jawsurgeryforums.com
General Category => Functional Surgery Questions => Topic started by: jawbreakerbeach on December 03, 2014, 12:28:57 AM
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Hello there, transplanting from Archwired. I'd like some honest feedback on my results. However please don't PM me asking for personal details or more pictures or whatnot. What I'm comfortable putting up here is up here.
So I'm about 11 months postop and I'm just not happy with my results.
I went with one of the renowned expensive surgeons who is mentioned a lot on boards like these. He seemed sooo confident from day one that he could fix everything and I guess I just lapped it up like a sick puppy dog.
My biggest concerns pre-op were recessed mandible, asymmetry left to right (chin juts out to one side), canted jaw, midlines off center, gummy smile, and an uneven overbite-almost-a-crossbite.
I can't find my sheet with the exact movements but the general idea was maxilla up and forward, mandible rotated up, genio, both jaws supposedly leveled and aligned for the cant and asymmetry.
POST-OP.
• Profile / side view looks great. Can't complain.
• Bite is better and teeth are straight but the braces mostly did that.
• No gummy smile, still some tooth show at rest but largely improved.
• It looks like my jaw is still slanted just as much as pre-surgery! Though my surgeon swears he leveled it out. What is the point of having straight teeth when the whole mouth is slanting in the wrong direction.
• My midlines are still off center. Surgeon admits to that and says "I usually get them on straighter than that and I'm not happy with it either." But then backpedals saying because of anesthesia and all the ligaments softening and whatnot that what I have is an acceptable margin of error.
• My chin still juts off to the left. He said this was fixable pre-op but now says there was nothing he could do???
All these are post-op.
(http://i57.tinypic.com/15zo1dz.jpg)
My ortho wasn't happy with my outcome but the surgeon talked him down, and then they both talked me out of braces and told me to wait it out. I had a lot of swelling late in the game (~7 months) so it made sense at the time. Now I'm pretty sure there's no swelling left and it doesn't look right.
My surgeon did offer to redo the surgery "if I really wanted" but also said there was no guarantee he could do it any better. Am I crazy for thinking it should have turned out differently? Is this as good as it gets?
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You look great, bite looks AWESOME. I'd die to have that bite. No one is symmetrical and everyone has off midlines a bit --its actually very common. You're obsessing about nonsense. You need to enjoy your results and move on. Don't play with fire.
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Point taken.
I'm almost not asking SHOULD I HAVE SURGERY AGAIN because going through that again would probably be insane. But from a purely hypothetical IS THIS REALLY THE BEST SURGERY that 70k can buy. I went with the best because it's my face and it all fell short. I think I could have gotten the same bite from the guy down the road...my bite was not terrible to begin with.
The cant/slant being what it is postop still seems way off. If you take a ruler across my midline it almost hits the pupil of my left eye. Not what I expected from this particular surgeon.
It'd be easier for me to come terms with it all either way, either that I am bats**t crazy for caring OR that I could have had a better result with the money I paid and just got unlucky. I'm leaning towards the second just because my ortho really put up a stink and he's not the type to do so.
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Point taken.
I'm almost not asking SHOULD I HAVE SURGERY AGAIN because going through that again would probably be insane. But from a purely hypothetical IS THIS REALLY THE BEST SURGERY that 70k can buy. I went with the best because it's my face and it all fell short. I think I could have gotten the same bite from the guy down the road...my bite was not terrible to begin with.
The cant/slant being what it is postop still seems way off. If you take a ruler across my midline it almost hits the pupil of my left eye. Not what I expected from this particular surgeon.
It'd be easier for me to come terms with it all either way, either that I am bats**t crazy for caring OR that I could have had a better result with the money I paid and just got unlucky. I'm leaning towards the second just because my ortho really put up a stink and he's not the type to do so.
Well you went with A/G probably. Listen, this surgery results in SO MANY COMPLICATIONS normally, that if you don't actually feel you have functional issues, then I'd DEFINITELY let it be. No one can see this asymmetry but you. Your surgeon will do a free redo?
