Would you be happy with my result? PICTURES

[Gregor Samsa]

What were the terms of the revision your surgeon offered you? Would you have to pay for anything?

[jawbreakerbeach]

What were the terms of the revision your surgeon offered you? Would you have to pay for anything?

I won't have to pay surgeon fees but will have to pay everyone else involved again so it's not exactly free, and I have to accept all the risks a second time for example more numbness etc, and of course a blanket disclaimer that "it may not end up better." He won't do the workup for a revision unless I strongly commit to doing it again, so I'm not even sure HOW he thinks he could improve on the result. He personally seemed most upset about where my midlines ended up (off center and canted). He said he wouldn't try to fix the chin/yaw issue without an implant addition.

It actually all looked pretty even for the first few months because the swelling took FOREVER to go down and it hid the true result for a long time.

In the end the aesthetics bother me more than the loss of feeling. I'm a former pro ballerina so I've spent most of my life in excruciating pain to achieve a certain movement or shape. So who cares how it FEELS right? Also I was prepared for the russian roulette of numbness but I figured we could at least get everything on straight since it was planned out to the T.

There you go. Full face but I did filter it because I can't stand to have my face plastered on the internet. Again this is from a perfectionist's perspective so sorry if the minority of it all bothers those of you with bigger problems. I think it's magnified/worse in real-life and 3D, but what isn't.

[LoveofScotch]

Sorry, jawbreakerbeach.

Did you have a cant pre-op? I know you said it worsened, but was it there before albeit less obvious? I often wonder, for people who have some frontal asymmetry pre-op, even if it's partially corrected with surgery maybe part of the reason it can appear worse is because of the advancement. So, a person starts crooked, it's partially corrected with surgery, but it actually appears worse because everything was also advanced. I'm not sure if that makes any sense or not; it's just a thought.

If both your smile appears crooked and you also favor talking out of one side of your mouth, any chance that could just be muscular? Could you do physical therapy (or something) for that? If you can find a good acupuncturist, and have a little money to throw at the problem, would you be open to acupuncture? I'm not suggesting it's going to fix anything, but it may offer some help/improvement.

Also, from one former athlete to another, yes, eventually you have to care how it feels. You f**king deserve to not be in pain all the damn time. My family jokes that one day I could be dying, and I'll be smiling and laughing saying, "Oh, it's only a flesh wound, it's all good, no worries." I'm just saying that as a friendly, compassionate reminder that being in pain is not normal (referring to chronic stuff, not acute). Anyway, obviously more surgery won't fix numbness, but if you're actually in pain and/or cannot move your mouth properly I think that's a different story.

I'm sure this is hugely subjective, but I think a picture taken straight on will show flaws that people never notice in person. I think that's why most people are inclined to tilt/angle their face for pictures. Maybe your SO (and everyone else) seriously doesn't see the issue when they're talking to you?

Take care

[jawbreakerbeach]

The surgeon was the one who said I had a maxillary cant. TBH I could baaaarely see it preop and even drawing lines on my preop face it seems much milder than it is now.

I was more concerned about the bite and bringing the recessed mandible forward. I had full tooth height show at rest. When I was still dancing I got yelled at by coaches to stop gawking. I just physically could not close my lips thanks. But that's neither here nor there.

 I initially thought it would just be lower jaw but every surgeon I saw said I required two jaw surgery and also pushed genio because my chin pretty much didn't exist. Like I said it all makes sense from the profile view but it's jacked up in the front.

He also said what you're saying, that advancement makes things more obvious. Accurate but not comforting. And it emphasized that the cant was not fully corrected as outlined in the surgical plan.

I wish the lower lip was in pain because it might mean the feeling would come back. It's just dead there. The most I feel is sort of that dead fish sensation.

[Lazlo]

The surgeon was the one who said I had a maxillary cant. TBH I could baaaarely see it preop and even drawing lines on my preop face it seems much milder than it is now.

I was more concerned about the bite and bringing the recessed mandible forward. I had full tooth height show at rest. When I was still dancing I got yelled at by coaches to stop gawking. I just physically could not close my lips thanks. But that's neither here nor there.

 I initially thought it would just be lower jaw but every surgeon I saw said I required two jaw surgery and also pushed genio because my chin pretty much didn't exist. Like I said it all makes sense from the profile view but it's jacked up in the front.

He also said what you're saying, that advancement makes things more obvious. Accurate but not comforting. And it emphasized that the cant was not fully corrected as outlined in the surgical plan.

I wish the lower lip was in pain because it might mean the feeling would come back. It's just dead there. The most I feel is sort of that dead fish sensation.

I hear you. Hopefully the asymmetry is not too perceptible if you don't have the lines etc. drawn on. But yes, it does exist. Again, I'm not sure I'd notice it without the grid superimposed on it. And hopefully the lip will eventually regenerate --it always could. Different modalities such as acupuncture, physical therapy, etc. perhaps they might help? Or of course you could have the surgery redone. I suppose only your surgeon can figure that out. I dunno, maybe another consult would be in order since this clearly bothers you. It's up to you.

[LoveofScotch]

If you're comfortable answering this, can I ask if you had any HA? If so, where was it placed?

Thanks

[jawbreakerbeach]

If you're comfortable answering this, can I ask if you had any HA? If so, where was it placed?
Thanks

No HA. At least not augmentary type, there may be some smoothing stuff where the cut the bone on the mandible.

