That looks incredibly improved Evan. Fantastic work and so glad to see you feel so much better. Thank you for posting content to keep us informed of the ins and outs. Very much appreciated. A good one in the future would be a look at how you recovered please, how you lived your daily life post op?
Aesthetic improvements you got were substantial and they alone are worth it, sleep apnea is a nightmare legit ruins lives still waiting to have my MMA.
Just by watching this journey I can see a difference in you! Your eye and neck twitching have decreased significantly! You look so much more rested! So happy for you!
Hey Evan, thank you so much for doing these update videos telling us everything, it helps so much I have to do the same journey you went threw but I'm wondering now a days how are things?
Happy to hear your improving! You look much more well-rested. I hope you continue to see improvements. I'm hopefully getting surgery in late winter/early spring 2023 on the East Coast, so I would love to hear more about how you picked your surgeon and post-ops tips. It feels like a massive puzzle at the moment!
Hey Evan, to begin, thank you so much for sharing your long detailed journey with this enigmatic disease we call UARS. It's truly a misunderstood sleep problem that we still are trying to fully grasp so your videos help tremendously. Love the new look!! Wow, you really look great. I've seen all your videos, it's a delight to see you so happy!! I sincerely hope you are feeling better now. BTW, is there any chance you can post a 1 year recap video of how you are doing now and what you've went through in the last year?? I think the community would be most grateful, even if you experienced challenges or set-backs, we all would be interested in hearing the truth on how your sleep has been effected through this last surgery plus your overall feelings.
Good to hear you're feeling better. The myofunctional therapy seems like a great idea because I guess your brain developed around having to deal with a difficult airway, and now even the parts that work during sleep have to figure out the new hardware. My brain wakes me at the slightest disturbance and, looking back, restricted airway symptoms were there as early as I can remember. Finding treatments for the awful fatigue and other weird symptoms is worth anything. I hope a lot more people are inspired by your videos.
Your looking really good !! Love your videos. You've been through alot. Im soo happy for you. I didn't realise I had sleep apnea until I saw a new dentist and he advise for MSE surgery. I relate to issues with dentist procedures. The basic things that people take for granted just to breathe !!
Awesome results, my friend. I’m happy to hear you have more energy and are sleeping better. I’m posting some videos of my EASE procedure soon. Will keep you posted!
Evan love the content! It is very informative. You have been one of the few people on TH-cam who have went through DJS for sleep apnea. Just wondering how your life is going for you a year after the surgery. Excited to hear from you. Also I am going to make it a goal to see Dr. Yoon for a consultation this year
Wow so glad MMA has helped!! It's such a nightmarish journey, thank you for your videos. Who was your surgeon? Im looking to start MSE, no one understands this or knows how to help here in Canada. Exhausted and super cognitively impaired all the time. Anyway, hope you continue to heal, it's a huge major surgery for your poor body to recover from. ❤
Hey Evan, you look amazing. Glad to hear you're doing better in terms of getting rest as well. I'm also interested in Walline. Do you mind telling me how much you paid, particularly the hospital fees? Were the hospital fees exorbitant or not close to the estimations? Don't want to go for it and then get slammed with a hospital fee way higher than estimated with Jacquie...
Evan!!!!! I am so so so happy I decided to come check on you! You look so amazing and you are getting there! You poor thing you’ve fought so hard for this I’m so happy for you :) I’m having my MARPE Surgury august 15th❤️❤️
Hey glad you're doing better! I'm struggling with severe turbinate hypertrophy ruining my life, had a radiofrequency reduction 2 months ago and they're already growing back again :( . what would you suggest I do?
Thanks for the video, i´ll have a MMA surgery in a month for sleep apnea. I´m kinda scared, hope to improve the apnea. Your video helps alot. You should do a new polysomnography to compare it with the previos surgery ones
So very very very glad everything is going well! I would like to comment on a few things if I may. - I think aesthetically it's basically perfect. That also goes to show that those other plans were definitely off. I think to some degree hindsight is 20/20, it's very difficult to predict, not impossible, but very challenging. - Symptomatic improvement sounds really good, maybe even moreso than a lot of other "UARS people". CPAP is usually about 70-80% reduction in AHI, whereas MMA is about 80-90%. Given your movements you're probably closer to the 90% group. MMA is the only sleep apnea surgery which performs equally to CPAP, and even exceeds it in some instances. - Speaking of next steps, any follow-up sleep studies planned? One thing I've noticed is that some of the labs might score RERA, but like Peninsula for example they like to use AASM 1B to score the hypopneas. I think this is a major issue, I think it's very important they use AASM 1A for hypopneas, which I think is actually even more important than whether or not they score RERA (which is also still a very nice thing to have). - Jaw pressure is an interesting topic, I think you had a lot of risk factors for condylar relapse, except being female, so that could explain a bit about why you're feeling that way. So long as it doesn't lead to significant relapse I guess is what is most important. LACOMS like to do less advancement because of the risk, though I've heard of some cases especially on the female side have had lots of relapse with LACOMS even with their smaller advancement. I'm going to hypothesize a bit here but I think the root problem may be that they never do TJR (even in the highest risk patients), as opposed to the problem being too much advancement. - Not surprising that your nasal congestion is much improved. I thought originally that it could all be related to the maxilla movement opening up the airway, but now I actually think that tongue posture may actually play a role in turbinate hypertrophy. Ironically people say that the best place is on the roof of the palate, but in severely recessed individuals when the tongue is in this position it can actually push back into the airway and press against the soft palate, even in the daytime. I think the negative pressure and resistance in the nasal passages can impact the size of the turbinates. When the jaws are advanced you can significantly impact this, especially in the daytime. It's possible that during the night, your tongue is pushing back against the soft palate and creating the same kind of situation again which enlarges the turbinates. Of course whether or not this is happening to you is all speculation, a sleep study is the best way to investigate that. In terms of soft palate collapse post-MMA I'm currently thinking either Inspire or BRP might be the most sensible options (and leaning towards Inspire, Vik Veer's video goes into some of the logic behind why that is (though I don't believe in 100% of what he said in his new video)).
Really great points and thanks for all your guidance Shuikai. It all worked out. I want to give your comment that time it deserves for a reply. Just want to let you know that I read it and I will reply soon.
