Hello. I'm sorry for the thread's length, but there's a lot to be said.
I (now 21) went through a double-jaw orthognathic surgery in last September; I wore braces through about ages 14-16, but they didn't really get a good result (possibly creating or accentuating the issue) and the orthodontist was rather incompetent in foreseeing the requirement of a surgery and leading the treatment in that direction (he blatantly decided during our last meeting that he cannot close the open-bite I had any further and kind-of on-the-spot decided to remove the braces). Before going into surgery I basically had these issues:
There was an underbite -not extreme but still apparent- with a deviation of the lower midline by (I think) ~6mm to the left (the mandibular midline met the maxilla almost at the edge of the first left incisor), while there also was a frontal open-bite - possibly already more pronounced before the surgery at the left side of the mouth due to what seemed to me as an X-axis slant of the mandible, with the left teeth being lower than the right ones (except for the badly grown left mandibular wisdom tooth which they didn't ask to extract for some reason! - Probably also a part of the bad results).
When the staff at the hospital gave their assessment, they wanted at first to operate solely on the maxilla (while I've thought the whole issue is due to the mandible) as they believed it would result in a more steady bite, and that no-one would notice the off-center midline (suggesting only doing a genioplasty of the chin instead). They said it's rather the maxilla being sank-in and all sorts of BS, but eventually after several meetings with an orthodontist the hospital's lady-surgeon has suggested me (to get an opinion) whom argued the result wouldn't be good enough if they'll operate on the maxilla alone, they've agreed on doing a double surgery. Now, I need to point out - I was still in the army back than, and this type of surgery is usually (when deemed medically beneficial) covered over where I'm at in the civilian medical-care, but during the months I've been meeting with all these doctors they said that a recent change in the MC dropped this surgery's coverage, and thus that if I wouldn't manage to get it done before the end of my service I could end up paying full-price. Other than the braces I wore during school, I haven't had any pre-op orthodontics; the bite wasn't supposed to be 100% perfect at first and I was told I would need a small (as in "few months") orthodontic treatment post-op, but nonetheless they've said they've found a steady-enough bite and that it should be good for surgery. The part about the medical-care ended up being bull as it has been put back into the civilian MC program soon after, so the somewhat of a rushing wasn't too helpful in the end.
What was supposed to be done was an advancement of the maxilla with a posterior (I think) impaction, while the mandible was to be rotated to the right; they wanted to leave the mandible 1mm off-center as they thought it would be more stable. I can't even say that it felt steady to me while I was in a 6-weeks IMF, but they didn't care too much, brushing me off like another patient who knows nothing (believe me that I do my research and don't get exited over negligible stuff); I believe they simply didn't do the surgery right, but it most likely got even worse through the time my jaws have been shut. As soon as she took off my IMF, I could see it didn't sit exactly as planned - at first, when slightly opening (as your muscles are weak) and re-closing the mandible, it didn't keep the 1mm-to-the-left deviation - it was actually (superficially) more symmetrical; the doctor thought it came out even better than expected, but frankly it only showed that the results are unraveling as inconsistent with the pre-op plan. The more I could move my mouth the more I've seen how badly does it close: I had an underbite? Now I have an overbite. The teeth at the right side of my mouth actually closed pretty well in-between each other (in the cogwheel fashion) before? Now because of the overbite and the fact that the mandible's angle is more F'ed up than before (more on that later) maybe two teeth meet together, awkwardly at their tips. I didn't have any off-center deviation of my upper midline? I now have apparently a 1-2mm to the left, and it affects my nose as well. I was also left with an almost complete lack of sensation in the left side of my lower-lip and chin. I was told about 70-80% regain pretty much full sensation, so I'm not sure about this issue as well.
Basically, every orthodontist I've seen after the surgery didn't want to treat me or was very reluctant in suggesting so (in comparison to the "small post-op touch-ups" I was initially destined to need), and the one with whom I've met before the surgery said that while he doesn't remember my exact previous condition (I've only met him through a couple of months) and the plaster molds have been thrown by the hospital, it most definitely went wrong, and after a quick look said that the mandible is in a wrong position while the maxilla "seems to be 'pretty' ", though I now understand that wasn't exactly right as well.
