jawsurgeryforums.com
Before/After Photos => Overbites => Topic started by: Langpam on December 01, 2014, 06:16:55 AM
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Photo 1: 2 hours before surgery on 12 Nov 2014
http://imgur.com/6fzp8BM
Photo 2: 6 days post op
http://imgur.com/SVJ3yEv
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Just to put my last post into context:
I started looking on this site some months ago and given that the members are generally in their 20s or 30s I wasn't sure it was going to be useful.
However I did actually get the name of the surgeon I ultimately chose from a discussion on this site albeit a negative one!! Some of the criticisms such as short surgery time, actually appealed to me, given that I am over 60... The last thing I wanted was a lengthy operation.
And since the aim of the surgery was to cure my sleep apnoea I am over the moon with the result.
I look different now, younger and with a great profile.
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What told your Doctor about micro / mini-plates ? You have to remove them in few years ?
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What told your Doctor about micro / mini-plates ? You have to remove them in few years ?
Unless they cause trouble - become visible because the skin is thin, get infected,etc., they stay in place.
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Photo 1: 2 hours before surgery on 12 Nov 2014
http://imgur.com/6fzp8BM
Photo 2: 6 days post op
http://imgur.com/SVJ3yEv
do you have full sensation or tingling at least in your lips/chin?
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Rico, as PloskoPlus said, the doctor said the mini plates and screws would stay unless there were an infection, though he said that is rare.
Lazio, I have full sensation everywhere except in my lower lip and chin. The chin has been tingling since week 1.
I posted another photo, 20 days post op, though I got the angle slightly wrong ( on another thread)
What do you think? I'm very happy and people actually tell me it has taken 20 years off my look!!
http://imgur.com/7C9TpKw
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Just to put my last post into context:
I started looking on this site some months ago and given that the members are generally in their 20s or 30s I wasn't sure it was going to be useful.
However I did actually get the name of the surgeon I ultimately chose from a discussion on this site albeit a negative one!! Some of the criticisms such as short surgery time, actually appealed to me, given that I am over 60... The last thing I wanted was a lengthy operation.
I look different now, younger and with a great profile.
Thanks for posting here. It's somewhat re-assuring seeing older people go through this procedure. I agree with minimizing the time spent under general anesthesia.
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Rico, as PloskoPlus said, the doctor said the mini plates and screws would stay unless there were an infection, though he said that is rare.
Lazio, I have full sensation everywhere except in my lower lip and chin. The chin has been tingling since week 1.
I posted another photo, 20 days post op, though I got the angle slightly wrong ( on another thread)
What do you think? I'm very happy and people actually tell me it has taken 20 years off my look!!
http://imgur.com/7C9TpKw
When it comes to foreign objects in the body I'm afraid of cancer. But at the same time cancer may develope even when You do not have any metal inside ;)
BUT........ Your bones changes a little untill death. The installed metal not. So there is kinda risk that small deformation may occour in the future. I've read article about this problem. What about this issue ? Probably Doctor didn't tell :) Perhaps ask him...
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I did all the research on the topic well before committing to this surgery. My son is also a doctor and was able to support me throughout.
In terms of risk assessment, Rico, it's possible to be hit by a car or a bus, but if you thought about this possibility too much you would never go out.
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I did all the research on the topic well before committing to this surgery. My son is also a doctor and was able to support me throughout.
In terms of risk assessment, Rico, it's possible to be hit by a car or a bus, but if you thought about this possibility too much you would never go out.
Sorry, I don't know if you saw my question, do you have full sensation (or any sensation at this stage) in either of your lips and chin? I'm trying to figure out how common nerve damage is in this operation. Thanks.
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Lazlo
Rico, as PloskoPlus said, the doctor said the mini plates and screws would stay unless there were an infection, though he said that is rare.
Lazio, I have full sensation everywhere except in my lower lip and chin. The chin has been tingling since week 1.
I posted another photo, 20 days post op, though I got the angle slightly wrong ( on another thread)
What do you think? I'm very happy and people actually tell me it has taken 20 years off my look!!
http://imgur.com/7C9TpKw
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Yes, you look fantastic. It has improved your nose considerably and your whole look. Please do keep posting on your progress! And I'd very much like to know if the lip feeling improves.
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Yes, you look fantastic. It has improved your nose considerably and your whole look. Please do keep posting on your progress! And I'd very much like to know if the lip feeling improves.
