#111 – Dr. Jay Neugarten – The Custom Plate Debate: A Point by Point Response to Dr. Sullivan

Dr. Jay Neugarten is an oral and maxillofacial with around 3,500 jaw surgeries behind him, 100% custom since 2019. In this episode, he answers Dr. Steven Sullivan's case against custom plates, covering condylar seating, the digital surgical disconnect, and why he uses four plates instead of one. Plus MARPE complications, expansion vs advancement for the airway, and why he does more revision jaw surgery today than ever.Book a 1:1 Coaching Call with Ronhttps://jawhacks.com/coaching/Get the JawHacks Field Guidehttps://field-guide.jawhacks.com/Join the JawHacks Newsletterhttps://jawhacks.com/newsletter/TIMESTAMPS00:00:00 - Intro00:00:55 - 4 jaw surgeries a week, and a practice gone international00:03:58 - Sleep, the 8 hour rule and why oxygen matters more than hours00:10:56 - What CBCT and sleep studies can and cannot tell you about the airway00:19:13 - Why jaw surgery is an art, movement limits and the bullseye problem00:22:02 - The simulated video patients see, and how soft tissue is predicted00:27:31 - Airway versus aesthetics and the patients who struggle with the change00:33:41 - Revision jaw surgery and why it is never the plate00:37:15 - Why so few surgeons actually do orthognathic surgery00:44:03 - Looksmaxxing, Reddit and orthodontic camouflage00:46:16 - MARPE, SARPE and the complications he has to repair00:52:43 - SFOT and the real limits of segmental expansion00:59:48 - Wanting MARPE for nasal breathing, and why surgery does not flip a switch01:04:44 - Expansion or advancement, what actually opens the nasal airway01:12:16 - The MARPE smile, the soft palate and the revision LeFort01:17:01 - Hypermobility, EDS and what it changes about recovery01:22:32 - Inside NYCOMS, 3,500 jaw surgeries and the speed question01:30:20 - From stone models to Gen 3 custom titanium01:33:12 - Guides, plates and splints, where custom workflows go wrong01:43:22 - Answering Dr. Sullivan on custom plates and condylar seating01:55:14 - Accepting the debate and the mandible fudge nobody admits02:02:22 - Plate companies, titanium and why plate removal is worse than you think02:12:33 - Segmental maxilla and correcting asymmetry with custom plates02:19:02 - Aligner based surgery, Botox and bite force monitoring02:22:39 - Clenching, splints and morning headaches02:28:57 - Wrapping up and what is coming in part 2CONNECT WITH GUESThttps://www.nycoms.com/jay-neugarten-dds-md/https://www.instagram.com/drneugarten/DISCLAIMERNO MEDICAL OR DENTAL ADVICE. Ronald Ead and JAWHACKS, LLC, dba JawHacks (collectively, "we") does not give medical advice. We are not licensed medical professionals. The information provided in this video is for educational and informational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare provider with any questions you may have regarding your health or a medical condition.