Surgery without braces?

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#1 Post by **laxtreme56** » Sat Jun 13, 2009 3:37 pm

Well was I pleasantly shocked yesterday..I went for a surgical consultation at Monteifore Oral and Maxillofacial center in the Bronx, NY. The first thing the doctor told me is that braces are not always mandatory prior to surgery and about 10-15% of his patients can forego braces and just get the surgery. I have a class III underbite and have gone to several orthodontic and surgical consultations the past 3 months as well as having my wisdom teeth removed 3 weeks ago. I've been told my teeth are very straight and would only need 3-6 months of braces Tops before sugery, and would likely get a BSSO to move my lower jaw back.

Early this morning I got a call from the surgeon, he says I do not need braces. After looking at my models all my teeth would fit perfectly with the surgery with the exception of one of my top molars that is slightly crooked. He says it would not affect my bite or cause functional problems. What further suprised me is he thinks my lower jaw should be left alone and my top moved forward. I'm not sure what I think about this. I do like my chin, as its very strong and although it' a bit bigger it does not really "jet out" like many class III. By moving the top forward my face will look fulller and my cheek bones more pronounced, however I'll still have a bit of a longer face. We plan to discuss the options sometime next week as they submit the xrays, molds, etc. to my insurance company for pre-authorization.

All in all I was very happy with this consultation, though it almost sounds too good to be true. Even with a fresh wisdom teeth extraction it should not complicate the surgery or have to wait longer for the extraction site to heal. He's worked with my insurance company many times and believes they will cover the surgery and hospital expenses 100%. If all goes well I could be underbite free by end of the summer.

Has anyone ever had oral surgery without braces? Do you believe I should get another opinion? Any and all suggestions are welcome.

#2 Post by **charlsie142** » Sun Jun 14, 2009 5:36 am

Laxtreme56--

Congrats on the good news and quick surgery time!! Some of us have to wait at least a year due to our braces, so you are very lucky!

While I myself also have braces and have yet to have surgery, I have a friend who had a Lefort I (likely the surgery you'll have- upper jaw) who posted on here a little over a year ago who went through it all without surgery. If you don't hear from others on here to answer your questions, you might want to check out some of her previous posts. Her nickname on here was sspidermom. I'm not sure if she still checks in, but I see her in person fairly often, so I can always give her a nudge to check her messages on here.

Please do keep us updated on what you find out and certainly when your surgery will be!

charlsie

#3 Post by **cyn** » Thu Jun 18, 2009 2:57 pm

That's great news!
I'm not sure if this will help you, but instead of getting braces, I chose to go the invisalign route - so technically, I don't have braces

I wore my invisalign for about a year before I had my surgery ( I had a BSSO to correct my class III on June 5th). Although my teeth were not "perfect" before having the surgery, they had moved enough so that my bite could be approximated. So in your case, you are SO LUCKY that your teeth are straight, and if your surgeon has looked at your study molds and saw that your teeth "meet" in your new bite, that's great!! In my case, since I didn't have braces for the elastics to hook onto, I had 8 "mini-screws" drilled into my gums for the elastics to hook onto. They are used to "guide" the jaws for your muscles to re-learn your new bite ( 4 on the top, and 4 on the bottom). BUT, maybe since your surgeon is recommending your maxilla to be moved instead, you won't need these screws, which is even better! I wish you all the best on whichever decision you make - that is so exciting that you may be underbite free by the end of summer

I know that personally, although I still have chipmunk cheeks and bruises on my face, this was the best decision I had ever made and waited waaay too long for!!

