Well, frankly, I'm going to spare you the details and make this quick. (Although still fairly long, which i guess is the story of my life (read: this case) )
Essentially my surgeon told me, after delaying my Lefort 1 BSSO genioplasty surgery for the third time, I needed extractions in my lower jaw to move the teeth backwards so he could line them up better, and move my chin forward more. Well, 4 days later, he calls my dad and told him he "thought about it" and "changed his mind", and now wants to attempt to do a 3-piece Lefort instead to give him more room to move the teeth,.
Naturally, losing confidence, I went to see another surgeon, who thought the three-piece was too risky and would recommend the extraction route, but on top instead of the bottom.
It seems like no one has any idea what they are doing anymore, and cannot agree on anything. My case mainly consists of a gummy smile, open bite, and a receded chin.
I don't know if any of you by some luck actually have experience in this field medically, and want to take a look at my mouth to give me an opinion, if so , I'll post pictures if asked.
I really just want to get rid of my gummy-ness, be able to close my mouth comfortably, and a chin that isn't soooo recessed.
I'm going to a third surgical group soon to get a third opinion on this matter.
I just feel helpless. I've been involved in Orthognathic work since I was 13 (I'm 18 now) and I just can't see the end in sight.
Any thoughts?
Zach
Case just gets more complicated [Updates -- pics if asked]
Moderator: bbsadmin
I'm sorry you seem to be getting more questions than answers. I know your frustration when it comes to medical opinions, but we have to remember that doctors PRACTICE MEDICINE. It isn't like they always know what the correct answer is, and many times they formulate opinions based on experience. Every profession does this, and doctors are no exception. I'm not saying there is anything wrong with this, but we as patients need to keep it in mind, especially when we are seeking advice with something this important. If you go to 10 oral surgeons with your case, I'll bet you that you'll get 5+ differing opinions. That is, unless your mouth is so messed up that you literally have one choice (that's me) 
Zach, if I were you I'd try and find the most experienced and respected oral surgeon in your area, and consult with him or her. I'm a bit surprised an OS told you a 3 piece LeFort is "too risky", because any OS that has any extensive experience with corrective jaw surgery can do that procedure with minimum morbidity (and yes, I realize a 3 piece is more "risky" than a 2 piece, which is more risky than a 1 piece, but an experienced OS can perform them all). I know many people on here have had 3 piece LeForts.
My opinion is that you are a case that simply can get to their end goal in different ways. My advice is to embrace that choice, and be sure you are getting very clear information on what your expected outcome would be.
And remember, don't commit to anybody or do anything until you and your family are comfortable with that specific OS and/or Orthodontist.
And one last thing, TAKE YOUR TIME in all of this. Remember, Rome wasn't built in a day.
Zach, if I were you I'd try and find the most experienced and respected oral surgeon in your area, and consult with him or her. I'm a bit surprised an OS told you a 3 piece LeFort is "too risky", because any OS that has any extensive experience with corrective jaw surgery can do that procedure with minimum morbidity (and yes, I realize a 3 piece is more "risky" than a 2 piece, which is more risky than a 1 piece, but an experienced OS can perform them all). I know many people on here have had 3 piece LeForts.
My opinion is that you are a case that simply can get to their end goal in different ways. My advice is to embrace that choice, and be sure you are getting very clear information on what your expected outcome would be.
And remember, don't commit to anybody or do anything until you and your family are comfortable with that specific OS and/or Orthodontist.
And one last thing, TAKE YOUR TIME in all of this. Remember, Rome wasn't built in a day.
Having your Ortho and OS in disagreement has to be completely frustrating, and I feel for you. What really frustrates me is that they seem to be putting you in the middle. They should work out their differences of opinion and then come to you with solutions...not bickering back and forth as that shatters your confidence in both of them.
I wouldn't freak out about your current OS only doing a handful of 3 piece LeFort procedures per se, ASSUMING he has a lot of experience doing LeFort procedures in general. In reality here, all we are dealing with is another cut. I'm not trying to downplay that, as the more cuts there are clearly the bigger chance of morbidity with the procedure, but as long as the OS is familiar with the overall procedure and they are board certified, I am sure you'll be in good hands.
