jawsurgeryforums.com
User Blogs => Standard & Video Blogs => Topic started by: Antbee on October 09, 2012, 08:23:33 AM
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Hi everyone, surgery is on Thursday! Cannot believe I'm actually doing this. Still, trying not to freak out and focusing on the end result and the fact that by 2013 all should be much improved.
Final surgical plan was decided yesterday. Upper is now being moved up a further mm - 5.5mm and forward 2mm. He's also doing an upper lip reconstruction to even out my upper lip which is wonky and much thinner than my lower. He also says I'll have tooth support for my upper lip now which I haven't had before. He talked a bit about how all my ortho work had made my chin lose shape (extractions from the front of my lower jaw).
The lower jaw is coming up and forward, probably no genio and he's going to level my lower jaw as it's currently off, leaning to the left. Genio may happen once he's in there. I'm having a TON of augmentation with HA etc. oh and some CCW and my midlines are off to they are moving a bit too.
One thing I'm really worried about is my tooth roots are very close and he says doing the 3-piece segmenting will be tight and in his career he's seen 60 teeth die due to upper surgery like this, but he says he needs to segment my upper because it's much narrower than the lower. He says if a tooth dies I'll need a root canal but can't really fix it for a year (not sure why yet but I would hate to have a grey front tooth for a year! I'm worried about that one).
Oh also my nerves are unusually low and toward the outside of my lower jaw line which is a risk factor for permanent damage. Jeez. But he didn't seem massively worried and said I didn't have the other risk factors.
I feel quite anxious and a bit panicky about the long haul ahead/ risk factors but am trying to think it'll be worth it in the end. Zach (surgery with Arnett 10/4) has been a real help telling me how he's doing which has been great.
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You are about 3 months ahead of me (my surgery with arnett is 1/17/2013) so I am jealous! Best of luck to you and just know that you are in the very best hands (thats what my orthodontist keeps telling me whenever I say im scared of surgery haha).
I wonder which teeth are most prone to dying/needing root canals? Is it usually just in the upper jaw? The canines? Incisors? Im curious about that.
Keep us in the loop!
Edit: also, considering arnett has done this surgery over 4500 times, having only 60 teeth die is not bad at all.
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Good luck. Be sure to keep us in the loop, which I'm sure you will. I believe I'm next in line after you. I just try to relax and avoid thinking about what actually goes on during surgery. You're asleep and won't feel a thing. Just a nice long power nap. Just think, you only have one more day of your misaligned jaw!
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Good Luck to you Antbee! I would be (will be?) quite nervous myself, but remember you will be in expert hands. I'll be checking on your status :)
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Good luck!!!
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I know it's a little late, just wanted to tell you good luck with your recovery Antbee! Can't wait to hear how it went :)
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Received a text this morning from her that she's doing alright :)
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What do they do to help with the swelling? Hope things get better soon for you.
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It's good to hear from you. It's that bad huh? That's not exactly what I wanted to hear with 5 weeks to go but I appreciate the honesty. How has your pain/ breathing and discomfort been?
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Hi guys, well I'm home after staying an extra night in hospital (I couldn't drink enough). I'm not going to sugarcoat it, this is extremely hard going. Plus the nurses at the hospital were kind of mean. Dr A was pleased though and said everything went well. He did end up doing the genio after all.
I cannot begin the explain how intense the swelling is! It's so huge I can't move my lips or face. Numbness is hard to tell because the swelling may be adding to that weird sensation. I have some feeling everywhere except my chin.
Il update with photos once the swelling is a bit better. Thanks for all your support.
mean nurses? that is not cool. AG have la special relationship with the hospital, i mean they bring huge business so patients get special treatment, probably $900k-1mill and possibly more for patients who pay for additional days. this assuming AG do ~100 surgeries year, which is a conservative estimate i think.
it's good you have some feeling, my whole face was numb for about a week.
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A/G don't really give you stuff to counteract swelling -no ice or heat allowed so that might be part of the reason. I had mainly HA augmentation and some BMP. Basically i'm plodding through the days looking ahead to when I feel better.
yeah, cause it delays swelling and can mess up the HA if patients were to press to hard with a cold/hot pack. how was the morphine lol?
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Antbee! Glad to hear your surgery went well, it seems the epic swelling is normal especially for the grafts. When do you see Dr.A next? How are you spending your time? Getting enough sleep?
