Revision double jaw surgery. Advice needed..

[drizzlesome]

Well, here is my entire story.

I'm a 27 year old male. I had a double jaw surgery to treat a mild sleep apnea in Dec, 2015. The AHI (Apnea Hypopnea Index) on my sleep study was not high. But I was not able to fall asleep on my back. Also, I had a lip incompetence, about 6mm. The surgeon performed a counterclockwise rotation on me. My lower jaw was advanced for 10mm. Ever since that surgery, I've been living in hell. That surgery ruined my life entirely.

The benefit of the surgery:
- I sleep a little better than before. However, I'm still not able to fall asleep on my back
- My lip incompetence is improved a tiny bit, now I have about 4~5 mm upper incisor show

What I hate about the surgery:
- My jaw has become extremely stronger (wider and longer) than before. It's very unbalanced because the upper parts of my face are relatively small. I look very stupid because of the big jaw.
- The midline of my upper incisor is shifted to the right for about 2mm.
- My lower jaw and chin has become very bony and asymmetric.
- I've been left with a much more protruding mouth. The horizontal length of my lips has been increased significantly.
- I've left with a significant wider nose.
- I don't like how I look now at all. I used to have an oval shaped face, which made me look young. Now I look 10 year older than before.
- The aesthetic result made me anxious. I try to avoid seeing people I used to know. And I'm tired of living the life like now.

Fortunately, I've found a doctor who is willing to do a revision surgery on me. He's planning to push my lower jaw entirely back. Since my upper teeth is already 4mm above its original position, the doctor wants to keep the height, make clockwise rotation and push it back. The surgery plan sounds very good to me. Look like I'm going to regain the old shape of my lower jaw and chin. My lip incompetence is going to be improved as well.

Right now I'm exactly 3 month post the first op. I've regained 80% of the feeling back on my chin and lips. I've also regained about 60% feeling back for my top palate. I'm planning to have the surgery in the 4th month. What is the risk to having a revision surgery if I still have some numbness from the first surgery? I've heard that the feeling of top palate will always come back. Is it true? I think I'm still having a tiny bit of swelling. If I have a revision surgery before it subsides, will it ever subsides after the second surgery? My new surgeon already gave me some opinions, but I really want to hear the voices from other people.

Thank you for reading the post. I'll really appreciate your opinions.

[ditterbo]

Your story is almost exactly describing why I'm concerned about getting double jaw surgery.  My only issue is an AHI of 14, 'soft' facial features and a small jaw.  Would you mind telling us who performed your surgery? 

Sorry I'm not of any help here, but I think you may get better advice if you post a ceph and/or pictures for people to evaluate.  I'd also wonder if what you see right now will improve as you might still be somewhat swollen? 

Best of luck!!

Edit: a quick post history search indicates your dr choice.  NVM

[drizzlesome]

Your story is almost exactly describing why I'm concerned about getting double jaw surgery.  My only issue is an AHI of 14, 'soft' facial features and a small jaw.  Would you mind telling us who performed your surgery? 

Sorry I'm not of any help here, but I think you may get better advice if you post a ceph and/or pictures for people to evaluate.  I'd also wonder if what you see right now will improve as you might still be somewhat swollen? 

Best of luck!!

Edit: a quick post history search indicates your dr choice.  NVM

Hi, Thanks for replying. I think every one has a different situation. I would like to disclose my first surgeon after all problems are solved. If everything goes well, I'll also recommend my second surgeon.

[molestrip]

An upper midline shift of 2mm is not bad actually. It might be more than before but that's probably typical for an average person. Muscles pull bones, hard to control.

Your surgeon forgot to perform alar cinch it sounds like.

Protruding lips should fade with time, takes up to a year for soft tissue to thin.

As I sent in PM, send us details. Surgeons have different philosophies regarding sleep apnea. The Riley model is to advance to a PAS of 11-13mm. Most seem to think 10mm advancement at the osteotomy because that's the most they can do and more is better, right? Nevermind lateral wall collapse. Once we see your details, we can figure out what a new surigical plan should look like. You don't want to mess with sleep apnea for sure, don't give up airway without some idea that you're sleep disorder will still be cured.

[JimmyTheGent]

An upper midline shift of 2mm is not bad actually. It might be more than before but that's probably typical for an average person. Muscles pull bones, hard to control.

Your surgeon forgot to perform alar cinch it sounds like.

Protruding lips should fade with time, takes up to a year for soft tissue to thin.

As I sent in PM, send us details. Surgeons have different philosophies regarding sleep apnea. The Riley model is to advance to a PAS of 11-13mm. Most seem to think 10mm advancement at the osteotomy because that's the most they can do and more is better, right? Nevermind lateral wall collapse. Once we see your details, we can figure out what a new surigical plan should look like. You don't want to mess with sleep apnea for sure, don't give up airway without some idea that you're sleep disorder will still be cured.

What is lateral wall collapse?  What causes it and how can it be prevented? 
Thanks buddy!

[drizzlesome]

An upper midline shift of 2mm is not bad actually. It might be more than before but that's probably typical for an average person. Muscles pull bones, hard to control.

Your surgeon forgot to perform alar cinch it sounds like.

Protruding lips should fade with time, takes up to a year for soft tissue to thin.

As I sent in PM, send us details. Surgeons have different philosophies regarding sleep apnea. The Riley model is to advance to a PAS of 11-13mm. Most seem to think 10mm advancement at the osteotomy because that's the most they can do and more is better, right? Nevermind lateral wall collapse. Once we see your details, we can figure out what a new surigical plan should look like. You don't want to mess with sleep apnea for sure, don't give up airway without some idea that you're sleep disorder will still be cured.

Hi molestrip,

Thank you very much for replying. I don't think my lateral wall collapsed. It's just the base of my nose.

Right now I don't give a damn to the sleep apnea thing. I'd rather get my old face back, although it's not pretty but I like it. My current surgeon told me that after the 2nd surgery, the net effect will be that I'll have my maxilla impacted for 4mm and a little forward comparing with the original me. The shape/size of my lower jaw and chin bone will be roughly similar to the original. As a result of auto rotation, my chin will be 4mm advanced than its original position. And airway might be a little wider than before.