Author Topic: Double jaw surgery mm  (Read 1305 times)

kavan

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Re: Double jaw surgery mm
« Reply #15 on: November 02, 2017, 04:51:45 PM »
Ditterbo, I really don't want to post my pics online, sorry.

More info about my surgery, I want to know if these things are common.

-I never got a proposal from my surgeon
-He said he would decide on the day of the surgery wether I needed genio or not depending on how the surgery went (he ended up not doing it)
-I had deviated septum so he performed a septoplasty. He removed my anterior nasal spine (he does not admit it, he sais it was missing before surgery, but that is not true) as a result my nose is flat. Is it common to remove the anterior nasal spine while performing LF1 and septoplasty?
-My gums on the left side receded a lot with the surgery. Does that mean bone loss? Why does that happen?
-He segmented my maxilla on that same left side, but left it in the same position and left me with an open bite on that side that had to be fixed (partially, its not 100% closed) by the orthodontist (this was surgery first, but I had no open bite pre surgery, only class II malocclusion, receded jaw and maxilla and sleep apnea).

No Photos:

No photos=NO aesthetic advice= don't bother asking about such or even expect your self assessments to be visually cross referenced by others. No photos= DON'T ASK whether this or that mm displacement was 'too much' for YOU specifically.


Proposals:

A proposal arises from a full WORK UP where cephs are taken. A ceph analysis is then done. After that a ceph DISPLACEMENT analysis is done which shows the original ceph tracing with an overlay tracing of HOW they wish to CHANGE things along with a read out of the displacements. A proposal can constitute a SURGERY PLAN. Doing all the DIAGNOSTICS that need to be done for such a surgery PLAN/proposal is TIME CONSUMING and are not just 'automatically' given out by each max fax one consults with. IF and WHEN they are, the CONSULT with the max fax can be LONG and in the $500 range. Patients 'shopping around' for a max fax wanting to get a surgery proposal USUALLY need to PAY (extra) for it. Patients wanting to compare plans/proposals from a number of max fax docs, usually ASK for them FIRST. Subsequently, the PRICE to DO is given to them.
Perhaps Ditterbo can tell you more about the costs of his consults WITH surgery proposals.

ANTERIOR NASAL SPINE:

It is common for it to be MOVED with the lefort 1. Better double check whether yours was MOVED or 'removed'.

SURGERY FIRST TECHNIQUE

It is common to be left with a NOT SO GOOD bite that requires 'fixing' AFTER the surgery. SF, the whole point of it, is to have the ortho LATER.

WHAT IS COMMON:

The most common complaint with sleep apnea surgery is advancement in excess of what it would be IF someone were NOT getting the surgery for apnea. So advancement BEYOND what is aesthetically optimal is the MOST common complaint associated with bi-max solely for apnea.
Please. No PMs for private advice. Board issues only.

kavan

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Re: Double jaw surgery mm
« Reply #16 on: November 03, 2017, 10:49:01 AM »
Thanks Kavan,

No photos: In my last message, none of my questions were related to aesthetics, but Id like to access the private forum if that is possible.

Proposal: I understand what you are saying. Before surgery, I though that jaws had an optimal position and mine were not in that position, so the doctor would just put them were they were supposed to be. I went to 4 different maxfacs and all 4 of them said I needed a bimax, but I didn't ask for a surgery plan. Then I decided which doctor I preferred (just based on his reputation and his before and afters) but he never told me how much he was going to advance my jaws or whatever he planned on doing. So my question is, do people never get a surgery plan or proposal unless they ask for it and pay for it?

ANS: My ENT sais that my maxfac removed it, and he asked my why. I have no idea why he did this. After the surgery my maxfax said that it was missing... My nose is completely flat now. Is this fixable?

Receded gums: Why does this happen? Is it due to bone loss?

Common:

That is my main complaint. I feel my jaws were moved way too much forward, but I am not asking you guys if you agree, because obviously you would need to see my pics. That and my nose being flat because of ANS removal make me regret my surgery. I didn't know this was a common complaint about sleep apnea patients. My sleep apnea was not very severe, so I wished they didn't move my jaws past the optimal position, and left my ANS where it was. That would have been a good surgery outcome for me, because that probably would have been enough to cure my mild sleep apnea.

