I'm absolutely terrified. Day 5 after revision surgery lefort 1 + genioplasty

[Greek21]

I'm absolutely terrified. I'm currently day 5 post op after my second surgery. I had a lefort 1 advancment 5mm with bonegraft from the hip and a genioplasty with an advancment of 6mm.

Last year i had a bsso to set my mandible back and had an extreme overbite and asymmetry. It was pushed back way to far back but luckily it relapsed and sat around 3mm ahead of my upperjaw. My upper jaw was not touched although it was very set back and was also tilted.

I planned to go ahead this year to fix my underbite with a lefort 1 with a  different surgeon, who recommend a genioplasty as well. The goal was for a 2mm-2mm overjet-overbite occlusion wise.  A few hours after the operation i looked great. After a day and a half i got very swollen and my upper lips became massive as well as my nose became very piggy looking. I'm very upset and scared as the change I'm seeing is far more extreme then last year (when swollen). 

Is a Lefort 1 with a 5mm advancement extreme when you have midface deficiency?
Is a couple of hours after the operation what you're persumably going to look like when everything settles?

Im very worried as this was the last thing I wanted to happen and one day before the operation i was considering of cancelling it. I've been 8 years in braces all my life and ive had enough of orthodontists and surgeons. I was hoping i would end all this madness very soon but recovery so far is showing otherwise. I wish i had never got into this sick game. I have attached of what i look like 4 days after the upper jaw surgery and two previous pictures of me.

[GJ]

If you looked great right after the operation, then the changes since then are due to swelling. You have to wait about 3 months for all the swelling to drop, though at about 1 month you should have a good idea. Hang in there.

You look normal to me, but I am not seeing the before photos you mention.

[Gadwins]

It is a long road until all swelling will go off, maybe 6month or a bit more.  I would consider, that 3 months are a bit optimistic. Maybe you can see after 3month already the final results, but it depends on your face structur. Swelling could enhance your look or worsen it.

All in all, le fort I gives you a lot of swelling around your nose. Swelling has a peak on 3rd day and goes slowly off after that. Sometimes it will get more and sometimes less.

[Greek21]

This was me before a couple of months before the op.

Is a few hours after the op presumably (before peak swelling) what more or less the final result will be? Sorry here is what i looked like before.

[GJ]

Do do look dramatically different, but from what I can tell it's not bad. Just a lot stronger jaw/uber masculine look. If that's now what you were going for, I can understand why you're upset. Still, give it months to see.

[Greek21]

All i wanted was to fix my bite. Hopefully  5mm wasnt extreme.......i

[kavan]

 Soon after an operation,there are still substances in your system they use to keep swelling down WHILE DOING the surgery. But they are meant to subside AFTER. So post op SWELLING is NORMAL. It reaches PEAK a few days AFTER surgery and gradually subsides. Bone cuts to face, can take up to a year for all residual swelling to subside. This is especially so for the NOSE area.  But BULK of most swelling can subside within a few months.

As to your GENERAL question about a SPECIFIC mm displacement for Mid face deficiency, there are NO specific mm 'answers' to your question. That is because the millimeter extent of ANY displacement (here you ask about a 5mm advancement) is planned out ahead of time BEFORE a surgery and with AIM to be consistent with the optimal amount in the process of FACTORING in ALL other displacements needed for the surgery.

If your surgeon didn't tell you there would be a LOT of SWELLING after the surgery, maybe he assumed that MOST patients would know that already.

[Gadwins]

Soon after an operation,there are still substances in your system they use to keep swelling down WHILE DOING the surgery. But they are meant to subside AFTER. [...]

Do you have knowledge how good they keep swelling down in a long surgery, for example 9hours? I ask that, because I met an doctor in the clinic of my surgeon, who told me that I lost a lot of swelling (4 weeks after surgery). She kept an eye on me after the surgery till I gained consciousness again and after that she never saw me again until this moment.
So I assume either I didn't have any kind of those substances or they didn't work well in a long surgery.

[Greek21]

Soon after an operation,there are still substances in your system they use to keep swelling down WHILE DOING the surgery. But they are meant to subside AFTER. So post op SWELLING is NORMAL. It reaches PEAK a few days AFTER surgery and gradually subsides. Bone cuts to face, can take up to a year for all residual swelling to subside. This is especially so for the NOSE area.  But BULK of most swelling can subside within a few months.

