Author Topic: Revision double jaw surgery - advice  (Read 18763 times)

Brachy

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Re: Revision double jaw surgery - advice
« Reply #90 on: June 04, 2018, 11:53:14 AM »
Guys, what if theoretically I found a surgeon who is willing to perform LeFort 3, would it be a better solution than making lower third less protrusive.
Also, I have read on one of posts that S-N line can't be increased - is it the case if monobloc is performed?
Thank you very much

uj

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Re: Revision double jaw surgery - advice
« Reply #91 on: June 07, 2018, 12:30:38 AM »
I appreciate your comment. I wish I had never undergone jaw surgery process and would wish to come back to my old situation (no teeth show, short face). I hate my big, protrusive jaws and even consider going back to the old situation.
However, surgeons would probably consider "middle" version as solution. I have very much regreted the operation and the worst thing is that I often notice smile on people's faces while I talk.

Brachy,

How many mm were you advanced? Surely you could be set back the same, if you didn't have apnea before?

I'm sorry this has happened to you; I actually feel similarly about my surgery  :'(

CCW

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Re: Revision double jaw surgery - advice
« Reply #92 on: June 07, 2018, 02:26:42 AM »
Guys, what if theoretically I found a surgeon who is willing to perform LeFort 3, would it be a better solution than making lower third less protrusive.
Also, I have read on one of posts that S-N line can't be increased - is it the case if monobloc is performed?
Thank you very much
If you are unhappy with your jaw surgery, getting a risky operation like LF3 to match it doesn't sound like a very logical approach. If you're unhappy with your jaw surgery, you should get a revision. It looks as though you got too much linear advancement when you should've gotten CCW. You need a setback with CCW because your OP is still too steep.

Brachy

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Re: Revision double jaw surgery - advice
« Reply #93 on: June 07, 2018, 07:40:01 AM »
Brachy,

How many mm were you advanced? Surely you could be set back the same, if you didn't have apnea before?

I'm sorry this has happened to you; I actually feel similarly about my surgery  :'(


Thanks on the comment - lower jaw was advanced 7mm, upper 1 but was downgrafted 5mm.. a lot of clockwise rotation has been performed.. i will most probably revise cca 50% of the movement, i.e. jaws setback, counterclockwise rotation of the occlusal plane,  decrease in anterior face height (chin counterclockwise)

Brachy

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Re: Revision double jaw surgery - advice
« Reply #94 on: June 07, 2018, 07:42:57 AM »
If you are unhappy with your jaw surgery, getting a risky operation like LF3 to match it doesn't sound like a very logical approach. If you're unhappy with your jaw surgery, you should get a revision. It looks as though you got too much linear advancement when you should've gotten CCW. You need a setback with CCW because your OP is still too steep.

Thank you very much on the comment, yes most probably I will revise jaw surgery and go back to prior situation, i.e. less teeth show, counterclockwise rotation of the occlusal plane, jaws setback..

Brachy

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Re: Revision double jaw surgery - advice
« Reply #95 on: June 07, 2018, 11:14:19 AM »
What questions should I ask craniofacial surgeon?
How many LF3 surgeries performed, results b/a, complications, range of possible advancements, type of incision, vision damage

kavan

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Re: Revision double jaw surgery - advice
« Reply #96 on: June 07, 2018, 07:12:25 PM »
What questions should I ask craniofacial surgeon?
How many LF3 surgeries performed, results b/a, complications, range of possible advancements, type of incision, vision damage

Ask him how easy it is to revise IF you don't like it.
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kavan

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Re: Revision double jaw surgery - advice
« Reply #97 on: June 07, 2018, 07:13:05 PM »
If you are unhappy with your jaw surgery, getting a risky operation like LF3 to match it doesn't sound like a very logical approach. If you're unhappy with your jaw surgery, you should get a revision. It looks as though you got too much linear advancement when you should've gotten CCW. You need a setback with CCW because your OP is still too steep.

BINGO!
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Brachy

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Re: Revision double jaw surgery - advice
« Reply #98 on: June 07, 2018, 08:39:26 PM »
Ask him how easy it is to revise IF you don't like it.

How easy to revise LF3 or jaw surgery?

kavan

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Re: Revision double jaw surgery - advice
« Reply #99 on: June 07, 2018, 08:49:01 PM »
How easy to revise LF3 or jaw surgery?

