Hi everyone,
I signed up here recently at the suggestion of another member who had recently undergone surgery with Gunson and shared his before/after photos with me. Here's my story.
Growing up, I was told I would need jaw surgery or at least some kind of intervention to deal with my underdeveloped upper / overdeveloped lower jaw. I was able to ignore it for a good while, at least push it out of my consciousness, until I turned about 21 and my wisdom teeth started coming in and pushed everything out of alignment and really gave me trouble with speaking. Finally at around 22 or 23, I decided I needed to do something about it, and a local orthodontist told me he could fix my bite with braces alone, and that jaw surgery would not be necessary. Although it felt like maybe not a great idea, I agreed. The plan was to extract 3 wisdom teeth, extract 1 bicuspid, and leave the remaining wisdom tooth on the side where the bicuspid was extracted. This would align my centre-line and improve my facial symmetry. Here's my drivers license photo around the time the teeth were extracted (I think slightly after):
It took about 2.5 years, and here is the final result.
It's a result that I'm unhappy with. I tried to articulate why I was unhappy... I told my orthodontist,
"the right side of my face just feels uneven"
"I don't feel I can be 'at rest'"
"I clench/grind my teeth at night"
I told him I wanted the tooth he removed implanted back, and to undergo jaw surgery. He told me I was crazy and gave me a splint to stop me from grinding my teeth at night, then said he had filed some kind of pre-emptive complaint against me to the Orthodontist Assocation or whatever he called it in case I decided to file against him. Well, I never wanted to file anything, I just wanted to fix my problem.
In any case, I started going to different orthodontists in my area and told them of my issues and what I wanted. Most of them (not all) told me what I wanted was unreasonable and dangerous, and that I would not achieve a better visual result through jaw surgery (they all assumed this was my problem). Still, I wanted to consult with as many orthodontists and surgeons as I could.
Finally, at the bottom of my list, I went to see an orthodontist who specialized in TMJ and treatment of TMD - one of the only ones in my area.
Her new patient questionnaire was much longer than I've seen anywhere else and very specific... even though I was pretty sure I wanted just to know about my perceived jaw imbalance, there was an option there for "clicking jaw" and "jaw joint pain" so I circled them just because they were there... I also said my face feels unbalanced, etc.
Her assistant began to examine my TMJ muscles on both sides, by poking each specific one on each side of my face with her finger, both outside and inside the mouth. I thought... this is weird... I'm not really here for this problem, but strangely enough it really hurts when she is poking those muscles on the right side of my face. They hooked me up to a machine which measured jaw joint vibrations and noticed quite a high amount of inflammation in the joint.
Then the Dr. told me to speak out the numbers from 60 to 70 out loud while she watched my mouth move. I counted... sixty, sixty-one, sixty-two, sixty-three... and then she told me to STOP between numbers. I froze my mouth, and she immediately put a toothpick inbetween the jaws so they did not move... then her assistant filled the space between them with a kind of foam which hardened in a few minutes, which basically created a kind of simple splint.
That was really interesting, because by interrupting my counting those numbers, she was able to pinpoint the amount of vertical discrepancy that is in my jaws - I mean, there is a GAP which should not be there in normally-aligned people when they speak. Normally when people count those numbers, their mouth fully closes between each number, but not in me. In a natural rest position, my jaw and mouth is slightly open.
She gave me those hardened foam pieces to keep in my mouth throughout the day to see how I feel, whether I still have that pain and imbalanced feeling. Well... it seemed to go away. And it made a lot of sense... my jaw did naturally want to remain slightly open when I'm at rest, but I never thought about it before. I had been ignoring that pain for so long that I thought it was mild... but when it began to go away, I thought I was nearly crying with joy. Those foam pieces were perfectly filling the gap of where my teeth should actually meet.
Unfortunately, I fell asleep with those pieces in my mouth. I felt so relaxed that I forgot about them, and I didn't feel any discomfort. But since I grind my teeth at night, I started to grind on those pieces and they completely shattered in my mouth which woke me up in a few hours. Even though I only slept about 3 hours... I felt more rested than perhaps ever in my life.