Take care :)
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Antbee I think you've won half the battle by having a positive mindset and knowing that this is all so temporary in the grand scheme of things! I think Zach has his appointment on Wed as well ! Take it easy dear, and get as much rest as you can. Do you have a blog at all ?
hugs :)
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You did it!!!
Now you can relax a bit, perhaps. It is good to hear that you are keeping yourself encouraged; that should be a big help in the healing process.
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Congrats on making it through. Kinda freaked out about recovery tho; everyone says it's harder than they realize. 10 mm is a lot of shortening!
Honestly I would say something to Arnett or the hospital about how you were treated. Every a&g patient ive talked to says how great the nurses are so it surprises me that they'd be that way to you...id be pretty ticked off.
Glad to hear you're doing well. You seem like a strong person and I know youll recover wonderfully.
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Antbee you're welcome :) Did you have an impaction of your upper jaw (gummy smile?) or what? Would love to know more about your case!
:)
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you'll do great. funny, i also had two "bad" nurses. one was a bully, and tried to force me take more affirin than what gunson prescribed, and the other was totally absent whenever i pressed the bottom. also tried to taper me off the IV much too soon than i wanted, but i think that's deliberate because AG want you to be able to swallow on your own and be able to drink liquids.
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Yeah they want you to give up the suction and the IV and be making it on your own drinking and taking meds etc. My thing is I don't respond well to being bullied or this one guy being so flat-out rude. I would have responded better if they'd been compassionate about it. However when my friend told the nurse to stop shouting and let me do things in my own time, he did apologize and was helpful after that. I did manage to call him an asshole when he left the room though, even though speaking was so difficult. I guess needs must!
i never really used the suction thingy because i was so wonked out on the morphine lol. plus the huge thing around my head and neck and all the discomfort. i did use it when the nurses said i had to but it was hard to know where to suction when you don't know where your features are (kinesthetic sense.) and the mirror was so SMALL.
w/o insurance, hospital is close to 10k. most of that is for OR time but like i said AG bring the hospital probably 1 million a year in fees. though it is a private hospital i would say it is understaffed. im glad my first nurse was super awesome, because the first evening is pretty bad.
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What do you mean when you say your teeth don't touch properly? That is one of the main goals of jaw surgery afterall.
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He implants a hook in the lower jaw and puts a screw in the upper jaw. These two points are used to mount the center elastics. I believe at about 3-4 months post-op they are both removed. I can tell you, it's quite odd looking inside my mouth and seeing a hook coming out of my lower gums. I can't see the head of the screw on my upper jaw because I haven't been brave enough to pull my upper lip up that far yet. Don't want to mess with the stitches and whatnot!
the hook in the lower jaw is removed, but the hooks on your braces - where you loop the bands on your own - remain for the duration of the surgical recovery. i dont think they are removed because they are attached to the braces.
can you see how many bands you have in your mouth right now?
You were in bands two months? I thought it was just a few weeks until you went on a soft diet.
let me think. you are in bands 24/7 for the first few weeks. then about a month later you only wear them part of the day (ie., 5-10 hours off each day, wear bands at night) until eventually the bands are dropped. i dont remember when i stopped wearing them completely, but i do recall still wearing the bands on-off daily until the 7th week? maybe 9th week. you can always ask. bands aren't that big of deal, training yourself to put them on on your own is a pain though. z will learn that eventually lol.
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let me think. you are in bands 24/7 for the first few weeks. then about a month later you only wear them part of the day (ie., 5-10 hours off each day, wear bands at night) until eventually the bands are dropped. i dont remember when i stopped wearing them completely, but i do recall still wearing the bands on-off daily until the 7th week? maybe 9th week. you can always ask. bands aren't that big of deal, training yourself to put them on on your own is a pain though. z will learn that eventually lol.
Is it really as much of a pain in the ass as everybody says it is? Today marks Day 12 and I honestly feel ahead of the curve. Zero pain thus far (crosses fingers) and I'm just doing my best to rest and let my body heal. Going to my 2nd post-op appointment tomorrow and can't wait to get a chance to open up and brush my teeth. Mouth feels GROSS inside! Only complaint is the feeling of pressure I get at times from the bands. It's hard to tell but it almost feels like I'm clenching but I think at times I'm just more aware that they're on there.
