them stop looking manly.  Of course all the surgeons just ignore your concerns or whatever, but I'm constantly worried that they won't be able to bring my jaw within female range bc its definitely not right now.  For instance, how much can the take off the underside to shorten the length of your face overall.  I agree that oral-maxofilial surgeons would have the most experience working on jaws but some of the top FFS do not have an oral-maxofilial specialization like Dr. Spiegel, would he still be skilled enough in that case?  Or could it actually be of benefit to see different surgeons for different features but then I always heard and assumed that could just be too complicated and also you end up with conflicting aesthetic directions.
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myfairlady49

Quote from: SamSparks on July 08, 2015, 07:03:50 PM
I'm also interested in this.  It seems impossible to figure out if they can change jaws enough to actually make them stop looking manly.  Of course all the surgeons just ignore your concerns or whatever, but I'm constantly worried that they won't be able to bring my jaw within female range bc its definitely not right now.  For instance, how much can the take off the underside to shorten the length of your face overall.  I agree that oral-maxofilial surgeons would have the most experience working on jaws but some of the top FFS do not have an oral-maxofilial specialization like Dr. Spiegel, would he still be skilled enough in that case?  Or could it actually be of benefit to see different surgeons for different features but then I always heard and assumed that could just be too complicated and also you end up with conflicting aesthetic directions.

You could arrange for a consult with Dr. O, in San Francisco.  He was first trained in maxillofacial / orthognathic surgery and then plastic surgery and then craniofacial surgery with the doctor in France that invented craniofacial surgery.  Dr. O  has probably done 5 or 10 times as many of those types of jaw reduction surgeries on MTF patients as any other surgeon in the world. 

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SamSparks

Quote from: myfairlady49 on July 08, 2015, 09:45:18 PM
You could arrange for a consult with Dr. O, in San Francisco.  He was first trained in maxillofacial / orthognathic surgery and then plastic surgery and then craniofacial surgery with the doctor in France that invented craniofacial surgery.  Dr. O  has probably done 5 or 10 times as many of those types of jaw reduction surgeries on MTF patients as any other surgeon in the world.
Yea but hes not practicing anymore.  Also I live in the Midwest so.  I had a consultation with Z and it was very generic.  I feel like they cant really tell you much specifics and they all bull->-bleeped-<- about how much they will be able to do for you.  BUt ya he really has all the best training for FFS.  Dr. Spiegel is very experienced at the craniofacial side of things and I feel he does a great job on foreheads usually... but it would be nice if he had more specific lower face training like O did.
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myfairlady49

Quote from: SamSparks on July 09, 2015, 11:01:45 AM
Yea but hes not practicing anymore.  Also I live in the Midwest so.  I had a consultation with Z and it was very generic.  I feel like they cant really tell you much specifics and they all bull->-bleeped-<- about how much they will be able to do for you.  BUt ya he really has all the best training for FFS.  Dr. Spiegel is very experienced at the craniofacial side of things and I feel he does a great job on foreheads usually... but it would be nice if he had more specific lower face training like O did.

From other messages on the board,  it appears that Dr. O is still seeing patients and is still going to the operating room with the younger doctor with whom he is turning his practice over to.  From what I learned at one of the events last year, the other younger doctor is also extensively trained in jaw surgery in Switzerland from  the  Swiss surgeon  who first developed that type of jaw surgery. I cannot remember his name, right now.   If you want to get a definitive answer to your question - -  you might give Dr. O a try,  otherwise,  you may go on wondering  "what if ?"  for a long time.


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orangeskipper

Another option to be aware of is one I learned of while getting a jaw reduction consultation. In combination with, or in lieu of, jaw surgery, some are starting to use Botox to cause atrophy to the masseter muscle. I haven't seen any results as yet. Does anyone have more info about this?
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orangeskipper

To address the question of how much bone can be removed, this is almost entirely defined by the amount of bone that can be removed while avoiding any possible damage to the mental nerve. The aperture where this nerve exits the jaw is very distinct, and your x-Rays would be used to judge how much could be removed. Damage to the mental nerve is very bad indeed, and you will want to be as confident of the capabilities of your surgeon as possible. You may find it helpful to get a copy of Dr O's 'Feminization of the transsexual' on Amazon or wherever. I have no affiliation with him or his office.
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