March 2016 surgery buds

[jawa]

Acclimate how? Physiologically? Psychologically?

[adz]

I just had my surgery yesterday. Upper jaw.

This morning my teeth aren't lining up when they tried them again with the splint. They said it might be because my muscles are tense and they'll wait for things to fall back in a week, otherwise I'm having surgery again.

This sucks man, I have exams in may ffs.

[snapdresser]

Acclimate how? Physiologically? Psychologically?

I meant psychologically, but now that you mention it my surgeon said something about smaller movements being good in terms of your body's ability to acclimate (easier for your muscles to get used to the new position, certain complications are less likely, etc. maybe?). But I can also understand why some people have a preference for larger movements.

[cbrfoltz]

No, the oral surgeon told me that I have about 10% of a "normal" airway, when I'm awake and standing. That's based on whatever normal is. They wanted to see at least 150mm to begin with for me to be considered the lowest end of normal. But, like the other surgeon told me, it's still the Wild Wild West, and although they think anecdotally those numbers might be right, he couldn't say so based on empirical research.

[jawa]

150mm is 15 centimeters. That is just under 6 inches. Are you saying the lower end of normal airway width is a half foot? The width of my entire neck is less than a half of a foot.

[cbrfoltz]

Well, Golly. I never did that math. You're right. 6" would be a huge airway.

All I know is that on the CBCT, it looked like the airway actually closed in one spot.

I know that I'm getting my whole face moved forward quite a bit. I've seen the computer generated pictures, and they're not overly pretty. But, at 55 years old, I am not ready to have to sit on a couch the rest of my life and only be able to color in coloring books for grownups and play on the computer.

I'm thinking that the psychological part of the surgery, what my face looks like, is probably going to be the hardest thing. But, even if my face looks worse than the pictures, I want my life back.

[jawa]

I'm sure you will be beautiful. I think people overestimate how much different they will look. I sure did. Even if I had larger advancement I don't think it would be that much different than the subtle changes that take place from gaining or losing some weight.

[MagnoliaMama]

Claire,

My movements weren't quite as aggressive as yours will be (6mm maxillary and nearly 10mm mandibular), but I definitely got the lucky "extra tight" banding experience. I'm grateful that my healing has been rapid and without complications for the most part. I'm surprised at how little fight my facial muscles have put up with how much my jaws have moved. My appearance underneath the remaining swelling seems to have changed dramatically, but not unpleasantly. I was worried about that because I liked my face. I'm actually a retired pageant girl and this face won every contest I ever entered. One of the most profound things about my new anatomy is my amazing ability to breathe! Who knew this was what breathing is intended to feel like! Take heart, girl. The process is long and grueling but even at not quite 3 weeks post-op I can say I'm very very glad I went ahead with it.

While I didn't have a UPPP, I did have my tonsils and adenoids removed in '06 and a complete nasal reconstruction (including straightening a septum that had grown spurs through the walls of my sinuses, reducing my turbinates, rebuilding the mid vault and internal valves, and a bit of cosmetic work because if I'm doing all that...why not, right? Lol) in '15. I hope this surgery is the last and that your quality of life improves beyond your wildest dreams!

[snapdresser]

While I didn't have a UPPP, I did have my tonsils and adenoids removed in '06 and a complete nasal reconstruction (including straightening a septum that had grown spurs through the walls of my sinuses, reducing my turbinates, rebuilding the mid vault and internal valves, and a bit of cosmetic work because if I'm doing all that...why not, right? Lol) in '15. I hope this surgery is the last and that your quality of life improves beyond your wildest dreams!

MagnoliaMama, I tried sending you a PM but for some reason it's not leaving my Outbox. Did your insurance cover that work on your nose?

[MagnoliaMama]

Snap,

They covered everything except the cosmetic portion of the surgery and the portion of the anesthesia that was used during however long the cosmetic part took. I had a pretty awful nasal airway, so it was definitely done primarily for functionality not esthetics. I'm waiting to see when the rest of the swelling from the jaw surgeries goes away, but I think I might have a dent in my bridge now. It'll be a real bummer if that's the case, but I'm crossing my fingers that it's just swelling. The dent I'm seeing is exactly where my altered sensation starts, so I'm telling myself it'll resolve itself in time.

[snapdresser]

Hmmm... That's interesting to think that the LeFort procedure could have affected the bridge of your nose that much. I know they put in sutures on the sides cuz they have to separate the tissue in that area and otherwise it'll cause widening of the nose. Are you thinking they messed up the work that was done on your nose previously, or that the previous work on your nose had created the dent and you just weren't able to tell before because of the swelling?

How much did the nasal work end up being out of pocket, if you don't mind my asking? I see the ENT next Friday and I'm considering going in that direction. Of course, I'll have to see what he says, but I'm still having difficulty breathing through my nose after the bimax and I'm thinking it's congestion in my nose.

[sakura]

My nose widened a bit from what I can tell. My nose is also slightly turned up a bit.

I too had some work done on my nose. My left nostril was always a bit blocked but I never saw anyone for it. During the surgery, my surgeon said that side was covered with polyps which explains the blockage. He cleared that up for me (well he had to make sure it wasn't anything sinister) so I breathe a lot better now. I can't tell you how much it cost since it is cover by the NHS.

[MagnoliaMama]

Snap,

After enlisting my husband to look closely at my nose and the dent, he's assured me that I'm just seeing residual swelling and that there is no dent. I knew going into my LeFort that my nose would be prone to puffing back up since those tissues were mightily disturbed not that long ago. Any manipulation of the area in the first 18 months post rhinoplasty = swelling. The work was just done on the area this past October, so I only had 5 months under my belt with the new nose. The LeFort definitely raised my tip slightly, which I was prepared for, and actually had the ENT/plastic surgeon account for when he was in there. (Didn't want a piggy nose, and I'm very very tall for a woman so too much upturn would mean a clear view directly up my nostrils). I'm thrilled with where it ended up. They did do the alar cinch during surgery to prevent excessive widening, but I can see that there's been some spread. Not bad, but some.

My out of pocket for the nasal work came to about $6k, for the pre-op appointments, surgery, facility fee, anesthesia, meds, etc. Total cost on my EOBs was close to $32k, but my nose was a disaster internally so there was a lot of reconstruction above and beyond your garden variety septoplasty.

[cbrfoltz]

Update on 150-300mm2 vs 15-30mm2

That was the AREA of the circle that is your airway. If you take the area of a 300mm2 circle, the diameter is about 19.54mm , or 0.769 inches in diameter, so about 3/4 an inch.

At 150mm2 area, the diameter is 13.82 mm, or 0.505 inches in diameter, or about 1/2 inch

Mine at 36mm2 area, the diameter was 6.76 mm, or 0.266 inches in diameter, or just over 1/4 inch

Mine at 15 mm2 area, the diameter was 4.36 mm , or 0.172 inches, or closer to 1/8 inch.

The way I've have it described to me is that "an obstructed airway is like trying to breathe through a straw, and my airway is like trying to breathe through a coffee stirrer."

I'm so glad that you called me out on that. The whole 300mm2, 150mm2 thing never made sense to me, and besides that, I think in inches, and diameter, not metrics and area. Having to admit that I hadn't done the math made me go back and review exactly what I'd been told by my doctors. They had told me area all along, but in my mind, I'd converted it to diameter. It never matched with the picture of my throat basically closed off on the CBCT, but being 15mm across.

There is some good that's coming out of all of this, I'm going back and relearning basic geometry!!!

Baire

[jawa]

Jfl232 how are you holding up?