Oh yes also wanted to say- when I got my DISE dr zaghi discovered I was doing “breath holding” aside from my obstructive events - I.e my body has so much anxiety from years of apnea’s that now I hold my breath in my sleep as an anxiety response. I even catch myself doing this during the day. It’s like a sub branch of central apnea’s. I’m wondering if this could be happening with you? I’ve noticed if I’m very very disciplined around breath work throughout the day (slow conscious breaths for about 15-20 mins twice a day) this goes WAY down within a couple weeks. Just a thought!
Holy moly! Thought I was nuts, I do this as well! No one seemed to understand when I said “I sometimes forget to breathe!” 😬 And definitely worsens with stress! Glad to know I’m not alone!
Does your doctors know why you are still tired? I’ve also done a double jaw surgery and I’m not feeling better at all. Im getting checked for tongue tie now
Nobody knows for sure. Maladaptive breathing habits, residual nasal congestion, poor airway muscle and tissue tone, and under-advancement are my guess for my case.
Hey thanks for the great videos. I appreciate you sharing all this. You are in a similar situation I am in. I hope this reaches you. How are things progressing? Did your maxilla expansion get both anterior and posterior expansion? I just saw a thing from Kasey Li that describes posterior expansion as being very important. Best wishes man, thank you. I hope you make the videos you were talking about in this one. They would be very helpful to many people, myself included.
@@evanlavizadeh4032 Awesome! That is great to hear. Were you able to get your nasal breathing any better over time? And how has your tongue position been? When you said you could collapse your airway in this video and then post surgery you couldn't it gave me so much hope because that is where I am at and that is one of my goals for my procedure.
I have inspire and I am happy with it, however, OSA and UARS are very complex, and I feel I need a multilateral approach. So I am considering MSE and MMA on top of inspire, and if that is not enough which I DOUBT, then I will do soft tissue surgeries as a last resort. Happy to chat if you want.
Evan I already have MMA surgery and now planning for MSE proccedure. Now that you have both do you think MSE after MMA is worth it? Your honest opinion about would be appreciated.
I've seen it work post-MMA, but like 1 year after the MMA. Might be more likely to split than pre-MMA.. EASE is more guaranteed to split well, it probably depends on your age and gender, bone density.
You look great Evan! Your jaw-line looks very masculine now. Glad to hear you're doing well, although bummed for you that it isn't where you wanted it to be. Do you know how many millimeters your jaws were advanced? I'm over a year out from EASE now, still in braces, and the results have seemed to get much better over time. Probably half the nights I sleep normal now without CPAP. The other half of the nights are variable. For a small surgery it was a big result, so I'm not sure I'll be going forward with an MMA anytime soon.
Thanks for sharing, Tom. I am currently undergoing nasomaxillary expansion with the EASE - I’m about 1.5 months in and still have maybe 2 months of expanding to go. How much better did your nasal breathing improve from before EASE?
@@GrowYourFace That’s great to hear man, I’m happy for you. Is the expansion process gnarly or do you find it becomes mundane just turning the screw everyday?
Have you observed any posture improvement after djs? I mean is it now easy for you to maintain a good posture? Also how's the jaw pressure/ clicking now? Do you still use nasal strips at night? Full treatment cost?
really curious how you are recovering. I haven't done jaw surgery, but my tiredness improved after unlocking some emotional blockages. I know this sounds strange. But for me it was emotional and somatic.
Hi Evan, thanks so much for posting and documenting your journey. This has honestly been super helpful to me as I'm also dealing with UARS (Doctor diagnosed, not self diagnosed). I've had 2 sleep studies, one showed 11 RDI/h and 2.5 AHI/hr and the second measured an AHI of 5.9 /hr. I also use the Oura ring and I constantly see oxygen level drops almost every night. Had septoplasty and turbinate reduction ~1 month ago which helped nasal breathing a lot but obviously did not fix anything. However during the same procedure I've also done DISE and found 100% collapse at the soft palate, 50% collapse of oropharynx and 25% base of tongue. No collapse at epiglottis. I have malampati class 3 -- always feel like there's not enough space in my mouth. I'm using a MAD which helps a tiny bit (started experiencing dreams lately) but I still feel like there's not enough space for air to go through. The Doctor that did the DISE has recommended me a barbed reposition pharyngoplasty (they also have to do tonsillectomy before) and said it should help and might cure, even though he said "it's a pretty rough procedure for a relatively mild condition". I'm also considering MMA but feel like it would be the next step if the BRP would not work. I plan to do CBCT soon and check my airways. WDYT about that BRP - waste of time & effort? Should I just go for MMA? Also, very curious, what about your headaches and dizziness? Is that cured for you?
Thanks for the kind words Eli! I'd have to see your scans to make any judgement on what treatment path to consider (and even then, remember, I'm not a medical professional) I'm generally not a fan of soft tissue procedures but I especially feel that way when patients have clear skeletal deficiencies.
@@evanlavizadeh4032 Thanks! Makes sense - I'm working on getting those. Could you share an update regarding your headaches and dizziness? I remember you mentioned you have those in one of your earlier videos.
@@elirozen3858 Hey Eli. I'm writing from Germany and also am in the same boat like you. 3,6 ahi and 4,6 AHi second. But my arousal were quite high. I had a MMA and it didn't help. MY Ent did a DISE and I get the NOSE + Palate done with tongue coblation. This was on Monday. I will see if it even helped a bit. What's your status? Thanks in advance.
I think you have a dysfunction in your ATM, the joints of the maxillary/mandibule, and it could produce pain in some tooth. A question! the MMA could reduce the distance between the nose and the lip and reduce the nasoangle?
You know it's funny how you mention your airway obstructing when your tongue is pushed back. At this point for mine to completely seal all I need to do is either, A. Relax my muscles around my throat B. Tilt my head/neck back (correct forward head posture) C. Tilt my head 90 degrees to the side And there is a complete cessation in breathing until it's corrected.
Hi Evan. I'm having surgery with the same surgeon soon. Similar case to yours. Paying out of pocket from another country so a tad nervous about outcomes. How do you think you'd feel today if you did the mma, but skipped the marpe entirely? Basically what % of your current state is attributed to the marpe vs. mma. Also, was the genio for aesthetics or was there a functional component to it? Thanks!
Evan, I'm also planning to get double jaw surgery with Walline and would love to hear about how you worked with him to achieve such a great outcome. Were there any specific adjustments you made to his surgical plan, or was there anything you felt was important to incorporate in your surgical plan that Walline otherwise would not have done?
