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Hi All,

I have been reading the posts on this list for a while now but never

posted anything myself. Now that I actually have more of an

understanding and surgery coming up, I'd like to get on here and

write!

I've had braces since November, and now my surgeon is telling me

that I need to schedule a date for surgery. It appears that I am

having wisdom teeth extraction and upper/lower jaw surgery to

correct an overbite. I am getting nervous because the surgeon seems

to be leaving some serious decision making to me. He says that if I

decide not to get wired there is a 5% chance that I would need

surgery again, which he basically left up to me. He is also leaving

it up to me to decide whether I want lower jaw or both upper/lower

jaw done. He says the jaw can be fixed either way, but the

difference is cosmetic. I have an appointment this week to go over

pictures of what it would look like under each scenario. This seems

so odd to me to be making these kinds of decisions myself??! Has

anyone else had to make these decisions?? Shouldn't the surgeon be

telling YOU what you need to have done?? I am so worried that my

jaw will be disjointed forever or my face will look messed up after

going through this. He also didn't mention anything about

genioplasty, so should I also be concerned that he hasn't mentioned

having this either??

I did have confidence in my surgeon, but after the last time that I

went in for a consultation I'm concered that I'll be making the

wrong decisions!

Thanks!

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My surgeon sort of gave me the same choices you have. He said that

it was true that wired jaws heal in the position they're supposed

to, and that unwired jaws might shift. He felt that the

psychological benefits to NOT being wired were worth the chance of

shifting, which could probably be corrected with rubber bands. He

said that if I wanted, he would wire me, so in that respect I

suppose I had a choice. I opted as he suggested, to not be wired.

He also gave me the option of upper only, or upper and lower. The

upper only would completely fix the problem, but leave me with what

he called a 'strong jaw for a woman'. He said the upper and lower

would be as though he did the upper to correct the problem, then

took the two jaws together, with the proper bite, and rotated them

up slightly to soften my jaw. Purely cosmetic.

I opted for the upper only. I like my strong jaw, and so does my

hubby, so it seemed logical not to have more work done than

necessary. My OS said that some people are very tied to the

cosmetic and he lets everyone know what's possible and reasonable.

He would be willing to do it either way, as long as the patient

understands that with more surgery comes more risks.

I can see how it might be frightening if you were given options but

didn't understand the full ramifications of them, or how he, as a

surgeon, felt about them. My OS had his opinions, but let me choose

how cosmetic I wanted to go. Ask your doc specific questions - if I

have this done vs this done, what does that mean as far as recovery,

final results, risks, cost, etc? If you were his daughter/wife/mom,

what would he feel would be best? His other patient who have done

it this way or that way, how did things turn out for them? Tell him

you want him to be specific, blunt, and detailed with you. You

can't make an informed decision unless you're informed.

It might also help to take someone along to your appointments.

Perhaps they might understand things that you're not catching, and

be able to offer a good opinion. I brought my husband, mother, and

mother-in-law to my decision-making appointment, and we all decided

together. It also helped to have their questions when I couldn't

think of any, and it gave them a chance to understand what I was

going to go through so they could be a better support team.

Kris

> Hi All,

>

> I have been reading the posts on this list for a while now but

never

> posted anything myself. Now that I actually have more of an

> understanding and surgery coming up, I'd like to get on here and

> write!

>

> I've had braces since November, and now my surgeon is telling me

> that I need to schedule a date for surgery. It appears that I am

> having wisdom teeth extraction and upper/lower jaw surgery to

> correct an overbite. I am getting nervous because the surgeon

seems

> to be leaving some serious decision making to me. He says that if

I

> decide not to get wired there is a 5% chance that I would need

> surgery again, which he basically left up to me. He is also

leaving

> it up to me to decide whether I want lower jaw or both upper/lower

> jaw done. He says the jaw can be fixed either way, but the

> difference is cosmetic. I have an appointment this week to go

over

> pictures of what it would look like under each scenario. This

seems

> so odd to me to be making these kinds of decisions myself??! Has

> anyone else had to make these decisions?? Shouldn't the surgeon

be

> telling YOU what you need to have done?? I am so worried that my

> jaw will be disjointed forever or my face will look messed up

after

> going through this. He also didn't mention anything about

> genioplasty, so should I also be concerned that he hasn't

mentioned

> having this either??

>

> I did have confidence in my surgeon, but after the last time that

I

> went in for a consultation I'm concered that I'll be making the

> wrong decisions!

