Fist post I think

[uncleg]

I have been lurking for a while and I think this may be my first post. A little more info than you asked for, but thats the full picture, also I am a 52 year old male, who has had sleep issues my entire life.

I have severe sleep apnea.  I can not use a C-Pap machine due to insomnia, as in I never will go to sleep with it on and the few times I do I remove it.  My first sleep study had me at 101 interruptions and hour,  I have had implants in my nose to prevent nasal collapse and sinus material removed and now sleep with an oral appliance.  My last sleep study had me at 36 interruptions an hour, still severe and my oral surgeon say we can do better.  He sent me back to ENT who did previous surgeries, to see if I was a candidate for Pillar implants, I am not.

I meant with my surgeon yesterday discuss MMA surgery, cost, insurance etc.  I have decided to move forward with double jay surgery

My sleep specialist, oral surgeon and ENT have all three said I have to facial deformities that would make me a good candidate for this surgery.  I am told I have one of the smallest airways they have seen and often get choked for no reason when awake. I generally crash due to exhaustion 1 day a week, just to tired to carry on, and is starting to affect my work schedule.  AND to make matter worse I have developed TMJ over the last 2 years, load popping in left jaw and often painful when I chew.

I hoping for relief from sleep apnea and just feeling awake instead of sleepy all the time.   I will also admit that in the back of my head I hope it will make me look better.   I am not a good looking man, no jaw, almost no chin, my side profiles are terrible and really look deformed.  Looking at me straight on is like looking at a pie plate with a beak.  LOL  I learned to live with and know no one would ever find me attractive.  I am kind of excited at the prospect of looking normal.

[kavan]

You sound like an excellent candidate for MMA bi-max surgery and that the LARGE advancements that sound like they are needed to BOTH jaws will improve your appearance. In general, it can make a very DRAMATIC change, one where you will look  a lot different to yourself and would be noticeable to people who KNOW you. So be 'braced' for those who know you blurting out; 'What happened to your face?' When they need to make LARGE advancements, even IF you look better with those, it's not like plastic surgery where those around you will notice something different they can't put their finger on and say stuff like; 'You look refreshed and well rested.'...'Did you lose weight?'  They will ask; 'What happened to your face?' or 'OMG, i did not recognize you.'  So on the 'psyche' front, you need to be ready to deal with those who know you blurting out responses like that.

Also, you need to take inventory of what parts of your face you are 'attached' to or you come to 'identify' with as being 'you'. For example, if it's your smile, that will CHANGE, usually for the better but it won't be what you are used to seeing. If it's your nose, that will change too. Might even be a TRADE OFF where it might look worse or some other part can look worse to you with the positive changes ELSEWHERE.

What I'm saying is that improvements in some places and especially relief from the apnea comes with trade offs in other places whether it be one feature having to be 'sacrificed' as not looking so good in order for the jaws to be in better balance or the trade off of looking DIFFERENT even though the difference is a better looking person but a different 'you'.

[uncleg]

Thanx for the reply, fortunately I am not attached to my face, I avoid photographs and mirrors as much as possible except too shave and brush my teeth.  LOL

I am not sure how quickly all of this is going to happen, I go back o see surgeon in two weeks and they will show me a computer model of the changes being made to my jaw/face, at that point I guess I will be seeing an orthodontist to have braces put on again, I had them as a teen.

I have also talked with my bank today about a home equity loan to cover the surgery cost and there will be no problem setting that up when the time comes.  I am going to have to pay the surgeon his charges before the surgery as he accepts no insurance and wait to be reimbursed after claim is filed.

[kavan]

Thanx for the reply, fortunately I am not attached to my face, I avoid photographs and mirrors as much as possible except too shave and brush my teeth.  LOL

I am not sure how quickly all of this is going to happen, I go back o see surgeon in two weeks and they will show me a computer model of the changes being made to my jaw/face, at that point I guess I will be seeing an orthodontist to have braces put on again, I had them as a teen.

I have also talked with my bank today about a home equity loan to cover the surgery cost and there will be no problem setting that up when the time comes.  I am going to have to pay the surgeon his charges before the surgery as he accepts no insurance and wait to be reimbursed after claim is filed.

Be sure to request they give you the computer model and your cephs (in digital format) in the event you want to put them up here.

[PloskoPlus]

Don't skimp on the surgeon. Most are absolute garbage.

[uncleg]

I will try to remember that.


Thanx for advice on surgeon,  I have got one of the best in the state and he teaches this procedure at a well known medical university, I am in good hands.

