Revision Genio Question

[GJ]

I have a lot of tightness and pulling in my chin, to the point it's turned to pain. I'm pretty sure it's scar tissue or the muscle somehow entangled with the plate. When I asked a surgeon about plate removal, they said it would likely get worse if the plates are removed.

Anyone know why this would be? I'll follow up and ask of course, but that's not until the next time we talk. I know it's another procedure that would require cutting and healing, and maybe even more scar tissue, but if it's currently entangled around the plate and pulling, wouldn't removing the plate provide relief?

[kavan]

I'm not sure. But perhaps explore if they do cortisone injections to soften scar tissue.

[GJ]

I'm not sure. But perhaps explore if they do cortisone injections to soften scar tissue.

Thanks. I will ask.

I was also curious to get an MRI to see what is going on with the muscles but was told it wouldn't be useful since there was no baseline prior to surgery. But it would show if a muscle was tangled up in a plate or if the scar tissue was excessive or deleterious, no? It would be nice to see what is going on without having to make cuts.

[kavan]

Not sure but I think it might be able to show if a muscle was off kilter. But with MRIs it would depend on the reader of it who is usually some kind of radiologist. Like do they look for that sort of thing or would the maxfax be able to read the MRI or depending on the radiologist to convey what's in there? Depending on when you got this genio and with reference to plate removal being done about a year out after they are put in, IF the plates were in for a long time, they could be covered with bone and thereby harder to remove.

Exploration might resolve to first getting a numbing injection to a specific place to see if the pain stops and from there, if assessed as a nerve, then some kind of nerve ablation or maybe the exploration could be limited to a  cortizone (steroid) shot.
Such a venue of exploration might not be limited to the maxfax surgeon and could 'cross pollinate' into venue of nerve doctor.

[GJ]

Cool thank you. That's what he recommended over the MRI is to shoot the area with local anesthesia and see if it helps, as a diagnostic.

[kavan]

Cool thank you. That's what he recommended over the MRI is to shoot the area with local anesthesia and see if it helps, as a diagnostic.

Well, that's what pain doctors do if they are to ablate a nerve that is cause of pain. You would need to ask your maxfax guy about that option/possibility. Also, ask your maxfax doc if the reason he doesn't suggest removing the plate is because bone has encapsulated it. That situation can probably be seen in an X-ray.

[Post bimax]

I wonder if a surgeon would be willing to do debridement and re-suspension just to see if the issue is alleviated.  I think it's also worth removing any screws/plates still present.

I had persistent parasthesia on a small spot on the right side of my mandible near my chin after my first surgery.  After my revision, it's completely gone unless i touch the spot directly, and even then it's reduced.  I think this is because there was a screw very near the nerve on that side after my first surgery which was removed during the revision.  Weird stuff like that can make a difference. It's worth trying, i think.

[GJ]

Thanks, guys. He suggested kenalog injection to see if it softens up the scar tissue. If that doesn't work, plate removal would be next.
This seems like a good approach. It turns out my depressor muscle, not the mentalis, is the main source of pain. Both have pain, but it's the depressor that is worse, and only on the right side.

I'll leave the thread up for anyone else dealing with this issue.

[thedude]

If you’re still not happy after removing the plates and having things looked over, you could inject some stem cells into the area. They seem to help the body repair itself to an extent that isn’t naturally possible once you start getting older. I had a chin implant removed and things always felt off, albeit not to the extent you described, until I injected some stem cells into the area. After I did that I haven’t given it another thought. These were the type of stem cells derived from cord blood.

I have a hunch a stem cell infusion a few weeks after double jaw surgery will become a recommended practice as people begin to appreciate the powerful healing effects of this stuff. I’ve heard of bone surgeries that were expected to take months to heal do so in weeks with the addition of stem cells.

[GJ]

Stem cells is a good idea, and that they helped you is encouraging to hear.
Totally agree that stem cells could become a routine recommendation during recovery.

[panda]

Have you consulted with other surgeons besides the original one?