jawsurgeryforums.com
Before/After Photos => Other => Topic started by: hara.v on May 27, 2012, 06:59:50 AM
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Hello!
I have left condylar, ramus and mandibular body hypoplasia. My x-rays look quite similar as well... Have you had 3D models done? Its really weird to be able to hold your jaw and see whats going in there, I was shocked when I saw the difference between the right and left ramus!
Here is a picture of what it looks like from the back
(http://i49.tinypic.com/2hxqb9s.jpg)
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I had my 4 month ortho appointment this morning. Apparently my ortho thinks I'm ahead of schedule and that nothing has really changed since my last visit. I just need a few teeth vertically adjusted that should only take a month. He seemed to think that I'd be ready for surgery at my 6 to 7 month mark, which would put me around mid October for surgery. I can't believe this is actually going to happen soon. I'm extremely nervous to go under the knife but I'm anxious to have this all behind me. Just thought I'd share as I know there are a number of other people here looking to have surgery with A/G.
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He takes molds each time I go in but Dr. G has only requested 6 month molds. Based on his experience, he was just estimating. Dr. G. may come back and say I've got more time, who knows. Guess I'll find out in Sept.
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this thread needs an update.
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Well, I have a scheduled date in November.
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Well, I have a scheduled date in November.
for surgery?
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For a cavity.... Yes, for surgery.
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For a cavity.... Yes, for surgery.
well sweet.
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Updated my blog for anyone who is interested.
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Updated my blog for anyone who is interested.
do you think the upper jaw surgery will fix the gaps on your upper teeth or will that be completed during post-surgery braces? i dont have any gaps as far as i know, but my overbite increased ~3mm in the last 10 weeks which will be corrected by my braces.
gaps was one fear i had because i saw a video of someone who had good results but still gaps between his teeth.
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If you look closely, there are coil springs in my braces creating these gaps. They are needed to create more room for my upper jaw to fit over my lower jaw after the 3 piece upper jaw surgery that will widen the palate. My laterals are naturally narrow so I plan to bond them or get crowns. I definitely don't plan on using post-surgical braces to close the gaps.
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If you look closely, there are coil springs in my braces creating these gaps. They are needed to create more room for my upper jaw to fit over my lower jaw after the 3 piece upper jaw surgery that will widen the palate. My laterals are naturally narrow so I plan to bond them or get crowns. I definitely don't plan on using post-surgical braces to close the gaps.
ah, that's smart. im glad i didnt have to get coil springs. did gunson also say you had to wait 1 year after surgery before you could correct the gaps?
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did gunson also say you had to wait 1 year after surgery before you could correct the gaps?
I haven't asked about that. I've heard that you have to wait a year for any dental work. This whole process has been one long waiting game, whether it's insurance or braces. Waiting another year will be annoying but if that's the case, I guess I just have gaps in my teeth for the time being.
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Bonding just adds resin material to natural teeth. I think I'll opt for crowns.
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You can try the bonding first and if your not happy you can always get the crowns or veneers after. Bonding is relatively inexpensive and looks great also keeps your whole tooth intact.
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Bonding can fade over time and it's not permanent. I do have a dentist in the family. Free dentistry is a bonus!
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Surgery hooks are on. I believe they are called Kobayashi Hooks. I have just about a month to go. I am extremely uncomfortable with my current bite so I'm very excited to get this over with. I will put up a new blog post soon for anyone interested.
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wooho! I'm really excited for you. Hopefully I'll get to meet you at the office sometime. I feel like I'm going to be in there for the rest of my life currently! Lots and lots of post-ops (reassuring really).
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Yeah, I took some self portraits today and I've noticed that the asymmetry is more pronounced now, referring to upper and lower jaw asymmetry I'm not pleased to say the least, however, it will be that much more rewarding when everything is put back in the position it should be.
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wooho! I'm really excited for you. Hopefully I'll get to meet you at the office sometime. I feel like I'm going to be in there for the rest of my life currently! Lots and lots of post-ops (reassuring really).
Definitely. I'll be in the area for just over a month.
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On the road to SB.
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Best of luck man. Ru driving/being driven or flying?
