Author Topic: Revision Surgery  (Read 1079 times)

jawsurgery029184

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Revision Surgery
« on: October 06, 2020, 10:27:29 AM »
* edited for privacy purposes *
« Last Edit: October 31, 2020, 05:45:42 PM by jawsurgery029184 »

GJ

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Re: Revision Surgery
« Reply #1 on: October 06, 2020, 12:00:16 PM »
My upper jaw was moved too much in ways that were completely unnecessary to fix my overbite. It was moved up too much, moved forwards a lot, and expanded a lot even though my xrays showed that it was mainly my lower jaw that was too far back and other surgeons recommended only moving the lower jaw. I really regret not listening to the other surgeons and not backing out of the surgery after finding out that his plan was different from the others, but regret and anger does not solve the issue I am currently in.

My entire face is saggy and droopy, my nasiolabial folds are huge, and I have a punched-in old lady look. Technically my tooth show is correct, but my face definitely is not right when I smile. My surgeon wanted to impact the upper jaw so much for no reason and advance my upper jaw to make up for the impaction, but it does not work in reality. He should have just left the upper jaw alone or impact it just a little.

What I want to ask is, has anyone had any success moving the upper jaw back to where it was originally and did it make you look close to the way you used to? By the way, it I is definitely not an attachment to the way my upper jaw used to look, a lot of family and friends have agreed, and it takes a lot for people to admit that you look worse.

Technically you can move the jaw anywhere so long as there isn't permanent bone damage from the first surgery, but I doubt you'd look the same, because for one the nose/nasal base will look different from cutting those muscles, and secondly soft tissue might settle differently. You can't "unring the bell" as they say, which is why it's so important to get good planning from the start. You can probably have a revision that makes you look better than your current state, if you get a talented surgeon with the right plan. That's about the best one can do once things go wrong. If you seek revision, post the plan so everyone can have a look. If you want, post records so we can see what happened here.
Millimeters are miles on the face.

kavan

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Re: Revision Surgery
« Reply #2 on: October 06, 2020, 01:47:42 PM »
http://jawsurgeryforums.com/index.php/topic,7495.msg65855.html#msg65855

Well, in the above thread, I tried to explain your facial geometry was on the complicated side and basically how it was understandable (to me) the 'how and why' behind the BSSO only suggestion a doctor originally gave you. But looking back on that, you were inclined to CCW anyway.

Did you get that and if so, was it with a doctor known for kicking up good results?

That said, a revision surgery is going to be a complex deal since the simple thing to do for the initial surgery was not selected. That, of course,is water under the bridge at this point. The new bridge to cross would indeed be with with a surgeon known to be conversant in revision surgery and spend time with you explaining which things can be undone and which things can't. In general, especially for the maxilla, they need to go through the same cuts as were made prior. So, ya, as GJ suggests you could put up the plan you got. But since this is a revision, I would add to seek out an expert in the venue of revision and to also give the name of the one you sought out so that people who might be familiar with a surgeons revision work can chime in too.
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jawsurgery029184

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Re: Revision Surgery
« Reply #3 on: October 06, 2020, 02:31:49 PM »
*removed some details for privacy reasons*

It does not sound that dramatic, but it really left me a mess.. I will consult with Gunson and Wolford for sure. Let me know if you have  other recommendations.
« Last Edit: October 07, 2020, 07:15:27 AM by jawsurgery029184 »

kavan

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Re: Revision Surgery
« Reply #4 on: October 06, 2020, 02:48:59 PM »
Gunson and Wolford are certainly known for revision surgeries.

Not sure but my guess would be the main culprit of the displacements you got would be the advancement given the frontal maxilla and teeth looked really 'bucked out' to begin with.
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jawsurgery029184

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Re: Revision Surgery
« Reply #5 on: October 13, 2020, 08:13:28 AM »
Hi GJ, I was wondering if you could mention more specifically the kind of nasal base changes that can’t be undone from cutting the muscles.

GJ

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Re: Revision Surgery
« Reply #6 on: October 13, 2020, 11:41:52 AM »
Hi GJ, I was wondering if you could mention more specifically the kind of nasal base changes that can’t be undone from cutting the muscles.

Sure. Widening of the nostrils, mainly. It's about 1mm on average from the first surgery. Expect that to increase a little more with a revision, even if they use an alar cinch.

Alar cinch suture restores the normal alar width by preventing the lateral drift of the naso-labial muscle and thereby reducing the postoperative nasal flare significantly.

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5083686/
Millimeters are miles on the face.