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As for the price. You definitely could have taken his/her plan and shown it to a very good surgeon and probably saved like 40 grand. But listen, this is your face and your life. The midline no one can see and your bite looks great. the slight asymmetry in the chin can probably be corrected in other ways. You know how many people i know who have had this surgery and just wish they never had it done because of all the functional problems? Many. So you're very very lucky.
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Hey, truly, I get it, I'm super lucky and there are people starving in Africa and I could die tomorrow just by getting in a car and then truly no one would care about my slightly deviated jaw.
I'm really not all depressed about this, more like buyer's remorse and wondering if others who bought a Ferrari jaw would be disappointed when they ended up with a perfectly serviceable Hyundai. But yeah, I am lucky to have the luxury of that conversation. All opinions are worth something. Thanks for your input :)
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how's sensation by the way? If you have full sensation, then let me tell you girl, it was worth the 70 grand.
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what did you look like pre op?
my opinion: if you don't take money into account, the results are good.
however, i can understand your frustration about the price tag, because i agree with you that for 70k $ i would also expect a perfect result.
the expectation of a perfect result is why you paid 70k instead of 35k in the first place.
if it were my body, i would not go through another surgery because the flaws are minor just as lazlo said.
if the only pain you feel is in your wallet, you came out ahead.
just my 2 cents.
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My heart sank after reading the first few lines of your post and as someone with a real botched surgery behind me I feared the worst...until I scrolled down and saw your pics.
I agree with the others, your issues are so minor and only apparent if you really scrutinise, understandable that you would after shelling out that much money - it's only natural that you would expect mm perfection, unfortunately bodies don't always conform.
You need to put it behind you and move on, enjoy your life and your new bite :)
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Yeah I was expecting perfection for who I went with and price I paid.
I don't mean to sound ungrateful or minimize anyone who has had a worse outcome.
I do NOT have full feeling. I have a big horizontal strip starting at my lower lip and extending to my chin. Weirdly I can feel my chin okay which my OS said is usually what stays numb. I can't feel my lower lip all the way across and about a quarter inch under that. It's not just a spot it's a whole band that feels completely dead, no tingling. The surgeon is baffled by that as no nerves were severed and we can't see any compression. So practically speaking I can't eat soup without dribbling over myself and kissing is unpleasant now. I kind of talk out of one side of my mouth because I guess I can't feel how to readjust. So it's not all roses and sunshine I will probably have that for the rest of my life since its a year out.
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I think you are right to feel the way you do. I'd most likely be disappointed too if I didn't end up with a perfect result (or at least close to it) after having paid that much for the surgery. Your pictures don't really show the issues you've described though.
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I may post some more pictures and some preop ones later, but the chilly reception has me feeling uncomfortable now. It seems like there are tons of posts on here of people micro-analyzing their face but I guess most don't post pictures so who knows if their issues are "minor" or not.
To answer the question of how I looked pre, it's similar to these people:
(http://orthocj.com/journal/uploads/2000/06/lower-jaw-advancement.jpg)
(http://1.bp.blogspot.com/-iCVUR0JzEK0/UGROSm6J8oI/AAAAAAAAAJw/s4aT0w_sA5U/s1600/jaw+correction.jpg)
(http://www.google.com/imgres?)
(http://2.bp.blogspot.com/-KyM_l-VbixI/UVHXwt9A0WI/AAAAAAAAAHI/o1W_khsnyLE/s1600/untitled.png)
From the side I looked a bit worse because my nose is huge and my forehead is taller than any of those pics. My chin also has no natural bump or projection, it's like a flat board so it made the recession more pronounced.
The weird slanting and midline misplacement is what bothers me most postop. For whatever reason it is much more noticeable postop than it was preop. I look at preop pictures and still struggle to understand why my midline looks further off and more slanted in my postops. When surgeon says that it should be much more level and roughly the same horizontal placement.
In my opinion, side aesthetics improved and front AT REST aesthetics improved. But I do not like my smile from the front. My SO took a couple of pictures on a trip recently and asked me why I was smiling crooked (and he doesn't even notice when I get my hair cut!), so it's hard to ignore my feelings that things were misplaced in my mouth somehow.
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Yeah I was expecting perfection for who I went with and price I paid.
I don't mean to sound ungrateful or minimize anyone who has had a worse outcome.