The angles of my jaw...the corners by the ears? I don't remember what they're called were uneven before surgery. Meaning one was higher than the other. The idea was that with my level of asymmetry that evening those out would have also improve the rest. Those corners do look level now but it didn't do much for the overall facial harmony.

If I can answer a question with a question, what are you looking into HA for? I'm curious because I've heard good and bad things.

[jawbreakerbeach]

I hear you. Hopefully the asymmetry is not too perceptible if you don't have the lines etc. drawn on. But yes, it does exist. Again, I'm not sure I'd notice it without the grid superimposed on it. And hopefully the lip will eventually regenerate --it always could. Different modalities such as acupuncture, physical therapy, etc. perhaps they might help? Or of course you could have the surgery redone. I suppose only your surgeon can figure that out. I dunno, maybe another consult would be in order since this clearly bothers you. It's up to you.

I go back and forth. It'd be nice to have the full, honest story.

When things started looking funny it was like "your midlines aren't off [skeletally]....oh fine I'll compare the CT scans to prove it to you...oh wait it looks like we only moved your midlines 0.5mm instead of the 3mm we were supposed to...[long rant about how jaw surgery isn't always exact]...you don't have a cant...look let's do some measurements...well actually you do have a cant it's really not that bad it's just more obvious on your facial structure..."

I don't want to go down a rabbit hole of unhappiness, but I would like SOMEONE to just say straight out what went right, what went wrong, not try to cover their ass and turn me into a hypochondriac.

And god I wish we could just remove the "no one else will notice" phrase from the vocabulary of all medical professionals. I NOTICE and really how can anyone claim they know what everyone else in the whole world will "notice" or not, yeeeesh. (That's not a reference to your comment by the way, I just think it's silly when a doctor tries to speak for the mass population).

I'll look into acupuncture. I did read a paper on pubmed about techniques for nerve regeneration after jaw surgery and did those exercises for a good while...nada...but maybe acupuncture is different. I don't know much about it except it involves needles or something.

[Gregor Samsa]

Correct me if I'm wrong, but it sounds like your surgeon has been pretty honest with you when it comes to evaluating the result. Most surgeons would never in a million years admit that anything was wrong.

[jawbreakerbeach]

Correct me if I'm wrong, but it sounds like your surgeon has been pretty honest with you when it comes to evaluating the result. Most surgeons would never in a million years admit that anything was wrong.

Most surgeons would never in a million years admit they were wrong? Wow. Scary thought. That's really how it is?

I just meant that I had to fight over every single little thing to even get him to LOOK at the pre and post op and not just say things were wonderful. But clearly I'm expecting too much honesty(?) from doctors.

The conversations went like this:

Me: I think this is off/wrong/incorrect
Surgeon: No it looks great
Me: Really I do
Surgeon: I'll prove to you that it's fine
Surgeon: Oh wait.
Surgeon: Okay so it's not but no one will notice!

Repeat x10

You're right, he's not being outright dishonest just clearly not wanting to notice flaws in his own work. In my career(s) you don't get better unless you notice flaws and you are admitting these to other people ALL THE TIME. I guess I have no idea how a sleazier surgeon would respond.

[PloskoPlus]

Maybe make your surgeon to concentrate on fixing leveling the bite. Ching wing osteotomy and implants later to fix the skeletal asymmetry. (Pretty sure your surgeon does not do the latter.)

[PloskoPlus]

That's a cop out.  People don't notice things consciously, but on the subconscious level they sure do.  Consciously it's "looks good, doesn't look good".

[Gregor Samsa]

You're right, he's not being outright dishonest just clearly not wanting to notice flaws in his own work. In my career(s) you don't get better unless you notice flaws and you are admitting these to other people ALL THE TIME. I guess I have no idea how a sleazier surgeon would respond.

My surgeon walked out of the room and refused to come back when I questioned the result. Based on what I've heard from other people, this kind of behaviour from surgeons seem to be the norm. If your surgeon is who I think it is then I'm guessing that a revision will cost around 20k USD. Why can't the surgeon pay for that himself? It's his mess after all...

[LoveofScotch]

If I can answer a question with a question, what are you looking into HA for? I'm curious because I've heard good and bad things.

I'm still deciding on a surgeon (I've narrowed it down to two), and one of them uses HA (Gunson). I too have heard good and bad, and am pretty stuck with the whole decision making process. I think I'm fine if it does nothing, but I'm afraid of it resorbing unevenly down the road.

Thanks for your response!

[treevernal]

They can do a lot with cosmetic dentistry to hide uneven bite/teeth issues.  You could look into gum contouring/tooth bonding/equilibration to mask some of the bite issues. 

I'm not certain you're drawing the vertical line correctly; it doesn't seem to fall center between the lower teeth...if it did you'd prob see less of a discrepancy.  Also, teeth themselves can be variable in size and shape which is also modifiable via cosmetic dentistry.

I went with Arnett and my result is not perfect and I too have some asymmetry issues.  I also lost 2 teeth and will need to get root canals.  Also, my tmjs are in terrible shape after having gone through surgery...but overall it was a win as my airway expanded by 4x and my face is much more balanced esp in profile.  Basically, I suggest you not get the surgery redone.  Besides more numbness you could lose viability in a few teeth, suffer tmj breakdown plus the downside of putting your body through general anesthesia and surgery again.  I know this is a really personal decision but I do strongly believe you can mask many of those dental issues with cosmetic dentistry.