Author Topic: Alternatives to jaw surgery?  (Read 5248 times)

babyjaw206

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Re: Alternatives to jaw surgery?
« Reply #15 on: January 27, 2018, 08:42:55 AM »
1: Having to UNDO what was best not done in the first place in order to do the right thing the second time around.

Intuitively it seems that correctly repositioning the jaw(s) would provide a result that holds up better over time than an implant would. Have you actually seen this play out? I’d be interested to hear if there are people out there who had a chin implant when they should have had jaw surgery and then later regretted it (and why specifically).

kavan

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Re: Alternatives to jaw surgery?
« Reply #16 on: January 27, 2018, 09:10:10 AM »
Intuitively it seems that correctly repositioning the jaw(s) would provide a result that holds up better over time than an implant would. Have you actually seen this play out? I’d be interested to hear if there are people out there who had a chin implant when they should have had jaw surgery and then later regretted it (and why specifically).

Yes. Of course I have. But there is no way to transfer to someone else my many many years of this type of observation.

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swsee

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Re: Alternatives to jaw surgery?
« Reply #17 on: January 29, 2018, 12:06:57 PM »
Intuitively it seems that correctly repositioning the jaw(s) would provide a result that holds up better over time than an implant would. Have you actually seen this play out? I’d be interested to hear if there are people out there who had a chin implant when they should have had jaw surgery and then later regretted it (and why specifically).

I would fit that description. Had a very large chin implant put in (10mm) a few years back, and even after multiple revisions it looked horrible. I had a steep mandibular angle, and the chin implant more or less just added bulk and length to my face, rather than anterior projection. Looked ridiculous. I had it removed and just lived with my recessed jaw for a few years until I decided to have double jaw surgery + genioplasty, which I'm currently ~ 1 year post-op. Chin implant is a horrible solution when the issue is anything beyond a slightly recessed chin.

ditterbo

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Re: Alternatives to jaw surgery?
« Reply #18 on: January 29, 2018, 08:06:57 PM »
I would fit that description. Had a very large chin implant put in (10mm) a few years back, and even after multiple revisions it looked horrible. I had a steep mandibular angle, and the chin implant more or less just added bulk and length to my face, rather than anterior projection. Looked ridiculous. I had it removed and just lived with my recessed jaw for a few years until I decided to have double jaw surgery + genioplasty, which I'm currently ~ 1 year post-op. Chin implant is a horrible solution when the issue is anything beyond a slightly recessed chin.

Hi swsee, how are you TMJ's doing after your massive advancement?  Were they able to close the posterior open bite?  Would you say your jaw narrowed from the nature of jaw advancement or could it be from the teeth extractions?  Did you notice your tongue get more cramped since the extractions supposedly narrow the arch?  Thanks?! Your an interesting case to me, given your doc choice (near me) and sort of similar starting point and journey. 

swsee

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Re: Alternatives to jaw surgery?
« Reply #19 on: January 30, 2018, 07:54:59 AM »
Hi swsee, how are you TMJ's doing after your massive advancement?  Were they able to close the posterior open bite?  Would you say your jaw narrowed from the nature of jaw advancement or could it be from the teeth extractions?  Did you notice your tongue get more cramped since the extractions supposedly narrow the arch?  Thanks?! Your an interesting case to me, given your doc choice (near me) and sort of similar starting point and journey.

Sorry to OP for taking this off topic....

Posterior open bite closed up no problem, and my bite fits perfectly. Have another 6 weeks of invisalign to fine tune everything, and then I'm done. TMJs feel fine. I honestly thought they were screwed, since I was still having pain and restricted ROM up until ~ October. Fortunately that resolved itself, almost out of nowhere. ROM still isn't at where it was pre-op, but I can eat burgers and don't have pain, so for all intents and purposes it's not an issue. Also, I gained a good amount of width back in my jaw angles, that I assume was caused by masseter atrophy after surgery. Now that I'm chewing, and FINALLY getting back to a "normal" life they sort of bulked back up. Main complaint would be the large notching as a result of the rather significant advancement. Not sure how/if I'm going to address that yet. Feel free to PM me with any other questions. I still pop in here occasionally and am happy to share the ups and downs of my procedure. I might make a thread at some point with pictures,details,etc.

babyjaw206

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Re: Alternatives to jaw surgery?
« Reply #20 on: January 31, 2018, 04:43:20 PM »
Thanks everyone for your feedback. It’s given me a lot to think about. I’ll post an update after my consultation.