Yes, I had another plan from a different surgeon and that one seemed a little too extreme but Walline's seemed a little too conservative. I asked him if he can make a plan that was somewhere in the middle and he did
@@evanlavizadeh4032 okay thanks! marpe and mse are the same thing right? it is very confusing! Are you able to share who your jaw surgeon was? thanks again! I also see Zaghi - he's amazing!
I'm currently recovering from the same surgery done by Walline. How long did it take for your lower chin/lip to regain full sensation like you referenced to in the video?
you look much better after the surgery, but you said your jaw joints are under pressure. are you sure your maxilla is not pushing down on your mandible? unfortunately l suffer immensely from all those kinds of pressures and sleep apnea because of wrong and some unnecessary treatments l got, dental extractions, having my maxilla and mandible pushed far back and downwards, now my jaw joints are dislocated, hurting, my air way of course is narrowing more and more and l'm suffocating. ln conclusion, l wanted to say that, if your maxilla is not pushing your mandible downwards or backwards, l don't understand why they should be under any pressure. l assume, with a little bit of tipping of the upper front teeth upwards, maybe your maxilla would not push your mandible down any more, wish you all the luck with your situation, which already improved so much
Hello! First off, I'm sorry to hear about your situation. Yes, I'm positive that is not the case. BSSO surgery itself causes jaw joint pressure. This has to do with the geometry of the movement itself. I should make a video on it sometime because then it would be clear as to why this happens. But it's very common, and an unavoidable part of bsso.
@@evanlavizadeh4032 ah ok, l'd like to watch that video, also because it would provide useful information for people having problems regarding jaws and jaw joints, on pros and cons of the operation. lt's better to hear things from the perspective of the experiencer
Hi Evan can you please tell me the time Between doing Marpe expansion and MMA? I am currently doing Marpe and want to do MMA soon im just not sure how soon I can do it after MSC expansion, without causing relapse
Ahh shoot yeah It's totally supposed to be there. I made it flash for a second at the very end to be funny. I can't see it on my android phone but i can see it on my girlfriend's iphone. I think it depends on what OS you're using :/
Ben, I saw the flash photo. I recorded a screenshot video. Then played it slow motion until the quick screenshot appeared. Swelling, but without black and blue! Nice 👍
Hello, I feel a little awkward because English is not my first language. Please understand. Have you ever taken ssri or other psychiatric drugs? withdrawal or reducing this type of drug causes problems with serotonin and acetylcholine levels, which reduces the ability to maintain respiratory muscle tension during sleep. This also causes sleep apnea.
It looks like a very good result! you said it's not the result you would have gotten through natural development - do you think that result could have been achieved but wasn't? or that there's no way to get a surgery that would achieve that?
Hi Evan, thanks for sharing your journey. What changes did you notice about your smile if any? Like the position/curve of your lips and how far they can stretch compared to before? Does it feel more restricted now or is the same?
The biggest change to me is that I have new scar tissue on my upper lip frenum. I wish that I had been stretching the frenum to prevent restrictive scar tissue because now, my smile is different and my upper lip has less mobility
@@evanlavizadeh4032 Thanks so much for responding, losing lip mobility is one of my concerns with MMA surgery, do you know if stretching the frenum early is a surefire way to prevent this, or perhaps you know where I could read more on this topic?
@@samferrell7757 no, stretching the frenum is something I made up. Not actual medical advice. I was stretching it naturally because it instinctively felt satisfying. I didn't know why. I was just puffing up my cheeks by blowing air in them to stretch and it felt good on my frenum. I later realized the scar tissue. Just a thought I had, but it doesn't hurt to try.
Hi Evan, glad your recovery has gone pretty well. I'm interested in what you've got to say regarding the joints. I already have TMD with internal derangement and I'm worried that MMA would make it worse, what do you think?
If your MMA consists of a BSSO on the lower jaw (there are alternatives, but they're much less common), then MMA will probably make TMD worse. It depends on how much advancement you need, but BSSO puts a lot of stress on the TMJ just due to the geometry of the movements. And it's somewhat permanent. You can look into alternatives, but I think they carry other risks. It's definitely good to do more research and consult with lots of top surgeons.
@@evanlavizadeh4032 There is hope! Thanks man, I will have a dig in the research and see what I can find. If you do remember any acronyms please let me know.
joe. im going through this as we speak. I am stabilizing and correcting TMD through bodywork and muscle retraining and release. then im using a splint (tmj specialist) to alleviate tmj and then going to use it to get a new more functional bite w/ orthodontics. I then will retrude the teeth (or whichever one brings them out) and finally once everything is symmetrical and ready I will get MMA. its a long process but there are no shortcuts I think of. 1 Release and retrain the muscles and functions. 2 while doing #1 take pressure off the tmjs and make a new stable healthy bite 3 after everything is stable and pretty damn symmetrical the mma should be okay for thr tmjs….fingers crossed….otherwise its too late for us and we will just have to do our kids better 😊❤ ps I am also healing my allergies and food sensitivities and working on handling my stress better otherwise my turbinates will stay inflamed and breathing will suck I am alllsssoo getting Nasal surgery to open up airways. :)
@@evanlavizadeh4032 Keen to hear your thoughts on why you eventually chose Dr. Walline. I’ve consulted Stanley Liu, Coppelson and Kasey Li (I did EASE with Li). Coppelson thinks I’m a great candidate for MMA, Li doesn’t want me to do it. I’m very torn :( can I email you?
@@roxannerubin6293 it depends entirely on the surgical planning. Patients should learn these details because they have a pretty direct outcome on nasal breathing.
Hey man, i thought I’d reach out. Im 21 M, Im currently expanding with MSE , and it’s been going pretty good and i split on turn 15. I’ve done about 15 turns since. I’ve felt improvements in nasal breathing, but I’m still getting stuffy and in the waves that I am clear I’m clearer and in the waves I get stuffy im usually less stuffy, but I’m just kinda worried about the breathing part. Is it too early to really expect super significant breathing benefits? I know it’s pretty much not how it works for someone to expand with MSE and not breathe better out of the nose but I’m just worried I guess. Was very narrow before I started.
hey friend, curious on whether you have considered Postural Restoration to continue your journey- I think it can help you continue to integrate all these changes in your body!
I did go to physical therapy to work on my posture. I put alot of work into it and saw no changes. Was pretty discouraging honestly. Any advice? I appreciate you!
This is totally separate but I was looking through some of your videos. Great stuff, I'm going to watch some more. I don't know if you noticed that all your videos are listed as "TH-cam for kids." I used to accidentally hit that button too. I think it makes your videos harder to find.
