Orthognathic surgery

[Guest guest]

Hi Sylvia,

I am 52 and in a similar situation. I have choking problems due to

my jaw. And an overly deep bite. I didn't relish doing this whole

process, but I went to three OD consults and then the OS consult.

They each said the same thing. I carefully weighed the benefit of

doing nothing, which for me was not a good choice. My problems were

getting worse, my teeth were breaking off, and cracking, and wearing

down to nubs, and that wasn't going to change. It was going to get

worse, which would have made the choking and abnormal eating worse.

So for me, I made the decision to proceed.

But I do think the extra consults help that decision. Definately!

I would highly recommend doing that. It is a big decision, and if

you are unsure, more information is your best friend! Good luck

with your decision.

Hugs,

Fran

> Hi,

> I am 50 years old and went to an oral surgeon regarding my jaw,

the

> referred pain I get. My top and lower teeth hit edge to edge. I

have

> no overbite and have been this way since I can remember. I wore

> braces as a child, my teeth are straight. I have a strong jaw and

do

> not like my profile. He recommended this surgery, but first told

me I

> have to wear braces for months before the surgery and also after

the

> surgery. He told I would have my jaw broken and it would either be

> wired shut for 6 weeks or I could not have it wired it shut. He

did

> tell me I would stand a greater chance of having numbess and

tingling

> in my lip area if I did not have it wired shut.

>

> This is such an invasive procedure. I am scared shitless. Is it

worth

> all the pain for the unknown. My jaw would be softer but their are

no

> guarantees that my clenching of the teeth and the pain in the

joint

> areas would be relieved. How painful is this surgery, the recovery

> period, how much time do you really off of work. Has anyone had

the

> surgery without their jaws being wired shut. Have you had any

> permanent side effects from this type of surgery either not wired

or

> wired. Why should I choose being wired together. Please give me

your

> feedback all the gory details and pain please. Please don't sugar

> coat it. Is it really worth it. I live in NYC and would like a

second

> opinion. Please New Yorkers give me another referral to see. I saw

> Dr. Sacks in Long Island. Ever hear of him and his work. Thank you

> everyone for any help you can give me. All of you are so brave to

go

> through this surgery. I applaud you. Please provide me with more

> things to read regarding this type of surgery.

>

> Sylvia

[Guest guest]

Hi Sylvia,

I'm five months post-op from upper jaw, major nose reconstruction,cheek bone and

bone graft surgery. I wasn't wired shut as my surgeon said it wasn't necessary.

I was inhospital for nine days after surgery.

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[Guest guest]

Hi Sylvia,

No pain, no gory details, in my case. I had upper/lower/genio in

August 2002, and had an easy recovery. I was almost 47 years old at

the time.

Wiring or no wiring is a personal preference of individual surgeons.

My own surgeon doesn't wire, he says it's better not to, that the

muscles have more of a chance to get used to their new position,

whereas if you wire, the muscles tend to snap back into their old

position when released. But if you've found the right surgeon, one

you are confident in, you should go with whatever method that

surgeon uses. There are lots of people here who were wired, and lots

more who weren't. In my opinion, you'll have the risk of numbness

and tingling whether you are wired or not, but there may be less

risk of permanent numbness with the method your surgeon proposes.

I'd ask more questions of the surgeon, or even see a second surgeon.

You'll find lots of info, FAQs and links to other information on the

geocities site I set up at

http://www.geocities.com/orthognathicinfo/ and also on site two at

http://health.groups.yahoo.com/group/orthognathicsurgerysite2

Check out the PERSONAL SURGERY EXPERIENCES on the geocities site.