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Is it really as much of a pain in the ass as everybody says it is? Today marks Day 12 and I honestly feel ahead of the curve. Zero pain thus far (crosses fingers) and I'm just doing my best to rest and let my body heal. Going to my 2nd post-op appointment tomorrow and can't wait to get a chance to open up and brush my teeth. Mouth feels GROSS inside! Only complaint is the feeling of pressure I get at times from the bands. It's hard to tell but it almost feels like I'm clenching but I think at times I'm just more aware that they're on there.
yeah, looping the bands is a pain. it would take me maybe 30 mins to take them off and on when i first started. it's hard to hold your lips out to do it. one of the assistants will walk you through it but it's still hard.
did they say you could brush at your second week? i think you'll only be able to brush the surface (facial part) of your front teeth, definitely not the back or under areas of the teeth. that feeling is totally normal with the bands. of course any brushing has to be really light, no electric tooth brush or flossing. stitches are still vulnerable.
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yeah, looping the bands is a pain. it would take me maybe 30 mins to take them off and on when i first started. it's hard to hold your lips out to do it. one of the assistants will walk you through it but it's still hard.
did they say you could brush at your second week? i think you'll only be able to brush the surface (facial part) of your front teeth, definitely not the back or under areas of the teeth. that feeling is totally normal with the bands. of course any brushing has to be really light, no electric tooth brush or flossing. stitches are still vulnerable.
I'm sure the brushing will be minimal as you said the stitches are still vulnerable. I can just feel all sorts of gross buildup on the inside of my molar bands (I have the kind that has a hook on the inside as well as the outside). Do you think they'll let me brush there? It feels extremely unsanitary and rather nasty.
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I'm sure the brushing will be minimal as you said the stitches are still vulnerable. I can just feel all sorts of gross buildup on the inside of my molar bands (I have the kind that has a hook on the inside as well as the outside). Do you think they'll let me brush there? It feels extremely unsanitary and rather nasty.
not sure. i was restricted to brushing only the front areas of my teeth, and that was 2 weeks post-op. just do the 8 rinses a day. yeah, it does feel grody, especially behind the teeth.
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Still really swollen but gradually improving. Saw Dr A today for the first tooth brush and mouth opening session which was good. Huge relief to brush even if I'm only allowed to do the front ones at this stage. I'm still on pain meds because I have quite a lot of discomfort when I try and go without. I'm also already getting tingling in my cheeks to signify nerves returning, it's maddening though.
I have pretty much full feeling in both lips and am only really numb completely on my chin and next to my nose. Dr A says he didn't compromise my nerves and expect full feeling to return.
I can only just see my teeth - I'm told not to attempt to lift my lips manually to see. They look so weird and my bite is way deeper than its ever been- basically my jaw closes as it should. My tongue also has enough space to fit entirely in my mouth and for the first time ever I can breathe comfortably and entirely through my nose, which is so bizarre I can hardly believe it.
Looks wise- it's been hard as I really bear very little resemblance to either my old self or my new one (I hope) my face is super square and my eyes are rounded, nose a tiny bit wider. All these things are, I'm assured, caused my swelling. The HA and BMP causes waaaaay more swelling in G/A patients than others. Lena told me today that others' progress is not comparable to their patients because they do a lot more, causing a lot more swelling. That made me feel better.
The main weirdness has been the square face, but I can see clearly how huge swelling along my jawline and neck is causing that and I have faith that ill look like my old self only with a more compact face in future.
Awesome post! Sounds like youre gonna have a full recovery (no numbness) and you can already breathe through your nose...amazing. so happy for you.
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My tongue also has enough space to fit entirely in my mouth and for the first time ever I can breathe comfortably and entirely through my nose, which is so bizarre I can hardly believe it.
This just made my day.
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Yeah congrats! Both you and znewton sound like you're doing really, really well both functionally and aesthetically so it's great to hear these positive results. Gives me hope!
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yeah, my nose was sort of the same - but just pure numbness. nasal floor harvesting or something?
good to know you're feeling fine. everyone swells up differently. i would anticipate random swelling in the next few weeks, i freaked out originally when that started happening (no swelling on left side, two days later swelling shows up.)
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My ortho attended the course and told me about it.
You mean the conversation about my lower jaw and lip placement? I initiated it. I detailed in my post what he said. He's very to the point and doesn't extrapolate a lot. But he listens. I've seen many examples later of him really paying attention to what I said. e.g. today - my worries about my nose were taken seriously and exercises prescribed, even though my nose is only a teeny bit wider.