Yes. That's exactly the question you need to ask what ever surgeon you ask for a LF3; 'How easy it is to revise IF I DON'T LIKE IT?'  You could also ask which ever surgeon you plan on doing your REVISION surgery how easy is that to revise again IF YOU DON'T LIKE IT.

Repeat after me: 'Doctor, how easy it is the surgery I am requesting from you to be revised IF I DON'T LIKE IT?'
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Brachy

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Re: Revision double jaw surgery - advice
« Reply #100 on: June 08, 2018, 12:08:13 AM »
Thanks Kavan, I will most probably revise jaw surgery.. however, I have few surgeons to consult on LF3 before making final decision. I will post more information after next week's consultation

PloskoPlus

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Re: Revision double jaw surgery - advice
« Reply #101 on: June 08, 2018, 03:43:17 AM »
AFAIK LF3 is not revisable.

Dogmatix

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Re: Revision double jaw surgery - advice
« Reply #102 on: June 08, 2018, 04:27:53 AM »
Repeat after me: 'Doctor, how easy it is the surgery I am requesting from you to be revised IF I DON'T LIKE IT?'

If I were a surgeon and got a question like that, I would think twice about even offering to perform the surgery. Doing a LF3 on a patient that is not even sure he wants it, doesnt need it for functional reasons, and already is talking about revision is a setup to get an unhappy patient. Patient should also understand that it would be a logical approach to wait with the decission then.

CCW

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Re: Revision double jaw surgery - advice
« Reply #103 on: June 08, 2018, 05:03:00 AM »
This guy doesn't need a LF3. Getting a revision jaw surgery with a reputable surgeon is way easier and safer. Why does everyone suddenly think they need a LF3? Have you actually seen what LF3 patients look like?

kavan

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Re: Revision double jaw surgery - advice
« Reply #104 on: June 08, 2018, 10:23:29 AM »
If I were a surgeon and got a question like that, I would think twice about even offering to perform the surgery. Doing a LF3 on a patient that is not even sure he wants it, doesnt need it for functional reasons, and already is talking about revision is a setup to get an unhappy patient. Patient should also understand that it would be a logical approach to wait with the decission then.

Yes. BINGO!

He needs to DISCLOSE to the doctors he's consulting about L3 that he has a HISTORY of asking for things he does not/did not fully understand ramifications of request and NOT LIKING the result. Hence, he SHOULD NOT implicitly assume he will like the RESULT of the surgery he requests to be done which is WHY he needs to ask the doctor; 'What if I don't like the result, can it be reversed if I don't like it.'

My impression of the OP is that he might not understand what he is asking for and why or just has a hard time processing information. I've already told him in this (long) thread not to toss in L3 with the myriad of possibilities he is juggling and struggling with because it is something to put on BACK BURNER and something people consider AFTER their jaw to jaw situation is already in BALANCE. Not to mention, there is also the option of 'mimicking' a (modified) L3 with face implants. Not to belabor that particular option BUT the SALIENT point (at least the one I, myself have tried to stress to him) is NOT TO EVEN THINK about L3 at this point in time.

If you 'read between the lines', he's asking OTHERS to THINK ABOUT this FOR HIM. Also, if you read some of my earlier responses to him where I became frustrated when it did not appear to me that he was PROCESSING INFORMATION, my concern is that he's just asking for stuff in the absence of understanding the ramifications of what he is asking for. You will also note in this (long) string where I began to grill him of what he possibly asked for in the first place and why, he mentions he was hoping to 'CORRECT HIS SPEECH' via the first surgery. But as the grilling went on, he equated speech with the way PEOPLE LOOK AT HIM when he talks. That made NO logical sense to me that this 'speech problem' turned out to be HOW PEOPLE LOOK AT HIM and to me, IMO, revealed a FAULTY REASONING process where the END RESULT is that he ASKS FOR SOMETHING, (a surgery) for a weird reason and later DOES NOT LIKE HOW it looks ON HIS FACE.

That said, I most certainly will not give him any information about L3 or what to ask a doctor about concerning that OTHER than what he REALLY NEEDS TO THINK ABOUT which is 'What if he does not like' what he is requesting after it's accommodated and done.
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