And it's official - Surgery on the 7th! (Updated)

[Icy]

Hi again all!

So I have officially got my surgery date, and I will be going in on the 7th of December. I have my final consultation with my surgeon on the 23rd, at which we will discuss the surgical movements again and also decide whether it will be bimax or just BSSO. Is there anything I ought to bring up with my surgeon at the final consultation? My ortho is definitely favouring bimax, but at our last appointment my surgeon didn't seem too keen on it, so I'm hoping that doesn't cause any issues. I think with the proposed movements I will probably land up having bimax, but anyways. Does anyone know if going BSSO only would worsen downturned lips at all? I'm starting to get rather pronounced lines there despite my young age and good skincare... :/ in any case, I'm so happy that it's finally going to happen, this has been such a long road!

[CCW]

You need bimax for optimal results. It would give you better lip support, make your face appear slightly wider and straighten your profile. You should just tell your surgeon you want both jaws done because doing only the lower jaw would be a compromise.

[Icy]

Those were my thoughts too, I still don't totally like my upper tooth show, so I would prefer a slight forward movement which would improve that, I just worry a little bit about my midfacial area getting left behind as I do have quite deep tear troughs and dark shadows under my eyes, but I guess that's a problem for another time. 

You need bimax for optimal results. It would give you better lip support, make your face appear slightly wider and straighten your profile. You should just tell your surgeon you want both jaws done because doing only the lower jaw would be a compromise.

[PloskoPlus]

Single jaw surgery is almost always a compromise. I know this from experience.

I don't understand why you don't see reyneke even for a second opinion. He's world class. Jaw surgery is not a hair cut, it's an ordeal. Has your surgeon even showed you before and afters of cases like yours? Don't get snowed by "best guy in town", "does more surgeries than anyone". I was and I regret it. Max fac is a huge field. They count everything as surgery - pulling teeth, dental implants, you  name it. You want the surgeon who mostly doess orthognathic surgery and has the results to show.

[Icy]

In all honesty Plosko, I'm not sure how much Reyneke's name means. I made a friend this year, never knowing that she had had bimax already; however, when I told her that I was going to have it this December the first words out of her mouth were "you're not with a Dr named Reyneke are you?". She had surgery with Reyneke and it seems that it was a pretty bad job from what she told me. She said she had never had such a bad experience with a surgery, and at this point her result has actually relapsed to the point that she looks about the same as I do, I haven't seen what she looked like after her surgery but I trust her word.
I trust my orthodontist, she has been with me through every step and specifically selected my surgeon due to his skills with TMJ issues and his focus on achieving optimal facial balance because she knows how sensitive I am about my appearance. My roommate had surgery already this year, not with my surgeon but with the other surgeon that my ortho works with, and she looks great and is healing well, so I can't see there being any issues with my surgeon as my ortho is truly face-focused and helped me push for jaw surgery even though my case was borderline. I'm well aware of the risks with jaw surgery, I've been researching this for a long time, but I also want to get this over with and move on with my life.

In any case, I'm going to be very clear with my surgeon at our next consultation, as it has been quite a while since he last saw me and my teeth have moved a lot so perhaps he'll be less inclined towards BSSO only.

Single jaw surgery is almost always a compromise. I know this from experience.

I don't understand why you don't see reyneke even for a second opinion. He's world class. Jaw surgery is not a hair cut, it's an ordeal. Has your surgeon even showed you before and afters of cases like yours? Don't get snowed by "best guy in town", "does more surgeries than anyone". I was and I regret it. Max fac is a huge field. They count everything as surgery - pulling teeth, dental implants, you  name it. You want the surgeon who mostly doess orthognathic surgery and has the results to show.

[PloskoPlus]

In all honesty Plosko, I'm not sure how much Reyneke's name means. I made a friend this year, never knowing that she had had bimax already; however, when I told her that I was going to have it this December the first words out of her mouth were "you're not with a Dr named Reyneke are you?". She had surgery with Reyneke and it seems that it was a pretty bad job from what she told me. She said she had never had such a bad experience with a surgery, and at this point her result has actually relapsed to the point that she looks about the same as I do, I haven't seen what she looked like after her surgery but I trust her word.
I trust my orthodontist, she has been with me through every step and specifically selected my surgeon due to his skills with TMJ issues and his focus on achieving optimal facial balance because she knows how sensitive I am about my appearance. My roommate had surgery already this year, not with my surgeon but with the other surgeon that my ortho works with, and she looks great and is healing well, so I can't see there being any issues with my surgeon as my ortho is truly face-focused and helped me push for jaw surgery even though my case was borderline. I'm well aware of the risks with jaw surgery, I've been researching this for a long time, but I also want to get this over with and move on with my life.

In any case, I'm going to be very clear with my surgeon at our next consultation, as it has been quite a while since he last saw me and my teeth have moved a lot so perhaps he'll be less inclined towards BSSO only.

Wow, I had no idea. Reyneke lectures with Gunson.  It's just that I went through single jaw surgery and while the bite is solid, the aesthetic result is not great.  It sounds like you surgeon is very much like mine - get a class I occlusion with the least movement possible, however it looks on the outside.  I really have no recourse to complain because... class I!  If you TMJ and bite are the only problems and your surgeon is not comfortable doing double jaw surgery just for cosmetic reasons, I would do single jaw surgery.  Vertical changes to the face can have the most impact on the face for better or worse.  Maxillary surgery is basically hard (or just an aesthetic crapshoot) unless very small movements are made.  You may come out looking worse.  And tooth show is also a function of  lip length.  A good lip lift (they do exist) may be all you need.

[Icy]

A small update before my next consultation next week: looks like I'll be having LF1 and BSSO, I just need to have one more consultation with my orthodontist to make sure my teeth are all in position and then my surgeon will go into detail about the specific movements. He confirmed that I have a canted upper jaw which will be corrected, and that performing the LF1 will give me a better more forward smile and lip support, so I'm happy. More to follow on Tuesday!

[Icy]

Final update before my surgery! My final meeting with the surgeon went very well! He explained everything to me in detail, what to expect before and after surgery, and luckily for me he's a firm believer in alllll the pain meds so I won't be uncomfortable. The proposed movements for the LF1 are 3mm forward and down, with more movement on the left to mitigate my upper jaw cant. He said he'll make sure my nose doesn't upturn or widen, so I'm also happy about that, I don't fancy the piggy look! For the BSSO, he'll be bringing my lower jaw 5mm forward and rotating it to address my deep bite. From what I gathered from the simulation he showed me, the rotation will be clockwise, so I'll finally have complete upper tooth show! I'm so excited, but also super nervous! Had my hooks put on today and final impressions made - everything is set, I just have to wait now!

[molestrip]

Reyneke has a textbook I think, I've skimmed parts of it and he's a smart guy. Can't comment on his surgical skill. All surgeons have unhappy patients, relapse happens even to the best of them.

[Icy]

Reyneke has a textbook I think, I've skimmed parts of it and he's a smart guy. Can't comment on his surgical skill. All surgeons have unhappy patients, relapse happens even to the best of them.

Funny thing I just found out, it turns out that my uncle has worked extensively with Reyneke - he told me on Saturday that he's semi-retired now. Even if he was within my budget lol, my orthodontist only works with two surgeons and I'm comfortable with her choice of surgeon after our consultation on Tuesday, as well as after speaking with my uncle who is familiar with my surgeon and his work. He said he's a great surgeon and I shouldn't be worried about the osteotomies, so I'm really not feeling too anxious about that. The wait is killing me though! I can't believe after over a year of waiting it's going to happen at last!