I would have been somewhat less angry about the results if the surgeon at the damn hospital would have at least admitted what's very apparent to the naked eye - it doesn't look right, and it most definitely doesn't match the pre-op plans. But nope, she said it had probably only "retracted a bit at the mandible" so I was left with some overbite (now, I wasn't supposed to have the mandible shortened - so unless my bone has been reabsorbing like crazy, it couldn't get shorter, i.e. they didn't check the muscle tone during the surgery and thought to maxilla should be advanced more than it actually should've been), but I told her it's pretty obvious its angle is completely wrong - remember how the midline seemed generally consistent to her at the previous inspection (though it since then has settled back at around 1-2mm to the left [and don't forget that now the maxilla's midline became off-center as well])? I've seen it wide and clear through a simple self-inspection (and a surgeon from a different hospital I've recently seen agreed with me, saying I "explained what takes him several months to teach his students"), but the lady-surgeon either lied or is numb in her head as she declared it "impossible" - the left side of the mandible is actually still shorter than the right (you can even see how the left teeth are more posterior), but the midline is (again, SUPERFICIALLY) correct? "C'est impossible!" - Unless your doctor doesn't not their job, and then it's just simple geometry a 3yo would understand: the mandible is still pointing to the left, but it was sled as a whole to the right on the X-axis, so what happens now is the frontal part of it projecting to the left of where it begins. It also results in my jaw looking even less symmetrical than before as now the right side looks more swollen and... basically like the whole jaw is pointing to the left. She and an orthodontist she's brought to agree with her have brushed it off as "soft tissue... Has nothing to do with the jaw". That orthodontist also said he "could fix the bite" [using implants and sh*t I didn't need before] if I'm willing to commit into a full, 3-years-long orthodontic treatment. And she seemed fine with it. SERIOUSLY? They cannot admit how completely unrelated to any planned procedure it now is?
These were during the last time I've met the lady-surgeon, on the 6-months-post-op checkup. I realized how ridiculous is their lack of professionalism and went to an external dentist (whom of course agreed upon the results being bad, telling me "don't be offended, but it's a total mess" while stating that I should never go through an orthodontic treatment at this condition as it would ruin my teeth) whom referred me to a different hospital (she said she has had her internship there during the tenure of its previous head-of-department and that she considered it [at the time, at least] the best in the state... Though I've heard some good things of the lady-surgeon so it doesn't necessarily mean jack).
I met with the head of orthognathics of the new hospital about 3 weeks ago, and I had an appointment with an intern whom took some measures today; the head doctor was pretty astonished at how bad it is in comparison to the pre-op photos, and said that a complete re-surgery plan would be made after some more testings and with the plan of an orthodontist that would actually put braces on me this time (I met with one who said it should take less than a year, but I haven't started that as of yet). I asked him if there's a chance I only need to re-do the mandible and he answered he isn't sure yet, but I got the opinion they're both F'ed (remember the gift of asymmetry). He said that the surgery made a deformation I didn't have in the bones before and that now it would actually make into a more difficult surgery than if I would've come to him in my original condition.
I wonder if anyone has ever had to do a repeating surgery? Was anyone here left with numb parts? I asked the intern from the new hospital why does it always happen on the left lower lip and chin (as I've read/heard of a couple more who got these, even if they didn't have a rotation performed), and she said it isn't always there and could happen everywhere around the mouth. I don't think any nerve is supposed to be completely cut during the surgery, but the surgeon who made it said something about making a different incision to "bypass the nerve" on one side. I thought it was the left (as I thought it's always the problematic one), but as the intern said the nerves are symmetrical and sometimes people are left with numbness all around their mouth (that sounds TERRIBLE! I hope that's not really common at all), I'm not sure what was done here. The head surgeon of the new hospital said while looking at the post-op x-rays I've brought that for some reason they've "decided to make an asymmetrical surgery in the mandible"; I explained that the lady-surgeon said something about bypassing the nerve, but he said that he thinks they just had a problem with the un-extracted wisdom-tooth on the left side of the mandible, and when I explained I still have numbness he actually looked a bit surprised.
I'm basically afraid of it now damaging my nerves even further, and I don't know if there's any susceptibility of further problems to the bones and tissues under a repeating surgery. I also currently suffer from consistent clicks, popping sounds and mild pain in my left mandibular-joint.
Thanks to whoever has read this far.
Edit: here are the photos I've added in the comment.
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