Dr Arnett - Input Anybody?
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Dr Arnett - Input Anybody?
My DD recently went to see Dr Arnett in CA for consult. I know that he has a strong reputation, has done thousands of surgeries etc. I was wondering if others who have had surgery with him would be willing to share their experiences good/bad. Also will he work with insurance. Please feel free to PM if you like. Thanks!!
Kelsie had her surgery done with Dr. Arnett. She is all done now, but here is a link to her blog. Hope it helps.
http://orthognathicsx.blogspot.com/
http://orthognathicsx.blogspot.com/
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Brandyleigh35
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Just an FYI, I don't think Kelsie has contact info on her blog, but she is sick of answering questions about Dr. Arnett. Which is why I didn't reply sooner with her blog info. I think she feels like her surgery is a thing of the past now and just isn't interested in constantly discussing her doctor. She's moved on with her life, and orthognathic surgery is pretty much history now.
With that being said, she was advanced a huge amount. 18mm, Dr Arnett has only done one other person further then that. She looks fabulous, and is very happy she had it all done, so I think his expertise pretty much speaks for itself. I can tell you that Dr. Arnett is expensive, though and that Kelsie paid a very big chunk of cash towards her surgery out of her pocket, upwards of about $20,000. Hope this is helpful.
Brandy
With that being said, she was advanced a huge amount. 18mm, Dr Arnett has only done one other person further then that. She looks fabulous, and is very happy she had it all done, so I think his expertise pretty much speaks for itself. I can tell you that Dr. Arnett is expensive, though and that Kelsie paid a very big chunk of cash towards her surgery out of her pocket, upwards of about $20,000. Hope this is helpful.
Brandy
Hi Brandy,
I had been to Kelsie's blog in the past, but could not remember where I saw it. I did get the drift she was "done" by her last post which she labeled as such. I can certainly understand being tired of all this. I've been researching this for almost a year now and I am tired before even beginning. I am glad she left blog up it is of great help.
Dr Arnett is super expensive there is no doubt of that. His initial recommendation has been for a 13.7mm advancement in lower and about a 5.8 mm advancement in upper for DD. We are OK with both of these. We are debating the chin/cheek procedures. They would be only cosmetic and I'm not sure if it would be too much. If anyone has input in this area it would be great. BTW, I have also been to your blog Brandy, you look fabulous! I don't know how to do the whole blogging thing so have not been able to figure out how to post comments.
I had been to Kelsie's blog in the past, but could not remember where I saw it. I did get the drift she was "done" by her last post which she labeled as such. I can certainly understand being tired of all this. I've been researching this for almost a year now and I am tired before even beginning. I am glad she left blog up it is of great help.
Dr Arnett is super expensive there is no doubt of that. His initial recommendation has been for a 13.7mm advancement in lower and about a 5.8 mm advancement in upper for DD. We are OK with both of these. We are debating the chin/cheek procedures. They would be only cosmetic and I'm not sure if it would be too much. If anyone has input in this area it would be great. BTW, I have also been to your blog Brandy, you look fabulous! I don't know how to do the whole blogging thing so have not been able to figure out how to post comments.
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Brandyleigh35
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- Joined: Mon Jan 23, 2006 4:25 pm
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I would talk with the doctor seriously about the chin advancement. I don't know too much about the cheek stuff so I can't really comment on it, but I know for me, I was unsure of getting it done. I spoke with my surgeon about it and asked him, if it was your daughter, would you recommend it, or would you consider it to just be cosmetic and unnecessary? He told me in my case he would recommend it. I really trusted my surgeon (he is a really honest guy) and I'm so glad I had it done now. I imagine that would be a very tough decision to make for your daughter though. If it was my son I don't know how I would feel about it. 13.7mm is a pretty large advancement.
Here's a question for you though. Is the 13.7mm advancement including everything along with genio? or no? The reason I ask is I was moved 3mm on top, 4mm on bottom and 5mm at chinpoint for a total of 12mm of advancement. That is sortof how they calculate it, but adding the top bottom, and chin. I'm wondering if he is talking 13.7 total, with top, bottom, and chin. If he advances her 13.7 plus 5.8 that is a enourmous advancement! Almost 20mm and that is not even with chin. I know that doctor Arnett has only done one other person farther then Kelsie, and that would make your DD very close to that persons advancement.