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How exciting! Good luck! I'm right behind you. :)
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Thanks everyone. Last meal behind me. I'm not too nervous yet. This may change in the morning though.
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Here we go
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You'll do great man! You'll be waking up to a perfect bite :)
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I hope everything goes smoothly!! Please update when you can! Take care man
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Best of luck!
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Best of Luck!
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So far so good. Still pretty loopy and stiff.
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Glad your ok. Do you get discharged today?
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No. I have 100% insurance coverage so I requested to stay an extra night. The suction and morphine are worth it to stay.
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That's great. I can't imagine having to leave after one night. What kind of insuance do you have? Is post surgery everything you imagined so far?
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Glad to hear Ryan, hope you're feeling ok.
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Good to hear everything went well :)
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Congrats Ryan, you're on the other side of the journey now :). Hope the recovery process goes smoothly with you.
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You've done it...that must be such an amazing feeling.
Happy healing :)
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Not going to sugar coat anything. I barely numb so I can feel it all.
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Not going to sugar coat anything. I barely numb so I can feel it all.
Holy crap, is the pain at least bearable?
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Yeah it's bearable but barely at some points. I feel much better at home instead of the hospital.
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Yeah it's bearable but barely at some points. I feel much better at home instead of the hospital.
you'll feel better after the weekend. this is the worst pain you'll have if the numbness is mostly gone, it can only get better.
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I never had numbness in my upper. I think it will start getting better too.
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Ok this scares me a bit. Hopefully it gets better soon, man.
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the weekend is the worst. imo the painkillers prescribed are pretty close to ineffective in combating the pain caused by swelling and pressure. goes away quickly though.
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Yeah, I think I'm reaching that point CK
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They always say no pain with jaw surgery.... Guess that's a lie!
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Hey everyone. I'm finally getting through the first weekend. Feel free to ask any questions.
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I probably need more time to let a lot of the swelling subside.
My TM Joints were reseated "perfectly". Haven't had any issues but also have not been moving them a whole lot.
Tongue space is different than I had imagined. It is larger, wider and flatter. There's still plenty of swelling that needs to come for this too.
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It feels that way. But it's wider so the tongue now fits.
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It feels that way. But it's wider so the tongue now fits.
That's encouraging but the pain and swelling is so scary.
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Did you have someone to look after you when you left hospital? Do you think this is necessary?
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Yes. Two people. Absolutely necessary.
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Thanks, appreciate it.
How are you finding breathing? I'm very scared of being too blocked up to breath through my nose and too tightly banded to breathe through my mouth.
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I think I have the tongue spacing issue as well, and I'm not sure if it's related but my mouth produces A LOT of saliva (like my old dentist would always make a big deal out of it cause they gotta suction it out). Would be interested to know if you had this before? I know it's probably too early for you to tell if it was corrected if you did have it before.
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Hey Ryan just wondering how your doing as it's been a week since your surgery.
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Doing well. Just still in the early stages of recovery.
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How is your swelling?
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Still quite swollen but it's on the way down.
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I haven't had many dessert cravings. I did decide to blend up some pumpkin pie with some milk. It wasn't very good but it was satisfying for the time being. I've mostly been having fruit smoothies to satisfy any calorie dense cravings.
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How have your energy levels been? Have you felt up to doing much?
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I've been taking it pretty easy. I've gone to the beach a couple times.
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My favorites so far:
Lasagna
Chicken Noodle Soup from Lazy Acres
Chicken Burritos with ranch and guacamole
Cream of Corn Soup
Turkey Chili
Beef and Been Burritos
Spaghetti
Fruit Smoothies
Banana Peanut Butter and Chocolate Protein with Milk
Cream of Wheat
Blackberry Milkshakes
Biggest fails so far:
Orange Chinese Chicken. It turned to paste and was awful.
Shepards Pie
Potatoe Salad
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you can chew burritos now? are you on soft-chew now?
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Yeah, aren't you?
No, those are all blended.
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Are you using a blender or food processor?
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Yeah, aren't you?
No, those are all blended.
oh yeah for quite awhile. im surprised you can tolerate blended burritos/lasagna. i tried blending simple pasta and coudnt tolerate it.
guess you palate is more developed than mine. are you teeth sensitive at all? obviously you cant bite but when the foot hits your teeth/gums?
