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User Blogs => Standard & Video Blogs => Topic started by: treevernal on December 25, 2012, 08:51:01 PM

Title: jaw surgery 1/17/13
Post by: treevernal on December 25, 2012, 08:51:01 PM
I've been on this site for a while now and have found it to be very helpful.  I'm starting this thread to document my surgery as others have done.  Not sure if I will be posting public pictures yet but I do plan on talking a lot about my surgery here.

Ill be having surgery on 1/17/2013 with Dr. Arnett in Santa Barbara.  Living in San Diego, it's luckily not too far away.

I had braces as a teenager for 5 years which straightened my teeth but did not correct my bite problems.  I've been in braces for the past 15 months to decompensate and prepare my jaws for surgery.  My incisors have been torqued out slightly, my laterals bonded wider, my worn cusps bonded higher, and my lower curve of spee flattened.  All the bonding material is temporary and will be replaced with permanent resin once treatment is complete.

My reasons for surgery are both cosmetic and functional:
- narrow/high palate
- class 2 malocclusion
- open bite
- arthritic tmjs
- bruxism/clenching
- small airway
- lip incompetence
- deviated septum and mouth breathing
- forward head posture
- retrognathic profile
- facial asymmetry

I could go on but those are the main problems.  After surgery, I plan on continuing to see my orofacial myologist to work on swallowing, breathing, and sleeping correctly.  A chiropractor could also be helpful to help de-compromise my posture once my facial structures are corrected and airway opened.  Here's what I'm tentatively having done surgically:

- 3-piece lefort 1 counterclockwise advancement
- bilateral sagittal split osteotomy counterclockwise advancement
- septoplasty
- bilateral cheekbone augmentations with hydroxyapatite
- upper lip V-Y reconstruction

I have been on doxycycline and piroxicam for over 2 months now to help stabilize my joints pre-surgery.  I donated a pint of my blood last week to have on hand in case an emergency transfusion is necessary (rare).  The hotel is booked and my parents will be staying with me for a few weeks to see me through recovery.

I am nervous but confident in my decision and in the surgeon.  I've never had any surgery before.

Feel free to follow me along :)

Dan
Title: Re: jaw surgery 1/17/13
Post by: Lazlo on December 25, 2012, 11:23:55 PM
hi, thanks for the info, do you have any before/afters of what the VY-plasty for the lip is for? I mean what it looks like. I have a somewhat long upper lip area (i.e. area between top of my upper lip and the base of my nose) does this technique shorten that distance? What does it do exactly? Thanks.
Title: Re: jaw surgery 1/17/13
Post by: Marisama on December 25, 2012, 11:55:17 PM
Good luck.  It has all been much easier than anticipated.  It's definitely a very long recovery but I am so happy that I went through with it.  Be sure to ask for valium for the night before.  It really helped with the anxiety even into the morning of surgery.
Title: Re: jaw surgery 1/17/13
Post by: treevernal on December 26, 2012, 08:03:25 AM
Thanks for that Ryan.  I will def ask them about it.
Lazlo, I tried looking up pics but most showed reconstruction of patients with major defects or people with normal lips who wanted a bigger pout; I am neither of those categories lol but there might be some good examples if u keep looking.  I will too.

Oh and as far as what it does, in my case anyway, is increase the vermilion (red portion) of my upper lip and also increase the thickness.
Title: Re: jaw surgery 1/17/13
Post by: Heavyweight on December 26, 2012, 02:57:10 PM
Sounds like you had a long time in braces considering you had no extractions. What did your bite look like before braces and what does it look like now? How large an overbite would you estimate was created?
Title: Re: jaw surgery 1/17/13
Post by: treevernal on December 26, 2012, 09:18:27 PM
Sounds like you had a long time in braces considering you had no extractions. What did your bite look like before braces and what does it look like now? How large an overbite would you estimate was created?

Braces were estimated to be 9 months pre-op; I just took longer to get ready financially...I was surgery ready back in Oct if insurance didn't give me the run around.

Before this round of braces I had a 5mm overjet and 0mm overbite.  I'd say with decompensation my overjet doubled and my open bite opened up 2mm (only approximations tho).

As a teenager I had a palate expander and herbst appliance.  The herbst broke and the expander (I believe) caused periodontal decline of my molars and led to increased sensitivity along the gumline.  I believe this round of braces (coupled with softer brushing, better flossing and sensitivity toothpaste) centered these teeth back into the gum tissue and the sensitivity is gone :)
Title: Re: jaw surgery 1/17/13
Post by: CK on December 27, 2012, 02:31:01 AM
Did Dr. Arnett explain how he would address the high and narrow palate during surgery?
Title: Re: jaw surgery 1/17/13
Post by: treevernal on December 27, 2012, 06:54:59 AM
Did Dr. Arnett explain how he would address the high and narrow palate during surgery?

Yes, the 3-piece lefort 1 advanced counterclockwise moves the posterior portion of my maxilla (hard palate/nasal floor) down and it will be widened to match the mandible.  He didn't go into that much detail tho other than to say that it widens and the posterior portion moves down; I researched the other bit on my own.  I'm gonna ask him to explain more on how my nasal breathing will improve.
Title: Re: jaw surgery 1/17/13
Post by: Marisama on December 27, 2012, 07:53:22 AM
My nasal breathing has improved tremendously. It's effortless now.
Title: Re: jaw surgery 1/17/13
Post by: treevernal on December 27, 2012, 08:22:47 AM
My nasal breathing has improved tremendously. It's effortless now.