@@evanlavizadeh4032 hey so this is where I tell folks that not all physical therapy is made equally. An orthopedic/muscle based approach is pretty typical insurance model. Postural Restoration (PRI) is a neurological approach that takes into account cranium, ribcage, pelvis (jaw and everything development) Check out my much more saavy TH-cam creator Neal Hallinan and highly recommend finding a PRI specialist to work with - th-cam.com/video/JEUKZv-Jnl4/w-d-xo.html
Hi Evan, hope you can answer me. For your experience and people you have met, what appliance can actually improve aesthetics in general excluding surgery? Thank you in advance
@@evanlavizadeh4032 thank you. Since this is a few months after your 6 months op. Are you noticing more of a difference? Would you consider it a success? Do you think you will need to go back on CPAP?
@@evanlavizadeh4032 Well if other people in the world are checking out your TH-cam videos and they want to know if this will work for them surely they will want to know if they go through all of the effort that you did will it pay off? So I'm hoping you will! Kudos and excellent work for taking your health so seriously to get rid of your apneas. It is a journey many of us are on.
@@publicname515 yeah but last time I got a sleep study, my copay was $600. I'll prob do it, but I'm dragging my feet with it. Thanks for the support :)
@@rickrobinson8417 I was already wide enough for my previous procedures, but you can do segmental lefort expansion during MMA and get it all done at once
@@evanlavizadeh4032 I too plan on having surgery done with him. Thanks for the feedback. It would be great if you could talk about aesthetic aspects of the surgery in a future video.
That looks incredibly improved Evan. Fantastic work and so glad to see you feel so much better. Thank you for posting content to keep us informed of the ins and outs. Very much appreciated. A good one in the future would be a look at how you recovered please, how you lived your daily life post op?
Aesthetic improvements you got were substantial and they alone are worth it, sleep apnea is a nightmare legit ruins lives still waiting to have my MMA.
Just by watching this journey I can see a difference in you!
Your eye and neck twitching have decreased significantly! You look so much more rested! So happy for you!
Haha yeah you noticed that! It definitely did. And it has lessened even more lately!
bro let me tell you just your aesthetic gain from the surgery is worth it haha
Would love to hear your post 1 year updates, nerve sensations, and muscle tightness
Glad to hear that your pros far outweighed your cons. Congrats!
Thanks so much for posting…You help a lot of people by doing these videos 🙏
Hey Evan, thank you so much for doing these update videos telling us everything, it helps so much I have to do the same journey you went threw but I'm wondering now a days how are things?
Happy to hear your improving! You look much more well-rested. I hope you continue to see improvements. I'm hopefully getting surgery in late winter/early spring 2023 on the East Coast, so I would love to hear more about how you picked your surgeon and post-ops tips. It feels like a massive puzzle at the moment!
Hey, which surgeon did you pick and how did you surgery go?
I’m also curious who you used and how it went.
Hey Evan, to begin, thank you so much for sharing your long detailed journey with this enigmatic disease we call UARS. It's truly a misunderstood sleep problem that we still are trying to fully grasp so your videos help tremendously. Love the new look!! Wow, you really look great. I've seen all your videos, it's a delight to see you so happy!! I sincerely hope you are feeling better now. BTW, is there any chance you can post a 1 year recap video of how you are doing now and what you've went through in the last year?? I think the community would be most grateful, even if you experienced challenges or set-backs, we all would be interested in hearing the truth on how your sleep has been effected through this last surgery plus your overall feelings.
Being overwhelmed with all the consultations and conflicting information rings so true to me! That's where I am right now.
Ahh I totally get it
You have an inspiring attitude through all of this. Thank you so much for sharing your journey and mindset!
So glad you're feeling improvements Evan, thanks for sharing your journey!
Good to hear you're feeling better. The myofunctional therapy seems like a great idea because I guess your brain developed around having to deal with a difficult airway, and now even the parts that work during sleep have to figure out the new hardware. My brain wakes me at the slightest disturbance and, looking back, restricted airway symptoms were there as early as I can remember. Finding treatments for the awful fatigue and other weird symptoms is worth anything. I hope a lot more people are inspired by your videos.
Good point. Yeah there's probably a lot of maladaptive habits I've developed. And good luck on your treatment. Good things are to come
@@evanlavizadeh4032How much does your surgery cost?
Your looking really good !! Love your videos. You've been through alot. Im soo happy for you. I didn't realise I had sleep apnea until I saw a new dentist and he advise for MSE surgery. I relate to issues with dentist procedures. The basic things that people take for granted just to breathe !!
Great everything went good!. Was your surgery medically covered by your insurance? Or you had to pay out of pocket?
Awesome results, my friend. I’m happy to hear you have more energy and are sleeping better. I’m posting some videos of my EASE procedure soon. Will keep you posted!
Awesome, I'd love to see that. Good luck, and yes let me know when you post it.
@@evanlavizadeh4032 here’s the pre and post op vids: th-cam.com/channels/c6j3aMRF-SiATp-wem5nKQ.html
By the way, what were your mm movements?
@@anishtheone 21mm pogonion
@@evanlavizadeh4032 Wow. That’s a massive distance 👏🏽
your smile looks great man, how much did the entire process cost if you don't mind me asking?
Evan love the content! It is very informative. You have been one of the few people on TH-cam who have went through DJS for sleep apnea. Just wondering how your life is going for you a year after the surgery. Excited to hear from you. Also I am going to make it a goal to see Dr. Yoon for a consultation this year
Wow so glad MMA has helped!! It's such a nightmarish journey, thank you for your videos. Who was your surgeon? Im looking to start MSE, no one understands this or knows how to help here in Canada. Exhausted and super cognitively impaired all the time. Anyway, hope you continue to heal, it's a huge major surgery for your poor body to recover from. ❤
Dr.Benjamin Walline. Good luck!
@@evanlavizadeh4032 can you post a one year update?
@@mladend6481 eventually I will!
Hey Evan, you look amazing. Glad to hear you're doing better in terms of getting rest as well. I'm also interested in Walline. Do you mind telling me how much you paid, particularly the hospital fees? Were the hospital fees exorbitant or not close to the estimations? Don't want to go for it and then get slammed with a hospital fee way higher than estimated with Jacquie...
Evan!!!!! I am so so so happy I decided to come check on you! You look so amazing and you are getting there! You poor thing you’ve fought so hard for this I’m so happy for you :)
I’m having my MARPE Surgury august 15th❤️❤️
Thank you so much Alexandra, I appreciate the support ❤️ good luck, I think it's gonna go well!
