Francesca Moors

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eppley is calling it a pipedream basically due to the combination of major health risks and aesthetics ones (eye assymetry, which i wouldnt mind at all in my case, since being assymetric is infinitely times better than hideous and deformed) and the consensus from what i see its that its a very complicated surgery performed only on the 'clinically deformed', evene riskier than the lefort 3.
what would be the odds of a guy like me persuading a surgeon to perform it, assuming that im aware of all the possible risks and complications and that i 'have no problem with it', and do you believe there is a 'trend' in the maxfac community or a shift if you like, of approaching eye spacing, either with orbox or any other surgical innovation(?) (using distraction osteogenesis maybe?)?. ive seen many people in the other forum discussing leforts 3 etc so i assume there will be a rise in demand in the near future and surgeons will eventually comply and start performing more cosmetically. but sadly theres not any talk about orbbox (makes sense since advancing sounds simpler than separating your orbitals) and most of the people cope by 'accepting' their eye spacing and doing nothing or other 'masking' procedures such as cheekbone shaving which i dont consider satisfying so not an option in my case. tbh im feeling pretty hopeless about it and im literally having suicidal tendencies over the whole looks part (my jaws are recessed but my eyes are atrocious) so yeah i cant be running away from the problem (my eyes) anymore.

tldr : does any non 'medically deformed' patient have any chance in getting orbital box osteotomy and if no why and what do you think about the future of such proedures and increasing eye spacing in general

* would it theoretically be possible to perform it only on one eye? both for aesthetic reasons (only one eye being 'sunken') and for minimizing complications

thanks in advance @Surgerymax
 

eyebrows

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Barely read, 0 percent chance a good surgeon would risk his career and reputation to possibly deform you.
 

Francesca Moors

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Barely read, 0 percent chance a good surgeon would risk his career and reputation to possibly deform you.
i cant end up looking worse than i do now
and the results i see online end up with minimal (if any at all) assymetry, ill take it
 

Rigor Mortis

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Everything you have read is correct

it isn’t really feasible or likely u would find a decent surgeon willing to do this , although I recall way back in the dayon jsf ,theee were. Rumors of a couple users getting it since they inquired about it w some dr and then wentdark, never to post again

The margin of error in such a procedure is greater than the amount desired in cosmetic cases iirc, basically meaning yes, u could in fact end up worse off than pre op , lol. Hell, u need a neurosurgeon present during op in the theater, that should tell u what kind of surgery we are dealing w here. Afaik it’s the most brutal max fac procedure (yes worse than lf 3) aside from maybe monobloc but That isn’t done post maturation .

pardon any typos I have to use a half decade old electric telephone that lags, changes words, and over heats to the point of almost blowing up. I’m getting a new iPhone when it comes out in a couple months
 

Francesca Moors

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Everything you have read is correct

it isn’t really feasible or likely u would find a decent surgeon willing to do this , although I recall way back in the dayon jsf ,theee were. Rumors of a couple users getting it since they inquired about it w some dr and then wentdark, never to post again

The margin of error in such a procedure is greater than the amount desired in cosmetic cases iirc, basically meaning yes, u could in fact end up worse off than pre op , lol. Hell, u need a neurosurgeon present during op in the theater, that should tell u what kind of surgery we are dealing w here. Afaik it’s the most brutal max fac procedure (yes worse than lf 3) aside from maybe monobloc but That isn’t done post maturation .

pardon any typos I have to use a half decade old electric telephone that lags, changes words, and over heats to the point of almost blowing up. I’m getting a new iPhone when it comes out in a couple months
Yea im aware of the brutality of it and psosible complications (even death or permanent brain damage). Im not 'really' thinking of doing it anytime soon (or even getting it ever), its more of a 'if things dont fix and get to a point of no return where the alternative is killing myself due to how bad my life is' type of scenario. And im not saying this as means of forcing any surgeon to operate me but just stating the reality of my life and what my choises would be.

As for the margin of error, from what ive seen, cosmetically, there are no huge trade offs (or maybe for those who arent symmetric in the first place or extremely ugly (ofc you compare with the presurgery deformed face so the overall imrpoveent overshadows assymetries etc)) plus like I said i doubt a guy like me would end up looking worse afterwards. Theres bigger chance that I turn up looking like a slightly assymetric male model and thus saving my life than anything else tbh.
 

Rigor Mortis

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Yea im aware of the brutality of it and psosible complications (even death or permanent brain damage). Im not 'really' thinking of doing it anytime soon (or even getting it ever), its more of a 'if things dont fix and get to a point of no return where the alternative is killing myself due to how bad my life is' type of scenario. And im not saying this as means of forcing any surgeon to operate me but just stating the reality of my life and what my choises would be.

As for the margin of error, from what ive seen, cosmetically, there are no huge trade offs (or maybe for those who arent symmetric in the first place or extremely ugly (ofc you compare with the presurgery deformed face so the overall imrpoveent overshadows assymetries etc)) plus like I said i doubt a guy like me would end up looking worse afterwards. Theres bigger chance that I turn up looking like a slightly assymetric male model and thus saving my life than anything else tbh.
I don’t remember the exact Margin for error but I do remember a thread I read on jsf where kavan mentioned it and how it was way greater than any cosmetic patient would be ok w , the scenario being (don’t take these numbers as gospel just an ex ) a patient wanting 2 mm alteration where the margin for error is 3 mm, lol.

plus like u said it’s p much reserved for syndromic patients.

Def don’t mention any sort of desperation or suicidal ideation w surgeons lmao, would be labeled an extreme SIMON (term used in rhino but can be applied to other fields within plastics imo) and tossed out.

if u reallt are some odd case where u don’t have a condition but truly some major issue regarding orbit positioning , idk I guess it can’t hurt to book a consult. Could prob find who the surgeon was by searching for the procedure on jsf and reading any pertinent threads that pop up.

best of luck man
 

Surgerymax

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This really depends on the extent of your problem - pictures are worth one thousand words.

If the expansion you hope for is very small MSE might be able to help, a modified SARPE/Facial Bipartition Distrac†ion Osteogenesis even better.

As for a one sided, yes that is a known technique called a U-SHAPED OSTEOTOMY for vertical orbital dystopia:


If Eppey said no, it may be hard. He co-authored the Orbital Box Osteotomy chapter in the 2020 Operative Techniques of Plastic Surgery.

Please inbox a picture.