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General Category => Functional Surgery Questions => Topic started by: UKMaxfac on January 03, 2017, 09:37:19 AM

Title: Nasal surgery at the same time as Bimax?
Post by: UKMaxfac on January 03, 2017, 09:37:19 AM
When I saw Joel Defrancq and a UK surgeon they both said that if needs be, they could put spreader grafts in at the same time as performing Bimax.
My first instinct was a 'hell no' because the thought of them having to put the breathing tube into a mouth that's just undergone bimax a matter of minutes before seems insane... and perhaps that will make the swelling and recovery even longer / worse.

Does anyone have any insights into this? Is it worth doing? (bear in mind I have compromised breathing following a rhinoplasty 1 year ago) Has anyone done it?
Title: Re: Nasal surgery at the same time as Bimax?
Post by: diculo on January 03, 2017, 12:30:24 PM
What are the grafts for?
Title: Re: Nasal surgery at the same time as Bimax?
Post by: UKMaxfac on January 03, 2017, 02:00:08 PM
What are the grafts for?

For whatever reason (I'm unclear) despite my septum being realigned (not perfectly but atleast improved) i have compromised breathing post-op.
The spreader grafts are to widen the dorsum and open up the nasal valves so they don't constrict when I breathe in.

At least I think thats what they do... I'm not an expert on rhinoplasty by any means.
Title: Re: Nasal surgery at the same time as Bimax?
Post by: ditterbo on January 03, 2017, 03:15:56 PM
Well this is anecdotal (me) but spreader grafts, septoplasty, turbinate reduction.. the works has made my breathing WORSE than it was pre-op. This was a standalone rhinosepto.  I've read of other people who just don't get breathing improvement from these surgeries, and some even get it worse.  Supposedly my voice turned more teenager raspy sounding as well.  But also read people breathe better from nasal surgery during bimax (eg Posnick people).  Do you have a bleeding disorder or just prolonged bleeding in general to things? I think I do so I personally would want to just opt out of nasal surgery at time of bimax. 
Title: Re: Nasal surgery at the same time as Bimax?
Post by: UKMaxfac on January 03, 2017, 03:43:27 PM
Well this is anecdotal (me) but spreader grafts, septoplasty, turbinate reduction.. the works has made my breathing WORSE than it was pre-op. This was a standalone rhinosepto.  I've read of other people who just don't get breathing improvement from these surgeries, and some even get it worse.  Supposedly my voice turned more teenager raspy sounding as well.  But also read people breathe better from nasal surgery during bimax (eg Posnick people).  Do you have a bleeding disorder or just prolonged bleeding in general to things? I think I do so I personally would want to just opt out of nasal surgery at time of bimax.

Oh god... ok thanks for telling me at least.
Did they narrow the nose significantly? Any damage at the nasal valves?
Title: Re: Nasal surgery at the same time as Bimax?
Post by: kjohnt on January 04, 2017, 12:10:53 AM
IDK s**t about nose surgery so take this fwiw, but personally, I would definitely wait until jaws are healed first.  You can then analyze nose function (and appearance if that's part of it) without the extra variables.
Title: Re: Nasal surgery at the same time as Bimax?
Post by: brian626 on January 26, 2017, 12:37:27 AM
Ive had septoplasy and it's impossible to breathe through your nose. I don't think you'll be able to breathe very well through your mouth after jaw surgery either. if you think you can endure it then doing both would be more convenient than separately, but be prepared for hell
Title: Re: Nasal surgery at the same time as Bimax?
Post by: Lord-of-the-Cartilage on January 26, 2017, 12:43:20 AM
Am I right in thinking that spreader grafts can widen the nostrils?
I want my nostrils to flare like a neanderthal.
Title: Re: Nasal surgery at the same time as Bimax?
Post by: PloskoPlus on January 26, 2017, 02:17:43 AM
Am I right in thinking that spreader grafts can widen the nostrils?
I want my nostrils to flare like a neanderthal.
Lol. I have that and jaws well ahead of my brow ridge too.
Title: Re: Nasal surgery at the same time as Bimax?
Post by: Jbird on January 26, 2017, 08:19:20 AM
Dr. Wolford recommended for me to do all at once plus a UPPP at the same time for severe sleep apnea.  I went ahead and got my nose done while I'm waiting for bimax, partly because I had the same concern as you about breathing after the surgery.  But I got septoplasty and turbinate reduction done and results are amazing.   I can breathe through my nose perfectly now which makes it easier to use CPAP.
Title: Re: Nasal surgery at the same time as Bimax?
Post by: Lord-of-the-Cartilage on January 26, 2017, 08:29:28 AM
Lol. I have that and jaws well ahead of my brow ridge too.

I know, I want to look like you, I think I said that a while ago. We always want what we don't have  ;D
Title: Re: Nasal surgery at the same time as Bimax?
Post by: UKMaxfac on January 26, 2017, 12:18:55 PM
Dr. Wolford recommended for me to do all at once plus a UPPP at the same time for severe sleep apnea.  I went ahead and got my nose done while I'm waiting for bimax, partly because I had the same concern as you about breathing after the surgery.  But I got septoplasty and turbinate reduction done and results are amazing.   I can breathe through my nose perfectly now which makes it easier to use CPAP.