Hey dude! Thanks for sharing! I consulted w/Walline as well and like him a lot. Who was your ortho?
Dr.Audrey Yoon
@@evanlavizadeh4032 awesome! She is mine as well. Do you have ANY regrets about the Yoon/Walline combo?
@@justinlong1223 nope :)
Been looking foreard to thos one, thank you broski👍🏾
Glad to hear you’re feeling better buddy, you look great 💙
Hey glad you're doing better! I'm struggling with severe turbinate hypertrophy ruining my life, had a radiofrequency reduction 2 months ago and they're already growing back again :( . what would you suggest I do?
Do you have any scans and photos of the various parts of your airway and mouth to share?
Thanks for the video, i´ll have a MMA surgery in a month for sleep apnea. I´m kinda scared, hope to improve the apnea. Your video helps alot. You should do a new polysomnography to compare it with the previos surgery ones
So very very very glad everything is going well!
I would like to comment on a few things if I may.
- I think aesthetically it's basically perfect. That also goes to show that those other plans were definitely off. I think to some degree hindsight is 20/20, it's very difficult to predict, not impossible, but very challenging.
- Symptomatic improvement sounds really good, maybe even moreso than a lot of other "UARS people". CPAP is usually about 70-80% reduction in AHI, whereas MMA is about 80-90%. Given your movements you're probably closer to the 90% group. MMA is the only sleep apnea surgery which performs equally to CPAP, and even exceeds it in some instances.
- Speaking of next steps, any follow-up sleep studies planned? One thing I've noticed is that some of the labs might score RERA, but like Peninsula for example they like to use AASM 1B to score the hypopneas. I think this is a major issue, I think it's very important they use AASM 1A for hypopneas, which I think is actually even more important than whether or not they score RERA (which is also still a very nice thing to have).
- Jaw pressure is an interesting topic, I think you had a lot of risk factors for condylar relapse, except being female, so that could explain a bit about why you're feeling that way. So long as it doesn't lead to significant relapse I guess is what is most important. LACOMS like to do less advancement because of the risk, though I've heard of some cases especially on the female side have had lots of relapse with LACOMS even with their smaller advancement. I'm going to hypothesize a bit here but I think the root problem may be that they never do TJR (even in the highest risk patients), as opposed to the problem being too much advancement.
- Not surprising that your nasal congestion is much improved. I thought originally that it could all be related to the maxilla movement opening up the airway, but now I actually think that tongue posture may actually play a role in turbinate hypertrophy. Ironically people say that the best place is on the roof of the palate, but in severely recessed individuals when the tongue is in this position it can actually push back into the airway and press against the soft palate, even in the daytime. I think the negative pressure and resistance in the nasal passages can impact the size of the turbinates. When the jaws are advanced you can significantly impact this, especially in the daytime. It's possible that during the night, your tongue is pushing back against the soft palate and creating the same kind of situation again which enlarges the turbinates. Of course whether or not this is happening to you is all speculation, a sleep study is the best way to investigate that. In terms of soft palate collapse post-MMA I'm currently thinking either Inspire or BRP might be the most sensible options (and leaning towards Inspire, Vik Veer's video goes into some of the logic behind why that is (though I don't believe in 100% of what he said in his new video)).
Really great points and thanks for all your guidance Shuikai. It all worked out. I want to give your comment that time it deserves for a reply. Just want to let you know that I read it and I will reply soon.
Are you saying proper tonge posture will cause congestion in recessed individuals
Oh yes also wanted to say- when I got my DISE dr zaghi discovered I was doing “breath holding” aside from my obstructive events - I.e my body has so much anxiety from years of apnea’s that now I hold my breath in my sleep as an anxiety response. I even catch myself doing this during the day. It’s like a sub branch of central apnea’s. I’m wondering if this could be happening with you? I’ve noticed if I’m very very disciplined around breath work throughout the day (slow conscious breaths for about 15-20 mins twice a day) this goes WAY down within a couple weeks. Just a thought!
Huh wow yeah that might be worth looking into. I wonder if it goes away on its own over time after sleep apnea treatment?
@@evanlavizadeh4032 for me it is 100% connected to anxiety levels. Every time my stress goes up it gets worse.
@@coyotestarastrology good to know. That's motivating, thank you. :)
@@coyotestarastrology i also breathe arythmically when i sleep sometimes i wake up with heart palpitations
Holy moly! Thought I was nuts, I do this as well! No one seemed to understand when I said “I sometimes forget to breathe!” 😬 And definitely worsens with stress! Glad to know I’m not alone!
Does your doctors know why you are still tired? I’ve also done a double jaw surgery and I’m not feeling better at all. Im getting checked for tongue tie now
Nobody knows for sure. Maladaptive breathing habits, residual nasal congestion, poor airway muscle and tissue tone, and under-advancement are my guess for my case.
Bro…..you can tell that you are a rested individual. Wtg!
Hey thanks for the great videos. I appreciate you sharing all this. You are in a similar situation I am in. I hope this reaches you. How are things progressing? Did your maxilla expansion get both anterior and posterior expansion? I just saw a thing from Kasey Li that describes posterior expansion as being very important. Best wishes man, thank you. I hope you make the videos you were talking about in this one. They would be very helpful to many people, myself included.
Hello!
My expansion was perfectly parallel. Things are good! I'm cured! Good luck to you.
@@evanlavizadeh4032 Awesome! That is great to hear. Were you able to get your nasal breathing any better over time? And how has your tongue position been? When you said you could collapse your airway in this video and then post surgery you couldn't it gave me so much hope because that is where I am at and that is one of my goals for my procedure.
A good question to ask is, has MMA changed how your throat collapses and is that collapse compatible with inspire? If you're still considering that.
Yea MMA can eliminate a complete concentric collapse making you eligible for inspire
I have inspire and I am happy with it, however, OSA and UARS are very complex, and I feel I need a multilateral approach. So I am considering MSE and MMA on top of inspire, and if that is not enough which I DOUBT, then I will do soft tissue surgeries as a last resort. Happy to chat if you want.
Evan I already have MMA surgery and now planning for MSE proccedure. Now that you have both do you think MSE after MMA is worth it? Your honest opinion about would be appreciated.
I've seen it work post-MMA, but like 1 year after the MMA. Might be more likely to split than pre-MMA.. EASE is more guaranteed to split well, it probably depends on your age and gender, bone density.