I do NOT have full feeling. I have a big horizontal strip starting at my lower lip and extending to my chin. Weirdly I can feel my chin okay which my OS said is usually what stays numb. I can't feel my lower lip all the way across and about a quarter inch under that. It's not just a spot it's a whole band that feels completely dead, no tingling. The surgeon is baffled by that as no nerves were severed and we can't see any compression. So practically speaking I can't eat soup without dribbling over myself and kissing is unpleasant now. I kind of talk out of one side of my mouth because I guess I can't feel how to readjust. So it's not all roses and sunshine I will probably have that for the rest of my life since its a year out.
Yeah okay, that's a concern for sure. That said, don't worry there may be sensory improvements. Nerves can indeed regenerate, but s**t, it's my biggest fear with regards to kissing. I love kissing girls, I mean I live for it. And if my kissing was impaired in any way I'd be severely (more) depressed. I thought functionally you were perfect, but I understand your frustration. For 70 grand, yes I'd expect perfection.
But I'll let you and everyone else on this board in on a little secret NO SURGEON WILL EVER TELL YOU. THEY DON'T KNOW s**t!! THE STATE OF THIS ART IS SO BLOODY PRIMITIVE AND FULL OF CHANCE AND FACTORS EVEN THE BEST SURGEONS IN THE WORLD HAVE NO UNDERSTANDING OF.
BE WARNED: When you agree to jaw surgery you're playing russian roulette. There is NO SUCH THING AS A PERFECT RESULT. It's a f**king breaking of your face apart, moving it around and reattaching it. The body does the healing, not the surgeon. It's sad but true and something after three years of researching this bloody game I realize. Surgeons, even well intentioned ones ALL LIE. I think it's part of their training.
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You're misreading my tone. I'm incredibly supportive of you. Just being honest about what I think. The sensory stuff has me a lot more sympathetic towards you than the chin asymmetry. But truth be told, I can't really see how bad the chin is from such a close-scale fragment photo. You'd have to post a longer scale pic.
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I also had jaw surgery recommended after a first attempt in braces which failed to correct my bite. It wasn't all about aesthetics but I was terrified of having someone break my face and put it back together, and so I wanted to make sure everything looked right after.
My bite wasn't terrible and actually looked okay cosmetically from the front, but the asymmetry of my jaw was just enough that it wouldn't "settle" with braces alone. I had to basically rip my food and eat on one side.
To Lazlo, yes I am tired of the runaround. If nothing else at least I guess I can warn other people that you may not get butchered by the world's top surgeon but there are plenty of imperfect cases out there.
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What were the terms of the revision your surgeon offered you? Would you have to pay for anything?
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What were the terms of the revision your surgeon offered you? Would you have to pay for anything?
I won't have to pay surgeon fees but will have to pay everyone else involved again so it's not exactly free, and I have to accept all the risks a second time for example more numbness etc, and of course a blanket disclaimer that "it may not end up better." He won't do the workup for a revision unless I strongly commit to doing it again, so I'm not even sure HOW he thinks he could improve on the result. He personally seemed most upset about where my midlines ended up (off center and canted). He said he wouldn't try to fix the chin/yaw issue without an implant addition.
It actually all looked pretty even for the first few months because the swelling took FOREVER to go down and it hid the true result for a long time.
In the end the aesthetics bother me more than the loss of feeling. I'm a former pro ballerina so I've spent most of my life in excruciating pain to achieve a certain movement or shape. So who cares how it FEELS right? Also I was prepared for the russian roulette of numbness but I figured we could at least get everything on straight since it was planned out to the T.
There you go. Full face but I did filter it because I can't stand to have my face plastered on the internet. Again this is from a perfectionist's perspective so sorry if the minority of it all bothers those of you with bigger problems. I think it's magnified/worse in real-life and 3D, but what isn't.
(http://i61.tinypic.com/2ew0ehh.jpg)
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Sorry, jawbreakerbeach.
Did you have a cant pre-op? I know you said it worsened, but was it there before albeit less obvious? I often wonder, for people who have some frontal asymmetry pre-op, even if it's partially corrected with surgery maybe part of the reason it can appear worse is because of the advancement. So, a person starts crooked, it's partially corrected with surgery, but it actually appears worse because everything was also advanced. I'm not sure if that makes any sense or not; it's just a thought.
