Jaw surgery 2 weeks - need to decide Bimax or BSSO!!!

[crr7]

I’m due to have jaw surgery performed by Prof. Maurice Mommaerts in Belgium in under 2 weeks time. I’m booked for bimaxillary surgery (double jaw advancement) but I’m getting a bit cold feet now and wondering if I should change the plans to just have mandibular advancement surgery instead. Prof. Mommaerts told me either BSSO or bimax was an option but that the bimax would give a slightly more ideal aesthetic result. My lower jaw was my main concern being too retrusive but it was pointed out to me by Prof. that my upper jaw is also only slightly retrusive and not giving me enough paranasal projection. On the photo simultations done by Prof. the bimax does give a slightly better look than the BSSO. Upper jaw advancement would also improve my obtuse naso-labial angle, but another concern is that it may further rotate up and widen my nose tip (although Prof. said this would be minimal as he can take measures of prevention). My nose tip is already upturned enough and is one of my salient flaws which I do wish to get fixed with rhinoplasty later down the line but I worry if I might make things worse for myself. I’m also having jaw angle augmentation with hydroxyappetite during the jaw surgery.

I guess I just wish to hear from others about bimax to help me decide whether it is worth the extra risk for the promise of more ideal facial aesthetics compared with mandibular advancement alone? Getting permanent numbness and nerve damage is my main worry.

[suzanna]

If you're worried about permanent numbness/nerve damage, there is a very very small risk of nerve damage during upper jaw surgery. It's a much smaller risk than compared to lower jaw surgery.

It would help if you posted a picture if you want people's opinions. I had upper/lower jaw surgery and the upper gave me more pronounced cheek bones and a slightly more up turned nose. I don't really not any widening of my nose though.

[crr7]

Thanks Suzanna that's really helped me feel better. Did you have any permanent change in sensation after surgery? I really don't want my nose to upturn any more than it is already but since I plan on having rhinoplasty in the future anyway it might not have to be such a worry. I'll try and post some pics tommorrow.

[Teeth of Cthulhu]

I'm in the same boat - retruded lower jaw and slightly retruded (3-4 mm I think) upper. For an ideal aesthetic result I've been recommended bimax though could go down the one jaw root too.

I'd go for the option that provides the superior aesthetic outcome in regards to the jaws and leave the nose for a later date. A small movement shouldn't lead to any notable changes in the nose anyway.

[crr7]

Yeah I guess you're right Teeth, hopefully the difference in the nose will be minimal. I've decided to definitely go for the bimax. I'll update this post to let you guys know how it goes. Good look with your surgery Teeth.

[crr7]

Hi guys, I've had the bimaxillary surgery & hydroxyappetite jaw angle augmentation and I am 5 days post-op!! I can't really see the results properly yet because I am very swollen. Actually, I told my surgeon I think that my lower jaw and chin still looks recessive in profile view but he said it just looks that way because there is no swelling on my chin but there is on all the surrounding areas like my upper lips, cheeks and jaw angles which are protruding further than the chin and therefore make it look recessed in comparison. He said it will all come into line when the swelling comes down. I really hope he is right about this but I shouldn't doubt him as I have seen his work and it is very good. I don't really see any improvement in my naso-labial angle yet but this could be due to swelling. Luckily I didn't get any more upward rotation of my nose tip as Prof. Mommaerts said he made sure he would prevent this as much as possible.

As for my healing I'm taking one day at a time. Day 3 was the absolute worst (max swelling, feeling sick and ear ache). The ear ache seems to have almost gone now but occasionally get it in one ear. I have numbness in my teeth & gums, left side of lower lip, underneath the left lip and left side of the chin. Also numb on the left side of my tongue where there is a lot of swelling. Hopefully the feeling will come back in these areas and it won't last permanently. Most of my discomfort is when I first wake up after sleeping and when I'm eating during which I feel more tightness and congestion and slight pains. The other annoying thing is that I still have a bit of blood seeping from the wounds which I have to spit out often along with a constant build up of saliva all day. My bruising is really bad all over my face and neck right now. But I realise this is all part of the healing process and I am making baby steps in recovery each day so hopefully I will get through all this.

I will post before and after pics of the results when all the swelling has gone down.

[Teeth of Cthulhu]

Jaw and chin always look recessed for the first few weeks after surgery. Nothing to worry about. Check out this dude for example:

Before surgery: http://www.flickr.com/photos/ralmand/4094298575/
Days after: http://www.flickr.com/photos/ralmand/4114752099/
Months after surgery: http://www.flickr.com/photos/ralmand/4463389905/

Do keep us updated - I plan on going with Mommaerts myself (infact I believe I recommended him to you in early 2010 on Miss J's forum, i think?)

[crr7]

Hi Teeth of Cthulhu, yes I do remember you from MissJ's forum. Thanks so much, how are you? I looked for my original thread on MissJ but it no longer seems to be there, maybe it was deleted, but why?

Thanks so much for those photos, they've made me feel so much better since I was fretting I couldn't see any advancement. Yes I do see the difference in that guy a month after surgery so hopefully it is just a matter of time for me.

Another thing I'm fretting about is the occasional pain/discomfort in my right ear. I hope this settles cos I felt a popping a sensation of movement a few times when I was spitting out saliva.

[crr7]

Hi guys I'm now 6 weeks post-op so wanted to update you. I can now see the difference and there is improvement, however, my chin is still recessed so I will need a genioplasty also. This is not a surprise as I always knew I would need genio as well and Dr M told me to wait and see results of Bimax before I decide as it can affect the chin.

I'm pretty much all recovered now. The ear pain stopped soon after my last post thankfully. All that is left is complete numbness on the left side of my tongue and numbness in my upper gums. I am certain that I will regain feeling in time but even if I didn't it's something I can live with.

Anyway here is a link to see my before and after photos:
http://s1099.photobucket.com/albums/g387/maxfac/
username = maxfac
password = maxfac7

[Teeth of Cthulhu]

Looking good. Your mandibular length is clearly greater and the angle between the neck and chin more clearly defined. You do need the genio though.