Do you know?
Brandy
Here's a question for you though. Is the 13.7mm advancement including everything along with genio? or no? The reason I ask is I was moved 3mm on top, 4mm on bottom and 5mm at chinpoint for a total of 12mm of advancement. That is sortof how they calculate it, but adding the top bottom, and chin. I'm wondering if he is talking 13.7 total, with top, bottom, and chin. If he advances her 13.7 plus 5.8 that is a enourmous advancement! Almost 20mm and that is not even with chin. I know that doctor Arnett has only done one other person farther then Kelsie, and that would make your DD very close to that persons advancement.
Do you know?
Brandy
That's a LOT of expansion. I don't quite understand why so much expansion is necessary vs. not expanding the upper quite as much. Frankly, from what I've heard, I think you might get better, more personalized treatment with someone who's not a "big name" in this - I felt like my surgeon not only was experienced and talented, but very personable and treated each situation and each case as unique. I skimmed the blog, and I would NOT be comfortable having surgery with a surgeon I only met for the first time in person a WEEK before op. No way Jose.
You guys, just because they have the big name doesn't mean their the best. Do you buy designer everything? Designer socks? undies? sunglasses (in which Arvensis is a hypocrite since she owns three pairs of designer sunglasses)? Just because someone works out of a different office or isn't named "Arnett" or "Wolford" doesn't mean they aren't talented. Unless you have a VERY specialty case or VERY difficult case, I can't see using one of them. But this is just me.
You guys, just because they have the big name doesn't mean their the best. Do you buy designer everything? Designer socks? undies? sunglasses (in which Arvensis is a hypocrite since she owns three pairs of designer sunglasses)? Just because someone works out of a different office or isn't named "Arnett" or "Wolford" doesn't mean they aren't talented. Unless you have a VERY specialty case or VERY difficult case, I can't see using one of them. But this is just me.
I'm sorry Brendan, I'm not conceding your point. Experience matters if it's a super complex procedure, like that girl who was here 6 months ago with a skeletal condition that left to severe deformation of one entire side of her face, but it is NOT as important if its one of the more "routine" procedures... and jaw surgery has most definitely become "routine."
If the surgeon has done a procedure 500 times, why would I (needing that 500 times same procedure surgery) go to someone whose done 4500 procedures, including both the one I require and more complex specialty ones? How does his added experience with particularly difficult problems - something I don't necessarily have - make him a better choice?
That doesn't make sense. It'd be like having a broken arm and insisting that you had to be taken to the man that invented casts, rather than allowing your local emergency room doc to fix it up. You have a broken arm, either way, and the fix-up by a competent doctor will be the same.
Think about how many people here have gone to have surgery, and how FEW of them have gone to one of the big names. And how many of us are dissatisfied with the results? How standard has this process become? How routine has jaw surgery become? How standard are the techniques, the technology, the procedure? THIS is what determines in medical procedures whether you go to a big name or not. For instance, prostate cancer. Techniques vary WIDELY across the medical field. Some surgeons remove the entire prostate; some save the nerves; some only take the cancerous parts; some use really really tiny instruments to leave less scars; some are talented enough to remove the cancer while leaving the nerves; some aren't. So you go to the big-name or someone trained by the big-name so that you recieve the benefit of their different techniques.
This is MUCH less true in something such as jaw surgery; sure, the surgeons may be of different innate talent level, I'll give you that, but their techniques, what is standard for how the work is done, is relatively the same across the board. I'd bet that my doctor and Dr. Arnett use the same screws, the same fasteners, make the same incision points, etc etc.
If the surgeon has done a procedure 500 times, why would I (needing that 500 times same procedure surgery) go to someone whose done 4500 procedures, including both the one I require and more complex specialty ones? How does his added experience with particularly difficult problems - something I don't necessarily have - make him a better choice?
That doesn't make sense. It'd be like having a broken arm and insisting that you had to be taken to the man that invented casts, rather than allowing your local emergency room doc to fix it up. You have a broken arm, either way, and the fix-up by a competent doctor will be the same.
