dd

[Lazlo]

xx

[JimmyTheGent]

How on Earth does a regular person who doesn't know all about jaw surgery find a surgeon who knows all these techniques to give the best aesthetic outcome?  I wouldn't even know what to ask for.  How should I know how much tooth show a surgeon should give me???  How do I know what type of stitch maximizes the aesthetic outcome of my lips?  How much advancement is enough and what about the amount of CCW rotation?  It sounds like there can be several surgical plans for the same person.  I guess a jaw surgeon should also have some plastic surgery experience so he can fix your bite and airway, all while maximizing the aesthetic outcome. 

[The Quest for Aesthetics]

Okay well I'm Day 11 post-op with Dr. Sinn.

WOW each day is an improvement. But I have to say the most horrifying situaiton the flight from Texas through Detroit to Toronto which literally was as traumatic as being captured by some rogue army and tortured for 24 hours should be a lesson for you all: 1) probably better not to travel a week out of surgery and 2) make sure you ha not a refill but a surplus of your painkillers post-surgery. No matter what people say this surgery is f**kING PAINFUL.

Okay, now I believe it's too early to say that this surgery has been a bonified success but I can comment on certain things for sure.

TEETH, BITE, SMILE AESTHETICS:

okay WOW my smile looks amazing, FULL WHITE SMILE, Dr. Sinn said it was specifically how he would stictch the mouth back together that would allow the teeth to show in particular ways and he asked me how I wanted my smile to look, how much gum to show (I actually said be genereous cause the lip would droop with age so best to give me a couple mm of gum show) and also I wanted the teeth to fill the buccal corridors. DR. SINN delivered. First week it was a bit surprising to see this and also smile was a bit awkward due to sweelling. But I have a young hollywood smile so awesome.

 The bite is perfect. Now I'm really happy my ortho has really dove in to make sure the bit develops propersly over the crucial following months. It's really important to see your ortho weekly since the teeth and gums right now are hyperplastic and there will be multiple changes within a day. So my surgeon and ortho have e switching elastics multiple times a day.

I cannot believe that at Day 11 I am also opening my mouth almost 5 cm and closing perfectly. My speech is almost normal. I have a bit of pain in the same place I did before: the chin. I have a feeling that this extra pain in this area has to do with all the work that was done here, i.e. chin was lengthened, widened and projected with grafts and clearly the soft tissue here was stretched quite a bit and cut up. But yeah the chin area burns more than anything. I could probably survive without painkillers at this point, but really why tolerate the discomfort?

Aesthetics: Wow, tons of friends who haven't seen me in a long time have immediately commented on how good I look. How different and how good. What do I think: amazing.

Now Dr. Sinn did do a CCW on my but not to the degree that was in Sinn's plan. I understand why now it was because I had specifically asked for a very youthful smile with a lot of tooth show and even gumshow and forward advancement. So I still got around 8mm of lower jaw advancement through ccw (only like 4 mm less than what Arnett had planned) but I got 9mm of genioplasty and it was a wide one. Plus I got tons of upper jaw advancement. I asked Sinn to stitch my lips down so that you couldn't see the lower teeth and wow, there is ZERO lower teeth show and tons of upper teeth show. You should really talk to your surgeon about ll these things because some surgeons like Dr. Sinn actually have surgical techniques to manipulate such things.

Again, it's too early to claim this surgery is an uncontested success. I want to investigate further the claim that my surgical plan was botched --but just from my own observation I don't think so, quite the opposite. However, I am seeing a top maxillofacial surgeon here who I will be giving all of Sinn's measurements and documentation to and she will assess the results and let me know truthfully.

Hope you all are well, and I'm just quite a bit happier right now.

Lazlo can you explain a bit about how the surgery is able to manipulate the lips and smile?

[JimmyTheGent]

YEah Grey and Blue is right. I've been searching for years. I've consulted with arnett and gunson, Schendel and Jacobson, Dr. Eugene Keller of the mayo institute in Mayo Clinic, Dr. Cameron Clokie head of max fac society of america, Dr. Claudio Tocchio, Dr. Marco Camenneti, Dr. Stephen Ho

 
It seems like there are quite a few "expert surgeons" but if you read their reviews and study the various message boards and groups on Facebook you can find patients who have legitimate gripes with each and every great surgeon.  No surgeon is infallible so how do you make the leap of faith to trust one?

Most of you veterans thought I was too scared to ever get surgery but instead I was just waiting for the right surgeon. 

 
Again, when you have so many good surgeons how do you really know who is best for you???  Some are just DDS oral surgeons, some are DDS & MD's, while some are DDS, MD, and plastic surgeons.  Do you go with someone who strictly does jaw surgery or would someone who does multiple types of surgery and also has plastic surgery experience be better since jaw surgery requires some talent concerning aesthetics??  Its sooooo difficult when deciding who you are going to trust with your face and mouth, after all it is just your looks, your ability to chew, and breathe that are at stake.
Jaw Surgery is like jumping out of a plane with a parachute.  You really only have one shot (ok may 2 with the emergency ripcord) at getting this right. 

[meepmeepmeep]

the thing about just taking arnett and gunson's plan is that they don't do a full assessment of your situation until you've given them a huge amount of money and committed fully to surgery with them. at least that was my friend's experience and what i witnessed. at the initial consultation that cost $250 dr gunson suggested a 13mm bsso advancement but 4 months later when the bite was ready and prepped for surgery and we went in for his final surgical consult the number had jumped from 13mm to over 21mm. maybe this isn't the case for everyone but this is what we experienced. 8mm is significant with this surgery.

[meepmeepmeep]

its totally possible they have a more than one option for consultations and how in depth they are. i know someone else who took the plan given to them by A&G to dr. terry taylor and wound up very happy for a very very very small fraction of the cost of A&G.

[Wheatsnax]

Its great when people like A and G are generous with their expertise. I've been having a few consults, albeit mostly regional, and they tend not to divulge into full fledged advise or planning till I commit deeply for awhile.

[Schrödingers Jaw]

Lazlo what about Sinns age, will he eve be an option during the coming 5 years?

[GJ]

I'm thinking this site should become more about helping people heal and you know answer questions about jaw surgery rather than all this hunt for Professor Henry Higgins

Says the guy who started a thread entitled "Dr. Sinn Day!!"... and made this post in said thread entitled "Dr. Sinn Day!!"

We have our surgeon of the month, folks.