Revision double jaw surgery - advice

[Brachy]

I apologise, after I come from work will post before pictures. I do not have exact lateral ceph before surgery at home, but will ask orrho to pass me. I only have CBCT before surgery at home. Sorry, once again

[kavan]

I apologise, after I come from work will post before pictures. I do not have exact lateral ceph before surgery at home, but will ask orrho to pass me. I only have CBCT before surgery at home. Sorry, once again

It's TOO LATE. I already gave up on this thread.  You certainly can show them if you like. But a request from me to do so prior, followed by your not doing so in a timely manner must not be construed as an implied promise from me to continue on with this thread. I'm still passing the torch for OTHERS to participate here. Time to continue on with this thread given the communication problem her EXCEEDS my capacity to give it.

[Brachy]

To begin with, I apologise for communication without arguments. Still my knowledge is very much limited and have to learn a lot. I would just use the opportunity to say high words about dr. Z. He certainly very much cares about his patients, excellent doctor.
He suggested removing screws and plates from jaws and chin before adressing possible revision in future. I would say that he thinks that my surgeon has overcorrected me and conventional genioplasty going back is not the best option. I would appreciate whether someone on the forum has the experience of how much swelling will be present after removing the hardware and would I be able to travel from Berlin to Croatia in 2 days time. Thanks in advance

[haven]

I think he meant the type of genioplasty that reduces your chin's height. Not one that goes back.

[Brachy]

https://youtu.be/0XlsOlSmYDk

20:37 specifically said that going back is the hardest to achieve with genioplasty.. in my case vertical lengthening only made lip incompetence worse

[haven]

No, no. I'm pretty sure Kavan is saying you should look into a genio that vertically shortens your chin because the vertical lengthening you got is likely contributing to your lip issues. I think this is what he's talking about. So by moving it in the direction of the arrow they would be reducing the height. Or that's how I understand it anyways. Not sure if that's what you understood from what Kavan was saying to you.

https://imgur.com/4qoH8OZ

[kavan]

No, no. I'm pretty sure Kavan is saying you should look into a genio that vertically shortens your chin because the vertical lengthening you got is likely contributing to your lip issues. I think this is what he's talking about. So by moving it in the direction of the arrow they would be reducing the height. Or that's how I understand it anyways. Not sure if that's what you understood from what Kavan was saying to you.

https://imgur.com/4qoH8OZ

Yes. That's basically what I was saying.  I also said this:

 [HINT: The appropriate doctor to make LESS your protrusion at the CHIN and to also make less your lip STRAIN would be the one in the capacity to remove a WEDGE shape section from your chin, to rotate the base of the chin in a counter clockwise direction in order to shorten it in addition to moving it backwards.

If you don't understand why THOSE displacements are important you WON'T be able to choose the appropriate doctor.]

Then I GAVE UP on him because after 5 pages I didn't feel he was processing information/communication.

[Brachy]

Thanks guys, I really appreciate your help.. I understand that to improve my lip incompetence I need vertical reduction of the chin.. I am just saying that in my case chin was brought back and down and in video from dr. Triaca it is said that conventional genioplasty going back is not possible (or at least not good for lips and estetics).. dr. Z. explained it is the hardest move

still my jaws are too big for the small midface that I have and I had a lot of unpleasant situations and hard time.. in long term, I am  thinking on revising whole surgery (less teeth show, vertically smaller chin, jaws slighlty back).. still waiting for lateral view before surgery, I will post before pictures.. it is face that I really liked, apart from smile, but at reast it worked.. my jaw width is > 35mm.. thank you very much

[Brachy]

I would appreciate if anyone on the board had experience with removing screws and plates.. how long does swelling last approximately? Also, if anyone tried to contact professor Obwegesser, how long does it take to receive a reply? I have used this mail.. thanks in advance
mkg-zuerich@hin.ch

[haven]

I would appreciate if anyone on the board had experience with removing screws and plates.. how long does swelling last approximately? Also, if anyone tried to contact professor Obwegesser, how long does it take to receive a reply? I have used this mail.. thanks in advance
mkg-zuerich@hin.ch

Is there more than one Dr. Obwegesser? One died last year and was probably the OG surgeon.

[kavan]

Is there more than one Dr. Obwegesser? One died last year and was probably the OG surgeon.

Good find. Yes. It was the OG (and lefort3) surgeon.

[Hugo Obwegeser (21 October 1920 – 2 September 2017) was an Austrian Oral Surgeon and Plastic Surgeon who is known as the father of the modern orthognathic surgery. In his publication of 1970, he was the first surgeon to describe the simultaneous procedure which involved surgeries of both Maxilla and Mandible involving Le Fort I and Bilateral Sagittal Split Osteotomy technique.]

[Brachy]

Thanks, I have tried to contact professor Joachim Obwegesser, dr. Sinn and few surgeons in Italy for opinion on midface problems before deciding on revision jaw surgery..thanks

[uj]

I would appreciate if anyone on the board had experience with removing screws and plates.. how long does swelling last approximately?

LyraM45 has had it: http://www.confessionsofametalmouth.com/plate-removal-surgery.html

"1 month post plate removal!  I still have a little bit of puff.  Bruising was gone about 2 weeks ago."

Also found this:
Screw and Plate Removal Surgery
Part 1: https://doublejawsurgery.wordpress.com/2013/03/05/screw-and-plate-removal-surgery/
Part 2: https://doublejawsurgery.wordpress.com/2013/03/05/titanium-plates-and-screws-continued/
Recovery from Plate & Screw Removal
Part 1: https://doublejawsurgery.wordpress.com/2013/03/07/recovery-from-plate-screw-removal/
Part 2: https://doublejawsurgery.wordpress.com/2013/03/12/recovery-after-titanium-plate-and-screw-removal-surgery/

"Me 10 weeks post operation still having swelling on and off"
"Me 4 months post plate removal.... swelling nearly gone..... at last!"

Anyone know how much this usually runs if paid privately? Is there any risk of permanent numbness?

[Brachy]

Thanks so much... up to 4 months?? I am so sad that they can't be removed during revision surgery

[uj]

Thanks so much... up to 4 months?? I am so sad that they can't be removed during revision surgery

Brachy, every surgeon I've asked says they remove the hardware during revision. Have any surgeons told you differently?

Thank you very much. I will be removing the plates but surgeon told me it would be better, if I decide on reoperation, to have everything done during one operation. I have scheduled meeting with him in August, until then I am consulting other surgeons and hope to decide when having more treatment plans. All of you guys have been great support and your advices are very helpful.

I apologize if I missed it, but who was your surgeon?