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Recommended surgeon for surgical mandibular procedure?

  • 11-08-2019 3:39am
    #1
    Banned (with Prison Access) Posts: 1,355 ✭✭✭


    Firstly - I guess the surgical designation needs clarifying;

    As I understand it, based by example, on general trauma or a facial break, it could be a plastic surgeon, ENT dude, or maxillofacial surgeon - ?

    For complex/major surgeries like orthognathic jaw reconfiguration, which surgeon would typically be the individual of choice?

    Google tells me there's a plastic surgeon by the name of <snip> that works out of the sports surgery clinic and matter private - specialty being craniofacial work but his background is plastic surgery?

    Some other dude called <snip> that runs his own private clinic but also works out of the Mullingar hospital - but I may have read his speciality is wisdom teeth - ?

    Couple other dudes that work out of an aesthetic institute - but one review website has a string of reviews absolutely slating one of them, "would not recommend to my worst enemy" etc.

    Google has reviews on a dude called<snip> that's done complex procedures like this before - ?
    His background seems to be maxillofacial?


    Can anyone bring me up to speed here?

    Basically looking for the most competent individual in this area with track record and reputation?


Comments

  • Registered Users, Registered Users 2 Posts: 158 ✭✭Darthvadar


    Needed significant treatment due to a genetic condition....

    Used a fabulous Maxillo-Facial surgeon, **RECOMMENDATIONS BY PM ONLY**... A true gentleman, and a fantastic surgeon... Only have good things to say about him....

    Good luck with your surgery....

    Darth...

    EDIT..... So sorry.... Didn't realise that I should only use PM... Apologies!....


  • Registered Users, Registered Users 2 Posts: 933 ✭✭✭Dianthus


    Why are you having surgery?
    Has your dentist/doctor given any recommendations?
    The work they do is nothing short of phenomenal. But it's insanely high risk; that's just the nature of the job. You're going to read the odd bad review- the practitioner who hasn't had a complication/suboptimal outcome/negative patient interaction, simply does not exist.
    (Reading all the references to "dudes" reminds me of a scene from the film "A Few Good Men" about the use of titles lol....but also serves as a reminder that so few women are surgeons at that level...)


  • Registered Users, Registered Users 2 Posts: 258 ✭✭Fishorsealant


    These treatments usually have an orthodontist on board as the final outcome is a combination of surgery and braces.
    In fact the decision for surgery is often decided part on the analysis of the underlying skeletal issue.

    Ortho consultation to see if surgery is necessary and they could recommend a surgeon they work with? You could ask to see before/after pictures etc..

    While you are right that different surgical specialities do perform orthognathic surgery I would say that you want someone who does many of these cases a year. For example there is one prominent max fac surgeon in the Munster region and it wouldn't be unknown for people to travel 3 hours for consultations as he does these cases on a weekly basis.


  • Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    Your orthodontist will work with a surgeon so its not going to be your choice. Choose the orthodontist as a primary. What surgery do you think you need?


  • Banned (with Prison Access) Posts: 1,355 ✭✭✭bo0li5eumx12kp


    Your orthodontist will work with a surgeon so its not going to be your choice. Choose the orthodontist as a primary. What surgery do you think you need?

    I don't have an orthodontist and the hell it's not going to be my choice - lol.

    Think I'm letting some dude come at me with scalpel and a pair of pliers without adequately vetting them first? (albeit that may mean anti-upping a couple or three consultation fees).

    The procedure?

    My mandible requires tending to - and I need a refined individual for the job.


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  • Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    Ok...very good :). Surgeons work on referral from an orthodontists for this work, you dont as a random punter with a google degree in dentistry, just rock up and request a surgery. You need braces beforehand (decompensation), surgical guides made by, and braces afterwards by an orthodontist.

    The orthodontist plans the surgery and how much advancement or protrusion. If you decide to use another surgeon with whom the orthodontist is unfamiliar, the orthodontist will likely discharge you from their care, because at the end of the day they have to work with the people they know can achieve the result. The orthodontist you choose will have a far greater effect on outcome than the surgeon.

    The orthodontist is the first port of call and good orthodontists will have a surgeon they work with all the time who understands what they are after. A good orthodontist will not ally themselves with a bad surgeon. Not that there really are bad surgeons out there just that some are more experienced than others at this sort of work.

    I know orthodontists that are big into computer guided orthognathics and get very nice results. I know the surgeon he works with. But one without the other is nothing.

    However to be honest with you here, you sound on a lot of your boards threads, like a bit of an aggressive know it all. Rocking in with your preconceived notions and demands and will get you nowhere. Getting involved with 2-5 years of treatment is like a marriage, and like a marriage professionals tend to be cautious who they commit to..you might be vetting them, but they are vetting you too.


  • Banned (with Prison Access) Posts: 1,355 ✭✭✭bo0li5eumx12kp


    I should clarify - this is not orthognathic surgery.

    My teeth are kool and gang (well, a little spacing but, can't do much about that - non-fluorescent composites are not a good look for me).

