jaw surgery 1/17/13

[treevernal]

I've been on this site for a while now and have found it to be very helpful.  I'm starting this thread to document my surgery as others have done.  Not sure if I will be posting public pictures yet but I do plan on talking a lot about my surgery here.

Ill be having surgery on 1/17/2013 with Dr. Arnett in Santa Barbara.  Living in San Diego, it's luckily not too far away.

I had braces as a teenager for 5 years which straightened my teeth but did not correct my bite problems.  I've been in braces for the past 15 months to decompensate and prepare my jaws for surgery.  My incisors have been torqued out slightly, my laterals bonded wider, my worn cusps bonded higher, and my lower curve of spee flattened.  All the bonding material is temporary and will be replaced with permanent resin once treatment is complete.

My reasons for surgery are both cosmetic and functional:
- narrow/high palate
- class 2 malocclusion
- open bite
- arthritic tmjs
- bruxism/clenching
- small airway
- lip incompetence
- deviated septum and mouth breathing
- forward head posture
- retrognathic profile
- facial asymmetry

I could go on but those are the main problems.  After surgery, I plan on continuing to see my orofacial myologist to work on swallowing, breathing, and sleeping correctly.  A chiropractor could also be helpful to help de-compromise my posture once my facial structures are corrected and airway opened.  Here's what I'm tentatively having done surgically:

- 3-piece lefort 1 counterclockwise advancement
- bilateral sagittal split osteotomy counterclockwise advancement
- septoplasty
- bilateral cheekbone augmentations with hydroxyapatite
- upper lip V-Y reconstruction

I have been on doxycycline and piroxicam for over 2 months now to help stabilize my joints pre-surgery.  I donated a pint of my blood last week to have on hand in case an emergency transfusion is necessary (rare).  The hotel is booked and my parents will be staying with me for a few weeks to see me through recovery.

I am nervous but confident in my decision and in the surgeon.  I've never had any surgery before.

Feel free to follow me along

Dan

[Lazlo]

hi, thanks for the info, do you have any before/afters of what the VY-plasty for the lip is for? I mean what it looks like. I have a somewhat long upper lip area (i.e. area between top of my upper lip and the base of my nose) does this technique shorten that distance? What does it do exactly? Thanks.

[Marisama]

Good luck.  It has all been much easier than anticipated.  It's definitely a very long recovery but I am so happy that I went through with it.  Be sure to ask for valium for the night before.  It really helped with the anxiety even into the morning of surgery.

[treevernal]

Thanks for that Ryan.  I will def ask them about it.
Lazlo, I tried looking up pics but most showed reconstruction of patients with major defects or people with normal lips who wanted a bigger pout; I am neither of those categories lol but there might be some good examples if u keep looking.  I will too.

Oh and as far as what it does, in my case anyway, is increase the vermilion (red portion) of my upper lip and also increase the thickness.

[Heavyweight]

Sounds like you had a long time in braces considering you had no extractions. What did your bite look like before braces and what does it look like now? How large an overbite would you estimate was created?

[treevernal]

Sounds like you had a long time in braces considering you had no extractions. What did your bite look like before braces and what does it look like now? How large an overbite would you estimate was created?

Braces were estimated to be 9 months pre-op; I just took longer to get ready financially...I was surgery ready back in Oct if insurance didn't give me the run around.

Before this round of braces I had a 5mm overjet and 0mm overbite.  I'd say with decompensation my overjet doubled and my open bite opened up 2mm (only approximations tho).

As a teenager I had a palate expander and herbst appliance.  The herbst broke and the expander (I believe) caused periodontal decline of my molars and led to increased sensitivity along the gumline.  I believe this round of braces (coupled with softer brushing, better flossing and sensitivity toothpaste) centered these teeth back into the gum tissue and the sensitivity is gone

[CK]

Did Dr. Arnett explain how he would address the high and narrow palate during surgery?

[treevernal]

Did Dr. Arnett explain how he would address the high and narrow palate during surgery?

Yes, the 3-piece lefort 1 advanced counterclockwise moves the posterior portion of my maxilla (hard palate/nasal floor) down and it will be widened to match the mandible.  He didn't go into that much detail tho other than to say that it widens and the posterior portion moves down; I researched the other bit on my own.  I'm gonna ask him to explain more on how my nasal breathing will improve.

[Marisama]

My nasal breathing has improved tremendously. It's effortless now.

[treevernal]

My nasal breathing has improved tremendously. It's effortless now.

That makes me so happy!  Lol, great to hear

[treevernal]

Just had a CBC and routine urinalysis done this am for the results to be faxed to Arnett.  That's pretty much the last official thing I have to do before driving up to SB in 2 weeks.

Happy new year everyone!

[treevernal]

Complete blood count

[treevernal]

A part of me thinks it could be to make sure you don't have any unreported diseases that you may not know you have.  Like, a high white blood cell count could mean cancer and you may not want to put your body through surgery if you need chemo.  I could be totally wrong though, just a guess.

[treevernal]

Got my surgical hooks on this morning and arrived in SB tonite.  Final records tomorrow.  Getting very nervous :s

[Marisama]

The anticipation is the worst part, I promise. It helped calm me to see ZNewton's results. He made it to the other side just fine and I assured myself that I'd be just fine too. Be sure to enjoy your favorite foods during the next couple days. Don't overeat the night before surgery because that is one thing that can lead to vomiting after surgery. I'm so glad that I never vomited.
Good luck pal. It really is much easier than I anticipated.