Surgery Dec. 9th

[JimmyTheGent]

Made it through surgery just fine yesterday. Swollen and sleepy now, but other than that, things are good.

Did you just have the lower jaw operated on or did you opt for double jaw surgery?  I can tell by your cheekbones and wide smile that you are gonna be a hottie once you are healed up.     

[Ginger]

Did you just have the lower jaw operated on or did you opt for double jaw surgery?  I can tell by your cheekbones and wide smile that you are gonna be a hottie once you are healed up.     

Hi Jimmy, thanks for the compliment! I ended up doing the lower jaw only. My lower jaw was pretty asymmetric... class 1 on one side and class 3 on the other. The surgeon ended up moving the class 1 side forward a tiny bit and the other side back.

It's day 12 and I'm still pretty swollen. Hopefully things settle down and I can post some pics next week.

[Ginger]

Congratulations on getting through surgery!  I am new to the forums, and am looking forward to hearing about your recovery.  Best wishes on it being speedy!   

Thanks! Hopefully swelling goes down a bit and I can post some pics soon.

[Ginger]

Happy New Year! Just wanted to post some quick progress pics. To help with my lower jaw asymmetry, my lower jaw was set back on one side, and the other side was moved forward slightly.

Before pic - from the month before surgery. I really didn't look this bad before braces. Decompensation made my face longer and my asymmetry even more apparent

After pic - from last week, day 19. Jaw and chin are more centered now. The side that was moved back is still waaay more swollen than the other side. The swelling in general is going down really slowly at this point. It's annoying but hopefully in a month or two I'll no longer look like a giant potato head. Lol

I'll try to get some before braces, before w/braces, and after pics up this week, including profile and 3/4 shots.

[Bobbit]

Happy New Year! Just wanted to post some quick progress pics. To help with my lower jaw asymmetry, my lower jaw was set back on one side, and the other side was moved forward slightly.

Before pic - from the month before surgery. I really didn't look this bad before braces. Decompensation made my face longer and my asymmetry even more apparent

After pic - from last week, day 19. Jaw and chin are more centered now. The side that was moved back is still waaay more swollen than the other side. The swelling in general is going down really slowly at this point. It's annoying but hopefully in a month or two I'll no longer look like a giant potato head. Lol

I'll try to get some before braces, before w/braces, and after pics up this week, including profile and 3/4 shots.

Ginger - -
When the swelling is gone - -  I think you should classify your results as very good.

You are a lucky lady.  Enjoy it all.

[Ginger]

Some comments on recovery and such...

Recovery - The pain kinda sucked and my bruising and swelling were especially bad. It wasn't the worst thing in the world but I honestly don't ever want to go through it again. I moved from the harder painkillers to ibuprofen after the first week and I'm still taking it.

Numbness - Still numb on one side of my lip and chin. My surgeon has me taking B1 and B6 and massaging those areas.

Bite - It feels so much better than my edge-to-edge, crossbite bite. No more pressure on my front teeth.

Headaches, TMJ - My asymmetry pushed the right side of my jaw into an uncomfortable position. I've had years of migraines, headaches and tmj issues on my right side. It's still very early days but I haven't had any of those issues since surgery.

Outcome - My whole face is asymmetric so things will never be perfect but this is certainly an improvement. Lower jaw is more centered. I might need to have my chin moved forward a bit but won't decide until a lot more swelling is gone. Also I'm still slightly gummy because I didn't let the surgeon impact my upper jaw. Hopefully my ortho can intrude my upper teeth a bit.

A big thanks to everyone who has given me advice and support over the past year!

[Ginger]

Ginger - -
When the swelling is gone - -  I think you should classify your results as very good.

You are a lucky lady.  Enjoy it all.

Thanks Bobbit!

[kjohnt]

I read through your first thread along with this one, and while maxillary impaction has been mentioned, one thing I never saw mentioned was a possibility of maxillary advancement in conjunction with the mandibular setback?  Because I believe you said the more prominent side of your mandible would be set back 7mm and the other 2-3mm... so wouldn't it make sense that in order to keep as much mandibular projection as possible to just modify as little as is needed for symmetry (i.e. set the "bad" side back until even with the "good" side) and then advance the maxilla to take care of any remaining underjet?  Or was that discussed and ruled out as a few mm would not be worth it?  I realize maxillary advancement would have costed more and would have come with more risks such as numbness and nasal changes... and you probably wouldn't want to risk upturning your nose.