@@shuikai272 thanks for pointing out EASE. Dr kaseys li's video helped understand these proccedures more but EASE seems super expensive.
Thanks for doing this video.
You look great Evan! Your jaw-line looks very masculine now. Glad to hear you're doing well, although bummed for you that it isn't where you wanted it to be. Do you know how many millimeters your jaws were advanced? I'm over a year out from EASE now, still in braces, and the results have seemed to get much better over time. Probably half the nights I sleep normal now without CPAP. The other half of the nights are variable. For a small surgery it was a big result, so I'm not sure I'll be going forward with an MMA anytime soon.
Thanks for sharing, Tom. I am currently undergoing nasomaxillary expansion with the EASE - I’m about 1.5 months in and still have maybe 2 months of expanding to go. How much better did your nasal breathing improve from before EASE?
@@GrowYourFace How’s the EASE procedure going for you? I just recently had a consult with Dr. Li to discuss starting it.
@@Itstimetogogo nice man. I’ve been making good progress. Steadily expanding but still have months to go. Nasal breathing is a little bit better
@@GrowYourFace That’s great to hear man, I’m happy for you. Is the expansion process gnarly or do you find it becomes mundane just turning the screw everyday?
@@Itstimetogogo very mundane. Not gnarly at all after the first few days after install. It takes me like 2 minutes in the morning. It’s like brushing
I needed this video thank you, how do you feel about your look
I like my new look
Have you observed any posture improvement after djs?
I mean is it now easy for you to maintain a good posture?
Also how's the jaw pressure/ clicking now?
Do you still use nasal strips at night?
Full treatment cost?
Wow this is a great result, did they move your chin as well (Chin osteotomy)?
Yes. Genioplasty.
Congratulations Evan! I hope you get more benefits soon.
I've noticed that you have difficulty swallowing a little bit. Why is that?
Thank you for the update. How many weeks were you off work?
8
really curious how you are recovering. I haven't done jaw surgery, but my tiredness improved after unlocking some emotional blockages. I know this sounds strange. But for me it was emotional and somatic.
Hey Evan, how are you doing now? Do you feel your voice has changed at all? Is it deeper or easier to project?
I'm doing well. My voice may have gotten deeper? I'm not sure honestly. Hard to say.
What were your movements and who did your work? I'm in the process of picking a surgeon now
Thanks for telling your story, really interesting
Hi Evan, thanks so much for posting and documenting your journey. This has honestly been super helpful to me as I'm also dealing with UARS (Doctor diagnosed, not self diagnosed).
I've had 2 sleep studies, one showed 11 RDI/h and 2.5 AHI/hr and the second measured an AHI of 5.9 /hr. I also use the Oura ring and I constantly see oxygen level drops almost every night.
Had septoplasty and turbinate reduction ~1 month ago which helped nasal breathing a lot but obviously did not fix anything. However during the same procedure I've also done DISE and found 100% collapse at the soft palate, 50% collapse of oropharynx and 25% base of tongue. No collapse at epiglottis.
I have malampati class 3 -- always feel like there's not enough space in my mouth.
I'm using a MAD which helps a tiny bit (started experiencing dreams lately) but I still feel like there's not enough space for air to go through.
The Doctor that did the DISE has recommended me a barbed reposition pharyngoplasty (they also have to do tonsillectomy before) and said it should help and might cure, even though he said "it's a pretty rough procedure for a relatively mild condition".
I'm also considering MMA but feel like it would be the next step if the BRP would not work. I plan to do CBCT soon and check my airways.
WDYT about that BRP - waste of time & effort? Should I just go for MMA?
Also, very curious, what about your headaches and dizziness? Is that cured for you?
Thanks for the kind words Eli!
I'd have to see your scans to make any judgement on what treatment path to consider (and even then, remember, I'm not a medical professional) I'm generally not a fan of soft tissue procedures but I especially feel that way when patients have clear skeletal deficiencies.
@@evanlavizadeh4032 Thanks! Makes sense - I'm working on getting those.
Could you share an update regarding your headaches and dizziness? I remember you mentioned you have those in one of your earlier videos.
@@evanlavizadeh4032 Also, I have a very scalloped tongue and was wondering if that resolved for you after palate expansion or MMA?
@@elirozen3858 headaches and dizziness greatly improved. I never had a scalloped tongue.
@@elirozen3858 Hey Eli. I'm writing from Germany and also am in the same boat like you. 3,6 ahi and 4,6 AHi second. But my arousal were quite high. I had a MMA and it didn't help. MY Ent did a DISE and I get the NOSE + Palate done with tongue coblation. This was on Monday. I will see if it even helped a bit. What's your status? Thanks in advance.
I think you have a dysfunction in your ATM, the joints of the maxillary/mandibule, and it could produce pain in some tooth. A question! the MMA could reduce the distance between the nose and the lip and reduce the nasoangle?
Hi Evan congratulations 👏 you sound great did your voice change in Any way post operation
Thanks! Not that I've noticed.
How are you man. You look good. Did this cure your sleep apnea?? I’m really looking fir a way out from this too as I have sleep apnea.
I can't say for sure without a new sleep study, but probably not. At least not yet.
@@evanlavizadeh4032sorry to bother u Man, but can u update us a bit?
@@danielryuu I uploaded a new vid
Please make an update on posture, sleep and energy levels.
and im curious whats your bolt score.
chech video on youtube: Nasal Breathing Test “The Bolt Score” by PJFPerformance
You know it's funny how you mention your airway obstructing when your tongue is pushed back. At this point for mine to completely seal all I need to do is either,
A. Relax my muscles around my throat
B. Tilt my head/neck back (correct forward head posture)
C. Tilt my head 90 degrees to the side
And there is a complete cessation in breathing until it's corrected.
Wow yeah that's extreme. Good indicator for MMA
R u waiting for MMA as well?
Sorry if it's been asked before Evan, but what were your movements?
I'll make a vid on it soon. POG was 21mm iirc.
Hi Evan. I'm having surgery with the same surgeon soon. Similar case to yours. Paying out of pocket from another country so a tad nervous about outcomes. How do you think you'd feel today if you did the mma, but skipped the marpe entirely? Basically what % of your current state is attributed to the marpe vs. mma. Also, was the genio for aesthetics or was there a functional component to it? Thanks!
25 marpe 75 MMA id guess. Idk about the genio question. There is a tongue base advanced from it I've hear but I just followed my surgeons plan there
Evan, I'm also planning to get double jaw surgery with Walline and would love to hear about how you worked with him to achieve such a great outcome. Were there any specific adjustments you made to his surgical plan, or was there anything you felt was important to incorporate in your surgical plan that Walline otherwise would not have done?
