Before and after photos (bimaxillary plus genioplasty)

[notrain]

I was asking because your jaws grew clockwise (facing the floor) which can be caused by mouth breathing. While snoring is technically mouth breathing, to successfully alter the growth vector of the jaws you would have to be a 24/7 mouthbreather.

[Langpam]

Having reflected on my pre-op breathing, I believe, based on what I was told by an eminent surgeon in the UK that I was indeed a nose breather, one of approx 15% who suffer from severe sleep apnoea, (since 85% are mouth breathers) However, due to my underdeveloped jaw and microgenia, as soon as I lay down to sleep my tongue acted as a stopper and blocked the already narrow airways. Whilst CPAP was effective, only double jaw surgery ( counter clockwise rotation) would cure the apnoea completely. The aesthetic benefits are a bonus.

[katie]

Your results are great! I believe that you underwent the surgery without the pre orthodontic work, I was wondering what was your bite like straight after surgery before you were fitted with post surgery braces. I have been told by 2 surgeons that braces would not be required while  2 others have  disagreed with this notion completely.

[Langpam]

It's interesting that you had a similar experience. I consulted four surgeons. One said I needed 18 months of orthodontic treatment pre-op, followed by about 9 months post-op, two said I didn't need orthodontics " at my age" as I had a functional bite. The surgeon I opted for said I was a candidate for Surgery First. So I had Invisalign fitted six days before the operation, but did not wear the trays during the operation and for the week immediately afterwards. Instead, the surgeon used screws at the front to keep the jaws in place ( via elastic bands) for eight weeks. Immediately after the operation you are on a liquid diet, gradually moving on to a soft diet. At one week post-op the orthodontist gave me elastics to place onto the molars, to start the process of improving the occlusion.
I can chew with the anterior teeth and I am gradually getting more confidence chewing with the molars, though the occlusion is not quite right yet. ( I am almost ten weeks post-op)

[katie]

It is interesting , you got a great result with the benefits of surgery first with a significantly reduced amount of time in braces. Braces can be tough on gums so the less time having to wear them the better. When I questioned one of the surgeons who had proposed surgery without pre orthodontic work , he told me my issue was purely jaw related, my upper jaw had grown a little wayward and it was holding my lower jaw in a more retruded position. He advised that my teeth were good in that there was no overcrowding, no crossbite, no open bite and that both arches were within normal range. He also did not recommend having any surgery on the lower jaw as I had no issue with sleep apnea.  The two who proposed lengthy pre braces time were suggesting double jaw surgery. It is interesting that there are so many different opinions  out there on this issue.

[Langpam]

One surgeon, whose method was 18 months of braces pre surgery, told me I had beautiful teeth!! I had already worn a brace to straighten my upper teeth about twelve years prior to seeing him. But apparently the teeth move quite quickly post surgery and braces are advisable as a result. But as you say, there are so many different views out there.  Since the position of the jaws changes as a result of surgery, I'm guessing that the teeth will also need some guidance into their optimal position. My surgeon had three options: Surgery First, Surgery After and Surgery Only. I was not a candidate for Surgery Only, but maybe you would be. Best of luck with your search.

[Langpam]

Yes, I am from London but spend several months of the year in Spain. I did see Prof Piet Haers who, I'm sure, would have done a great job, but I opted for Dr Hernández Alfaro in Barcelona for a number of reasons.
I particularly liked his short surgery time, due to the 3D cone beam technology which he uses in the planning. These three procedures took less than 2 hours and the recovery was very straightforward.
The other three surgeons were going to take five hours and it would have been necessary to spend five days in hospital ( which makes it very expensive). I spent one night in hospital and a week in a hotel in Barcelona. (€50-70 a night is very different from hospital fees).
I had my consultation with him by Skype and was able to send him my ceph and photos beforehand. His English is amazing and I immediately felt that he was the surgeon for me.
Best of luck with your search and final decision.

[Rico]

Did he show you before / after photos of his other patients during consultation ? However , because it is typical and "easy" surgery probably you could see it on his web

[Langpam]

I didn't ask to see his Before and After photos as everything is readily available on his website. I asked him how many of these operations he had done and how many people were cured of sleep apnoea. I also asked to speak to someone who had had sleep apnoea before the operation. At the end of the day that was my goal. I had a serious medical condition. As I've said previously, the aesthetic results were a bonus.

[Rico]

In most countries in Europe serious medical condition is treated for "free" , covered by health insurance. It doesn't work in England ?

I've never asked about this any surgeon, so since your surgery has gone well I'm asking it you - Do you feel scars inside the mouth ? when you touch them by your tongue  or any (even tiny) discomfort after this surgery ? (I'm not asking about nerves issue, but all other things)

[Langpam]

In most countries in Europe serious medical condition is treated for "free" , covered by health insurance. It doesn't work in England ?


I've never asked about this any surgeon, so since your surgery has gone well I'm asking it you - Do you feel scars inside the mouth ? when you touch them by your tongue  or any (even tiny) discomfort after this surgery ? (I'm not asking about nerves issue, but all other things)

Untreated sleep apnoea is a serious medical condition. The gold standard treatment in the UK for sleep apnoea is CPAP. This treatment ( CPAP) is free. Would you like to be attached to a machine every night?
I do not feel scars inside my mouth, which I find absolutely amazing. I guess there is a small amount of skin I feel behind the molars, but how often does anyone twist their tongue around to explore this part of the mouth??

[Rico]

Thinking that everyone is gonna have the same surgery and incisions in the same place is not good

In my case  incision will be above anterior teeth Additionally in my case there is risk I will have 2 surgeries. So the question is how big is that scar ?
For example I have little line in the inner side of the cheek between upper and lower teeth. When I touch this with my tongue I feel this very little line. Do not know if everyone has got something like this, but if you have , then please tell me if such post operative scar is much more sensible ? 

Writing this, I realised it's a question for someone after LF1. When somoene after LF1 read this, please put your comment here about this. If such scar above anterior teeth give any discomfort, for example  during smiling, etc

[PloskoPlus]

The other three surgeons were going to take five hours and it would have been necessary to spend five days in hospital ( which makes it very expensive).

Five days is what they say to cover their arse.  Virtually no-one is kept more than 2 nights.  Usually it's only one night.

[PloskoPlus]

Writing this, I realised it's a question for someone after LF1. When somoene after LF1 read this, please put your comment here about this. If such scar above anterior teeth give any discomfort, for example  during smiling, etc

Intra-oral scars should be the least of your concerns.  They heal fast, and you will probably have numbness at the site of the incision for quite some time.

[MrFox]

Five days is what they say to cover their arse.  Virtually no-one is kept more than 2 nights.  Usually it's only one night.

What?? I stayed 5 days no way would I have been able to leave after 2 nights