I think my exercises differ because I had such a huge impaction and upper lip reconstruction - my upper lip is really stiff now - which I knew to expect since Dr A had warned me about it.
i get what he said. this was during the pre-op? i mean arnett writes a lot about patient-surgeon expectations and information. did the atmosphere/climate seem normal, like this is the time to know everything?
edit: i realize this is a pretty dumb question. anyways, im glad you knew what to expect and everything.
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Good advice. Thank you for sharing. If you think of anything else like this, please do share.
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sucks about the stitch. i think i had one that had to be cut early as well. as far as nerves go, have you considered klonapin or something similar? just to relax i guess. the painkillers never worked for me, except for the morphine.
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Hi Antbee -
By looking at your morph I'm surprised at how subtle the difference is, at least compared to mine. I'm sure you notice all the little details about your face, but in the photos I mostly observe typical post-surgery swelling. Maybe as it continues to go down people will recognize you better? I can see why it feels strange to not be recognized right off. In everyday interactions, people don't stop to analyze.
As far as what someone might think during conversation, you are doing them a favor by helping them to get over themselves! If I had to interact, I'd just make it plain; "Hey, don't worry, I'm not on drugs. I'm doing my best to speak, but my mouth is numb and gimpy from jaw surgery".
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Antbee......thanks for posting pics.....really helps those of us in the pre surgery stages.... You really look great! You could be a model. Congrats and best wishes for smooth sailing in the future recovery stages.
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You're actually very attractive --I mean you were quite attractive before, albeit with a longish face(sorry just pointing out the obvious, don't worry I freely admit I have a weak chin/jaw so opposite problem), and now that that's been quite obviously fixed, yes, you might possibly be model material when all is said and done. You should be tremendously pleased. I would say you've even got great tweaks to your nose and upper malar region --so everything looks great --and you already had great skin, lustrous hair and striking eyes. I'm too lazy to go back and read your entire thread, what exactly was the lip reconstruction you had done?
It looks like the surgery has greatly improved your lower orbital region as well, I wonder if the HA paste was used to fill in and augment that area as well.
Regardless, you should be ecstatic.
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how do your cheeks feel?
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My cheeks are getting feeling back but feel kind of solid - that mask feeling has really hit me lately.
sorry a bit off-topic, are you like one of those e-news entertainment reporters or something?
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Yeah exactly but I'm not on camera. I just do print interviews.
oh that's awesome. well now with your new look you could totally do on air stuff too if you wanted to (i mean you could have before though, but you're one of those lucky few who had all the right features to have come out of surgery with a truly stunning result(I mean you can even tell now). It's cause you had such delicate bone structure and sharp features pre-surgery. see my hyper-critical attention to detail is as focussed on positive features as much as bad...you're quit fortunate.
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I'm missing wearing sunglasses and not looking bizarre'y swollen
can you clarify? do you miss wearing sunglasses or you're missing wearing sunglasses? in other words, do the sunglasses have an affect on your healing, like touching your cheeks?
weird question, just curious.
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Wow you are beautiful!
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2. I want to write something on how people's significant others may or may not view their partner differently (emotionally) post-surgery. I noticed a few cases on JSB of women who commented that their partners felt they were different people or too alien now after surgery. I imagine this happens with both sexes, it just happens that it's been women so far who've mentioned it in posts I've seen. Either way, something about how difficult it may be when your partner's face changes really radically. I 'd need to find people willing to take part since I did this as a single person.
I'd be willing to take part. I'm a bit worried about how my wife will react to everything. I'm hoping that I feel better functionally and second will have some minor cosmetic benefits that she will only appreciate. Only time will tell.
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also, your stomach shrinks from the liquid diet so you get full a lot quicker. you might get tired of the soups and creating blended cocktails (especially if you're the one doing it). in my case, i decided to just drink milkshakes almost exclusively and would throw in some protein powder every now and again. i still lost 20 pounds in less than a month.
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Thanks Tri. Glad you're finding it informative. In the spirit of that, here's two pics from today. I wanted you guys to have a clear idea of how tricky it is smiling and closing my mouth. You can also see how my mouth wants to go to one side in the 'smiling' pic. It's so weird how my face is trying to adapt. All this is temporary as far as I know and I feel fine today in general. Oh and you can see how my nostrils widen when I smile. Some of this is down to the huge effort I'm making to pull up the corners of my mouth. I imagine it will improve.