If both your smile appears crooked and you also favor talking out of one side of your mouth, any chance that could just be muscular? Could you do physical therapy (or something) for that? If you can find a good acupuncturist, and have a little money to throw at the problem, would you be open to acupuncture? I'm not suggesting it's going to fix anything, but it may offer some help/improvement.
Also, from one former athlete to another, yes, eventually you have to care how it feels. You f**king deserve to not be in pain all the damn time. My family jokes that one day I could be dying, and I'll be smiling and laughing saying, "Oh, it's only a flesh wound, it's all good, no worries." I'm just saying that as a friendly, compassionate reminder that being in pain is not normal (referring to chronic stuff, not acute). Anyway, obviously more surgery won't fix numbness, but if you're actually in pain and/or cannot move your mouth properly I think that's a different story.
I'm sure this is hugely subjective, but I think a picture taken straight on will show flaws that people never notice in person. I think that's why most people are inclined to tilt/angle their face for pictures. Maybe your SO (and everyone else) seriously doesn't see the issue when they're talking to you?
Take care :)
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The surgeon was the one who said I had a maxillary cant. TBH I could baaaarely see it preop and even drawing lines on my preop face it seems much milder than it is now.
I was more concerned about the bite and bringing the recessed mandible forward. I had full tooth height show at rest. When I was still dancing I got yelled at by coaches to stop gawking. I just physically could not close my lips thanks. But that's neither here nor there.
I initially thought it would just be lower jaw but every surgeon I saw said I required two jaw surgery and also pushed genio because my chin pretty much didn't exist. Like I said it all makes sense from the profile view but it's jacked up in the front.
He also said what you're saying, that advancement makes things more obvious. Accurate but not comforting. And it emphasized that the cant was not fully corrected as outlined in the surgical plan.
I wish the lower lip was in pain because it might mean the feeling would come back. It's just dead there. The most I feel is sort of that dead fish sensation.
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The surgeon was the one who said I had a maxillary cant. TBH I could baaaarely see it preop and even drawing lines on my preop face it seems much milder than it is now.
I was more concerned about the bite and bringing the recessed mandible forward. I had full tooth height show at rest. When I was still dancing I got yelled at by coaches to stop gawking. I just physically could not close my lips thanks. But that's neither here nor there.
I initially thought it would just be lower jaw but every surgeon I saw said I required two jaw surgery and also pushed genio because my chin pretty much didn't exist. Like I said it all makes sense from the profile view but it's jacked up in the front.
He also said what you're saying, that advancement makes things more obvious. Accurate but not comforting. And it emphasized that the cant was not fully corrected as outlined in the surgical plan.
I wish the lower lip was in pain because it might mean the feeling would come back. It's just dead there. The most I feel is sort of that dead fish sensation.
I hear you. Hopefully the asymmetry is not too perceptible if you don't have the lines etc. drawn on. But yes, it does exist. Again, I'm not sure I'd notice it without the grid superimposed on it. And hopefully the lip will eventually regenerate --it always could. Different modalities such as acupuncture, physical therapy, etc. perhaps they might help? Or of course you could have the surgery redone. I suppose only your surgeon can figure that out. I dunno, maybe another consult would be in order since this clearly bothers you. It's up to you.
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If you're comfortable answering this, can I ask if you had any HA? If so, where was it placed?
Thanks :)
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If you're comfortable answering this, can I ask if you had any HA? If so, where was it placed?
Thanks :)
No HA. At least not augmentary type, there may be some smoothing stuff where the cut the bone on the mandible.
The angles of my jaw...the corners by the ears? I don't remember what they're called were uneven before surgery. Meaning one was higher than the other. The idea was that with my level of asymmetry that evening those out would have also improve the rest. Those corners do look level now but it didn't do much for the overall facial harmony.
If I can answer a question with a question, what are you looking into HA for? :) I'm curious because I've heard good and bad things.