Hope that helps,

[Guest guest]

Hi Sylvia,

Wiring or not wiring is not only the personal preference of the doc --

it has to do with which surgical procedure they perform. My first

surgeon said that due to my age I would probably have numbness for

the rest of my life. Due to other things I didn't like about him, I

got a second opinion. The new surgeon is a little older. He said

that my first surgeon said that because he wasn't using an older

method that takes better care of the nerves that run through the jaw

bone. He said that if he uses the older method, my jaw would be more

unstable and thus require the wiring versus the banding. The wiring

will be for 3 weeks, so I think I can handle it if it means no

longterm numbness.

Sue

> Hi,

> I am 50 years old and went to an oral surgeon regarding my jaw, the

> referred pain I get. My top and lower teeth hit edge to edge. I

have

> no overbite and have been this way since I can remember. I wore

> braces as a child, my teeth are straight. I have a strong jaw and

do

> not like my profile. He recommended this surgery, but first told me

I

> have to wear braces for months before the surgery and also after

the

> surgery. He told I would have my jaw broken and it would either be

> wired shut for 6 weeks or I could not have it wired it shut. He did

> tell me I would stand a greater chance of having numbess and

tingling

> in my lip area if I did not have it wired shut.

>

> This is such an invasive procedure. I am scared shitless. Is it

worth

> all the pain for the unknown. My jaw would be softer but their are

no

> guarantees that my clenching of the teeth and the pain in the joint

> areas would be relieved. How painful is this surgery, the recovery

> period, how much time do you really off of work. Has anyone had the

> surgery without their jaws being wired shut. Have you had any

> permanent side effects from this type of surgery either not wired

or

> wired. Why should I choose being wired together. Please give me

your

> feedback all the gory details and pain please. Please don't sugar

> coat it. Is it really worth it. I live in NYC and would like a

second

> opinion. Please New Yorkers give me another referral to see. I saw

> Dr. Sacks in Long Island. Ever hear of him and his work. Thank you

> everyone for any help you can give me. All of you are so brave to

go

> through this surgery. I applaud you. Please provide me with more

> things to read regarding this type of surgery.

>

> Sylvia

[Guest guest]

No pain to speak of, no gory details in my story, either, thank

heavens. I had lower advancement only.

One quibble with what Fiddlesticks, my most knowledgeable

friend, offers:

In the matter of lower jaw surgery, there is something called a

vertical cut. I'm not sure of the details of it, but far as I know,

it's reputed to be much less likely to cause numbness, but does

require wiring.

As a footnote, I will tell you that I had the plain old BSSO. My

surgeon promised to be very careful about the nerve. He was, and I

had no numbness, from the moment I awakened. That was his first

question to me, in fact.

Cammie

> Hi Sylvia,

>

> No pain, no gory details, in my case. I had upper/lower/genio in

> August 2002, and had an easy recovery. I was almost 47 years old

at

> the time.

>

> Wiring or no wiring is a personal preference of individual

surgeons.

> My own surgeon doesn't wire, he says it's better not to, that the

> muscles have more of a chance to get used to their new position,

> whereas if you wire, the muscles tend to snap back into their old

> position when released. But if you've found the right surgeon, one

> you are confident in, you should go with whatever method that

> surgeon uses. There are lots of people here who were wired, and

lots

> more who weren't. In my opinion, you'll have the risk of numbness

> and tingling whether you are wired or not, but there may be less

> risk of permanent numbness with the method your surgeon proposes.

> I'd ask more questions of the surgeon, or even see a second

surgeon.

>

> You'll find lots of info, FAQs and links to other information on

the

> geocities site I set up at

> http://www.geocities.com/orthognathicinfo/ and also on site two at

> http://health.groups.yahoo.com/group/orthognathicsurgerysite2

>

> Check out the PERSONAL SURGERY EXPERIENCES on the geocities site.

>

> Hope that helps,

>

[Guest guest]

Cammie, you are so lucky not to have had any numbness.