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Are you using a blender or food processor?
I bought a Vita Mix blender. I highly recommend one. It turns a burrito to liquid in seconds. Got it at Costco.
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oh yeah for quite awhile. im surprised you can tolerate blended burritos/lasagna. i tried blending simple pasta and coudnt tolerate it.
guess you palate is more developed than mine. are you teeth sensitive at all? obviously you cant bite but when the foot hits your teeth/gums?
Teeth aren't sensitive. I don't understand your other question.
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I bought a Vita Mix blender. I highly recommend one. It turns a burrito to liquid in seconds. Got it at Costco.
I'd love one but aren't they about $500 even wholesale?
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$379 on Amazon
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Hmm, worth looking into. I like how easily it can blend whole foods; I hope to be having fully balanced/blended meals like you are.
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Are most decent blenders capable of liquefying foods like burritos and such? I just went to consumer reports and while vitamix was rated #1, ninja was #2 and rated a "best buy" at under $100.00. Hmm, decisions decisions.
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Not sure pal. I just like how the Vita Mix comes with a stick that you can use to push food down to the blades while it's running.
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That is cool and useful.
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No, no, and yes.
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Ryan...are you going to do any updates to your blog? What were your final surgical movements?
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I'm doing alright. I still have residual swelling around my nose and upper lip. Some of the feeling has returned to my lower lip and chin area so I'm confident that it will all come back eventually. My bite feels great compared to where I was before surgery. I have a solid occlusion which is amazing to say the least. My airway feels wide open and I can breathe clearly through both nostrils. My TMJs are much more stable. On the aesthetic side, my asymmetry in my jaw has largely been corrected. Any remaining discrepancies are out of the realm of orthognathic surgery. My chin is more pronounced now, which is a great added benefit. The only thing that I'm still struggling with are the sutures, which still feel like they have a lot more healing left, and the blended diet, which is getting very old. Only two more weeks of blended diet and then on to soft-chew!
I'm happy to answer any specific questions.
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The remaining numbness doesn't bother me that much but maybe that's because I'm confident that its temporary. If it did remain, I would still have surgery. There are so many other benefits. It's not painful at all, just a tad annoying. Pictures sent to your inbox.
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The remaining numbness doesn't bother me that much but maybe that's because I'm confident that its temporary. If it did remain, I would still have surgery. There are so many other benefits. It's not painful at all, just a tad annoying. Pictures sent to your inbox.
Really happy for you man, glad you're doing so well.
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I'm still on medical leave. My family has been supportive. Some have commented on more definition and width but nothing overwhelming.
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I had grafting on my lower left gonial angle of the mandible, which was meant to vertically lengthen the appearance of the ramus. I don't believe any grafting was used to widen the lower jaw. I also had some grafting at the osteotomy site on the right side. This wasn't used for width either. My upper jaw was widened via a 3 piece lefort. I still have some swelling around the lower jaw grafting so maybe that's why it appears wider.
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If you don't mind I'd love to get a PM with some pictures as well. Glad to great you're doing well.
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Here are some pictures. I'll leave them up for a bit.
Before:
(http://i45.tinypic.com/1tqzxi.png)
(http://i49.tinypic.com/2nvgnip.png)
6 Weeks Post-op:
(http://i50.tinypic.com/rcotxw.jpg)
(http://i50.tinypic.com/nw08cg.jpg)
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great results! definitely the asymmetry was massively corrected as well as some of the under eye weakness. Your nose and everything else looks really good as a result. you should be tremendously pleased.
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Holy s**t dude, you look like a completely different person!
Amazing results, congrats! I'd nuke the state of Alaska for a result like that
How old are you? still partly swollen? what else did you have done besides double jaw surgery + sliding genioplasty ?
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significantly beyond aesthetics your breathing must be SO much better now. Sorry for the redundant question but how many mms was your advancement again? From what I remember was their a discrete genioplasty performed or no?
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Holy s**t dude, you look like a completely different person!
Amazing results, congrats! I'd nuke the state of Alaska for a result like that
How old are you? still partly swollen? what else did you have done besides double jaw surgery + sliding genioplasty ?
