jawsurgeryforums.com
General Category => Emotional Support => Topic started by: jawregret on September 27, 2016, 06:04:36 PM
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Don't get jaw surgery unless you're having very bad functional problems or are severely deformed. The risks are not worth it.
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Please expand on your experience
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Don't get jaw surgery unless you're having very bad functional problems or are severely deformed. The risks are not worth it.
I don't hold the same viewpoint. I think that individuals should make a determination for themselves of the costs and benefits associated with surgery. Each individual will have different metrics and valuation of those costs and benefits. I can certainly understand that someone's experience might shape their recommendations.
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Please expand on your experience
I had camouflage treatment done my by ortho for an overbite when I was young. Eventually when I got older, I became self-conscious of my somewhat receded lower jaw, so I went back to my orthodontist and asked what could be done about it. Ortho said that I could only get a proper class 1 bite (no camouflage) by getting jaw surgery, and that I would look much better after.
I agreed (pretty stupidly), so I went through decompensation treatment to prep me for surgery. A lefort 1, BSSO and genioplasty was planned.
Surgery comes, and I was impacted a bit over 3 mm when I had no gummy smile or excessive upper tooth show, and the surgeon advanced my chin waaaay too much.
I now show zero upper teeth at rest (ONLY lower teeth), and maybe 3 mm of upper teeth in a big smile. My chin is ridiculous.
Long story short: I came out looking way worse than I did going in. I didn't even have a horrible bite. The previous no surgery treatment had created a stable enough bite.
I still regret letting mild self-consciousness drive me to do something so invasive. I looked totally normal, and now I look like a much worse version of myself. I had no functional problems either.
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Over impaction is probably the worst aesthetic f**k up possible. Yet even the big name surgeons screw up like this.
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Over impaction is probably the worst aesthetic f**k up possible. Yet even the big name surgeons screw up like this.
Is there any hope for fixing this? It seems downgrafting isn't very stable...
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Is there any hope for fixing this? It seems downgrafting isn't very stable...
Down grafts are done all the time by the better surgeons.
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Down grafts are done all the time by the better surgeons.
ditto, i had an amazing downgraft done, brought out my entire smile.
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I don't think it was stupid at all! If your mandible was advanced, then you won't suffer from sleep apnea now or down the line. That's no small win! Talk to people who have it, it makes life beyond miserable. Most of your peers who didn't operate will discover it the hard way, after years or decades of problems they didn't realize were connected. No autopsy ever cites "sleep apnea" as a cause of death, only the complications from it.
I don't get why you had double jaw, though, usually overbites are single jaw problems. Any surgeon can downgraft the maxilla. Did he say what material he would use? It won't ever be good as new and they all have tradeoffs. Still, it's done and it's done routinely. You should also know that bony gaps of up to 3-4mm are expected to heal without grafts. The graft is there primarily for structural reasons. Agree on the chin work, I don't like SG either but when done well typically they're small. FWIW, I don't have any tooth show at rest either pre-op but have a good smile still somehow. If you came out of it without functional problems, then you had a decent outcome. We've seen some really s**tty/scary stuff on here.
That being said, I'll be checking my surgical plan before my surgeon goes in lol. But I have confidence about what the plan should look like and there will be no impaction for me.
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I don't get why you had double jaw, though, usually overbites are single jaw problems. Any surgeon can downgraft the maxilla. Did he say what material he would use? It won't ever be good as new and they all have tradeoffs. Still, it's done and it's done routinely. You should also know that bony gaps of up to 3-4mm are expected to heal without grafts. The graft is there primarily for structural reasons. Agree on the chin work, I don't like SG either but when done well typically they're small.
What do you mean by it won't be as good as new? Like, ever (for the rest of my life)? Or just during the healing phase (one year or whatever) where relapse is most likely?
Do you also know if reversing a genio is a bad idea?
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Did he tell you he was performing an impaction?
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Did he tell you he was performing an impaction?
Short answer: yes.
I was a dumb teenager who trusted my doctors 100%. I didn't even know what the word impaction meant at the time and I also had no idea that millimeters here or there would make such a difference.
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What do you mean by it won't be as good as new? Like, ever (for the rest of my life)? Or just during the healing phase (one year or whatever) where relapse is most likely?
Do you also know if reversing a genio is a bad idea?
Depends on material used. The most stable materials aren't ever good as new. For that matter, that applies to surgery in general. You accumulate scar tissue with each operation. I view grafts as a form of bone scar tissue. Not the end of the world, most of the time these "scars" will function fine through life. I don't know the same can be said for joint replacements.
I don't know about reversing genio. I see a lot of problems with genios in general and I think they often look unnatural. For me the aesthetic gain has to be pretty big to justify getting one because there's a notable increase in the risk of paresthesia after getting one. It's a relatively minor procedure to revise it I think if that'd make you happy.