    My logic is, a surgeon who regularly chops up and aligns maxilla and mandibles, should regard what I require as straight forward and hopefully accomplish it with little to no complication.

    A OMF surgeon who focuses primarily on wisdom teeth and has been out of the real deep down and dirty for a while however, well, I'd rather go with the former - I think as any rational minded person would.


  • Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    What do you think you need done?...answer in plain words, dont try to be technical (cause you misusing technical terms trying to look smart ) or glib, just tell us what proceedure you think you need.

    DO you need an extraction, do you need an implant, do you need your jaws moved to improve your appearance, do you need sinus surgery, do you need a bone graft What do you need?


  • Banned (with Prison Access) Posts: 1,355 ✭✭✭bo0li5eumx12kp


    What do you think you need done?...answer in plain words, dont try to be technical (cause you misusing technical terms trying to look smart ) or glib, just tell us what proceedure you think you need.

    DO you need an extraction, do you need an implant, do you need your jaws moved to improve your appearance, do you need sinus surgery, do you need a bone graft What do you need?

    Unfortunately I'm not at liberty to discuss that information - certainly not on public forum.

    I understand recommendations or experiences can only be made via PM anyways so, no harm no foul.

    What I will say is, although the procedure is not regarded as "big", per se - I know it is tricky, and tricky to get right - with lots of possibility to get wrong - so I'm willing to go that extra mile; best surgeon, best hospital, you name it.

    I know, I know - "if it's not big, any surgeon could handle it".

    Technically yes, but realistically - no.

    It's not "routine" in the sense of a routine extraction, or a routine mandibular fixation etc.

    Top level, top shelf - the best, is what's required.


  • Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


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  • Moderators, Science, Health & Environment Moderators Posts: 21,693 Mod ✭✭✭✭helimachoptor


    Unfortunately I'm not at liberty to discuss that information - certainly not on public forum.

    I understand recommendations or experiences can only be made via PM anyways so, no harm no foul.

    What I will say is, although the procedure is not regarded as "big", per se - I know it is tricky, and tricky to get right - with lots of possibility to get wrong - so I'm willing to go that extra mile; best surgeon, best hospital, you name it.

    I know, I know - "if it's not big, any surgeon could handle it".

    Technically yes, but realistically - no.

    It's not "routine" in the sense of a routine extraction, or a routine mandibular fixation etc.

    Top level, top shelf - the best, is what's required.

    If you can post what you think you need done, there's not much point in asking for help on the forum tbh.


  • Registered Users, Registered Users 2 Posts: 6,127 ✭✭✭kirving


    My logic is, a surgeon who regularly chops up and aligns maxilla and mandibles, should regard what I require as straight forward and hopefully accomplish it with little to no complication.

    This to me indicates that you don't know what you don't know. Any true professional in any area will tell you that there is no such thing as a small job.
    Unfortunately I'm not at liberty to discuss that information - certainly not on public forum.

    So what's the point in asking if you're going to be so secretive?
    Top level, top shelf - the best, is what's required.

    That's an impossible question to answer, particularly given your reluctance to give any detail.

    Trying to get on the same level as surgeons dropping in technical terms, like Mandible, when everyone else on the planet called it a Lower Jaw isn't going to do you any favours when dealing with them.

    They need to hear in plain English what you're looking for, and let them handle the fine details. Absolutely nothing wrong with being inquisitive, getting a second opinion or researching for yourself at the same time of course.

    When you want to build a house, you don't go to the guy who built Croke Park and give him a set of plans.

    You go to a local architect who plans what you want done with you, and then selects a builder who can A) do the job and B) is familiar with all the other local tradespeople and local environment. That builder is the best for that particular job.

    I'm now 5 days post upper jaw surgery, and have at minimum 12 months of treatment remaining. My local orthodontist took some time in assessing my case with her colleagues and eventually selected the correct surgeon for me who happened to practice both publicly and privately.

    As it turned out I had just a couple of weeks waiting time in a public hospital since I was able to take a cancellation with 18 hours notice. I obviously have a long way to go but as far as I can tell, I would have received no better treatment, no matter where I went in the country.


  • Banned (with Prison Access) Posts: 1,355 ✭✭✭bo0li5eumx12kp


    This to me indicates that you don't know what you don't know. Any true professional in any area will tell you that there is no such thing as a small job.



    So what's the point in asking if you're going to be so secretive?



    That's an impossible question to answer, particularly given your reluctance to give any detail.

    Trying to get on the same level as surgeons dropping in technical terms, like Mandible, when everyone else on the planet called it a Lower Jaw isn't going to do you any favours when dealing with them.

    They need to hear in plain English what you're looking for, and let them handle the fine details. Absolutely nothing wrong with being inquisitive, getting a second opinion or researching for yourself at the same time of course.

    When you want to build a house, you don't go to the guy who built Croke Park and give him a set of plans.

    You go to a local architect who plans what you want done with you, and then selects a builder who can A) do the job and B) is familiar with all the other local tradespeople and local environment. That builder is the best for that particular job.