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I hear you. Hopefully the asymmetry is not too perceptible if you don't have the lines etc. drawn on. But yes, it does exist. Again, I'm not sure I'd notice it without the grid superimposed on it. And hopefully the lip will eventually regenerate --it always could. Different modalities such as acupuncture, physical therapy, etc. perhaps they might help? Or of course you could have the surgery redone. I suppose only your surgeon can figure that out. I dunno, maybe another consult would be in order since this clearly bothers you. It's up to you.
I go back and forth. It'd be nice to have the full, honest story.
When things started looking funny it was like "your midlines aren't off [skeletally]....oh fine I'll compare the CT scans to prove it to you...oh wait it looks like we only moved your midlines 0.5mm instead of the 3mm we were supposed to...[long rant about how jaw surgery isn't always exact]...you don't have a cant...look let's do some measurements...well actually you do have a cant it's really not that bad it's just more obvious on your facial structure..."
I don't want to go down a rabbit hole of unhappiness, but I would like SOMEONE to just say straight out what went right, what went wrong, not try to cover their ass and turn me into a hypochondriac.
And god I wish we could just remove the "no one else will notice" phrase from the vocabulary of all medical professionals. I NOTICE and really how can anyone claim they know what everyone else in the whole world will "notice" or not, yeeeesh. (That's not a reference to your comment by the way, I just think it's silly when a doctor tries to speak for the mass population).
I'll look into acupuncture. I did read a paper on pubmed about techniques for nerve regeneration after jaw surgery and did those exercises for a good while...nada...but maybe acupuncture is different. I don't know much about it except it involves needles or something.
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Correct me if I'm wrong, but it sounds like your surgeon has been pretty honest with you when it comes to evaluating the result. Most surgeons would never in a million years admit that anything was wrong.
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Correct me if I'm wrong, but it sounds like your surgeon has been pretty honest with you when it comes to evaluating the result. Most surgeons would never in a million years admit that anything was wrong.
Most surgeons would never in a million years admit they were wrong? Wow. Scary thought. That's really how it is?
I just meant that I had to fight over every single little thing to even get him to LOOK at the pre and post op and not just say things were wonderful. But clearly I'm expecting too much honesty(?) from doctors.
The conversations went like this:
Me: I think this is off/wrong/incorrect
Surgeon: No it looks great
Me: Really I do
Surgeon: I'll prove to you that it's fine
Surgeon: Oh wait.
Surgeon: Okay so it's not but no one will notice!
Repeat x10
You're right, he's not being outright dishonest just clearly not wanting to notice flaws in his own work. In my career(s) you don't get better unless you notice flaws and you are admitting these to other people ALL THE TIME. I guess I have no idea how a sleazier surgeon would respond.
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Maybe make your surgeon to concentrate on fixing leveling the bite. Ching wing osteotomy and implants later to fix the skeletal asymmetry. (Pretty sure your surgeon does not do the latter.)
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That's a cop out. People don't notice things consciously, but on the subconscious level they sure do. Consciously it's "looks good, doesn't look good".
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You're right, he's not being outright dishonest just clearly not wanting to notice flaws in his own work. In my career(s) you don't get better unless you notice flaws and you are admitting these to other people ALL THE TIME. I guess I have no idea how a sleazier surgeon would respond.
My surgeon walked out of the room and refused to come back when I questioned the result. Based on what I've heard from other people, this kind of behaviour from surgeons seem to be the norm. If your surgeon is who I think it is then I'm guessing that a revision will cost around 20k USD. Why can't the surgeon pay for that himself? It's his mess after all...
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If I can answer a question with a question, what are you looking into HA for? :) I'm curious because I've heard good and bad things.
I'm still deciding on a surgeon (I've narrowed it down to two), and one of them uses HA (Gunson). I too have heard good and bad, and am pretty stuck with the whole decision making process. I think I'm fine if it does nothing, but I'm afraid of it resorbing unevenly down the road.
Thanks for your response!
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They can do a lot with cosmetic dentistry to hide uneven bite/teeth issues. You could look into gum contouring/tooth bonding/equilibration to mask some of the bite issues.
I'm not certain you're drawing the vertical line correctly; it doesn't seem to fall center between the lower teeth...if it did you'd prob see less of a discrepancy. Also, teeth themselves can be variable in size and shape which is also modifiable via cosmetic dentistry.