With regard to the vertical cut, what I have read, however

briefly, ..... is that it only works if you're moving the jaw back,

not forward. It's less stable than the BSSO, which is why you need

to be wired. Even with the BSSO some patients need to be wired,

depending on how well your bones fit together, and how well the

screws go in. My friend had a lower jaw advancement with BSSO and

was wired for 6 weeks, I was fortunate and only have bands (thank

goodness). I'm not sure the vertical cut is an option for jaw

advancement, but...hey, I'm not a Dr., just a numb patient.

Pam

> > Hi Sylvia,

> >

> > No pain, no gory details, in my case. I had upper/lower/genio in

> > August 2002, and had an easy recovery. I was almost 47 years old

> at

> > the time.

> >

> > Wiring or no wiring is a personal preference of individual

> surgeons.

> > My own surgeon doesn't wire, he says it's better not to, that

the

> > muscles have more of a chance to get used to their new position,

> > whereas if you wire, the muscles tend to snap back into their

old

> > position when released. But if you've found the right surgeon,

one

> > you are confident in, you should go with whatever method that

> > surgeon uses. There are lots of people here who were wired, and

> lots

> > more who weren't. In my opinion, you'll have the risk of

numbness

> > and tingling whether you are wired or not, but there may be less

> > risk of permanent numbness with the method your surgeon

proposes.

> > I'd ask more questions of the surgeon, or even see a second

> surgeon.

> >

> > You'll find lots of info, FAQs and links to other information on

> the

> > geocities site I set up at

> > http://www.geocities.com/orthognathicinfo/ and also on site two

at

> > http://health.groups.yahoo.com/group/orthognathicsurgerysite2

> >

> > Check out the PERSONAL SURGERY EXPERIENCES on the geocities site.

> >

> > Hope that helps,

> >

[Guest guest]

Hi

Thank you for responding to my message. I do not understand what you

mean by lower/upper/genio. Your post op recovery doesn't sound like

what I have been readying about on this site. What exactly was wrong

with your jaw. Did you also clench or grind teeth at night. Do you

have any numbness or tingling in your face. That is what scares me

from what I am reading on this site there is a lot of pain afterwards

and throwing up. I am scared shitless. And first I have to wear

braces for a year or longer. I will check out the other websites you

gave me. Do you have any before and after pictures posted on this

site. What are you feeling today? Was it worth it? How have you

improved?

I am going back to the oral surgeon tomorrow for a second

consultation but I will get a second opinion. I was referred to him

by the dentist who treats my for my clenching and referred pain that

I get. I also got botox in the muscles in the cheek area. This one to

help me not clench so much at night. It was okay but I would not do

it again. botox is great for wrinkles but not for the contractions. I

could not move the left cheek area into a smile it was frozen for a

few months.

I will get a second opinion but right now I have to pay for each

visit out of pocket. The first OS charged me $375 and that included

just one set of xrays. I will submit it to my insurance but feel that

I will get nothing back

Talk you soon I hope.

Sylvia

>

> Hi Sylvia,

>

> No pain, no gory details, in my case. I had upper/lower/genio in

> August 2002, and had an easy recovery. I was almost 47 years old at

> the time.

>

> Wiring or no wiring is a personal preference of individual

surgeons.

> My own surgeon doesn't wire, he says it's better not to, that the

> muscles have more of a chance to get used to their new position,

> whereas if you wire, the muscles tend to snap back into their old

> position when released. But if you've found the right surgeon, one

> you are confident in, you should go with whatever method that

> surgeon uses. There are lots of people here who were wired, and

lots

> more who weren't. In my opinion, you'll have the risk of numbness

> and tingling whether you are wired or not, but there may be less

> risk of permanent numbness with the method your surgeon proposes.

> I'd ask more questions of the surgeon, or even see a second surgeon.

>

> You'll find lots of info, FAQs and links to other information on

the

> geocities site I set up at

> http://www.geocities.com/orthognathicinfo/ and also on site two at

> http://health.groups.yahoo.com/group/orthognathicsurgerysite2

>

> Check out the PERSONAL SURGERY EXPERIENCES on the geocities site.