Agreed, huge improvement, and it sounds like there was a big functionality improvement too. That's a win win.
It's interesting how it improved her nose, I have a similar nose to her before picture because of my maxillary hypoplasia.
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Agreed, huge improvement, and it sounds like there was a big functionality improvement too. That's a win win.
It's interesting how it improved her nose, I have a similar nose to her before picture because of my maxillary hypoplasia.
Nose will look smaller in profile.
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Fantastic results. How much did it cost you? I'm considering Dr.Alfaro for my surgery.
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One of most dramatic and positive change i have seen! Awesome result!!!
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Thank you Applejuice
Everyone who sees me thinks the same! My husband can't stop looking at me! Sometimes he asks me who I am, ha!
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He's got a younger looking model, no wonder he's pleased! ;D
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Great result. It help restore one faith in what is possible.
Your swelling seems to have went down very quickly! Do you do anything special to acheive that?
Thanks for posting here. It's somewhat re-assuring seeing older people go through this procedure. I agree with minimizing the time spent under general anesthesia.
Forgive my lack of knowledge but is general anesthesia harmful? And more harmful the more of it you have?
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Immediately after surgery until the next morning I wore an ice mask which was operated by an electric machine to maintain a consistent temperature.
Apart from that Arnica cream was applied three times a day for the bruising.
I walked every day for at least twenty minutes, sometimes more, on the advice of the surgeon.
Other than that, nothing.
For me minimally invasive surgery, which is Dr Hernández Alfaro's technique, is preferable.
Less time under anaesthetic, due to the planning, has to have contributed to my speedy recovery, for which I am very grateful.
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Your result is amazing, congrats for making it through :D
Did you have any surgery on your nose or were changes just result of the jaw surgery?
You truely look awesome!!
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Thank you Natalie.
The change to my nose was the result of the advancement of the maxilla.
The first thing the surgeon said to me was that my nose now had support!! I am so happy.
Another surgeon told me at a consultation that he could sort out my big nose ( for a fee) at the same time!
It's generally the first thing people say to me when they see me for the first time since the op.
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Wow that's awesome!
Was it harder than you expected for recovery or about what you thought?
I am having the same surgery next April. I have just recovered from SARPE - expanding my upper pallet by turning an appliance each day, now braces then double jaw surgery.
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Best of luck.
I am one month post op and there are aspects of my recovery that were unexpected, such as the change to my voice and some loss of hearing, but I understand from the surgeon that this is not permanent.
The great bonus for me, apart from the improved look, is the fact that I no longer have sleep apnoea.
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Four weeks post op
http://imgur.com/YcCo8Wh
The surgeon told me at my four week post op appointment that my swelling was 80% gone. I thought it was virtually all gone.
So I've gone from a class 2 malocclusion to a class 1 with the jaws now perfectly aligned and my sleep apnoea cured. Very happy.
Lots of tingling in the chin. Feeling restored everywhere else
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Four weeks post op
http://imgur.com/YcCo8Wh
The surgeon told me at my four week post op appointment that my swelling was 80% gone. I thought it was virtually all gone.
So I've gone from a class 2 malocclusion to a class 1 with the jaws now perfectly aligned and my sleep apnoea cured. Very happy.
Lots of tingling in the chin. Feeling restored everywhere else
One of the best results I've ever seen. Congratulations.
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One of the best results I've ever seen. Congratulations.
I think so too. Congratulations.
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Thank you.
I'm so happy with everything.
Even the bit of earache from doing the jaw exercises is tolerable. Well worth it.
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Do you know the movements? Can you get your cephs?
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The following ceph was taken in Zürich.
http://imgur.com/hos74Zf. The blue indicates a new profile plus you can see how narrow my airways were.
Dr Hernández Alfaro uses 3D cone beam technology. He intends to do the "after" scan at my two month appointment on 8th January.
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nice result. How much did it cost?
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Can't put a price on health. Yesterday, after a two night sleep study, it became official that I know longer suffer from sleep apnoea. Before CPAP and then jaw surgery I had 67 apnoeas an hour with an average length of 25 seconds, in other words very severe obstructive sleep apnoea. Now zero apnoeas.
I converted sterling to euros. Do you want we to tell you how much I paid in sterling?