I was a mouth breather my whole childhood, I believe that is why my jaws didn't fully develop. I just wished that my jaws would have been advanced to the point where they were supposed to grow to, not way past that point. And I don't get why he had to remove my ANS. The huge maxillary advancement added to the ANS removal left me with no nose and bimax protrusion :(

mazilla,

I understand that you don't like/are unhappy with your post operative appearace. I understand that because i know bimax for sleep apnea has capacity to over advance because it's done in accordance to something you CAN'T SEE on your face which is the AIRWAY. Not to mention it's not uncommon for bimax, even for people not getting it for apnea, to be a DRAMATIC change.
But beyond understanding that you are unhappy with the results, there is not much aesthetic advice that can be given to you in absence of any visuals.

There are also cases where people are very USED TO how they look and EVEN IF the surgery makes them look BETTER (to average onlooker), their attachement to what they are used to seeing over rides what could be considered attractive by others. Not only are you attached to how you used to look but you are also attached to the belief that your doctor did something 'wrong'. To that regard, your ATTACHMENT to your own opinion supercedes anything anyone here can say to make you feel better about your outcome. Afterall, you're not looking for re-assurance that it looks like an aesthetic improvement by others. Nor if it it looks worse by others. You just want to assert your assessment. Your posts just REPEAT your own assessment. Although you are entitled to your own assesment, it's NOT grounds for entry to the private forum.

As to your nose being fixable, most likely YES, by a good rhino doc where septal grafts would need to be constructed to build tip and base of the nose support. As to the ANS being 'missing', you would need the CEPH to evaluate. So, get a hold of that and have both the max fax the ENT show you on it where it was 'gone' or present BEFORE the surgery. Failure to provide a ceph on HERE precludes any feedback on whether or not it was there or not.

If you just want to re-assert your assessment in the absence of any visual info for which others could give you feed back, perhaps the 'Emotional support' section would be better place to post and perhaps to attract other posters who are good at emotional support. I'm just BRASS TACKS knowledge, information, aesthetics.
Please. No PMs for private advice. Board issues only.

kavan

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Re: Double jaw surgery mm
« Reply #17 on: November 03, 2017, 02:56:39 PM »
Kavan,

I never said I look worse post surgery. In fact, I believe that I look better.

My complain is that I look too different! And that could have been avoided by not advancing my maxilla 10mm and my jaw 19mm, and not removing my ANS. Sure, my surgeon advanced that much in order to open my airway as much as possible, but I am sure I did not need THAT MUCH advancement, I believe he just wanted to really make sure my airway was properly opened so he exaggerated the movements. Probably half of those numbers would have made the trick. 5mm maxilla and 10 mm jaw with CCW would have opened my airway A LOT already.

So, I believe that I look better, but not optimal, and I believe that I look too different, which bothers me a lot because I believe I don't look like myself nor my family anymore.

Also, I don't want to only assert my assessment. I wanted to know if some of the things that happened in my surgery are common or if it was the surgeon's mistake.

Also, I do want to know the opinion of other people about my aesthetic result. Just not here. In PM or the private forum would be better. I want to know if more knowledgeable posters believe that I was over advanced, or if it is only in my mind because, as you say I was too used to my old face. About my nose im pretty sure he ruined it removing the ANS.

Thanks

I told you what was common--common for more advancement than wanted when it's for sleep apnea.  in the absence of visuals, we don't discuss mm advancements. They are neither here nor there in absence of visual info.

Not sure how you determine which posters are 'more knowledgeable' but you are certainly invited to ask people  to PM you if you don't want to show any open photos.

Please. No PMs for private advice. Board issues only.

secondtimearound

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Re: Double jaw surgery mm
« Reply #18 on: January 01, 2018, 07:47:02 PM »
I'm kind of in a similar boat. I was class iii before surgery,  just a 6 mm maxillary advancement changed my profile from concave to convex. It just looks "wrong". My upper lip, maxilla now dominate my face. Facial hair is my only recourse. Unfortunately it makes my paraesthesia 10 times worse.

The worse thing about paraesthesia for me is shaving. OH HOW I HATE SHAVING.

It feels awful even though it's not painful or anything. I think it just annoys me because it reminds me of everything I've been through and how much more I'm still going to have to go through.

And also it means I HAVE TO LOOK IN THE MIRROR FOR 15 MINUTES TO DO A GOOD JOB AT IT.

FUCKING ARGHHHHHHHHHHHHHHHH

If I looked good with a wild beard I would just let it grow wild so I never have to do that ever. Both aspects suck. I hate shavers. I hate mirrors. The combination is crap.