#4 Post by **laxtreme56** » Sat Jul 25, 2009 10:58 pm

Well I'm going for surgery on Monday. I was approved by insurance on July 14, on July 21 I went for my pre-op with blood drawn, molds and pictures taken, and facial measurements. Now this Monday, July 27th I will be getting my lower jaw moved back 2-3mm and my upper advanced 5mm. Initally my surgeon believed I could forego the lower and keep my strong chin and just advance the upper. However he said that result would not be stable since he'd have to advance my upper by 8mms and without braces it would more than likely relapse. I am given the option of being wired shut for 6 weeks or keeping my mouth open, but by doing this i run a 15% chance of permanent nerve damage. I'm not sure which route I will choose. Obviously getting wired shut is safer but I just cant imagine not being able to talk efficiently for over a month and will most likely be out of work for an extended period of time as verbal communication is essential for my job. While I'm happy I was able to forego braces and have a quick surgery date, I'm also getting quite nervous and feeling a bit overwhelmed at the current moment. I will be sure to post some before and after pictures in the near future. After 22 years I will finally be underbite free!!!

#5 Post by **AF104** » Sun Jul 26, 2009 12:49 am

I think you're talking about IVRO being safer than BSSO in the sense of nerve functionality. Wiring isn't safer than rigid internal fixation and it isn't as stable(which is why wiring has been replaced for the most part).

#6 Post by **chicago29** » Sun Jul 26, 2009 9:38 am

laxtreme56...Wow, you really are on the fast track! Best of luck with everything tomorrow, and please post and let us know how things went once you are able.

Oh, and whether or not to go banded vs wired, I'd tell my surgeon to do what they are most comfortable with. Chances are they favor a specific technique. If the option is truly yours, I think most people go the BSSO/unwired route as that seems to be more popular nowadays. However, either technique should work for your case.

Anyway, best of luck!

-Chicago29

#7 Post by **laxtreme56** » Tue Jul 28, 2009 4:22 pm

Well guys I'm officially underbite free!! I had a Lefot 1 and an IVRO procedure (I originally thought i was getting a BSSO) this past monday July 27 at Montefiore Hospital in the Bronx, NY. The surgery lasted 5 hours. To my suprise, and to the suprise of my surgeon and his large staff I was talking relatively clearly and efficiently as soon as I awoke even with my jaw wired shut. I'm still talking pretty good 24 hours later though my mouth does tire easily after a while. Pain after the first few hours was pretty much non-existant. I will admit it hurt a bit more than I thought but once the morphine kicked in I was on cloud 9. Although I was tired and groggy I didn't sleep much last night as the nurses checked up on me and my roomate every hour, and constantly left the lights on even when I asked them to please shut them off. The IV machine also malfunctioned a bit and beeped sporadically throughout the night. After a few X-rays early this morning I was set to go. My Surgeon is extremely pleased with my healing. Swelling is minimal, there was very little blood loss, and I'm not completely drained of energy. As soon as i get my digital camera back I'll be sure to post some before/after pix. The next few weeks will be rough, but at least the hardest part is now officially over!

#8 Post by **chicago29** » Tue Jul 28, 2009 6:04 pm

Congratulations, laextreme56! You must be so excited. I hope that your recovery continues to be uneventful, and perhaps even pleasantly surprising!

Keep us posted on your recovery, and best wishes to you.

-Chicago29

#9 Post by **laxtreme56** » Fri Jul 31, 2009 5:02 pm

Here's some before and after pics. The before pics were taken before I left for the hospital and the after pics were taken today, 4 days after surgery. The swelling is still pretty bad but I was honestly expecting alot worse. The meds are doing a good job keeping the pain away and I've been getting a pretty good nights sleep. If i talk to much or strain myself I can feel my face get tighter and thats when the pain and discomfort increases. My surgeon said he'd loosen the wires up a bit in time, thankfully my speech wasn't affected as much as I thought it would. Most people can actually understand me pretty clearly. Tomorrow morning I go for a checkup with the surgeon. So far so good, I've lost about ten pound but my appetitie is slowly coming back. A liquid diet isn't really as horrible as it seems. I cant wait for my new face to settle in and I can get back to work and keep moving forward. I'll make sure to update regularly and post new pictures in the coming days.