Wow... lucky for you. I got septorhinoplasty and I can barely breathe now. No explanation from ENT's / other surgeons either. Life is a living hell.
Title: Re: Nasal surgery at the same time as Bimax?
Post by: JimmyTheGent on January 26, 2017, 01:17:31 PM
Wow... lucky for you. I got septorhinoplasty and I can barely breathe now. No explanation from ENT's / other surgeons either. Life is a living hell.

I had my septum straightened and my turbinates reduced.  Before surgery I could only breath out of the right nostril about 60% with the left fully blocked.  After surgery and an additional cauterization of my right turbinate I can now only breath out of my left nostril and my right is fully blocked.  The ENT's have no explanation for this for me either.   WTF??? Sounds like we are in the same boat!
Title: Re: Nasal surgery at the same time as Bimax?
Post by: Lord-of-the-Cartilage on January 26, 2017, 01:56:29 PM
My surgeon was going to reduce my turbinates but I got scared off by reading about empty nose syndrome, perhaps this is what you both have.
Title: Re: Nasal surgery at the same time as Bimax?
Post by: JimmyTheGent on January 26, 2017, 01:58:20 PM
My surgeon was going to reduce my turbinates but I got scared off by reading about empty nose syndrome, perhaps this is what you both have.

I didnt even know what ENS was at the time or I would never have let the second ENT do a cauterization after my 1st turbinate reduction. 
Title: Re: Nasal surgery at the same time as Bimax?
Post by: ditterbo on January 26, 2017, 03:27:03 PM
I don't understand how not being able to breathe post septo, etc can't be diagnosed by ENT's. There's CT scans of the septum, nasal endoscopies, etc.  that can show you everything that could be in the way.  Granted not every ENT is that observant, as I've seen first hand.

For me, the current explanation is the septorhino created a bone spur that jutted out the septum on the left side.  Both turbinates are moderately enlarged post radio beam reduction (forgot it's name). The 3D CT scan shows that my whole nose opening area is also just narrow in general.  So I can't breathe well out of either nostril, especially on the left.
Title: Re: Nasal surgery at the same time as Bimax?
Post by: UKMaxfac on January 27, 2017, 03:13:36 AM
I don't understand how not being able to breathe post septo, etc can't be diagnosed by ENT's. There's CT scans of the septum, nasal endoscopies, etc.  that can show you everything that could be in the way.  Granted not every ENT is that observant, as I've seen first hand.

For me, the current explanation is the septorhino created a bone spur that jutted out the septum on the left side.  Both turbinates are moderately enlarged post radio beam reduction (forgot it's name). The 3D CT scan shows that my whole nose opening area is also just narrow in general.  So I can't breathe well out of either nostril, especially on the left.

I don't know what to say either. Surgeon said he could put spreader grafts in but he doesn't know if it will help.

Here is what I know:
He said the surgery was very complex
He said that the vomer was 'corrected'
He made an intra-oral incision to move the septum onto the midline.

When I breathe in it's like an active action now, not a passive one, I actually have to think 'ok I should breathe now' - but admiteddly it's worse when my mind is focused on it. I don't tend to have trouble breathing when sleeping.

The recovery from the surgery was absolutely brutal. I couldn't believe how painful it was considering what I'd read. Most people were like 'Just had rhino, feeling good!' or 'Went back to work today, had surgery 2 weeks ago', meanwhile even walking around was painful for me 4 weeks post. I had thick wide gauze pads stuffed up in my nose for over a week post-OP which felt incredibly raw and painful, but with almost no bruising anywhere else. My mouth and nose felt extremely sore and sensitive for over 6 months post and the tip is still pretty numb over one year post-OP.

I posted images on realself and got the response that the nose had been 'over-corrected', that the nostrils had retracted and the cartilages had been generally weakened (something about dorsal attachments being weakened as well).

I met with the surgeon to address these concerns but he was very unhelpful. He firstly said he didn't narrow the nose, which is a flagrant lie. Then he told me he hadn't touched the nasal valves. Then he told me even if he HAD narrowed it, that is nothing to do with my laminar airflow and breathing volume, and that the tugging or pulling feeling is just 'a sensation'.

I tried using a neti pot recently - a thing full of salt and warm water that you stick up one side of your nose then allow it to fall out of the other nostril. I used to use it before the operation to relieve congestion, but now the water seemingly gets 'stuck' somewhere - it doesn't fall out of the other side of the nose much, if at all. There must be some sort of blockage up there, or he made the lateral osteotomies too aggressively and displaced the nasal bone, im sure.

Its a royal pain in the ass. I just wanted a straight aesthetic nose.

ALSO - having the surgery changed my whole facial shape - it's gotten shorter and the soft tissues look different everywhere (worse).