Thanks. I'm 27. I'm still a bit swollen around my nose and also around my chin. It's slowly coming down though. I had a 3 piece lefort, lower jaw advancement via BSSO, and some grafting on the cheekbones and lower left mandible. No genioplasty.
I don't quite get the Alaska reference! lol
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significantly beyond aesthetics your breathing must be SO much better now. Sorry for the redundant question but how many mms was your advancement again? From what I remember was their a discrete genioplasty performed or no?
Breathing is effortless now. It's quite an amazing feeling after struggling with breathing issues for so long. I believe I was moved forward around 13.5mm. It changed the day before surgery compared to my initial consult. No genioplasty.
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Thanks. I'm 27. I'm still a bit swollen around my nose and also around my chin. It's slowly coming down though. I had a 3 piece lefort, lower jaw advancement via BSSO, and some grafting on the cheekbones and lower left mandible. No genioplasty.
Ah cool, do you remember what kind of advancements that you had on the upper and lower jaw? You look heaps better: the eyes, cheeks, paranasal, mouths/lips, symmetry, lower jaw projection all around amazing, congrats. bet you're happy as hell
how long are you going to be in braces for (post-op) ? and how long did it take you to decompensate?
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Ah cool, do you remember what kind of advancements that you had on the upper and lower jaw? You look heaps better: the eyes, cheeks, paranasal, mouths/lips, symmetry, lower jaw projection all around amazing, congrats. bet you're happy as hell
how long are you going to be in braces for (post-op) ? and how long did it take you to decompensate?
I don't know the exact movements because they were changed just before surgery. The upper was moved forward something like 5 to 6 mm and the lower was moved forward somewhere around 13.5mm.
I went into this whole thing to address my TMJ issues. I currently don't have any pain or clicking. The aesthetic benefits are just an added bonus. I'm very happy I had it done.
I know I'll be in braces for at least 6 months after surgery. I am in no hurry to take them off. I want to make sure everything is perfect before I have braces removed. I was in braces nearly 9 months before surgery.
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Looking good Ryan, great result while still looking like yourself. I hope the same for myself. Glad you're feeling better too.
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Marisama, did you have your jaw angle augmented? how long were you decommissioned for (unable to leave the house?) how long did your surgery last?
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Marisama, did you have your jaw angle augmented? how long were you decommissioned for (unable to leave the house?) how long did your surgery last?
My lower left angle was vertically lengthened with HA grafting to match my right side.
I would say that I didn't really do much for the first week or so. I was driving after two weeks.
Surgery lasted just over 6 hours.
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Looks great Ryan. How much wider is your arch now in mm?
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Ryan .... Also if you don't mind answering... How did your surgical plan change and why from your original consult?
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Looks great Ryan. How much wider is your arch now in mm?
I have no idea. It's wide enough to fit perfectly over my lower arch.
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Ryan .... Also if you don't mind answering... How did your surgical plan change and why from your original consult?
Pre-surgery braces can change things a bit. Also, after the surgeon ran new measurements through VSP orthognathics, his 3D software, the precise movements were a little bit different than what was estimated 3 years prior.
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Marisama: did you have any sort of rotation? if so how many degrees?
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Marisama: did you have any sort of rotation? if so how many degrees?
Not sure. I don't have precise measurements.
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Pre-surgery braces can change things a bit. Also, after the surgeon ran new measurements through VSP orthognathics, his 3D software, the precise movements were a little bit different than what was estimated 3 years prior.
Where you able to get to see the projected changes from the front of your face on that software? If so, how close are the projected outcomes to real life?
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Where you able to get to see the projected changes from the front of your face on that software? If so, how close are the projected outcomes to real life?
VSP doesn't incorporate soft tissue analysis, it's hard tissue only.
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VSP doesn't incorporate soft tissue analysis, it's hard tissue only.
This is true
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not sue if you answered this already but what kind of lefort did you have?
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not sue if you answered this already but what kind of lefort did you have?