In any case, I suppose there's no sense in you worrying about those things now!  I'm just curious. 

I'll check back on this to see your profile shots and any progress.  I think your current picture shows some swelling still, but the symmetry achieved is quite noticeable.  Assuming your profile is okay, I think you're going to be pleased with the results and certainly happy you chose to go the surgical route as opposed to just having orthodontics (and teeth extracted!).  You were pretty before with nice eyes/cheeks/brows and this should help put the lower face in harmony.

[PloskoPlus]

If you like your face, don't advance the maxilla.  Unless it's a high cut close to the nerve, the risks of permanent numbness is quite low.

[Ginger]

Kjoint, thanks! Yeah, I'm glad I did surgery instead of braces only.

Hmm, the maxilla was never discussed except for impaction.

As far as the mandible, if I had added the maxilla impaction, the surgeon would have set back only the long side of my mandible like you mentioned. That plan probably would have been the best overall outcome.

If I end up needing genio I might do a slight maxillary impaction (only if my ortho can't do any intrusion). We'll see... lots of ifs at this point.

[Ginger]

If you like your face, don't advance the maxilla.  Unless it's a high cut close to the nerve, the risks of permanent numbness is quite low.

I think my nose would have upturned and blown up like crazy if I had advancement.

[kjohnt]

Kjoint, thanks! Yeah, I'm glad I did surgery instead of braces only.

Hmm, the maxilla was never discussed except for impaction.

As far as the mandible, if I had added the maxilla impaction, the surgeon would have set back only the long side of my mandible like you mentioned. That plan probably would have been the best overall outcome.

If I end up needing genio I might do a slight maxillary impaction (only if my ortho can't do any intrusion). We'll see... lots of ifs at this point.

Interesting... I assume he'd have only set back the longer side of your mandible if doing a maxillary impaction because an impaction would allow the mandible to swing slightly further forward?  So you'd therefore need more mandibular projection to align the jaws/bite?  But I wouldn't think an impaction could make the difference of 2-3mm of the mandible projection (i.e. moving the maxilla up creating that much room for the mandible outward)... I guess it depends on the amount of impaction?

Using that logic, I'd think at this point that a genio is really the only option you'd want to consider if anything further is needed, because impaction down the road might mean you'd need to mess with your mandible again to get the jaws to align.

[Ginger]

I think my nose would have upturned and blown up like crazy if I had advancement.

Actually, I'm wrong. I was just looking at pics of my mom and her siblings and they pretty much all have full maxillas with wide smiles. And none of their noses seem upturned or wide, so I probably could have had advancement along with slight impaction. Oh well.

[terry947]

Great results imo you look very pretty. Safe to say the surgeon did a good job with the asymmetry.

[Rico]

Headaches, TMJ - My asymmetry pushed the right side of my jaw into an uncomfortable position. I've had years of migraines, headaches and tmj issues on my right side. It's still very early days but I haven't had any of those issues since surgery.

Ginger: I have the same problem after surgery - zygoma bone reposition. Before surgery I didn't have such problem. My jaw now is noticeable deviated. No improvement after 2 months. I mean now I hear grinding from my joint (first time) and have some pain around. It's the beginning. It's getting worse very fast. Started 2 weeks post operatively. My masseter looks now very strange when I open my mouth. http://i.imgur.com/tXUd2zH.jpg
The surgeon has no idea what's wrong, but I have little....but too litle.

I had bone reposition after overlooked fracture. Rare surgery. Surgeon put the zygoma too much aside. He made me too symetrical on midface while my mandbular is not symmetric. Generally I'm not symmetric. Kinda Gosling like assymetry. One eye lower, etc + one of my cheek was always bigger. He didn't predict some things. It looks like the bone must be set much closer to my original position what is not easy

I sent to my surgeon my model of possible problem.  I think about rebreaking the bone, but I'm scared he again will damage my ION nerve. I'm afraid of totally damaged joint. I'm really worried

Do you know some technical stuff about this ?

http://i.imgur.com/qFS9Q9d.jpg