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Typo in last post
Should read
I NO longer suffer from sleep apnoea
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Dr Alfaro makes smaller incisions than other surgeons so he doesn't have to cut through as much muscle. Hence, less inflammation and quicker recovery of nerve sensation. Looking at your 4 week picture now, it's a great result. Prices are comparable to other top surgeons.
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UPDATE 8 weeks post op
I am very happy to know that my bones have fused ( had a scan at my 8 week post op appointment.
Thought I'd post some more pre and post op photos
1.two hours before the op http://imgur.com/xAHsyb2
2. 8 weeks post op http://imgur.com/b0vgRvf
3.two hours pre op profile http://imgur.com/6fzp8BM
4. 8 weeks post op profile http://imgur.com/nZJ08gQ
Remember I am much older than the rest of you. Hope this has worked!!
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wow you look like a different, more attractive person!
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Thank you, Lazio
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The following ceph was taken in Zürich.
http://imgur.com/hos74Zf. The blue indicates a new profile plus you can see how narrow my airways were.
Dr Hernández Alfaro uses 3D cone beam technology. He intends to do the "after" scan at my two month appointment on 8th January.
Amazing result.
The xray is impressive too. You got alot of rotation there which was of great benefit. If its ok, can i ask was the ramus lengthened? Or where along the mandible was the cut made?
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Amazing result.
The xray is impressive too. You got alot of rotation there which was of great benefit. If its ok, can i ask was the ramus lengthened? Or where along the mandible was the cut made?
No that's her before x Ray with a drawing of her proposed new profile.
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Reply to Balanced:
I am not aware of any lengthening of the ramus.
As Mr Fox said, that was a ceph from a different surgeon, with proposals annotated on it.
My surgery was
1. Bilateral Sagittarius counter-clockwise rotation and mandibular advancement
2. Maxillary osteotomy Le Forte 1 with counter- clockwise rotation
3. Genioplasty
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Ok thanks Fox and Langpam
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Typo
Bilateral sagittal........NOT Sagittarius!!!!
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Typo
Bilateral sagittal........NOT Sagittarius!!!!
You should be able to edit your posts.
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Langpam, do you remember if you were a mouthbreather when you were a child ?
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As far as I can remember I have mainly used my nose to compensate for the narrow airways. So, probably I was not a mouth breather.
I snored badly when I was a child, (so I'm told) and continued to snore as an adult ( my poor husband). Now I don't make a sound when I sleep, but he occasionally snores!!
(I had my tonsils removed when I was nine and I remembered the surgeon asking my mum whether I snored.....)
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I was asking because your jaws grew clockwise (facing the floor) which can be caused by mouth breathing. While snoring is technically mouth breathing, to successfully alter the growth vector of the jaws you would have to be a 24/7 mouthbreather.
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Having reflected on my pre-op breathing, I believe, based on what I was told by an eminent surgeon in the UK that I was indeed a nose breather, one of approx 15% who suffer from severe sleep apnoea, (since 85% are mouth breathers) However, due to my underdeveloped jaw and microgenia, as soon as I lay down to sleep my tongue acted as a stopper and blocked the already narrow airways. Whilst CPAP was effective, only double jaw surgery ( counter clockwise rotation) would cure the apnoea completely. The aesthetic benefits are a bonus.
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Your results are great! I believe that you underwent the surgery without the pre orthodontic work, I was wondering what was your bite like straight after surgery before you were fitted with post surgery braces. I have been told by 2 surgeons that braces would not be required while 2 others have disagreed with this notion completely.
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It's interesting that you had a similar experience. I consulted four surgeons. One said I needed 18 months of orthodontic treatment pre-op, followed by about 9 months post-op, two said I didn't need orthodontics " at my age" as I had a functional bite. The surgeon I opted for said I was a candidate for Surgery First. So I had Invisalign fitted six days before the operation, but did not wear the trays during the operation and for the week immediately afterwards. Instead, the surgeon used screws at the front to keep the jaws in place ( via elastic bands) for eight weeks. Immediately after the operation you are on a liquid diet, gradually moving on to a soft diet. At one week post-op the orthodontist gave me elastics to place onto the molars, to start the process of improving the occlusion.