As to your GENERAL question about a SPECIFIC mm displacement for Mid face deficiency, there are NO specific mm 'answers' to your question. That is because the millimeter extent of ANY displacement (here you ask about a 5mm advancement) is planned out ahead of time BEFORE a surgery and with AIM to be consistent with the optimal amount in the process of FACTORING in ALL other displacements needed for the surgery.

If your surgeon didn't tell you there would be a LOT of SWELLING after the surgery, maybe he assumed that MOST patients would know that already.

I know that there is a lot of swelling after an op.A few hours after the op i was hardly swollen before i reached the peak 48 hours. That period just after the op, is that a good prediction of what i might look like?

[kavan]

I know that there is a lot of swelling after an op.A few hours after the op i was hardly swollen before i reached the peak 48 hours. That period just after the op, is that a good prediction of what i might look like?

Am I being asked to make a specific PREDICTION for you? I don't make specific predictions for each unique individuals inflammatory response.

What you saw just after the surgery reflects the displacements they did during the surgery barring little to no relapse after the surgery. I would suggest you chill out and stop freaking out so soon because an exaggerated stress response can slow down healing.

[kavan]

Do you have knowledge how good they keep swelling down in a long surgery, for example 9hours? I ask that, because I met an doctor in the clinic of my surgeon, who told me that I lost a lot of swelling (4 weeks after surgery). She kept an eye on me after the surgery till I gained consciousness again and after that she never saw me again until this moment.
So I assume either I didn't have any kind of those substances or they didn't work well in a long surgery.

No, I don't because there's no need for me have all the surgical specificities that would be applicable to each individuals particular surgery. If generally SALIENT info is not enough, than ask your doctor if you are in pursuit of particulars meant to be specific to your surgery.

If you really need to know the names/ amounts of exact/specific substance/s they injected in YOUR surgery given the the amount of TIME, you can either ask your doctor or refer to your operative report where the protocol is usually listed. All I will convey here is the salient GENERAL info which is they are administered to suppress the INFLAMMATORY RESPONSE during the surgery which is WHY when a photo is taken immediately afterwards, one does NOT see all the swelling that will arise subsequent to the surgery.

[Greek21]

Am I being asked to make a specific PREDICTION for you? I don't make specific predictions for each unique individuals inflammatory response.

What you saw just after the surgery reflects the displacements they did during the surgery barring little to no relapse after the surgery. I would suggest you chill out and stop freaking out so soon because an exaggerated stress response can slow down healing.

No no I'm just a little confused! Last year when i had the bsso i was very swollen and all my features were just very big. This time with the lefort 1- my nose has massively changed and as well as my lips have become way bigger. I'm just wondering if just after the
op is a better indication of what i will look like.

[kavan]

No no I'm just a little confused! Last year when i had the bsso i was very swollen and all my features were just very big. This time with the lefort 1- my nose has massively changed and as well as my lips have become way bigger. I'm just wondering if just after the
op is a better indication of what i will look like.

Oh, I see, last year when you had a  BSSO,  areas outside of the DIRECT line of the surgery cuts didn't swell up as much. Well, take a WILD GUESS why there would be more swelling to those areas with a Lefort 1.

[InvisalignOnly]

I think you'll look great once the swelling goes down which can take a looong time. I had BSSO plus LeFort 1 plus genio 3 weeks ago and the doctor warned me beforehand that the LeFort area will be swollen for much longer than the mandible area, and I am glad he did, otherwise I would have panicked too. My upper lip and the whole area surrounding the nose is still very swollen and looks 'bigger' than the lower jaw area, but I can clearly see and feel (I did not lose feeling) that it is swelling, and this is after 3 weeks.

For now just concentrate on keeping the lips moist all the time by applying some balm or ointment constantly, try to keep your mouth clean inside as much as you can (I have been using syringes with salt water in addition to gentle brushing and mouth wash etc.), keep up your calorie intake and watch comedies on Netflix (word of warning: laughing hurts! ). Good luck and hope you'll feel better soon.