I consulted with Raffaini in Parma. Will get into the specifications here.
I have no choice but to go private and in Europe, Italian surgeons seem to be my best option since I can't go to the US or something and in Europe the Italian private ones are the ones that have the most clout / reputation. Not that that should be the leading factors but having to choose surgeons privately, these Italian private surgeons seem well ruled, so feels safer for me as compared to investing I don't know a less known e.g. German or French doctor with a language barrier that I have heard less about.
Heard many times people saying Raffaini was arrogant but honestly I liked him. Did not seem anything in particular, was pretty nice. Interesting how many different the experience can be from what you can read online. I have heard several things online about Raffaini, did not see that reflected in my experience at all.
The CBCT scans that were taken there were of high quality, whereas elsewhere I hadn't even received any. They also took pictures, I mean they always do everywhere, but the assistants were specifically trained to ensure decent neutral posture in the pictures. That's something I had not seen elsewhere. The whole place made a good impression with me.
Raffaini looked at the scans and saw the problem, called it an apparently narrow airway. It is not ridiculous narrow though, most UARS / OSA folks would be worse, on average. That makes me hopeful that this can actually be fixed surgically.
We've got some decent / sufficient nasal aperture or about 24mm. That is not great but it is above many UARS people. While nasal breathing can be better than this, this is probably not the major bottleneck that chokes me at night. So that's positive because that would be a separate, additional surgery that is mainly only done well in the US.
and we've got a tongue that doesn't fit well in the palate. It looks too big in proportion to the space that is there. That is probably the culprit. That's good because that's what we can do with double jaw surgery.
I was proposed a 10mm advancement (lower jaw, probably a bit less than that at the maxilla). Initially i was a bit anxious (because 10mm is a bit the minimum recommended for OSA / UARS. Minimum, meaning many get more hence the anxiety). Raffaini has also done before things like 25mm so it's not like he's not well versed in bigger advances, he just thought my face couldn't / shouldn't handle that. Initially anxious but after reviewing the scans in more detail I think I can see that something like 10mm should create enough space, I can see that from 10mm CBCTs I find online. It's not a small advancement, although neither it is a huge one. So I am feeling hopeful and I think I will go through with it.
I was also offered no preparatory orthodontics (surgery first approach). This is not so common generally speaking. I was bracing myself for like an additional year of preparatory orthodontics suffering. Almost seems too good to be true, but I can understand why he says that. The position is decent already (had many braces before), and usually premolars are extracted so as to pull the lower teeth backwards so as to allow a greater mandibular movement. Sort of creating an overbite, so that you can move the mandible more than the maxilla. But I already have an overbite. So it might actually be good and not too good to be true. I do need some post-OP ortho tho to be clear, that's pretty inevitable
I could say yes right now and do this in 2 months. But I will take my time to think. I will speak with Kasey Li online in July and perhaps a second time with Raffaini. But I am quite confident I will choose him.
Interesting how things go much quicker this way huh? More progress in this update than in the last 1.5 years.
modedit RM: afbeeldingen aangepast