FWIW, I have no tooth show at rest. My upper lip is too long. I guess I'm able to pull my lip up a lot because my smile is near perfect. It's gonna get worse with age but lip lifts aren't wonderful I hear. Wait and see for me.
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OP can you PM me some before/afters cuz for all I know, you could be imagining it.
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OP can you PM me some before/afters cuz for all I know, you could be imagining it.
My surgeon agrees, my ortho agrees, people I've PMed on this forum agree. I could show you, but I don't think I'm imagining it at this point.
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3mm is a large vertical impaction. I feel for your situation I have something of a similar situation, mine was more like a maximum of 5mm impaction but all posteriorly. It's a horrible situation to be in. I went in like you poorly informed, so
I'd say jaw surgery is still worthwhile for many but all practical steps need to be taken to ensure a good outcome and protection in the case of a bad outcome.
Do they acknowledge the 3mm impaction? In my case they will not, this is generally because they are only concerned with the anterior height of the maxilla ie incisor show. All of my impaction was posterior so I have taken on the appearance of a vertical deficiency and bite is very uncomfortable.
What are your plans for the future?
Regards
Ben
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I'm getting pretty desperate. As the swelling goes down it just looks worse.
How likely is it to have something closer to my old face in a revision? Is it possible to partially reverse?
I really don't know what do.
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I'm getting pretty desperate. As the swelling goes down it just looks worse.
How likely is it to have something closer to my old face in a revision? Is it possible to partially reverse?
I really don't know what do.
Which surgeons have you spoken to? Someone here had an overimpaction too and has had it revised that I know of.
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Which surgeons have you spoken to? Someone here had an overimpaction too and has had it revised that I know of.
I tried to get a second opinion from a surgeon in my city who basically stated that he didn't want to comment on my case at all. He wasn't comfortable and asked me to leave. (?!)
I've been considering seeing Gunson.
Like I've said, my surgeon offered a revision to bring my upper jaw back down, but in the original surgery I had a lower jaw advancement and an advancement through a sliding genio. So an isolated downgraft would just make my whole face even longer.
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I wonder if you can even get an isolated anterior downgraft without also having to partially reverse the lower jaw advancement? I'm trying to picture what would happen - an anterior downgraft would push the lower jaw down, which would in turn angulate the occlusal plane in the back, creating an open bite in the front.
Totally guessing and it might just be an orthodontic problem at the end of the day to realign everything.
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I wonder if you can even get an isolated anterior downgraft without also having to partially reverse the lower jaw advancement? I'm trying to picture what would happen - an anterior downgraft would push the lower jaw down, which would in turn angulate the occlusal plane in the back, creating an open bite in the front.
Totally guessing and it might just be an orthodontic problem at the end of the day to realign everything.
My surgeon said an isolated anterior downgraft can be done. That's no problem, but I'm worried about the effects on the rest of my face from having the single isolated movement. I wonder if there's any way to make sure that the added height from the downgraft can be removed some other way. Maybe from the chin?
This is such a freaking bother though, when you come out looking worse.
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I tried to get a second opinion from a surgeon in my city who basically stated that he didn't want to comment on my case at all. He wasn't comfortable and asked me to leave. (?!)
This is the norm. Only top docs will take on revision cases, otherwise "go back to your surgeon".
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Hi commenting again after your pm, pm sent also.
Tell me please is the impaction apparent on your soft tissues that is how is your lip posture with your molar teeth in resting contact or near contact?
If your lips appear squished it is also indication of vertical deficiency.
Forgive me if I've asked this before, I use this forum on my phone and find it awkward so checking my past activity before posting is frustrating!
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I tried to get a second opinion from a surgeon in my city who basically stated that he didn't want to comment on my case at all. He wasn't comfortable and asked me to leave. (?!)
At the very least I would have cursed at him every step I took leaving his office. Freedom of speech as long as you dont threaten anyone. Id also tell him i'd post my experience on any and every website available and when he threatened to sue i'd tell him to go ahead I have nothing anyway.
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What happens tends to happen from over impaction?
Biggest thing is the upper teeth don't show very much if at all. The lower teeth show a lot as a result of everything moving up. The chin looks bigger because of the CCW, but in my case perhaps too big. There also seems to be a lack of support for the soft tissue in the upper jaw area.
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Doesn't maxillary advancement compensate the loss of support due to impaction?
I mean, it should.
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Advancement might still provide upper lip support and accordingly reveal more upper incisor. the face though will still lack vertical support and look squished and frankly ugly. The lower lip might almost disapper with the jaws in a psychologically normal rest position, this with teeth in near or light contact. There will might also be deep bite depending on the angle of the occlusal plane. If there is the mandible will on closing want to rotate forwards but contact with upper incisors will force it backwards. It'll be really uncomfortable.
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ditto, i had an amazing downgraft done, brought out my entire smile.
Who did your surgery, Lazlo?