Just met up with znewton. He joined me at one of my work events. Unfortunately it was a food fair! Sheer torture. Gourmet food stands everywhere. Everything from sushi to home made carrot cake to BBQ ribs and burgers from the Counter. We ended up pitifully drinking juices from Pressed Juicery. I mean they're good but I would have LOVED the cake. I have a huge sweet tooth. In fact just now I tried to placate myself by sucking on a tiny piece of chocolate. It took me about 20 minutes to finish one square. Haha. By the way I want to emphasise how incredibly helpful it is to find a surgery buddy to trade info with. Really helps to keep me sane when I'm worrying about something, struggling or bored at home while everyone else is out having fun etc. Having someone who gets what you're going through is great. Maybe this forum could do what archwired does and post a surgery buddies thread every so often.
Thanks for the post antbee :) She's most definitely right that the food fair was utter torture but we ended up having a few cups of some really good fresh juice. To reiterate - I had planned to do what she just discussed regarding how patients having various plans to continue eating healthy/raw/sugar free diets post-surgery. Really, I just planned on doing a ton of raw and fresh juice post-operatively for the first two weeks while I was on liquids only, and let me tell you, that was the LAST thing my body wanted. I ordered a ton of my favorite juices from a place here in LA that I like and took advantage of their delivery service so I could have them in SB after surgery. There wasn't an once ounce of me that wanted anything to do with that juice after surgery and if anything it made me sick to my stomach to even think about. It sounds like Antbee and I survived off the same stuff the first two weeks: ginger ale and apple juice. That's all I could really stomach and I don't believe I took a stab at tomato soup until close to the two week mark. I just wasn't ready for anything but the juice, ginger ale, and boost/ensure I would force myself to drink. At this point I'm least concerned with maintaining a healthy diet and more concerned with just getting the calories and protein in as Antbee said. I normally eat very healthy and am really into staying active whether it's running, hiking, or working out at the gym. I've had to abandon my usual diet as to just get the calories in to heal and prevent further weight loss (been holding at a 15lb post surgery deficit since week two).
I apologize for hijacking your thread, Antbee ;) It was great meeting up with her today to share our stories and experiences thus far. It really does help to have someone going through this at practically the same rate as myself (she had surgery one week after I did). I never imagined I'd be making friends through the process of orthognathic surgery!
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Hey no worries. Hijack away! Yeah we definitely agreed on the food/ juice thing. We made a right pair at my work thing, both of us with our acrylic-bonded braces explaining to my co-workers how we met through our matching surgery. Hahahaah. I got a kick out of it anyway.
I was secretly laughing inside while you were explaining how we met - that's probably the last thing he was expecting to hear! Definitely looking forward to (and not so much) the day I head to the ortho to have the brackets replaced and one single archwire attached!
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Hi everyone,
I really like how znewton updates to try and help others know what to expect so in that spirit I have come back here - I've been posting on the facebook group in the meantime - but I get messages asking questions so thought might be helpful to show my pics. I'll only leave them up for a bit though probably.
General points:
Appearance: I'm really happy with my results and Drs Arnett and Gunson are really happy. However, for now I find myself avoiding mirrors - not consciously - I catch myself looking away from them. It's a weird reaction to looking different. I assume I'll adjust at some point but for now it's taking way longer to get used to than I thought it would. Don't underestimate how strange this might be - even if you like your results.
Teeth and bite: Two of my front teeth died during surgery. I was a high-risk patient for this I was told and the segmenting of my upper jaw caused the roots to die. I'll likely need root canals and internal bleaching to get rid of my two grey teeth. I was not thrilled to say the least but the surgery was a million times worth it. My bite is almost perfect. A bit more ortho but that's it.
Airway: My airway is over twice the size it used to be. I am like a new person in that I am just not sluggish and tired like I was. Also I am breathing through my nose with zero issues and I have never used my nose before! It's literally incredible and has changed my life so much.
Smell and taste: My sense of taste disappeared for a couple of months and is slowly coming back now. Dr A says he's only seen it in five other patients and all of them recovered fully. My sense of smell is still bad. But I had a huge amount of work done inside my nose - nasal floor removed etc so I'm not surprised. Surgery still totally worth it and smell is very slowly coming back.