That makes me so happy!  Lol, great to hear
Title: Re: jaw surgery 1/17/13
Post by: treevernal on December 31, 2012, 11:00:37 AM
Just had a CBC and routine urinalysis done this am for the results to be faxed to Arnett.  That's pretty much the last official thing I have to do before driving up to SB in 2 weeks.

Happy new year everyone!
Title: Re: jaw surgery 1/17/13
Post by: treevernal on December 31, 2012, 11:35:56 AM
Complete blood count
Title: Re: jaw surgery 1/17/13
Post by: treevernal on December 31, 2012, 02:01:31 PM
A part of me thinks it could be to make sure you don't have any unreported diseases that you may not know you have.  Like, a high white blood cell count could mean cancer and you may not want to put your body through surgery if you need chemo.  I could be totally wrong though, just a guess.
Title: Re: jaw surgery 1/17/13
Post by: treevernal on January 14, 2013, 09:51:01 PM
Got my surgical hooks on this morning and arrived in SB tonite.  Final records tomorrow.  Getting very nervous :s
Title: Re: jaw surgery 1/17/13
Post by: Marisama on January 14, 2013, 10:31:14 PM
The anticipation is the worst part, I promise. It helped calm me to see ZNewton's results. He made it to the other side just fine and I assured myself that I'd be just fine too. Be sure to enjoy your favorite foods during the next couple days. Don't overeat the night before surgery because that is one thing that can lead to vomiting after surgery. I'm so glad that I never vomited.
Good luck pal. It really is much easier than I anticipated.
Title: Re: jaw surgery 1/17/13
Post by: treevernal on January 14, 2013, 11:05:02 PM
Thanks Ryan, it really makes me feel better reading that.
Title: Re: jaw surgery 1/17/13
Post by: Lazlo on January 15, 2013, 07:27:03 AM
Got my surgical hooks on this morning and arrived in SB tonite.  Final records tomorrow.  Getting very nervous :s

Good luck, I'm sure everything will be fine.
Title: Re: jaw surgery 1/17/13
Post by: treevernal on January 15, 2013, 06:01:32 PM
Thanks guys, had the final records today it went well, tons of info!  Turns out ill be getting orbital rim augmentations in addition to cheekbones.  He's still not sure of the genioplasty, if he does it, it will be to center it only as my projection is good. 

Honestly, I started freaking out a bit at the end, until they reassured me that I did in fact need this surgery to prolong and improve my quality of life.  I have one of the smallest airways they've seen and it really helped to be reassured of my decision.  My mom, who accompanied me, felt better hearing that too. 

Bought a whole bunch of stuff this afternoon, now relaxing with dinner and a good movie.
Title: Re: jaw surgery 1/17/13
Post by: Kristen on January 15, 2013, 07:37:02 PM
Thanks guys, had the final records today it went well, tons of info!  Turns out ill be getting orbital rim augmentations in addition to cheekbones.  He's still not sure of the genioplasty, if he does it, it will be to center it only as my projection is good. 

Honestly, I started freaking out a bit at the end, until they reassured me that I did in fact need this surgery to prolong and improve my quality of life.  I have one of the smallest airways they've seen and it really helped to be reassured of my decision.  My mom, who accompanied me, felt better hearing that too. 

Bought a whole bunch of stuff this afternoon, now relaxing with dinner and a good movie.





How many mm's did they say your airway is .?      Should be on your ceph drawing.
Title: Re: jaw surgery 1/17/13
Post by: Kristen on January 15, 2013, 07:37:58 PM
And Good Luck!
Title: Re: jaw surgery 1/17/13
Post by: treevernal on January 15, 2013, 08:33:43 PM
3mm.  Also, awkward story; I'm going with Arnett but was told Gunson had jury duty this week and had to cancel his surgeries.  Patients flew in to see him but legally he couldn't get out of it.  Tough break.
Title: Re: jaw surgery 1/17/13
Post by: Marisama on January 15, 2013, 09:04:45 PM
I'm kind of jealous that you're having surgery this week. The feeling of seeing your bite and facial structure change overnight is really thrilling.
Title: Re: jaw surgery 1/17/13
Post by: treevernal on January 15, 2013, 09:19:51 PM
I'm kind of jealous that you're having surgery this week. The feeling of seeing your bite and facial structure change overnight is really thrilling.

By thrilling you mean scary as hell, right?  Lol.  But really, thanks for your support man.
Title: Re: jaw surgery 1/17/13
Post by: Marisama on January 16, 2013, 01:00:42 AM
No, I mean that it's very exciting. It's not something you will ever experience again. I was beyond happy when I first held the mirror and did jaw exercises and saw my bite come together perfectly.
Title: Re: jaw surgery 1/17/13
Post by: Kristen on January 16, 2013, 01:04:02 AM
3mm.  Also, awkward story; I'm going with Arnett but was told Gunson had jury duty this week and had to cancel his surgeries.  Patients flew in to see him but legally he couldn't get out of it.  Tough break.


Come on!!!     Please somebody tell me what they do in that situation.
Title: Re: jaw surgery 1/17/13
Post by: Marisama on January 16, 2013, 01:19:05 AM
That would be pretty tough. I paid in full for a month at a rental home. This was non refundable. I'd hope that they would squeeze you in as soon as possible somehow.
Title: Re: jaw surgery 1/17/13
Post by: Heavyweight on January 16, 2013, 06:27:41 PM
How much has your ceph treatment plan changed since your original consultation?