Yes, I had another plan from a different surgeon and that one seemed a little too extreme but Walline's seemed a little too conservative. I asked him if he can make a plan that was somewhere in the middle and he did
@@evanlavizadeh4032 Thanks! And please keep the videos coming, by the way. I'm a fan and find your videos very helpful
@@blockbuster1979 no prob! Ok I will make another :)
do you think the marpe helped you or would you skip it now if you knew you were going to have the MMA surgery?
Helped alot
@@evanlavizadeh4032 okay thanks! marpe and mse are the same thing right? it is very confusing! Are you able to share who your jaw surgeon was? thanks again! I also see Zaghi - he's amazing!
Evan can you talk a little more about your plans to address nasal congestion and turbinate hypertrophy?
No plans yet. Just time and general healthy living (exercise and diet)
Why not get them reduced and get immunotherapy
I'm currently recovering from the same surgery done by Walline. How long did it take for your lower chin/lip to regain full sensation like you referenced to in the video?
I don't remember, sorry :(
you look much better after the surgery, but you said your jaw joints are under pressure. are you sure your maxilla is not pushing down on your mandible? unfortunately l suffer immensely from all those kinds of pressures and sleep apnea because of wrong and some unnecessary treatments l got, dental extractions, having my maxilla and mandible pushed far back and downwards, now my jaw joints are dislocated, hurting, my air way of course is narrowing more and more and l'm suffocating. ln conclusion, l wanted to say that, if your maxilla is not pushing your mandible downwards or backwards, l don't understand why they should be under any pressure. l assume, with a little bit of tipping of the upper front teeth upwards, maybe your maxilla would not push your mandible down any more, wish you all the luck with your situation, which already improved so much
Hello! First off, I'm sorry to hear about your situation. Yes, I'm positive that is not the case. BSSO surgery itself causes jaw joint pressure. This has to do with the geometry of the movement itself. I should make a video on it sometime because then it would be clear as to why this happens. But it's very common, and an unavoidable part of bsso.
@@evanlavizadeh4032 ah ok, l'd like to watch that video, also because it would provide useful information for people having problems regarding jaws and jaw joints, on pros and cons of the operation. lt's better to hear things from the perspective of the experiencer
@@gulcint3050 ok! Been busy lately but I'll try to make that video
How long after the surgery did you have to eat through a tube and couldn't open your jaw
Evan Im looking for a new updated video
Hi Evan can you please tell me the time Between doing Marpe expansion and MMA? I am currently doing Marpe and want to do MMA soon im just not sure how soon I can do it after MSC expansion, without causing relapse
Prob 6 months minimum. I did 8 or 9.
Hey, was there supposed to be a photo at the end? Of peak swelling day 4 post op . . .
Ahh shoot yeah It's totally supposed to be there. I made it flash for a second at the very end to be funny. I can't see it on my android phone but i can see it on my girlfriend's iphone. I think it depends on what OS you're using :/
@@evanlavizadeh4032 No worries! And that makes sense, I'm on a Google pixel
@@blockbuster1979 same!
Ben, I saw the flash photo.
I recorded a screenshot video. Then played it slow motion until the quick screenshot appeared.
Swelling, but without black and blue! Nice 👍
Hello, I feel a little awkward because English is not my first language. Please understand. Have you ever taken ssri or other psychiatric drugs? withdrawal or reducing this type of drug causes problems with serotonin and acetylcholine levels, which reduces the ability to maintain respiratory muscle tension during sleep. This also causes sleep apnea.
Hmm that's very interesting, thanks for sharing. No I haven't taken drugs like that.
Who was your surgeon, and how much was your advancement?
Thank you for posting your experience
Can you share who did surgery on you please? Or at least list who you saw in consultation please.
Dr.Benjamin Walline
It looks like a very good result! you said it's not the result you would have gotten through natural development - do you think that result could have been achieved but wasn't? or that there's no way to get a surgery that would achieve that?
Hi Evan, thanks for sharing your journey. What changes did you notice about your smile if any? Like the position/curve of your lips and how far they can stretch compared to before? Does it feel more restricted now or is the same?
The biggest change to me is that I have new scar tissue on my upper lip frenum. I wish that I had been stretching the frenum to prevent restrictive scar tissue because now, my smile is different and my upper lip has less mobility
@@evanlavizadeh4032 Thanks so much for responding, losing lip mobility is one of my concerns with MMA surgery, do you know if stretching the frenum early is a surefire way to prevent this, or perhaps you know where I could read more on this topic?
@@samferrell7757 no, stretching the frenum is something I made up. Not actual medical advice. I was stretching it naturally because it instinctively felt satisfying. I didn't know why. I was just puffing up my cheeks by blowing air in them to stretch and it felt good on my frenum. I later realized the scar tissue. Just a thought I had, but it doesn't hurt to try.
Can you please talk about the aesthetic aspects. Also do you have any after photos where you are shaved?
4 months later - on a scale from 1-10, how was your sleep quality now? from 1-10, how was it before the surgery?
Hmmm. 2 before 6 after.
Any plans for an update video?
Hi Evan, glad your recovery has gone pretty well. I'm interested in what you've got to say regarding the joints. I already have TMD with internal derangement and I'm worried that MMA would make it worse, what do you think?
If your MMA consists of a BSSO on the lower jaw (there are alternatives, but they're much less common), then MMA will probably make TMD worse. It depends on how much advancement you need, but BSSO puts a lot of stress on the TMJ just due to the geometry of the movements. And it's somewhat permanent. You can look into alternatives, but I think they carry other risks. It's definitely good to do more research and consult with lots of top surgeons.
@@evanlavizadeh4032 What are the alternatives? IMDO?
@@joedimaggio3146 there's a few but I can't remember the acronyms. Sorry. But there are some which don't apply any pressure on TMJ
@@evanlavizadeh4032 There is hope! Thanks man, I will have a dig in the research and see what I can find. If you do remember any acronyms please let me know.
joe. im going through this as we speak.
I am stabilizing and correcting TMD through bodywork and muscle retraining and release. then im using a splint (tmj specialist) to alleviate tmj and then going to use it to get a new more functional bite w/ orthodontics. I then will retrude the teeth (or whichever one brings them out) and finally once everything is symmetrical and ready I will get MMA. its a long process but there are no shortcuts I think of.