Swelling: It's still there next to my nose making my skin look stretched and weirdly lumpy almost - no one else notices it except me though.
Bones and grafting: I had extensive grafting to my cheeks and lower jaw. My lower jaw is a bit bigger/ heavier-looking than Dr A (or I) would like but Dr A says it's the bone's reaction to trauma and it overgrows then shrinks back in the course of about a year so that will improve. It's nothing bad though, it's a small issue.
Nose: My nose is only now going back to it's normal pre-surgery width. I am 5.5 months post-op. It's still a bit wide when I smile but otherwise great. It looks better than it used to pre-surgery as the tip has lifted a bit.
Numbness: I am only now really getting feeling back in my chin and it's slow going. But it doesn't bother me much. My upper gums are numb in the center still. My cheeks are numb on the outer edge of the bone where the grafting is. But again it's slowly improving.
Work and speaking: I went back to work one month post-op. I looked horrendously swollen but I needed to go back. It actually speeded up my recovery I think because I had to get on with things. It made my feel better emotionally. Although the first time a friend didn't recognise me was like a slap in the face. It really did hurt. Speaking is still a bit hard when I'm tired but that's partly the braces and partly the scar tissue is tight and my lips won't close completely without effort. I do stretching exercises and it's improving fast now. Just this past week I found myself closing my lips without thinking about it. My chin dimples when I do this, but my face is changing so much still, the dimples are in a new spot every week. It's definitely working itself out.
No one really tells you that closing your lips and speaking as clearly as you did pre-surgery takes a bit of time to re-learn (or it did for me). The good thing is my old lisp pre-surgery has completely been cured.
Friends and family: My family were fine but not all my friends could accept it easily. One in particular seemed to need to believe I'd had plastic surgery. Basically if something improves or changes you not everyone is going to be comfortable so be prepared for some odd reactions. I think it's a bit like when people lose weight and their friends sometimes actually resent them for it. Also anything that makes you vulnerable, i.e. surgery, tends to be a time when you find out who your real friends are and that can be pretty tough to take. I recommend staying away from anyone but people you trust for a long as possible during recovery.
Eating: I can eat anything now except raw carrots and nuts and hard candy etc. I finally feel confident about chewing.
Overall: The recovery from this surgery has so many stages and there are feelings and worries that come up and play tricks on your mind seemingly every five minutes. I noticed i randomly freaked out about things I thought were problems some weeks and other weeks I felt totally calm about everything. It's great to have a surgery buddy during the first two months at least to text or call and share that with. (Props to znewton for helping me out!) Dr A's office were great though. My nurse, Lena, struck just the right reassuring note with me and she knew when to be firm and not let me panic about nothing too. I am beginning now to be able to imagine life where I have forgotten surgery even happened. It already seems so long ago and quite dim and distant. When I look back it's shocking that I went through all that. I feel as though my mind just went on a vacation while all of it was happening and at some point I woke up again.
NOw pics - there are two pre surgery ones and the rest were taken in the past couple of weeks:
BEFORE and AFTER:
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forgot to add for those who don't know:
I had double jaw surgery with genio and HA grafting. My upper was moved up 5.8mm, forward 2.2
Lower rotated up 4.8mm and forward 2.4 also some realignment for asymmetry but not sure of the measurements.
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Antbee, you look amazing. Seriously, you look like an actress in the after shots. You must be thrilled. Sorry to hear that not everyone has been supportive; I hope they'll come around.
Question for you about the dead teeth. I had surgery with Arnett on 1/17 and one of my upper incisors turned purple. Arnett told me that if it's purple its a good sign but if it turns brown ill need a root canal. Were your teeth ever purple/was there hope before they were declared dead? Just wondering if my tooth has a shot or not.
Anyway, sounds like things are going well for you! Hope your recovery gets better and better :)
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yeah, you look spectacular, you had greater features before hand, but yeah...if you had the desire to go on camera/act etc. you totally look great....
amazing to hear about the improvement in breathing
very scary to hear about the dead teeth and loss of taste/smell but as you say it's coming back so that's good, i'm sure you'll make a full recovery.....
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You definitely look great, no need to avoid mirrors. I'm sure that with time you will come to accept your new face.
There is a similar case going on over at lookyourbestuk, early 20s female patient had double jaw+genio with Prof MM had an amazing result but still she cannot accept her new self.
Why were you a high risk patient?