I went with Arnett and my result is not perfect and I too have some asymmetry issues. I also lost 2 teeth and will need to get root canals. Also, my tmjs are in terrible shape after having gone through surgery...but overall it was a win as my airway expanded by 4x and my face is much more balanced esp in profile. Basically, I suggest you not get the surgery redone. Besides more numbness you could lose viability in a few teeth, suffer tmj breakdown plus the downside of putting your body through general anesthesia and surgery again. I know this is a really personal decision but I do strongly believe you can mask many of those dental issues with cosmetic dentistry.
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Sorry if I've missed something, I haven't read every post on this thread.
I have asymmetry about as bad as you and have had jaw surgery. It didn't really get better. But, analyzing the problem, doesn't it start further up on your face?
(https://dl.dropboxusercontent.com/u/59152504/JBMarkings.jpg)
Doesn't the asymmetry start too high up for a BSSO to address this problem? Just looking at the angles (it's the same on me), wouldn't they have to realign the entire mandible to truly fix the asymmetry?
Maybe I'm way off.
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That's not her. ;D
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Ah my bad, well if it looks similar then my point still stands :)
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Sorry if I've missed something, I haven't read every post on this thread.
I have asymmetry about as bad as you and have had jaw surgery. It didn't really get better. But, analyzing the problem, doesn't it start further up on your face?
(https://dl.dropboxusercontent.com/u/59152504/JBMarkings.jpg)
Doesn't the asymmetry start too high up for a BSSO to address this problem? Just looking at the angles (it's the same on me), wouldn't they have to realign the entire mandible to truly fix the asymmetry?
Maybe I'm way off.
The purple pic is me. I'd be curious to see you do that on that pic and see if my asymmetry does begin further up the face. It's becoming a little too difficult for me to analyze my own pics objectively.
I had double jaw surgery and was under the impression they could angle the cut and realign the maxilla and the mandible to level out. Are you saying the eyes aren't level? I'm pretty sure my eyes are fairly straight across. The asymmetry seems to begin near the base of my nose.
I was told postop that getting my CHIN on center was not going to be possible without an implant, but that I shouldn't still have a visible cant in my bite.
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They can do a lot with cosmetic dentistry to hide uneven bite/teeth issues. You could look into gum contouring/tooth bonding/equilibration to mask some of the bite issues.
I'm not certain you're drawing the vertical line correctly; it doesn't seem to fall center between the lower teeth...if it did you'd prob see less of a discrepancy. Also, teeth themselves can be variable in size and shape which is also modifiable via cosmetic dentistry.
I went with Arnett and my result is not perfect and I too have some asymmetry issues. I also lost 2 teeth and will need to get root canals. Also, my tmjs are in terrible shape after having gone through surgery...but overall it was a win as my airway expanded by 4x and my face is much more balanced esp in profile. Basically, I suggest you not get the surgery redone. Besides more numbness you could lose viability in a few teeth, suffer tmj breakdown plus the downside of putting your body through general anesthesia and surgery again. I know this is a really personal decision but I do strongly believe you can mask many of those dental issues with cosmetic dentistry.
Thanks for your input.
I drew the line between my midlines on the upper midline only. The teeth on the upper jaw are at more of an angle than the lower jaw. The upper and lower midlines aren't entirely lined up with each other (though they're both not centered with the skull line).
Did your OS mention the possibility of your condyles(?) not being seated properly during surgery?
Mine said it's possible when everything softens up under anesthesia that things get unseated during the cutting. And I guess it's not entirely preventable..or fixable if it unseats midway through surgery?
(TBH I don't really understand what all this joint seating talk is, I can't visualize it, but I guess it makes things uneven).
About the cosmetic dentistry, did you just go to a dentist then and not an ortho? I have seen on the Archwired board that some orthos do TADs and can actually shift the whole arch over a few millimeters which would fix the midline issue and then some cosmetic dentistry could mask the slant I guess.
I just don't want to do a ton of bonding, veneers, shaving because my teeth are actually in really good shape. I'd rather anchor everything and pull it over and have a little 3mm empty spot in the back of my mouth on one side, but maybe that's a stupid thing to do.
I'm really sorry to hear about you losing teeth in the process :(( And the TMJ.