1 Release and retrain the muscles and functions.
2 while doing #1 take pressure off the tmjs and make a new stable healthy bite
3 after everything is stable and pretty damn symmetrical the mma should be okay for thr tmjs….fingers crossed….otherwise its too late for us and we will just have to do our kids better 😊❤
ps I am also healing my allergies and food sensitivities and working on handling my stress better otherwise my turbinates will stay inflamed and breathing will suck
I am alllsssoo getting Nasal surgery to open up airways. :)
Hey Evan this is abit off topic but have you had the Covid vaccine ? Was it required for surgery ?
I did get the vaccine but I can't remember if it was required
When you said you woke up from surgery and could feel how unnatural your jaws felt, did that feeling go away?
Yes!
who was your doctor/surgeon?
Who was your doctor? I have been suggested to get the surgery before and kinda worried. I’m in socal
Dr.Walline at LACOMS
@@evanlavizadeh4032 Keen to hear your thoughts on why you eventually chose Dr. Walline. I’ve consulted Stanley Liu, Coppelson and Kasey Li (I did EASE with Li). Coppelson thinks I’m a great candidate for MMA, Li doesn’t want me to do it. I’m very torn :( can I email you?
@@lezou4761 yeah email me :)
What surgeon did you end up doing it with?
How your posture changed? Forward head posture had to improve immensly also pelvis and whole body chain
I'm not sure yet. It doesn't seem like an obvious change, but I still need to take an after photo and compare them. I'll probably do that this weekend
Happy for you! I wanted to ask - did MMA improve your nasal breathing?
Yes it did! MMA can also worsen your nasal breathing. It depends on a few factors. Am planning on making videos about it soon
@@evanlavizadeh4032 yes please do. MSE has currently failed to improve my nasal breathing but I’m thinking of doing djs - probably also with LACOMs.
@@evanlavizadeh4032 Does it depend on surgical planning? Or is it hard to predict how nasal breathing will go?
@@roxannerubin6293 it depends entirely on the surgical planning. Patients should learn these details because they have a pretty direct outcome on nasal breathing.
Hey man, i thought I’d reach out. Im 21 M, Im currently expanding with MSE , and it’s been going pretty good and i split on turn 15. I’ve done about 15 turns since. I’ve felt improvements in nasal breathing, but I’m still getting stuffy and in the waves that I am clear I’m clearer and in the waves I get stuffy im usually less stuffy, but I’m just kinda worried about the breathing part. Is it too early to really expect super significant breathing benefits? I know it’s pretty much not how it works for someone to expand with MSE and not breathe better out of the nose but I’m just worried I guess. Was very narrow before I started.
Give us another update Evan!
Have you heard or considered Inspire Therapy (hypoglossal nerve stimulation)?
Yeah I know about it. Never considered it. Wouldn't have addressed my root cause (small jaws)
hey friend, curious on whether you have considered Postural Restoration to continue your journey- I think it can help you continue to integrate all these changes in your body!
I did go to physical therapy to work on my posture. I put alot of work into it and saw no changes. Was pretty discouraging honestly. Any advice? I appreciate you!
This is totally separate but I was looking through some of your videos. Great stuff, I'm going to watch some more. I don't know if you noticed that all your videos are listed as "TH-cam for kids." I used to accidentally hit that button too. I think it makes your videos harder to find.
@@evanlavizadeh4032 OMG thank you, I'm dying laughing. I am clearly not a youtube person (I'm more active on Instagram and LinkedIn)
@@evanlavizadeh4032 hey so this is where I tell folks that not all physical therapy is made equally. An orthopedic/muscle based approach is pretty typical insurance model. Postural Restoration (PRI) is a neurological approach that takes into account cranium, ribcage, pelvis (jaw and everything development) Check out my much more saavy TH-cam creator Neal Hallinan and highly recommend finding a PRI specialist to work with - th-cam.com/video/JEUKZv-Jnl4/w-d-xo.html
That bed head is for heroes 👌🏽 😊
I love you, Evan😭
Did you have braces throughout any of this or only Invisalign? I thought they couldn’t do surgery without being in braces.
Only Invisalign. You were told wrong.
Do you mind sharing where you did your surgery and who did it?
Dr.Walline at LACOMS
how much did marpe and double jaw surgery cost?
How much did you pay?
is it required to get removed your wisdom teeth for jaw surgery
Not in all cases
Who did your surgery?
Hi Evan, hope you can answer me. For your experience and people you have met, what appliance can actually improve aesthetics in general excluding surgery? Thank you in advance
Omg same, that tooth my MSE was anchored to kept hurting, so I got a root canal, not sure if it was infected or not lol.
I didn't do a root canal and it feels mostly better.
Potentially try something like the didgeridoo now that your airways are so much more open. (Okay, doing myofunctional exercises.... good idea I think)
How much was your advancement in MM? What was your previous sleep apnea AHI?
21 mm at Pogonion. Ahi 7, RDI 21
@@evanlavizadeh4032 thank you. Since this is a few months after your 6 months op. Are you noticing more of a difference? Would you consider it a success? Do you think you will need to go back on CPAP?
Will you be posting a sleep study before and after for all of your treatments?
Possibly, not sure.
@@evanlavizadeh4032 Well if other people in the world are checking out your TH-cam videos and they want to know if this will work for them surely they will want to know if they go through all of the effort that you did will it pay off? So I'm hoping you will! Kudos and excellent work for taking your health so seriously to get rid of your apneas. It is a journey many of us are on.
@@publicname515 yeah but last time I got a sleep study, my copay was $600. I'll prob do it, but I'm dragging my feet with it. Thanks for the support :)
@@evanlavizadeh4032 Understood! Thanks for your content!
How much advancement was performed?
21m pog
Can we get an update? How are you feeling now?
Same honestly
Did the surgery widen the jaws/pallet or just bring them forward?
Just forward.
@@evanlavizadeh4032 Can widening happen with a double jaw surgery or were you already wide enough from your previous procedures?
@@rickrobinson8417 I was already wide enough for my previous procedures, but you can do segmental lefort expansion during MMA and get it all done at once
Looking forward to another update video!
Also, how was your experience working with Dr. Walline?
Fantastic. He's great. We worked together to create a plan I was happy with.
@@evanlavizadeh4032 I too plan on having surgery done with him. Thanks for the feedback. It would be great if you could talk about aesthetic aspects of the surgery in a future video.
Bro how many MMA advancements did you do ?
1