I had a 3 piece. I'm not sure if that picture above is considered a 3 or 4 piece. I'm thinking it's a 3 piece, meaning that the upper jaw is segmented into 3 tooth bearing segments. I could be wrong, and maybe that 4th piece in the middle is counted as well.
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Maybe that's a question for the doctor to measure precisely, but when I rest my lips, I can see just a little bit of upper teeth. It looks completely natural to me and I'd imagine it to be somewhere between 2 and 3 mm.
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Oh and marisama can you speak normally now? And can you talk normally?
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Oh and marisama can you speak normally now? And can you talk normally?
I'd say I'm about 85 to 90% of normalcy for clearly speaking. What's the difference between speaking and talking to you?
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I'd say I'm about 85 to 90% of normalcy for clearly speaking. What's the difference between speaking and talking to you?
Lololol sorry man i meant speaking and eating. Are you eating normally... Your recovery is proceeding amazingly well!
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Lololol sorry man i meant speaking and eating. Are you eating normally... Your recovery is proceeding amazingly well!
No. I'm on a blended diet for 8 weeks. Today marks 7 weeks for me. 8 to 16 weeks should be soft-chew if I'm given the go ahead.
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Updated the blog with some X-Rays for anyone who is interested. The most interesting part of the x-rays are the increased space in the TMJ and the lower left mandible grafting.
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Love looking at the increased airway space. Where are the tmj on xray?
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Reposted with larger x-rays.
Kristen, I was referring to the ceph X-ray that shows the entire skull. You can see the space in the TMJ now.
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Reposted with larger x-rays.
Kristen, I was referring to the ceph X-ray that shows the entire skull. You can see the space in the TMJ now.
Are you still swollen? at what age did you first start having TMJ related problems?
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Are you still swollen? at what age did you first start having TMJ related problems?
Yes. Still swollen around my nose. I started having TMJ problems when I was 18, so about 10 years ago.
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Hey what position do you sleep in now? And how long after surgery did you feel comfortably sleeping on your wide or stomach? I usually sleep on my stomach.
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Hey what position do you sleep in now? And how long after surgery did you feel comfortably sleeping on your wide or stomach? I usually sleep on my stomach.
I'm still on my back, although it's flat now instead of propped up. At first it was really miserable trying to sleep on my back. I would want to roll over so badly but I didn't want to wake up with lopsided cheeks so I just stuck it out. Sometimes I'd catch myself resting my hand on the side of my forehead to change it up. I'm used to sleeping on my back now so it's not a big deal anymore.
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Yes. The first 2 weeks you have to stay upright. It's not fun. I just took sudafed or unisom to help keep me sleeping.
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I can't sleep on my back right now cause I choke once my muscles are relaxed. I guess I should practice sleeping on my back as well?
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Marisama, did you have a maxillary impaction? if so how many mm and how thick is your skull *circumference from temple to temple* <- this is important
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No. And I have no clue.
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Hey everyone. I just wanted to give an update on my recovery. I am now 4 months post-op. Surgery seems like a distant memory now. I was cleared for regular diet last week. As soon as I left the surgeon's office, I went straight to the highest rated burger place on Yelp in Santa Barbara. Eating regular foods really makes a big difference in my energy levels and overall well being. I feel close to normal again. I can still definitely tell that I had surgery. I have a decent amount of scar tissue around the suture sites. I still don't have full range of motion yet either. It's hard to describe the restrictive feeling around my mouth. It's kind of like the feeling you get when you've been in really cold weather and you can't move your mouth properly. It's feels a bit delayed. I hope that makes sense. I'm hopeful that it will continue to get better in the next couple of months. I really want to be able to speak clearly without any issues. My TMJ issues have pretty much been resolved. I no longer have pain, headaches, or clicking. My bite is solid. Orthognathic surgery was the best decision I've ever made, hands down.
My orthodontist said that I should only have about 2 more months in braces so that puts me at 6 months post-op. The day my braces come off, I'm planning on getting some cosmetic dental work done to fill in the gaps next to my laterals. I'm excited to have this entire journey in my rear view mirror. I'm happy to answer any questions.
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can you further describe this delay you have? i get the weather analogy, that's how my lower lips and corners of my mouth. slower response and more difficult to control when communicating.
is this what you are experiencing?