[PloskoPlus]

I will try to remember that.


Thanx for advice on surgeon,  I have got one of the best in the state and he teaches this procedure at a well known medical university, I am in good hands.

"The best guy in the state" did the simplest safest jaw surgery and left me with MASSIVE nerve damage, I don't know anyone with such permanent debilitating upper lip numbness (it NEVER happens). Oh wait, I'm lying. A guy on this forum had surgery for sleep apnea by "the best guy in the state" and was absolutely butchered - no feeling below the nose, massive asymmetry. He told me he'd take his sleep apnea a thousand times over to get his old face back (granted he liked how he looked before).

A year after my surgery I finally sought opinion of true world class surgeons. Both told me my surgery was lazy. One told me that my nerve was done for (even as my surgeon was lying to me "wait 6 months, wait 12, months, wait 18 months, wait 2 years") - he was right. Everyday I curse my surgeon's name. Don't trust anyone. Surgeons lie about their ability and experience. It's always easier to ask for forgiveness than permission.  Don't be lazy and gullible like I was, consult with world class surgeons.

[uncleg]

Hey Uncleg,

I had the same kind of surgery you are considering at the age of 27. I had 70 arousals per hour.

I had recessed jaws and small airway. With the surgery I hoped to get rid of my horrible condition, but also in the back of my mind I wished I looked better.

My surgery was a success, it cured my sleep apnea (haven't done a post surgery sleep study yet, but I feel way better), and also I look much better according to people that have met me post-op and have seen my pre-op pics.

BUT, I have had and still have, 2+ years post op enormous trouble getting used to my new appearance. My friends and family don't think I look better, they just think I look different. Everyone that knew me pre-op freaked out when they saw me for the first time. It still happens when I see someone that I haven't seen since before the surgery. They ask me questions like the ones Kavan told you.

I was not particularly attached to my face, but it has been tough getting it changed. Your face is a big part of your identity, and you have had it for 52 years now. If someone asks another person: ¨do you know uncleg?¨they might respond: ¨im not sure, show me a picture. Then the person will show a picture of your face, not of your elbows or your feet. Your face is basically WHO YOU ARE externally.

Keep in mind that this identity issues don't happen to every one that has this surgery. There are some people that have it and are delighted to finally rest at night and look better, all in one procedure. I am biased because I DO have those identity issues, and I have seen other people that have them, even with smaller surgeries such as rhinoplasty.

Also, the changes to your face are relative, and they depend on the quantity of mms that your surgeon decides to advance and rotate your jaws. The more advancement, the more your airway will be opened, but also the bigger change in your appearance.

I don't want to scare you out of surgery, but you need to know that this can happen.

Also, the surgery is gruesome, and the recovery is TOUGH. Read online about people describing their recoveries.

A common side effect is numbness. I have partial numbness in my lower lip and chin for life. It doesn't bother me near as much as the change in appearance, tough. You, being 52, are at a greater risk of numbness and other complications.

There are still other surgeries you can try before MMA, like pharingoplasty, uvuloplatal flap, and tonguesilectomy. Those are soft tissue procedures that open the airway and have no effect on you appearance. Just like the ones you had on your nose. I wished I tried those before MMA, and in case they didn't work, then go for MMA.

I appreciate your input and I am taking all of this into consideraration, I just told my parents what I am doing, my Mother is not happy that my face is going to change and wants to go with me to the Prediction visit.

I have looked into the soft tissue surgeries and discussed with my ENT, I have concerns because my father had the same soft tissue surgeries,  they did not help him and he still sleeps with a cap, and he constantly gets strangled and choked since those surgeries, he regrets having had them. The ENT also said he did not expect me to receive much relief from the soft tissue surgeries due to my airway and would still end up having jaw surgery.

My age, yeah I wish I had been able to do this when I was younger, but it's only been a few years since I finally found a Dr who took my sleep issues seriously.

I am concerned about nerve damage, I wonder if the extra skin on my face(jails and Double chins, regardless of my weight) will be of any benefit.

[kavan]

I appreciate your input and I am taking all of this into consideraration, I just told my parents what I am doing, my Mother is not happy that my face is going to change and wants to go with me to the Prediction visit.

I have looked into the soft tissue surgeries and discussed with my ENT, I have concerns because my father had the same soft tissue surgeries,  they did not help him and he still sleeps with a cap, and he constantly gets strangled and choked since those surgeries, he regrets having had them. The ENT also said he did not expect me to receive much relief from the soft tissue surgeries due to my airway and would still end up having jaw surgery.

