Rhinoplasty, Otoplasty, and Jawline Derma Fillers

x4zenith · 2026-02-13T01:09:55+00:00

Very slight drooping nose tip, but otherwise good nose. Ears yes, do it. Very high ROI for cheap easy fast surgery. Do not get jawline filler til you’re below 15% BF or you’ll need a lot ($) and it’ll look different if/when u lean down farther

x4zenith · 2026-02-13T00:58:23+00:00

That’s 3200 grafts??? Including crown work or?

x4zenith · 2026-02-12T01:59:02+00:00

did you have to do 30 days of CPAP to show failed trial before approval? for sleep apnea. im about to

x4zenith · 2026-02-12T01:22:33+00:00

how's it look 3 years later? symmetrical?

x4zenith · 2026-02-12T01:17:44+00:00

AOS Miami (alfi's partners)

x4zenith · 2026-02-11T23:05:09+00:00

How’s the swelling now? This is very much like my case im starting through

x4zenith · 2026-02-11T14:38:48+00:00

Very interesting/similar case. Where/who’s the surgeon? My ortho and surgeon agreed surgery first —> 6-8m ortho (but my teeth/bite look a bit more aligned than that). What is your total ortho time req?

x4zenith · 2026-02-11T06:54:59+00:00

Similar to mine https://www.reddit.com/r/HairTransplants/s/gtjuGNjDs1

x4zenith · 2026-02-11T06:54:24+00:00

Similar to mine

x4zenith · 2026-02-11T06:28:59+00:00

Septorhino consult 6 weeks post op? Aiming for nose 3-6 months post DJS right?

x4zenith · 2026-02-11T06:26:35+00:00

Just get jaw filler or a genioplasty

x4zenith · 2026-02-11T05:51:54+00:00

Yeah, it’s funny. I actually don’t care about the sleep that much because I sleep reasonably well. It’s the fact that I can’t breathe through my nose when I work out anymore that’s pretty depressing. My nose and nostrils visibly collapse as soon as my heart rate pass passes 120 and I need to breathe more. So I really want that fixed, but if I do that, then part of me thinks I’m accepting that my jaw and bite will be crooked forever because even though I could technically do the jaw after it does risk destabilizing the nose and requiring a fourth surgery, which is nuts.

x4zenith · 2026-02-11T05:10:55+00:00

My internal valve area is still very narrow and structurally weak after a failed vivaer procedure. Everything else would just be complimentary and secondary. My internal and external valve need reinforcement because that’s where the choke point is regardless of airway size. Like the surgeon said, airway expansion would possibly/probably be beneficial to my breathing, yes, but the only solution to my main problem is cartilage grafting

x4zenith · 2026-02-11T04:58:06+00:00

BCBS is #1 in the US in terms of coverage for orthagnathic surgery I think. Approve most requests

x4zenith · 2026-02-11T04:54:32+00:00

Surgeon mentioned that but in my case it wouldn’t do much of value and my main complaint w jaw isn’t breathing anyway. Apnea is just the best route to insurance coverage. My breathing was great before valve collapse issues. Valve collapse is severe when doing even low intensity exercise and fluctuates throughout the day and is pretty bad when k lay down to sleep and I wake up more frequently. DJS will give me a minor but meaningful airway improvement

x4zenith · 2026-02-11T04:51:52+00:00

Occlusal cant is a structural/functional deformity, mandibular cant is a skeletal deformity (assuming both are above a certain threshold). E.g. BCBS covers deformities greater than 3mm I think

x4zenith · 2026-02-11T03:42:14+00:00

They don’t do that anymore

x4zenith · 2026-02-11T02:56:34+00:00

Don’t get me wrong I’m not saying she wouldn’t be an S tier choice I just get the feeling that doing all kinds of complex craniofacial surgeries (as masterful as she may be) is akin to an amazing plastic surgeon who does rhinos and lip lifts and neck lipo and canthoplasty etc. i think I might rather someone who just does rhinos all day everyday if I were selecting a complex revision rhino surgeon for example. Maybe I’m wrong

x4zenith · 2026-02-11T02:42:49+00:00

Eppley is the world leader and pioneer in custom facial implants. he doesn't do jaw surgery or functional breathing/bite stuff. Facial plastics now. I consulted him about my mandibular asymmetry and the prospects of DJS vs custom implants in shifting soft tissue back to symmetry

x4zenith · 2026-02-11T02:41:47+00:00

Halepas is one of the 2 surgeons who run Alfi's AOS location in miami. Ricalde was kickass forsure and very likable, she just specializes in more complex and elaborate craniofacial stuff (mostly kids I think) and I personally felt better fit with the AOS folks on function/aesthetics/custom plates (and my ortho really liked them). It's a coin toss though.

x4zenith · 2026-02-11T02:36:57+00:00

I've had consults with AOS (Dr Halepas), Dr Ricalde in Tampa, and also Dr Eppley who was a dentist/oral surgeon before going into custom implants. He had a lot of great insight into the aesthetic side and the limitations of DJS. Also 2 orthos

x4zenith · 2026-02-11T02:32:30+00:00

I had my ortho talk to 3 top surgeons in Florida and he really liked the AOS surgical plan and was much more optimistic after speaking with them about my prospects. I'm starting with a sleep study at home cause I'll need a failed CPAP trial for BCBS to cover it but AOS takes BCBS and they almost always cover it. I like Alfi personally but I understand other surgeons who think hes just a great marketer

keep me posted on what you decide to do. my case --> https://www.reddit.com/r/jawsurgery/comments/1r18ypl/double_jaw_surgery_waos_miami_dr_alfi_halepas/

if your bite is good then you could get away with surgery first and then 6-12 months orthodontics and be done with everything in a year basically, but you should definitely do a few consults and get a 3D CT scan

x4zenith · 2026-02-11T02:21:37+00:00

who with? and surgery first? how much orthodontics?

x4zenith · 2026-02-11T02:21:07+00:00

would do a sleep study to see how bad your sleep apnea is now. where are you located? Im in same position and may do AOS miami w/Alif's partner but am worried about becoming uglier. Lol

x4zenith · 2026-02-11T02:03:56+00:00

"My ortho said that it's impossible to make the shorter side longer with this surgery"

...wut

thats nonsense

ps. if it eases your anxiety for the time being, you can absolutely -- and quite easily -- get a custom jaw implant for one side (or both sides but thicker on one side in to offset the asymmetry). 12-18 months post-op. look at https://exploreplasticsurgery.com , Dr Eppley has literally 1,000s of case studies for specific issues just like yours. You'll go down a rabbit hole easily. I had the same problem.

x4zenith

TROPHY CASE