I think my joints survived but I did have terrible earache type pain for a good 3 months after.
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I man treeneval went with on of the best surgeons in the world too and admits a bunch of problems. So you can see this surgery is inherently risky. If you don't have bite issues I'd leave it alone frankly.
Treeneval, do you have numbness too?
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I man treeneval went with on of the best surgeons in the world too and admits a bunch of problems. So you can see this surgery is inherently risky. If you don't have bite issues I'd leave it alone frankly.
Treeneval, do you have numbness too?
Laz you're still preop right? Do you know who you're going with / what you're having done?
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Laz you're still preop right? Do you know who you're going with / what you're having done?
Oh man, I'm so confused. So like there's Dr. S. I've ruled him out cause his partner is a f**king rat and he's sloppy it seems. Then I consulted with Arnett who was incredibly thorough, but sort of rubbed me the wrong way a bit, he kind of dismissed some of my aesthetic concerns as being "well the surgery is unpredictable if you're nitpicking about these types of things I don't think you'd be a good candidate for me" type of line --which perhaps he was being incredibly honest. I need a bi-max at the very least (advancement i'm class II). Then I've consulted with Keller at Mayo who I'm not going with but he offered me a modified lefort II which could advance the under eye area too (both the zygoma and the orbital rim). But for various reasons I don't want surgeery with him and have ruled him out. So now I'm really only left with Sinn, whom Earl had a "good" experience overall with, but it also feels like a bit of a default decision. I want jaw and cheekbone advancement and that makes my options very narrow. Yeah so that's my stance right now. Oh, I also consulted online with Mommaerts who offered a bunch of stuff and said he could do everything, but whose results I have not seen really and whom everyone here has had a really bad experience with!
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Thanks. I do have some minor issues but really, I'm very happy I had this done; the improvement to my looks helped my confidence so much and now I won't have sleep apnea like my dad does :/ The root canals don't bother me too much but my tmj issues do. I am still on medications to help stabilize my joints that I want to come off of (I hate being on any medication; I'm weird like that) so I'm just kindof waiting for them to get better. I have clenched my whole life and I've sortof had to learn not to do that anymore for the sake of my bite stability. It's not easy to unlearn that kind of muscle memory but I've gotten better.
I don't blame you for not wanting to put decent teeth through more trauma. I personally do not want to get veneers because they shave down decent teeth to put them on (blech!). But gum contouring and whitening I will probably do in a few more years. I'm still paying off this "Ferrari-jaw" as you phrased it, lol!
Numbness wise, just my chin and lower lip. It can be annoying but it doesn't bother me that much.
Lazlo, good luck doing whatever you decide. I know you've been at this for a while.
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Thanks. I do have some minor issues but really, I'm very happy I had this done; the improvement to my looks helped my confidence so much and now I won't have sleep apnea like my dad does :/ The root canals don't bother me too much but my tmj issues do. I am still on medications to help stabilize my joints that I want to come off of (I hate being on any medication; I'm weird like that) so I'm just kindof waiting for them to get better. I have clenched my whole life and I've sortof had to learn not to do that anymore for the sake of my bite stability. It's not easy to unlearn that kind of muscle memory but I've gotten better.
I don't blame you for not wanting to put decent teeth through more trauma. I personally do not want to get veneers because they shave down decent teeth to put them on (blech!). But gum contouring and whitening I will probably do in a few more years. I'm still paying off this "Ferrari-jaw" as you phrased it, lol!
Numbness wise, just my chin and lower lip. It can be annoying but it doesn't bother me that much.
Lazlo, good luck doing whatever you decide. I know you've been at this for a while.
Damn treeneval, so entire lower lip and chin has no feeling!? I mean Arnett told me that maybe 3 patients from his entire practice have ever had lasting numbness. What's the deal with that? Is he just a liar?
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It's not completely numb, just tingly and kinda strange still. I don't expect it to get much better as it's been almost 2 years since surgery though. From what I understand, the lower lip/chin lack of full feeling seems to be pretty standard. Most people I've talked to had the same issue. I accepted it as a strong possibility going in.
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It's not completely numb, just tingly and kinda strange still. I don't expect it to get much better as it's been almost 2 years since surgery though. From what I understand, the lower lip/chin lack of full feeling seems to be pretty standard. Most people I've talked to had the same issue. I accepted it as a strong possibility going in.