>

> Hope that helps,

>

>

[Guest guest]

Hi Sylvia,

Upper/lower/genio refers to upper jaw surgery (impaction of maxilla

in my case, plus a slight rotation), lower refers to lower jaw

surgery (advancement in my case), and genio is a short form term for

genioplasty, which in my case was reduction and advancement of the

chinbone.

Yes, I clenched and grinded my teeth at night prior to surgery. I

don't do it any more.

Numbness and tingling is something you will have to go through, most

likely. Some don't (Cammie had lower advancement and was one of the

fortunate ones who had no numbness). It is the most frustrating part

of this surgery for most people as it is individual to each person

and can take a very, very long time to subside. My surgeon said 5-7

years for full nerve recovery.

I had lower wisdom teeth removed some years ago, and can attest to

the fact that it takes a very long time for nerves to recovery, as I

was still observing change after about 7 years.

One of the misconceptions, though, is about how numbness feels, and

that can be fearful to people. I was numb from behind my eyeballs to

below my chin (and inside my mouth) initially post-op. That felt

very strange. But the major numbness subsides over the first month,

first fairly quickly, then it tapers off. What you may experience in

the long term is what I refer to as " altered sensation " . You have

feeling, but there's still a very slight tingling when you touch the

area. If you think of the last few seconds of dental freezing (or

Novocaine for Americans), that's what it feels like. It's not really

anything to fear.

Most everyone has to wear braces for an extended period, but this

also varies from person to person. I wore removeable ALF appliances

for the first year, then moved on to fixed braces.

You're correct in feeling that my recovery experience doesn't sound

like what you hear on this and other sites, that's because people

who have had a good recovery (and there are many, many of us)

sometimes feel guilty about posting it, when there are others who

have had a more difficult recovery. That's one of the reasons I stay

tuned to the sites (I moderate another site), since one can get a

very distorted view by reading only the difficult recovery postings.

Have a look at the geocities site I created (PERSONAL SURGERY

EXPERIENCES especially), and the oss2 site (my photos are posted

there under Fiddlesticks folder - you'll have to join to view

photos). I put these in my previous reply to you, but I guess you

overlooked them.

http://www.geocities.com/orthognathicinfo/

http://health.groups.yahoo.com/group/orthognathicsurgerysite2

Hope that helps. We're all scared when we contemplate what's going

to happen, but as you gain more information, it may become easier

for you. I know it did for me.

[Guest guest]

Does the surgery involve introduction of plates and screws?

Do they have to be removed or do they stay in?

Do they have traces of nickel?

Will it cause a rejection?

[Guest guest]

>

> Does the surgery involve introduction of plates and screws?

> Do they have to be removed or do they stay in?

> Do they have traces of nickel?

> Will it cause a rejection?

>

These are all questions that would be best answered by your surgeon.

There are several possibilities... you can have this surgery and be

given only rigid fixation (plates & screws), you can be wired shut

without the plates and screws, or you can have both... plates,

screws, and wired. The plates are usually intended to be

permanent.... they would only be removed if there is some sort of

problem with them (poor placement, they get bent/deformed, adverse

reaction in the body, infection, etc.). A possible bad

reaction/rejection to the plates is hard to predict... I guess if you

know you are allergic to a particular material that you know that

plates are made with.. then you would know prior to surgery if a

reaction is possible. But that would probably be discussed with your

surgeon ahead of time. In that instance, I'm sure using plates/screws

of a different material would be done. My surgeon uses resorbable

plates and screws. There is only one other member here that I am

aware of who also had them. But, I really don't know what is the

frequency of their use. They are made of some kind of compound that

the body breaks down until, ultimately they are completely gone.

Usually, I hear of the plates being either titanium or stainless

steel. Again, this is best discussed with the surgeon. He would know

what he uses/is most comfortable with, etc. best. Good luck getting

your questions answered. I hope this was helpful!

Katja