Think about how many people here have gone to have surgery, and how FEW of them have gone to one of the big names. And how many of us are dissatisfied with the results? How standard has this process become? How routine has jaw surgery become? How standard are the techniques, the technology, the procedure? THIS is what determines in medical procedures whether you go to a big name or not. For instance, prostate cancer. Techniques vary WIDELY across the medical field. Some surgeons remove the entire prostate; some save the nerves; some only take the cancerous parts; some use really really tiny instruments to leave less scars; some are talented enough to remove the cancer while leaving the nerves; some aren't. So you go to the big-name or someone trained by the big-name so that you recieve the benefit of their different techniques.
This is MUCH less true in something such as jaw surgery; sure, the surgeons may be of different innate talent level, I'll give you that, but their techniques, what is standard for how the work is done, is relatively the same across the board. I'd bet that my doctor and Dr. Arnett use the same screws, the same fasteners, make the same incision points, etc etc.
Arvenisis,
Your points are well taken. Our situation is such that where we are located, there are simply very few OS who do this type of operation. We have very little to pick from. I have spent months researching and posted on many boards and came up with only two from local OD referrals. We saw them both. One was extremely conservative and wanted to do a very small upper movement only. He simply was not going to address many issues. That would have been one way to go of course. This OS kept use waiting for almost two hours for consult and I had to insist upon a written report. The other wanted to do upper/lower/chin and do larger movements although I could not pin him down on how much. It was very difficult to talk with him. We were considering him because in experience and skill level he is best we could do locally and would not have to travel etc. Who knows if it does not work out with Arnett we may still go this route. I felt uncomfortable in having so few choices so I decided to travel. If we lived somewhere else, in most other large cities, I suspect we would have had more to pick from. Oh BTW, the local surgeon's fees are almost as much as Arnett. Price wise there was not a lot of difference. None of them are network providers, and they all wanted there $ upfront. It really shocked me to see that. The fees are astronomical, I will certainly agree on that point. But Arnett and Wolford are not the only ones charging these fees. If I had more local choices, I would try to stick to that. If you do, I think it is a blessing.
Your points are well taken. Our situation is such that where we are located, there are simply very few OS who do this type of operation. We have very little to pick from. I have spent months researching and posted on many boards and came up with only two from local OD referrals. We saw them both. One was extremely conservative and wanted to do a very small upper movement only. He simply was not going to address many issues. That would have been one way to go of course. This OS kept use waiting for almost two hours for consult and I had to insist upon a written report. The other wanted to do upper/lower/chin and do larger movements although I could not pin him down on how much. It was very difficult to talk with him. We were considering him because in experience and skill level he is best we could do locally and would not have to travel etc. Who knows if it does not work out with Arnett we may still go this route. I felt uncomfortable in having so few choices so I decided to travel. If we lived somewhere else, in most other large cities, I suspect we would have had more to pick from. Oh BTW, the local surgeon's fees are almost as much as Arnett. Price wise there was not a lot of difference. None of them are network providers, and they all wanted there $ upfront. It really shocked me to see that. The fees are astronomical, I will certainly agree on that point. But Arnett and Wolford are not the only ones charging these fees. If I had more local choices, I would try to stick to that. If you do, I think it is a blessing.
Rosy-
I looked at surgeons in Houston, Dallas, and Austin, as I live in Texas. I did not consider San Antonio, mostly because I didn't get any good recs for San Antonio doctors from anyone I talked to, and I considered out of state as a last resort. Arnett teaches at the San Antonio med school dept of Oral and Maxillofacial Surgery, but I don't think many of the doctors stay in San Antonio comparatively. Ironically, I did think of contacting Arnett's office before I found a surgeon here, because I have family in the area that I could have stayed with afterwards. So I completely understand choosing someone non-local if you don't have anyone good at it locally but I question whether you'd have just as good an experience in a big city in your state. For instance, here, there are a bunch of really good OS's in Dallas, a smattering in Austin (2-3 that I'd consider tops), and none in Houston that I would have been comfortable with. I too paid out of pocket for my surgery, as insurance did not cover it, but I got the hospital stay and most other fees covered as part of the necessary septoplasty/sinus work.
