Post Surgery for Le Fort 1 with pictures your feed back welcomed

[backward lowerjaw]

Hi,

I a new here.  I had le fort 1 Surgery 7 days ago.  I had my upper maxilla moved 4mm down and moved 4mm forward, you could not see my upper incisors previously when I talked or smiled.

The recovery was horrible for the first 4-5 day, not because of the pain as I was and still am numb but because of how uncomfortable it was not being able to breathe through my nose with it being clogged up.

I am still a bit tired and have spent most of the week in bed I can't open my jaw fully.

I have included photos I took for your feedback, I would appreciate you being honest and saying what you think I don't mind and believe this will help me.

Your thoughts would be appreciated.

Regards

J

[joesun]

You look great after 7 days. Here is some food for thought though. Do not make a final judge on your appearance  at least until the 6 month mark. Also do you think another 1-2mm is going to make a huge difference to your face?  Go grab a ruler and see miniscule it is...

[overbiter]

It's too early to say whether your jaws are recessed. By the looks of things you might be right about needing more advancement, but lets hope that when the swelling goes down your jaws appear more defined. If you can post more images in a couple of weeks I can give you a more accurate assessment. Did you have a private surgery or was this on the NHS?

[PloskoPlus]

Do you have any befores?

[PloskoPlus]

IMO, you are still too swollen to make a judgement.  I'm surprised they dropped you by a whole 4mm.  That just sounds like a hell of a big vertical movement.  You would have had to have zero tooth show in the before for that to be the case.  Are you sure it was really that much?  I have about as much tooth show as you did pre-op (possibly less), and my surgeon mentioned dropping the maxilla by 1 mm (with at least 6 mm advancement). 

OTOH, 4mm advancement doesn't sound like much.  You need to have a solid 3mm overjet post-op, because the bone is expected to relapse a bit after the operation (about 1mm).  Unless your bite was almost edge-on-edge before.

EDIT: Don't take anything I say seriously, I am not a doctor.

[PloskoPlus]

My over jet was about 2mm, they said I was a borderline case and needed a letter from a psychologist to go ahead with treatment as this was on NHS.  They did 4mm advancement so the upper jaw would sit in front of the lower for a class 1 bite, I feel they should of advanced the lower jaw aswell as the upper jaw as both were underdeveloped.

You mean 2 mm underbite?
Because that's what it looks like here http://jawsurgeryforums.com/index.php?action=dlattach;topic=2631.0;attach=949;image

I had a bad knock to my nose when I was 2 years old and couldn't breathe through my nose  and ended up mouth breathing because of this my upper jaw didn't grow properly I'm sure this had and effect on my lower jaw also. I always knew there wasn't something right.  It was only 2 years ago I fixed the breathing through my nose when my deviated septum was fixed.

I had a big knock as a kid as well, but I am pretty sure that my septum was deviated from birth.  And had a blocked nose often as well.  But I won't blame it for my underdeveloped maxilla.  Grandfather - underbite, mother - underbite, uncle - underbite... me?... underbite.

[PloskoPlus]

Haj,

Jealous of your siblings' very well developed jaws and dentition.    FWIW, I think I mouth-breathed a lot as a kid, and wore a palatal expander for some months, and have rhotacism (less so now).  I still think the underbite was just genetics for me.

[PloskoPlus]

For the past 10 years I have wasted money going back and forward to orthodontists trying to fix this.  My upper jaw was very narrow and I had an alf appliance fitted to expand my upper jaw.  The chap who I wont name ended up messing up by bite and my whole mouth was a mess. I later found out after 6000 pound down he didn't even have a licence! He ended serving 2 months in prison. At least now my breathing has improved.   I think what my plan will be Ploskoplus, is I will be seeing the orthodontist on Friday to see how everything is going I'm going to mention my concerns, and show him the pictures of what my expectations are and see what my options will be. I still think both jaws should be moved forward by about 5-6mm.  I understand being NHS they were looking for function more than aesthetics side.

If I have to pay out of pocket then so be at least now I know what needs to be done, and take I'll it from there.

I've never seen underbite cases where both jaws were advanced.

[overbiter]

Hi haj,
Looking at these newer images, I can see things from your perspective. I don't think your jaws are in the ideal position at all. I think they need to be advanced a bit. I saw the images you posted of your siblings, and I can't BS you, your brothers jaw aesthetics are far superior to your own. When you can make a direct comparison like that, it is easy to see if something isn't quite right.

I know how s**tty it is to be someones uglier brother from personal experience. So I understand what you are going through. I think you should get the surgery but I'm not sure that 5-6mm will even be enough. You might need more. The problem is I don't think you will get this done on the NHS. I'm sure you probably understand this. It's likely the surgery will be regarded as a cosmetic procedure and won't be covered. Anyway, good luck mate in whatever you decide to do 

[applejuice]

How is your bite? You look like you still have an underbite 

[LoveofScotch]

Sorry, for the troubles you are going through. Just an FYI, if you have had extractions, Dr. Hang will very possibly want to open the extraction spaces then have dental implants placed in the openings. I'm not saying that is good or bad; it's just something he recommends on a very regular basis. Also, if you work with him, then still need surgery, he requests that you see one of two surgeons.

Good luck!

[backward lowerjaw]

luckily I have never had extractions, so that's not an issue, the orthodontist I am seeing at the moment recommended extractions I am so glad I did not do this.  I knew from the moment I woke up from surgery the wasn't forward enough, you know your own body.

Have you been to see William Hang?

[LoveofScotch]

Hi again,

No, I have not worked with him, but I had an appt. scheduled (a few months ago)...that I canceled. I am actually pretty open to opening my extraction spaces, then placing implants. The reason that I canceled my appt. was simply because I refuse to work with the two surgeons that he requires. I'm sure they are great, but I have been unable to wrap my head around working with either of them. (Having options is a luxury, but this entire process sucks.)

I have heard many things about him, ranging anywhere from him being a quack, to he is impossibly talented and really on to something with what he is doing. Again, the only reason that I canceled my appt. was because I want to pick my own surgeon. Some of the best doctors that I have worked with have been labeled "quacks." Go from there...

[backward lowerjaw]

I agree. It's hard for me because I'm from the U.K and the surgeons are very conservative here.  I think what I will do now you have said that I will look into who the best surgeon's are in the US that do not charge an astronomical fee and then find an orthodontist here in the U.K who will work along side their plan. What surgeons did he offer and what reason did you decide not to go ahead with them?

He said to me he would find a surgeon, how much is jaw surgery in the US roughly as I wouldn't be covered for health care being from the UK and all.

[backward lowerjaw]

Loveofscotch can you remember the name of the surgeon or location in the Midwest? I have researched into Dr Wolford and his fees are way too high