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Thanks so much for the support guys. Tree- sorry to hear you're experiencing a tooth problem. Personally dr A and Lena have been extremely reticent to declare my teeth dead. They won't do this for a year. You also need to see an endodentist to test the life left in your tooth. I put my foot down and said ill be getting my teeth fixed before a year is up. I know they're dead- they're dark grey- plus I'm not willing to wait a year like that after going through all this. Apparently people experience temporary tooth color changes due to restricted blood flow. I finally put dr Gunson on the spot and said I needed to hear his opinion on if my teeth would recover. He said one of them was pretty certainly gone, the other may improve. I would say wait a few months and try not to worry. You have braces on so nothing you can do til they come off anyway. It sucks but if your tooth is dead it will be an easy fix I'm told. They remove the root and insert bleach pellets. Hope that helps.
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Pekay - thanks. I was high risk because my roots were so close together (very narrow jaw, large teeth). Dr A showed me an x ray and pointed out that getting a chisel between the roots to segment my jaw would be very hard. He didn't chip the roots but sometimes the teeth die if they're like this and there is no concrete reason.
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Yeah dead teeth will apparently function fine. They can cause pain I'm told though. Depends on the case.
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Hey antbee, I think I saw you at A&Gs this afternoon? I was brushing in the bathroom when you knocked. I thought you looked familiar! LOL
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Hey! I actually got in line for the bathroom twice and saw two different people come out - I had to check in wij Cindy in between - so not sure which one was you now! Haah.
I was there getting my 'braces off' release form. An auspicious appointment!
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Oh wow, might you be getting them off earlier than expected?
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Right at the six month mark as predicted:)
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so I got my final before and afters from the doc. Update on my progress: I've had two root canals and internal bleaching of my front teeth which has made them look normal. I still can't feel my chin or cheekbones entirely but I have 'surface' feeling in those areas. My upper gums are mostly still numb. After getting braces off two weeks ago, my face took a while to adjust, but actually things have improved since these photos were taken as my lips have got more used to not having braces behind them.
Otherwise, my new airway/ nose is still the most incredible thing ever. I can't smell quite as well as I used to yet but it's improving, and my sense of taste is almost back to normal too.
Swelling is still there next to my nose and below my lower lip a bit, also my lower jaw should 'shrink' a bit in the future as the bone is overcompensating a bit as is normal in the months following surgery according to Arnett. Now just the bite equilibration bonding to do and I'm completely done with surgery. Any questions, feel free to ask here.
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had to post pics separately as files were too big
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last one
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Great change. improvements in every area of the face.
no mid face/eye crap.
great improvement, you must be thrilled!
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that's actually quite remarkable, you look like a different person (much better). At first I thought the after pics were taken from a closer shot scale but they're not right? The contours of your face altogether are much, much more pleasing and attractive. I guess this must be the HA paste grafting they did to smooth out the transition from your cheekbones to maxilla (in the 3/4 profile) and your mandibular angles etc.. It's not just the advancement, it's the filling out in those areas which is remarkable --do you think all that was the HA paste?
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In 3/4 view you look a bit like Angelina Jolie now (srs)
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You look amazing that is for sure
What did you have done? maxillary impaction and HA augmentation to the cheekbones and orbital rims?
How long were you in braces for (pre-op) ?
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Yeah your cheekbones look similar to mine in having that groove from cheekbone to mouth at 3/4 view, but lacking forward projection. Would be interested to know how that area improved so much!
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thanks for the kind comments. Really helps as still weirded out by how different I look honestly. Seeing candid photos freaks me out the most as I don't recognise myself at all from some angles.
So to answer the Qs:
I had 5.8mm upper jaw impaction and my lower jaw rotated up 5.8mm
My upper was 3-piece segmented to widen and was brought forward 2.2mm (I think)
Lower was brought forward 2.4mm
Chin was brought forward (not sure how much)
I was in full braces to decompensate my bite for five months pre-op - but I have had four sets of braces and was already in braces on the inside of my upper teeth for a year when I made the surgery decision.
Dr A used a lot of HA paste under my eyes - orbital rims, cheekbones and lower jaw angles. It's remarkable he was able to do any of this but he was especially pleased with the under-eye area. For sure I needed that extra projection in my face as it was so flat before, but also to 'take up the slack' I think since my face is so much shorter now. I do think I look a bit older, but others have told me I look younger. It's weird, my skin wrinkles more around my eyes now because I have cheeks. Anyway, I think it was so so worth it, although like I said, getting used to a new face has been much weirder than I thought it would be.