My age, yeah I wish I had been able to do this when I was younger, but it's only been a few years since I finally found a Dr who took my sleep issues seriously.

I am concerned about nerve damage, I wonder if the extra skin on my face(jails and Double chins, regardless of my weight) will be of any benefit.

Yes. Some of the excess soft tissue will be re-uptaken by the surgery. It will make you a better candidate for a face lift if you later want one since face lifts don't look that good when done around a lot of recessive bone structure.

Not too sure about the idea of a 50 year old man bringing his mother along for some kind of 'approval'. You might not be 'attached' to your appearance and be in a good psyche state to CHANGE it. But she is probably 'attached' to how you look and can inject psyche issues to you that you may not have had without her opinion.

[uncleg]

Yes. Some of the excess soft tissue will be re-uptaken by the surgery. It will make you a better candidate for a face lift if you later want one since face lifts don't look that good when done around a lot of recessive bone structure.

Not too sure about the idea of a 50 year old man bringing his mother along for some kind of 'approval'. You might not be 'attached' to your appearance and be in a good psyche state to CHANGE it. But she is probably 'attached' to how you look and can inject psyche issues to you that you may not have had without her opinion.

LOL. That's what I am thinking, good lord I am a grown man, I have not lived under my parents roof since I was 19.   I think it's just concern on her part, because I am the still the single son with no family of my on, all my brothers are married with families of their ons.  So there is that concern that I am alone in this world.

[kavan]

Hi,
I've decided to keep your posts within the SAME thread. This will allow people to keep track of your situation. Hence, the quote below was extracted from a new thread and entered into this one.

I have been researching this procedure for about a year and a half my Oral surgeon brought up the possibility if other measures failed.

I like being an informed patient, it helps with being nervous.  I have read every blog out there and watched every Youtube video from people who have had this procedure including a very graphic one that shows the procedure, so I am somewhat informed.

So far the only questions I have are:


Will this procedure also help with the jaw pain I have on my right side?

Will I need to have a tooth implant to keep my teeth from moving? 
**  I was not born with a full set of teeth, two or three never developed and I also had three permanent teeth removed during my teens to relieve over crowding before I received braces.  This left me with a gap between my front teeth.  I have also had my wisdom teeth removed, actually two teeth and a small hunk of bone that never developed into a tooth, the fourth one never developed.

Right now that is all I have besides the obvious question concerning recovery and such.

Any suggestions?

[kavan]

I have been researching this procedure for about a year and a half my Oral surgeon brought up the possibility if other measures failed.

I like being an informed patient, it helps with being nervous.  I have read every blog out there and watched every Youtube video from people who have had this procedure including a very graphic one that shows the procedure, so I am somewhat informed.

So far the only questions I have are:


Will this procedure also help with the jaw pain I have on my right side?

Will I need to have a tooth implant to keep my teeth from moving? 
**  I was not born with a full set of teeth, two or three never developed and I also had three permanent teeth removed during my teens to relieve over crowding before I received braces.  This left me with a gap between my front teeth.  I have also had my wisdom teeth removed, actually two teeth and a small hunk of bone that never developed into a tooth, the fourth one never developed.

Right now that is all I have besides the obvious question concerning recovery and such.

Any suggestions?

Those are excellent questions to ask the maxfax. However, IF you would need tooth implants, I'm surprised he didn't convey that during the consult. Remember, I said; 'IF'.

[uncleg]

OK I am a planner by nature and like to have all my ducks in a row and perhaps someone can tell me if I am missing any "ducks".

Financially I can pay for the surgery two ways, refinance house or cash in an annuity, plus my savings.  I will be talking with a financial adviser concerning tax penalties for using the annuity.

Mentally, just trying to absorb as much information as possible and ask questions.

Physically, I have got to get myself back in the gym, I was a gym rat until a year ago, and get myself in good physical condition again.

What else do I need to prep for? I am at least 6 mounts to a year out from actual procedure from what I understand, I will know more after next week.

[uncleg]

Just an update, I had to cancel my appointment with surgeon yesterday, due to being ill.  I rescheduled first week of January

[uncleg]

Another update, been snowed in for 5 days,  appointment was cancelled  twice more due to weather.  I will be going this Wed for jaw surgery consult and also to discuss tooth extraction,  tooth under one of my crowns decided to crack New Years morning.  According to two dentist the tooth can not be saved.  I will discuss haveing tooth extracted and discuss when it will be best to get implant put in and how that will work with braces.