I can chew with the anterior teeth and I am gradually getting more confidence chewing with the molars, though the occlusion is not quite right yet. ( I am almost ten weeks post-op)
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It is interesting , you got a great result with the benefits of surgery first with a significantly reduced amount of time in braces. Braces can be tough on gums so the less time having to wear them the better. When I questioned one of the surgeons who had proposed surgery without pre orthodontic work , he told me my issue was purely jaw related, my upper jaw had grown a little wayward and it was holding my lower jaw in a more retruded position. He advised that my teeth were good in that there was no overcrowding, no crossbite, no open bite and that both arches were within normal range. He also did not recommend having any surgery on the lower jaw as I had no issue with sleep apnea. The two who proposed lengthy pre braces time were suggesting double jaw surgery. It is interesting that there are so many different opinions out there on this issue.
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One surgeon, whose method was 18 months of braces pre surgery, told me I had beautiful teeth!! I had already worn a brace to straighten my upper teeth about twelve years prior to seeing him. But apparently the teeth move quite quickly post surgery and braces are advisable as a result. But as you say, there are so many different views out there. Since the position of the jaws changes as a result of surgery, I'm guessing that the teeth will also need some guidance into their optimal position. My surgeon had three options: Surgery First, Surgery After and Surgery Only. I was not a candidate for Surgery Only, but maybe you would be. Best of luck with your search.
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Yes, I am from London but spend several months of the year in Spain. I did see Prof Piet Haers who, I'm sure, would have done a great job, but I opted for Dr Hernández Alfaro in Barcelona for a number of reasons.
I particularly liked his short surgery time, due to the 3D cone beam technology which he uses in the planning. These three procedures took less than 2 hours and the recovery was very straightforward.
The other three surgeons were going to take five hours and it would have been necessary to spend five days in hospital ( which makes it very expensive). I spent one night in hospital and a week in a hotel in Barcelona. (€50-70 a night is very different from hospital fees).
I had my consultation with him by Skype and was able to send him my ceph and photos beforehand. His English is amazing and I immediately felt that he was the surgeon for me.
Best of luck with your search and final decision.
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Did he show you before / after photos of his other patients during consultation ? However , because it is typical and "easy" surgery probably you could see it on his web
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I didn't ask to see his Before and After photos as everything is readily available on his website. I asked him how many of these operations he had done and how many people were cured of sleep apnoea. I also asked to speak to someone who had had sleep apnoea before the operation. At the end of the day that was my goal. I had a serious medical condition. As I've said previously, the aesthetic results were a bonus.
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In most countries in Europe serious medical condition is treated for "free" , covered by health insurance. It doesn't work in England ?
I've never asked about this any surgeon, so since your surgery has gone well I'm asking it you - Do you feel scars inside the mouth ? when you touch them by your tongue or any (even tiny) discomfort after this surgery ? (I'm not asking about nerves issue, but all other things)
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In most countries in Europe serious medical condition is treated for "free" , covered by health insurance. It doesn't work in England ?
I've never asked about this any surgeon, so since your surgery has gone well I'm asking it you - Do you feel scars inside the mouth ? when you touch them by your tongue or any (even tiny) discomfort after this surgery ? (I'm not asking about nerves issue, but all other things)
Untreated sleep apnoea is a serious medical condition. The gold standard treatment in the UK for sleep apnoea is CPAP. This treatment ( CPAP) is free. Would you like to be attached to a machine every night?
I do not feel scars inside my mouth, which I find absolutely amazing. I guess there is a small amount of skin I feel behind the molars, but how often does anyone twist their tongue around to explore this part of the mouth??
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Thinking that everyone is gonna have the same surgery and incisions in the same place is not good :)
In my case incision will be above anterior teeth Additionally in my case there is risk I will have 2 surgeries. So the question is how big is that scar ?
For example I have little line in the inner side of the cheek between upper and lower teeth. When I touch this with my tongue I feel this very little line. Do not know if everyone has got something like this, but if you have , then please tell me if such post operative scar is much more sensible ?
Writing this, I realised it's a question for someone after LF1. When somoene after LF1 read this, please put your comment here about this. If such scar above anterior teeth give any discomfort, for example during smiling, etc
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The other three surgeons were going to take five hours and it would have been necessary to spend five days in hospital ( which makes it very expensive).
Five days is what they say to cover their arse. Virtually no-one is kept more than 2 nights. Usually it's only one night.