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Oh I also thought this might be interesting. It shows how much longer one side of my jaw is than the other (most likely due to childhood accident when I broke my lower jaw). You can see how DR A moved my jaws sideways to try and make my face more symmetrical. Perfect symmetry basically never happens but considering the discrepancy he started with, he's done amazingly to make me look more even-jawed.
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You look really great.....so glad to hear about the better breathing too!
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Hi Antbee! How are your HA grafts holding up now a few years later ?
Hope you are happy! Please post some photos of you now if you can. Thanks!!
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Hi SGSeeker - haven't been on here in forever but happy to update people on the experience of being 2 years 9 months post op. After double jaw and genio with multiple HA grafts by Dr Arnett I was very happy with my results. At this point things have settled a bit and any residual swelling is finally gone (took over a year). I still have numbness in my chin and gums, my scar tissue is still tight and has to be stretched with exercises. Some asymmetry returned with the decreased swelling but that's to be expected and is nothing too bad. The HA grafts remain as solid and set as they were. After 8 weeks they truly become a knitted part of your own bone. My jaw clicks on one side now when I open it (it didn't before) but that's a small price to pay and it's not painful or constant, just occasional. My bite is still perfect. I required equilibration treatment from a Dr Arnett-recommended dentist - they file some teeth down and build others up to fine-tune the bite. That was expensive and boring but it's ensured my bite is perfectly stable and solid. My chin hardware from the genio had to be removed a few months ago as my lower lip was postured a bit low and I felt it was dragging. Dr Arnett had encouraged more stretching exercises but honestly I wasn't the best at doing those enough and dr Gunson suggested removing the chin metal as sometimes it gets 'caught up' in the muscle. I'd had Botox from dr G to freeze my chin muscle and try and make it move evenly but that didn't change much so he removed the metal under anaesthetic in the office. I was swollen for four days but fine. That surgery slightly changed the appearance of my chin and lower lip. My chin got slightly flatter, my lower lip turned in a tiny bit- very subtle changes. Dr G says he can do a procedure to make my lower lip turn out again (it's caused by the extra scar tissue and muscle positioning). I'm not too bothered though- but will ask about it at my next appointment. The lower lip being too low - too much lower teeth visible- is sort of unavoidable in my case as I needed so much impaction in my upper (5.8mm). Dr G is also looking into possibly shortening my chin with a genio revision but I probably won't do it, it's not necessary and can cause slack skin (no one wants that!!) I'm now 39 years old and despite all the impaction I've had, my skin is holding up well - probably due to all the HA I had, which helped pick up any slack! Any questions- I'm happy to answer them! Going to try and post photos for you guys in a sec
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Here are some pics- front and side. Then he before and after of my chin following hardware removal. You can see that the after shows a flatter chin and slightly smaller lower lip- as explained in previous post
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I think you look very beautiful Antbee. Thanks for sharing all this.
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Has your lip stayed the same (turned in) over time?
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How on earth do you look so young for 39!!?? Please tell me have you had any skin resurfacing or filler or Hylauronic acid treatments or do you use special creams or lasers!!??
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How's your jaw functioning though? Are you able to chew hard foods like steak no problem?
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Laslo- thanks so much for the kind words! Although my friends thought jaw surgery was plastic surgery of some kind, no I haven't done anything. Just retinol cream at night, sunscreen in the day:)
Serra- my lip turned in a little immediately after having the metal removed from my chin. It's the same but improves slightly when I do my stretching exercises.
Terry947 - like I said, my jaw clicks on one side occasionally but otherwise function is 100%.
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What is the procedure to make the lip more out?
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Serra - I'm finding out more about the procedure and am now looking into having my genioplasty revised to make my chin shorter as my lower lip hangs too low when I talk....
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Serra - I'm finding out more about the procedure and am now looking into having my genioplasty revised to make my chin shorter as my lower lip hangs too low when I talk....
Antbee - Okay, I saw your other thread. Let me know if you're discussing the procedure for your lower lip at all. I think it's probably a v-y plasty but I wanted to check with you to make sure.
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Old topic I know, but can someone explain to me why OP's chin looked flatter after plate removal? Did the actual bone move back or somehow lose projection?