You are in Florida, correct? I simply can't imagine that there wouldn't be anyone good in the entire state of Florida and it'd be easier to fly to California. Maybe your daughter's case is such that she requires Arnett's work, I don't know. I just don't know why the presumption of being forced to travel would require someone on the opposite side of the country instead of at least on the same coastline. I suppose it is easier to research the big names when one has to travel, thus making the big names more 'accessible' in a way.
Also, I could never pin my doctor down on how much movement until November before my December surgery, so I don't find this so strange. He waited until the teeth were in position from the braces before taking the models and determining via that how much movement. I suppose he could have done the lower as well - my ortho certainly thinks something was done with the lower every time I talk to him (but that's another issue; the man bounces. literally) but both he and I wanted a conservative approach. I wanted as little surgery as possible, and correct me someone if I'm wrong here, but isn't it more stable in healing and long run bone stability if you have less movement??
P.S. None of the big names did the nose/sinus/septoplasty work I needed. So they're not good for everything!!!
I looked at surgeons in Houston, Dallas, and Austin, as I live in Texas. I did not consider San Antonio, mostly because I didn't get any good recs for San Antonio doctors from anyone I talked to, and I considered out of state as a last resort. Arnett teaches at the San Antonio med school dept of Oral and Maxillofacial Surgery, but I don't think many of the doctors stay in San Antonio comparatively. Ironically, I did think of contacting Arnett's office before I found a surgeon here, because I have family in the area that I could have stayed with afterwards. So I completely understand choosing someone non-local if you don't have anyone good at it locally but I question whether you'd have just as good an experience in a big city in your state. For instance, here, there are a bunch of really good OS's in Dallas, a smattering in Austin (2-3 that I'd consider tops), and none in Houston that I would have been comfortable with. I too paid out of pocket for my surgery, as insurance did not cover it, but I got the hospital stay and most other fees covered as part of the necessary septoplasty/sinus work.
You are in Florida, correct? I simply can't imagine that there wouldn't be anyone good in the entire state of Florida and it'd be easier to fly to California. Maybe your daughter's case is such that she requires Arnett's work, I don't know. I just don't know why the presumption of being forced to travel would require someone on the opposite side of the country instead of at least on the same coastline. I suppose it is easier to research the big names when one has to travel, thus making the big names more 'accessible' in a way.
Also, I could never pin my doctor down on how much movement until November before my December surgery, so I don't find this so strange. He waited until the teeth were in position from the braces before taking the models and determining via that how much movement. I suppose he could have done the lower as well - my ortho certainly thinks something was done with the lower every time I talk to him (but that's another issue; the man bounces. literally) but both he and I wanted a conservative approach. I wanted as little surgery as possible, and correct me someone if I'm wrong here, but isn't it more stable in healing and long run bone stability if you have less movement??
P.S. None of the big names did the nose/sinus/septoplasty work I needed. So they're not good for everything!!!
Arvenis,
I spent a lot of time researching and in Florida I found very little. There is Dr Piper in St Petersburg and Dr McCain in Miam both of which do the TMJ surgeries. We made a decision to not do this so decided to not seek opinion from joint surgeons and did not pursue consults with them. There are a few others within driving distance but when I called their offices I was told they did very few (IMHO) per year 10 or so or less. As to why Dr Arnett, we have family in general area so this looked like a possibility. The scheduling is proving a challenge as are the finances. In TX, I found quite a few OS that appear to do this surgery. Looks like you are in right place.
I spent a lot of time researching and in Florida I found very little. There is Dr Piper in St Petersburg and Dr McCain in Miam both of which do the TMJ surgeries. We made a decision to not do this so decided to not seek opinion from joint surgeons and did not pursue consults with them. There are a few others within driving distance but when I called their offices I was told they did very few (IMHO) per year 10 or so or less. As to why Dr Arnett, we have family in general area so this looked like a possibility. The scheduling is proving a challenge as are the finances. In TX, I found quite a few OS that appear to do this surgery. Looks like you are in right place.