>

> Thanks!

>

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That's a good reply, Kris.

I was also faced with a choice, to have only lower (as my ortho

suggested) or upper/lower and possible genio (for my " strong " chin),

even possible palate expansion (surgeon wouldn't know until after

he'd done the mock surgery, so I went into surgery with this part

uncertain). I didn't consider any of it cosmetic, not really the

genio although you could argue it was. I just felt that if it was

required, better to do it all at once than have to do a second

surgery later. I did have some major problems with lip incompetence,

among other things, which was resolved with the combination I had

done.

I was kind of freaked myself that there was a difference between

ortho & surgeon's recommended, so I asked my ortho again, and he took

some more xrays to show me where things were (actually, I asked him

if surgery was absolutely necessary just 8 weeks prior to my date - I

was really freaked at that point).

My ortho said it was a decision between me and my surgeon, since " he

does way more of these in a year than I do " . I did ask my surgeon if

he still thought " the works " were needed, and he said yes. I won't go

into all the detail, but he wasn't doing more than was necessary.

I would suggest also asking the ortho what he/she thinks. If they are

both pointing to the same procedures, then it's probably more likely

they are needed. I think my ortho is a " surgery as a last resort "

type of person, so he would prefer less than more.

It's a tough decision, but I think it was best to leave it to the

professional with the most experience, at least in my case. Yes, I'm

involved in understanding and accepting the risks, but I don't really

know what would be the best from experience - that's where I trusted

my professionals.

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> Hi All,

>

> I have been reading the posts on this list for a while now but never

> posted anything myself. Now that I actually have more of an

> understanding and surgery coming up, I'd like to get on here and

> write!

>

> I've had braces since November, and now my surgeon is telling me

> that I need to schedule a date for surgery. It appears that I am

> having wisdom teeth extraction and upper/lower jaw surgery to

> correct an overbite. I am getting nervous because the surgeon seems

> to be leaving some serious decision making to me. He says that if I

> decide not to get wired there is a 5% chance that I would need

> surgery again, which he basically left up to me. He is also leaving

> it up to me to decide whether I want lower jaw or both upper/lower

> jaw done. He says the jaw can be fixed either way, but the

> difference is cosmetic. I have an appointment this week to go over

> pictures of what it would look like under each scenario. This seems

> so odd to me to be making these kinds of decisions myself??! Has

> anyone else had to make these decisions?? Shouldn't the surgeon be

> telling YOU what you need to have done?? I am so worried that my

> jaw will be disjointed forever or my face will look messed up after

> going through this. He also didn't mention anything about

> genioplasty, so should I also be concerned that he hasn't mentioned

> having this either??

>

> I did have confidence in my surgeon, but after the last time that I

> went in for a consultation I'm concered that I'll be making the

> wrong decisions!

>

> Thanks!

>

I had basically the same choices as you : banded or wired, lower only

or lower + upper (and genio in my case), plus two external cuts or not.

I discussed this with my ortho (he's saddistic, so he suggested the whole

procedure), and since he cares a lot for me, more than I would expect

from a health professional, I listened carefully to what he said.

I talked with my generalist. He said the lesser is better, but when I

explained why I was hoping to get the whole thing done (upper was for

cosmetic reason at the time, but it changed after an extensive set of

X-Rays were done some weeks ago), he went like this : I'm young (37),

it's not exactly major dramatic surgery (like removing an organ), and it's

not life treatning. So, I should do it if I want. The increased risks

are minimal.

I also talked with my old brother. He said he wouldn't do it, altogether,

but he understands why I'm doing it and listened to all the pros and cons.

He suggested to have the whole thing done. For more or less the same

reasons as my generalist. My sister in law, who is also someone I look

up for when I need advice, didn't hesistate an instant : GO FOR IT!, she

said... ;-)

Finally my friend said the same thing... I've been unable to smile for since

I was 9. It's like a rough time to endure, for something I really wanted

all my life.

So, at the end, I decided to have the whole thing done because I knew

the more I would get out of it, the less frustrated or tired I'd be when

the things wouldn't go round.

Except, I decided upon some options with the surgeon, like no cuts

in my face. I already had to spend 18 months with a dermato to remove

some things in my face, I wasn't about to add two new scars.. ! Also,

I asked to be rubber banded as opposed to wired, but I also agreed not

to use my jaws for a full 10 days, except in need (throwing up, say urgent

things, stuff like that).

Ray

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