Although I had heard Arnett talk about his emphasis on the airway before, I never realized how important it was to one's general well-being until I realized the critical role the jaws play in the airway, the quality of sleep you get, and so on. I'm convinced that many other problems in our lives become blown out of proportion far more than they need to, and it all stems from this issue.
After some more reading, and looking at how jaw alignment affects sleep, I compared it to my own profile x-ray (above). Take a look at Dr. Alfaro's website:
http://institutomaxilofacial.com/en/orthognathic-surgery/surgery-firstThe first image shows a jaw that doesn't properly close correctly, and is also angled downwards. In the second image, he has advanced the mandible and lowered the maxilla so that the teeth meet in a more horizontal position.
Now, I'm sort of at a crossroads. Either I pursue a surgical approach to correct my problem (which I THINK is primarily airway-related) and may involve a lot of time, expense, and pain with a potential tooth implant, or I go with the TMJ orthodontist's suggestion to correct this again with braces alone, but with prolotherapy to resolve my TMJ inflammation. Although the braces-alone approach would surely be less costly and stressful, after listening to the "braces-only" suggestion before and regretting it, I am reluctant to lose so much more time for what may be only a marginal improvement.
I'd appreciate your thoughts...
One final thing. I still believe the improvement to sleep and airway quality is the biggest factor to feeling good and being perceived as attractive. I've started looking at the eyes and mouth of a person whose mouth is in a natural, un-clenched mouth position. This is even more important than facial symmetry, in my opinion. Looking at this topic: http://jawsurgeryforums.com/general-chat/class-ii-best-beforeafter-pics-that-you-have-seen-%28males-only%29/ on the number one improved face. One person commented on the unbelievable improvement to the first guy's appearance. Another person claims it was puberty. I disagree. I think in the first phase this patient was already well into puberty. The incremental improvements you notice from Phase 2 to Phase 3 are from an improvement to the airway. For males, deep sleep is the key to the release of anabolic hormones that support male sexual and general health. I'm sure his testosterone levels have improved from his better sleep and from the reduction in stress and cortisol levels of having to keep tensing his jaw muscles to keep his mouth closed.
In my opinion, this is precisely the difference between someone who is a "natural beauty" or "naturally handsome" and somebody who is perceived as trying too hard. They're "trying too hard" only because they are fighting the natural tendencies of their airway to remain open both at night and during the day. This "struggle" increases cortisol levels, preventing the body from feeling rested, contributes to the breakdown of muscle tissue, and I'm sure, a whole host of other problems.
Look again at Patient 1, just the first column where his mouth is in its natural position. Notice the inverse relationship between how wide open his eyes are, and how wide open his lips are. In the first photo, he is practically sleeping because he undoubtedly has a sleep disorder. His lips are naturally very open. In the second photo, his lips have come together, but are not completely sealed. He looks far more rested. Now in the third photo, his eyes look nearly 100% alert, his lips are shut, and now he is finally perceived as being very handsome. We shouldn't look at the other factors... his hair length, his beard, even his age I don't think is an important factor here.
Finally, look at his posture improvement (second last column). Again we see an inverse relationship between the quality of his posture and his mouth protrusion. As one improves, the other follows. The ability to recognize the relationship between these factors (the jaw and airway as being the key to sleep quality and posture) is, I think, the mark of a quality physician. These are all closely inter-related issues, and the problems start at the jaw and airway and manifest themselves from there.)
When we see a person who would be described as handsome or beautiful and self-confident, our natural tendency is to look to the external factors that we think contribute to this... a muscular body, good posture, symmetry, healthy hair, a "nice smile", etc etc... but really, people miss the forest for the trees. All of these other factors just come naturally to an individual with a healthy, unconstrained airway. That, I believe, is the fundamental "core" that needs to be treated before all other issues. 