    I'm now 5 days post upper jaw surgery, and have at minimum 12 months of treatment remaining. My local orthodontist took some time in assessing my case with her colleagues and eventually selected the correct surgeon for me who happened to practice both publicly and privately.

    As it turned out I had just a couple of weeks waiting time in a public hospital since I was able to take a cancellation with 18 hours notice. I obviously have a long way to go but as far as I can tell, I would have received no better treatment, no matter where I went in the country.

    No kidding?

    Pfff - you got lucky.

    I was informed YEARS are not an uncommon waiting time for non-trauma/cancer patients when they're not going private (though if you had private treatment in a public hospital - that's different).

    I get your logic of course but, having looked into the reputation, training and backgrounds of the top dudes in the country, they practice from the two most expensive high tech hospitals mostly, and having contacted them, seem to have a preference for those locations.


  • Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    Seeing as you wont tell us what you need what is the point in continuing the conversation. Despite what you might think, a MaxFax surgeon may not be the best person to go to, there are actually very few things where a max fax surgeon is the best person.

    Its doesnt matter how expensive or high tech the hospital is...this is more of your confirmation bias.


  • Banned (with Prison Access) Posts: 1,355 ✭✭✭bo0li5eumx12kp


    Seeing as you wont tell us what you need what is the point in continuing the conversation. Despite what you might think, a MaxFax surgeon may not be the best person to go to, there are actually very few things where a max fax surgeon is the best person.

    Its doesnt matter how expensive or high tech the hospital is...this is more of your confirmation bias.

    I looked into this a little also.

    The issue I have is tending to a former facial injury (broken bones) that now requires re-tending to.

    The other options were plastic surgery and ENT (the dude who tended to the initial injury via fixation), however, the overwhelming feedback I got was that, maxillofacial is the most suitable discipline for this procedure.

    Really from those three, provided they have a residency is craniofacial surgery, I understand any such specialist may be suitable.

    But I'm open to being corrected.


  • Registered Users, Registered Users 2 Posts: 3,240 ✭✭✭Oral Surgeon


    I looked into this a little also.

    The issue I have is tending to a former facial injury (broken bones) that now requires re-tending to.

    The other options were plastic surgery and ENT (the dude who tended to the initial injury via fixation), however, the overwhelming feedback I got was that, maxillofacial is the most suitable discipline for this procedure.

    Really from those three, provided they have a residency is craniofacial surgery, I understand any such specialist may be suitable.

    But I'm open to being corrected.

    This thread is so useless.....
    Please recommend someone to fix my house.... I won't tell you if it's the foundations, the walls, the roof, the plumbing or electrics....!! But I want the best guy for the job that I'm not going to tell you about....


  • Registered Users, Registered Users 2 Posts: 7,939 ✭✭✭ballsymchugh


    This thread is so useless.....
    Please recommend someone to fix my house.... I won't tell you if it's the foundations, the walls, the roof, the plumbing or electrics....!! But I want the best guy for the job that I'm not going to tell you about....

    i know a lad. not telling you though.


  • Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    Funny thing here is that on this thread there are 5 dentists, 2 dental specilists and one of those specialist is directly involved in this area. Each one of those people knows exactly who they would go to themselves or send family of friend to. The oppertunity exists to get some really great advice based on years of experiance and seeing actual results. The OP here would rather try impress us than ask us. I really dont get what this is about. He said it was not orthognathics but then suggests that its to reset a miset fracture which is orthognathics...ortho meaning straight and gnathics meaning jaws.


  • Registered Users, Registered Users 2 Posts: 7,939 ✭✭✭ballsymchugh


    OP pick a town in the ar5ehole of brexit territory where the locals beat the crap out of each other every friday and saturday night, where the surgeons have plenty of practice. i'd hazard a go with Medway hospital in one of the biggest dumps ever.


  • Banned (with Prison Access) Posts: 1,355 ✭✭✭bo0li5eumx12kp


    Funny thing here is that on this thread there are 5 dentists, 2 dental specilists and one of those specialist is directly involved in this area. Each one of those people know exactly who they would go to themselves or send family of friend to. The oppertunity exists to get some really great advice based on years of experiance and seeing actual results. The OP here would rather try impress us than ask us. I really dont get what this is about. He said it was not orthognathics but then suggests that its to reset a miset fracture which is orthognathics...ortho meaning straight and gnathics meaning jaws.

    I don't see the details are relevant.

    I mean if you really wanted to put an answer to a question - some other poster threw some confusion into the mix earlier by suggesting maxillofacial was perhaps not the best discipline for such a procedure.

    So - plastic, ENT, or maxillofacial.

    What it is?


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  • Posts: 0 [Deleted User]


    Question: Plasterer, electrician, plumber, which one?

    Answer. Depends on the problem.


  • Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    In what world are the details of the operation you need not relevant to the surgeon that is best to see.....seriously am I on candid camera of something here, is this a joke.


  • Registered Users, Registered Users 2 Posts: 933 ✭✭✭Dianthus


    Everyone has reached the same consensus- without clear information as to what procedure you need, it's impossible to offer recommendations as to who to consult with.


This discussion has been closed.
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