Has it changed the pleasure you take in kissing?
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Has it changed the pleasure you take in kissing?
I have the same partial numbness on my lower lip and chin but If I can also answer the question, it hasn't had any negative effect on enjoying kissing :). Now if my upper lip was also partially numb, that would s**tty.
To the OP, I believe we had the same surgeon and if you look at my thread in the overbite forum, I have the same asymmetry post-surgery. PM if you like.
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I have the same partial numbness on my lower lip and chin but If I can also answer the question, it hasn't had any negative effect on enjoying kissing :). Now if my upper lip was also partially numb, that would s**tty.
To the OP, I believe we had the same surgeon and if you look at my thread in the overbite forum, I have the same asymmetry post-surgery. PM if you like.
Thanks for the response. Jesus Christ this numbness issue is disturbing me but it sounds like it's the norm. Why do these surgeons say "15 percent" chance or "20 percent chance" is that like a global statistic and all their patients are part of the bloody 20 percent?
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I think they mean 100% numbness as in like it feels when you get straight out of surgery.
If I'm going to be really technical about it I would probably say I'm 90% numb with no tingling which is worse than most.
In my view even something like 50% numb is still NUMB but I don't think that's how surgeons report the stats. Anyone who can kinda feel or still has tingles is shoved into the "not numb" or "slightly altered sensation" category.
Also so many people say "yeah I'm still kinda numb so but it doesn't bother me". But that's all subjective perception...so you get this idea that most people come out with full feeling or close to it when really they're only half there and just learned to ignore it.
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Has it changed the pleasure you take in kissing?
I wouldn't say so, no. But then again, I didnt do much kissing before surgery...I was more shy and awkward lol.
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I wouldn't say so, no. But then again, I didnt do much kissing before surgery...I was more shy and awkward lol.
awww that's cute!
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awww that's cute!
:D
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The purple pic is me. I'd be curious to see you do that on that pic and see if my asymmetry does begin further up the face. It's becoming a little too difficult for me to analyze my own pics objectively.
I had double jaw surgery and was under the impression they could angle the cut and realign the maxilla and the mandible to level out. Are you saying the eyes aren't level? I'm pretty sure my eyes are fairly straight across. The asymmetry seems to begin near the base of my nose.
I was told postop that getting my CHIN on center was not going to be possible without an implant, but that I shouldn't still have a visible cant in my bite.
I see your pic, but it isn't really possibly to do a meaningful analysis on it. It would need to be straight on and further away.
Lazlo: I'm pretty sure the lower lip always has some sort of residual numbness/stiffness - I have heard way too many accounts of it. It isn't the actual lip, it's the area where they make the incision inside the mouth and mostly affects the larger lower lip movements.
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FWIW, seeing posts like these make me nervous but also likely more tolerant to such problems down the line. There's really not much you can do, right? So you're preparing people for the realities of this surgery and thank you for that.
But we're touching on a new point worth mentioning. Less work is better. Everything a surgeon does has real risks so you want him to be conservative. Ideally, you have a guy who has enough experience to understand how to balance the two since you don't want more surgeries either. I'm likely opting out of genioplasty, for example, because opinions vary on whether it's good aesthetically and I'm accustomed to it already but it's associated with numbness in the region.
Local guys tend to excel here because they don't have a lot of confidence in this area. Another advantage to them is they don't need to wing their surgeries either, they can actually practice models in advance. They can react more quickly to problems. The flip side is they know less so can't handle complex cases well. My opinion is to keep routine cases local and send only complex ones to experts. It's the same philosophy with all medical care really.
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AFAIK, there is a markedly higher chance of persistent lower lip numbness when a BSSO is combined with a genioplasty.
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Lazlo: I'm pretty sure the lower lip always has some sort of residual numbness/stiffness - I have heard way too many accounts of it. It isn't the actual lip, it's the area where they make the incision inside the mouth and mostly affects the larger lower lip movements.
FWIW, my upper lip is pretty stiff and gets tired quickly from smiling and talking. My surgeon said it's the scar tissue and it takes a while to dissipate.