If it makes you feel better, I have heard stories on here where patients go into surgery thinking 1 piece and it ends up being a 2 piece, and a 2 piece ends up becoming a 3 piece. The bottom line is the surgeon, if experienced, will know what to do and he'll act in your best interests.
Good luck and please keep us posted...You certainly have an interesting case and everybody on here wishes you well.
I wouldn't freak out about your current OS only doing a handful of 3 piece LeFort procedures per se, ASSUMING he has a lot of experience doing LeFort procedures in general. In reality here, all we are dealing with is another cut. I'm not trying to downplay that, as the more cuts there are clearly the bigger chance of morbidity with the procedure, but as long as the OS is familiar with the overall procedure and they are board certified, I am sure you'll be in good hands.
If it makes you feel better, I have heard stories on here where patients go into surgery thinking 1 piece and it ends up being a 2 piece, and a 2 piece ends up becoming a 3 piece. The bottom line is the surgeon, if experienced, will know what to do and he'll act in your best interests.
Good luck and please keep us posted...You certainly have an interesting case and everybody on here wishes you well.
This talk about morbidity is a bit funny. Morbidity means dying. Maybe with longer operation there is very small extra chance to die. But really chance to die with jaw surgery is tiny.
Real extra risk when 3 pieces not 1 piece is that it is harder to do. More breaks to be made in bones and they might break wrong. And more different ways to move bones to get it right for good result. Need lots of previous experience doing 3 pieces surgery to help make this risk as small as it can be. So maybe you need a different doctor.
Real extra risk when 3 pieces not 1 piece is that it is harder to do. More breaks to be made in bones and they might break wrong. And more different ways to move bones to get it right for good result. Need lots of previous experience doing 3 pieces surgery to help make this risk as small as it can be. So maybe you need a different doctor.
Horton,
In surgical terms, morbidity refers to complications of a procedure. It has absolutely nothing to do with death. Mortality is the word used when it comes to survival rates from a specific medical procedure or disease.
If I am incorrect somebody please correct me.
Under no circumstance am I trying to suggest there is a hightened risk of death with any jaw surgical procedure. Of course, there is always mortality risk with anesthesia and any surgical procedure, but it is not something generally discussed with Orthognathic surgeries.
My posts were meant to simply state that there is a greater risk of complication with a 3 piece LeFort (as opposed to a 2 piece or 1 piece), but that any board certified maxillofacial surgeon with experience in Orthognathic cases can handle all of them and they are routine surgeries in their line of work.
Again, if I am mistaken, please correct me as I don't want to misinform anybody.
Thank You
Chicago29
In surgical terms, morbidity refers to complications of a procedure. It has absolutely nothing to do with death. Mortality is the word used when it comes to survival rates from a specific medical procedure or disease.
If I am incorrect somebody please correct me.
Under no circumstance am I trying to suggest there is a hightened risk of death with any jaw surgical procedure. Of course, there is always mortality risk with anesthesia and any surgical procedure, but it is not something generally discussed with Orthognathic surgeries.
My posts were meant to simply state that there is a greater risk of complication with a 3 piece LeFort (as opposed to a 2 piece or 1 piece), but that any board certified maxillofacial surgeon with experience in Orthognathic cases can handle all of them and they are routine surgeries in their line of work.
Again, if I am mistaken, please correct me as I don't want to misinform anybody.
Thank You
Chicago29
Zach,
My only thought as I read your post, is that if something doesn't feel right about a particular surgeon, keep looking. This is too important!
Be prepared to ask the surgeons questions at consults, and have them explain to you why THEIR plan is better than another one.
Remember, you don't have to do anything until you are ready.
Be well, and at peace,
Phil
My only thought as I read your post, is that if something doesn't feel right about a particular surgeon, keep looking. This is too important!
Be prepared to ask the surgeons questions at consults, and have them explain to you why THEIR plan is better than another one.
Remember, you don't have to do anything until you are ready.
Be well, and at peace,
Phil
There are no ordinary moments.
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