jawsurgeryforums.com
Surgeon Information => Surgeon Reviews and Leads => Topic started by: marcolob on November 16, 2014, 06:53:17 PM
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All went well, (big airway and good occlusion :) ) minus one thing: my negative vector orbit was seemingly not addressed and postoperatively I have scleral show and a suborbital rim volume deficiency probably exacerbated by the ccwr :( could this be from the swelling pulling my skin? Ideas?
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Unless you have something like a Le Fort III then there's just no way that jaw surgery is going to address the issues you mentioned. Did you have HA grafts?
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Yea probably being too much of a perfectionist he did his best with my existing craniofacial structure I suppose. He put HA on my cheeks and it looks really good at certain angles but I was surprised that it's mostly given lateral projection i.e. broadened my midface (which is good) whereas I really thought I'd be getting more anterior projection. He didn't want to do too much (or any as it turns out) suborbital augmentation he said as I have "deep set eyes" and on balance he thought augmentation of the orbits rim would make it look like my eyes were in tunnels (he even made tunnels with his hands to visually demonstrate his point). I don't know if that was mistaken though as now my eyes area looks sunken hollow and dished out, I'm just hoping it's the swelling exaggerating that look. Everything else is perfect aesthetically, beautiful jawline
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Is lefort iii literally the only way then?
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All things considered, are you feeling alright?
Pre-op did you not have scleral show, and now you do? How would that be possible?
Thanks for your post, and take care :)
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I had it before but it's noticeable now (the negative vector orbit) cause everything else was corrected so it stands out my eyes look quite sunken is what I mean. Otherwise I'm happy big airway good bite :)
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does anyone wanna see pics
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does anyone wanna see pics
Yes. How is your under eye area?
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i'd love to see pics and i can give you some analysis of your lower eye/negative orbit situation since I've become an expert on this topic.
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does anyone wanna see pics
Yes. I would be happy to! :)
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Reference for what I see as Average suborbital for comparison
[attachment deleted by admin]
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Was it right to not HA augment suborbitally? See above for explanation
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Was it right to not HA augment suborbitally? See above for explanation
I heard A/G charge a fortune for HA paste. Honestly, I don't think it does s**t. You probably made the right call.
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Thanks for taking the time to post. Can I ask how your joints are doing?
I think you look really good.
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Dr Gunson is pretty good with that stuff my joints are fine, limited opening still at 6 months tho
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In my quote, HA paste wasn't all that much. I'm told it's only useful for lateral projection. Otherwise, it has a tendency to droop or fall. That's why they don't like to do it I think.
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Do you have any frontal pictures? I think you look great in the pictures you've shown so far.
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Ccw rotation, bsso advanced, lefort 1 and genio everything went perfectly except for these HA grafts which are not great, has made me a bit depressed I won't deny it
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Minus the HA Dr G did a perfect job, my bite and bones themselves I'd say are flawless
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Ccw rotation, bsso advanced, lefort 1 and genio everything went perfectly except for these HA grafts which are not great, has made me a bit depressed I won't deny it
i would just get really strong medpor or silicon implants for malar and suboribtal or alternatively just accept and go with it. It's actually possible for men to rock a weak suboribital.
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My angle grafts are asymmetrical enough I notice it which I find upsetting and Yea he suggested fat or implants for suborbital too so yea, I hate the thought of implants tho so it's osteotomy or bust
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Awesome results my man! Congrats :) Any imperfections you're seeing are simply nonexistent from a stranger's point of view.
Can ask how you're doing in terms of numbness? I had surgery with Dr. Gunson approaching 2 weeks ago and my lower lip and chin are still completely numb. I pretty much had the same surgery as you. Lefort1 + BSSO + slight genio = CCW Rotation (bimax).
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No numbness at all, totally regained sensation but it takes a few months, only slight functionality issue is reduced opening (3 fingers instead of 4 preop) and some some crunchy feeling I don't like on my right condyle when I stretch open wide, but otherwise everything is good. You'll get there. Can I ask what grafting he did to you, if any? Ps my surgery was October 14
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That's good to hear! Yep, it says in the notes he did 10x bone grafts with the Lefort1, and 8x bone grafts with the BSSO, with 8x local bone harvest.
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No I mean like augmentation grafts to your cheeks etc to make you look fuller? Those other grafts refer to fillings between cuts to ensure union
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Ah I see. Dr. Gunson said my right cheekbone was asymmetrical to my left. It's wasn't noticeable pre-op but he said it would've been after the surgery. So I think he went in and added some HA paste or something of that nature to my right cheekbone to address the issue, for no additional charge. That was his idea and I trusted him, so I agreed to it.
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So it's day 16 on my road to recovery and I have a picture update. Now that the swelling has started to significantly subside, I'm starting to see the final results. Is it me or does the lower mandible still look a little recessed? Or does the lower mandible typically look recessed during the first few month or so of recovery?
(http://i.imgur.com/jsGUG9H.png)
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I would have killed to have the level of swelling at 2 weeks post-op. I had an unforeseen reaction to the HA paste and I looked so gnarly people would gawk at me when I dared to go outside. Or they'd give me that sad "awww poor guy" look, unaware I just had jaw surgery.
Yeah don't judge anything right now. Way too early even though your swelling isn't that bad.
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I heard A/G charge a fortune for HA paste. Honestly, I don't think it does s**t. You probably made the right call.
Not trying to hijack this thread but as much as I despise HA paste for the extreme swelling it gave me... my now visible cheekbones are entirely the result of it. Obviously it depends. Although I agree what they charge for it is egregious.
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I think you are looking really good my man!
Remember, we are our own worst critics. You made a major improvement. Enjoy!
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Not trying to hijack this thread but as much as I despise HA paste for the extreme swelling it gave me... my now visible cheekbones are entirely the result of it. Obviously it depends. Although I agree what they charge for it is egregious.
Not at all, any input is very welcome! My swelling has definitely gone down alot but the first week of surgery I was also a monster. Especially my lips, they looked like they were going to burst.
I think you are looking really good my man!
Thanks! :)
So I made the trek to Santa Barbara again today and instead the legendary Dr. Arnett saw me. I got prescribed some Tramadol, woohoo, and it seems to be working much better for my pain. So apparently, there are patients who feel too much sensation with the nerves coming back and I just so happen to be one of those. If my nerve pain and issues don't improve, they said they would put me on a medication to numb the nerves. Other than that, everything looks good although my jaw exercises don't seem to be improving my opening much. I hope to post my post-op x-rays soon too. Thanks everyone for your support and coming along this journey with me. It's made the experience 10x better.
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I think you are looking really good my man!
Remember, we are our own worst critics. You made a major improvement. Enjoy!
Who is this to? Me or chinny?
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Who is this to? Me or chinny?
That comment was pointed at the OP - aka you Marco....
You're life just changed.