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Writing this, I realised it's a question for someone after LF1. When somoene after LF1 read this, please put your comment here about this. If such scar above anterior teeth give any discomfort, for example during smiling, etc
Intra-oral scars should be the least of your concerns. They heal fast, and you will probably have numbness at the site of the incision for quite some time.
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Five days is what they say to cover their arse. Virtually no-one is kept more than 2 nights. Usually it's only one night.
What?? I stayed 5 days no way would I have been able to leave after 2 nights
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I stayed for one night. I know that surgeons commonly say you need to stay for five nights. But my surgeon said up front that I would be in for one night.
Mr Fox where and when did you have your surgery?
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Mine was 7 weeks ago in Zurich, I've just realised that your surgery wasn't too long maybe that's why one night was ok? How did you feel the next day?
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I felt fine immediately after surgery and on the next day. Twelve hours after the op I walked from the hospital to the clinic, about six minutes away and from the clinic to the hotel, about 10-15 minutes. I felt fine.
What was your experience like? Are you pleased with your results. Did you travel far to get to Zürich?Are you going to post some pictures?
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Yes like you I'm very happy with the results thanks.
My airways were also narrow, I snored but didn't have sleep apnea now I can sleep on my back and without snoring. I used to wake up about 6 or 7 AM but now I have to set alarm clocks because I sleep so well I just don't wake up lol.
Another positive benefit is that I used to get acid reflux but haven't had it post op so it could have been the narrow airways that were causing it.
Im so shocked that you felt fine after, I had no pain but was quite out of it... I think I had to recover more because the op was 14 hours (my surgeon did some augmentation as well).
I doubt that I'll post photos publicly but might post my experience soon (which was very good).
I'm from the UK but the flight is very quick :)
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OK, that may have been the difference. I had upper jaw surgery only and the operation lasted only 1.5 hours.
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Yes like you I'm very happy with the results thanks.
My airways were also narrow, I snored but didn't have sleep apnea now I can sleep on my back and without snoring. I used to wake up about 6 or 7 AM but now I have to set alarm clocks because I sleep so well I just don't wake up lol.
Another positive benefit is that I used to get acid reflux but haven't had it post op so it could have been the narrow airways that were causing it.
Im so shocked that you felt fine after, I had no pain but was quite out of it... I think I had to recover more because the op was 14 hours (my surgeon did some augmentation as well).
I doubt that I'll post photos publicly but might post my experience soon (which was very good).
I'm from the UK but the flight is very quick :)
Pleased that you are happy with your results. I know you went to a top surgeon ( I also consulted with him in Zürich). I guess if your surgery took so long, it's not surprising you were "out of it". Without wishing to be too personal, it must have cost you a lot of money?? My surgery in Barcelona cost significantly less than the quote I got from the Prof in Zürich.
I also wanted to have less time under general anaesthesia. Like you, I feel so much healthier now and my sleep is sooo much better. I used to have bloating in my stomach ( probably from the CPAP) but that has gone.
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OK, that may have been the difference. I had upper jaw surgery only and the operation lasted only 1.5 hours.
I actually had CCW upper AND lower jaw surgery AND genioplasty. So, quite a lot in less than 2 hours. The surgeon I opted for specialises in reduced surgery times, in order to minimise the after effects ( due to his 3D cone beam planning, so he told me)
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I actually had CCW upper AND lower jaw surgery AND genioplasty. So, quite a lot in less than 2 hours. The surgeon I opted for specialises in reduced surgery times, in order to minimise the after effects ( due to his 3D cone beam planning, so he told me)
This technology is widely available and I don't think it makes much of a difference. It's probably a good crutch for younger, less experienced surgeons. What makes a big difference is how well practiced the surgeon is. The more surgeries he does, the faster he operates. That's it.
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This technology is widely available and I don't think it makes much of a difference. It's probably a good crutch for younger, less experienced surgeons. What makes a big difference is how well practiced the surgeon is. The more surgeries he does, the faster he operates. That's it.
This may be the case, but I consulted with 4 surgeons and Dr Hernández Alfaro was the only one who used this technology. But you're right, he is extremely experienced and has done thousands of these operations.
I read that it's not advisable for younger, less experienced surgeons to use this technology, and definitely not as a crutch. It is only advisable when the surgeon is in fact experienced.
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amazing result how much advancement did you get?
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That result is astonishing! You must be over them moon.
Can I ask how many degrees your mandibular angle is - looks about 45 deg.?