tjarrr

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Re: Alternatives to jaw surgery?
« Reply #21 on: February 05, 2018, 06:30:40 AM »
I think it's a bit strange for people to be recommending that you get a bimax surgery to fix an aesthetic issue. That's at least a hundred thousand dollars and really only makes sense in cases where there are functional issues involved such as sleep apnea, TMJ, problems with chewing food, etc. You would indeed benefit from such a surgery, but it really doesn't make sense to do in your case unless you don't mind dishing out 100 grand. You look good. So I'd recommend camouflaging the maxillary-mandibular recession by either: sliding genio, and paranasal implants OR filler in your nasolabial folds / upper lip and on the anterior part of your cheekbones. Filler is probably a good first step because you can at least have something of a "preview" of what implants would look like should you decide to go down that route. Not the best long-term solution, however, because they're only temporary. You could also get filler done around your jaw and chin which can help mask the submental fat you're referring to and give you the look you try to achieve regularly by moving your jaw forward. Just so you know, by the way, it's normal for women to have SOME fat underneath the chin, even if your lower jaw is very well developed; this has to do with the fact that women store their fat subcutaneously. It's very important to understand this because its presence can lead to dysmorphia if it's thought to be abnormal rather than something that's found in the vast majority of women. You can diminish its appearance on your own right now by just contouring the area.
« Last Edit: February 05, 2018, 07:29:26 AM by tjarrr »

kavan

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Re: Alternatives to jaw surgery?
« Reply #22 on: February 05, 2018, 06:48:52 AM »
I think it's a bit strange for people to be recommending that you get a bimax surgery to fix an aesthetic issue. That's at least a hundred thousand dollars and really only makes sense in cases where there are functional issues involved such as sleep apnea, TMJ, problems with chewing food, etc. You would indeed benefit from such a surgery, but it really doesn't make sense to do in your case unless you don't mind dishing out 100 grand. You look good. So I'd recommend camouflaging the maxillary-mandibular recession by either: sliding genio, and paranasal implants OR filler in your nasolabial folds / upper lip and on the anterior part of your cheekbones. Filler is probably a good first step because you can at least have something of a "preview" of what implants would look like should you decide to go down that route. Not the best long-term solution, however, because they're only temporary. You could also get filler done around your jaw and chin which can help mask the submental fat you're referring to and give you the look you try to achieve regularly by moving your jaw forward. Just so you know, by the way, it's normal for women to have SOME fat underneath the chin, even if your lower jaw is very well developed; this has to do with the fact that women store their fat subcutaneously. It's very important to understand this because its presence can lead to dysmorphia. You can diminish its appearance on your own right now by just contouring the area.


Costs will vary depending if one has insurance and also which maxfax. Not all maxfax work is 100 grand.
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tjarrr

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Re: Alternatives to jaw surgery?
« Reply #23 on: February 05, 2018, 08:09:24 AM »

Costs will vary depending if one has insurance and also which maxfax. Not all maxfax work is 100 grand.

Right, that's why I said bimax, which is usually that expensive (MMA or Lefort I + BSSO) after you factor in the OR cost, the anesthesiologist fee, etc. Unless you get it done somewhere outside the US or Europe, which is risky if you don't do your homework right

babyjaw206

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Re: Alternatives to jaw surgery?
« Reply #24 on: September 25, 2018, 04:15:30 PM »
It’s been quite a while since I’ve posted an update, but it took a few months for me to fully explore my options and come to a decision. I was initially very hesitant to go the jaw surgery route, given the time commitment and risks involved. I went to a PS and got filler in my chin to explore the chin implant route and while the filler didn’t look terrible, it made it pretty obvious that a bigger chin would look weird and unnatural on me. I met with a couple of orthodontists who recommended jaw surgery to fix my bite. After finding a local ortho/maxfac team I felt comfortable with and getting insurance preauthorization I decided to bite the bullet and go for the jaw surgery. I have about 9 months left in braces and will be doing surgery next year. Initial general plan is Lefort 1 and bsso with ccw rotation.

ditterbo

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Re: Alternatives to jaw surgery?
« Reply #25 on: September 25, 2018, 08:56:32 PM »
Thanks for the update. Curious if the team allowed you to get preauthorization before you committed to do the surgery/ortho with them? That's partly been my problem with the bimax prospect. Docs don't want to battle with insurance for preauth if I'm not willing to front the whole cost of the surgery upfront regardless of where my insurance stands.

babyjaw206

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Re: Alternatives to jaw surgery?
« Reply #26 on: September 26, 2018, 03:50:22 PM »
My surgeon’s office submitted the request for preauthorization after my initial consultation. I expressed interest in moving forward with them but no hard commitment. They did explain that if insurance wouldn’t cover it then they would require full payment prior to surgery (but I’m not clear on at what point they would have required the payment). If the initial preauthorization request had been rejected and they had to appeal, then I’m not sure how that would have played out.