Need your opinions on this...

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#1 Post by **Paul** » Thu Jan 10, 2008 3:05 pm

I had an appointment with my ortho today, and it looks like Im almost ready for surgery. At my next appointment, 3d models are going to be taken, and they are going to have a surgical clinic thing, where I sit in the middle of the room, and 10 people standing round me discuss what they think is the best option.
I have already had this once, but its now make your mind up time.

At my appointment today, I was told I was going to be given the final say on what happens.

Now heres the two options Iam going to have:
(btw I have assymetry problem with my bottom and Im definetly going to have my top jaw moved forward)

1. Have only top jaw surgery, which would move my top jaw forward, and I think also have a chin augmentation?
Advantages: Less risk of nerve damage, less time under anaesthetic, less healing time.
Disadvantages: When completed, Iam still going to have assymetry, so my bite will only be 80% corrected. It might not look as good and also runs the risk of my teeth moving back over time.

2. Have both jaws operated on. Top moved forward, bottom rotated to fix assymetry.
Advantages: Will be as close to 100% bite as possible, assymetry fixed, will look better, teeth will also be in more stable position?
Disadvantages: Will be under anaesthetic for longer, probability of perm nerve damage in lower, longer to heal.

Right now, I feel like it would be a waste of time to go with the first option, and only have top jaw moved. I see it as it would only half fix the problem and would give me an unstable result.

Going by what you all know, what do you think the best option would be?
People that have had nerve damage from jaw surgery, is it a major problem, or can you live with it?

Thanks in advance,
Paul.

#2 Post by **Brandyleigh35** » Thu Jan 10, 2008 3:33 pm

Personally I would go with option number 2. I totally agree with you in that it seems like it would all just be a big waste of time to do option number 1, as it is not going to fix the problem.

In terms of surgery, having had both upper, lower, and genio done, and having SARPE before hand. I would say got for it all. First off, surgery is surgery...just upper, or upper and lower, is not going to make that much difference in terms of recovery and discomfort. I did both (upper twice) and both times it took about 15-18 days to be feeling back to normal. My SARPE took 50 minutes to complete, when I had upper, lower, and genio it took 6 hours. I was under anethesia for a long time and suffered no ill affects. Depending on your age, within about 2 weeks you should be feeling pretty ok. Yes recovery could be a bit longer (in terms of waiting for nerves to repair etc), and can be aggravating, but in the end it is worth it because everything functions as it should, feels and fits correctly. I'm currently at about 7.5 months post op. I'm still healing in terms of the nerves but everyday it gets better and I'm pretty positive that I will eventually get full feeling back. I currently have some numbness in my lower lip, it is very tingly and puffy feeling but it improves daily. Mostly I don't notice it much as I have full control over my lip, I just can't much feel it (if that makes any sense.) In the beginning I had some issues with tongue numbness, but over time it has all come back, and now I'm down to just a small area on my chin and my lower lip that are still repairing. Most people do not have really severe nerve damage or big issues with numbness. From what I have heard it is mostly a small patch of numbness here and there, or areas on the lower lip.

A friend of mine had upper, lower, and genio done 15 years ago and her whole lower lip and the area extending downward to her chin on boths sides is numb. She says it doesn't bother her at all, and is glad she had the surgery. Again she has control over her lip muscles and its movement, she just can't feel like if something is on it. If your surgeon is good and has done a lot of these surgeries then you are probably in good hands in terms of after effects. Of course how each person responds is different, but if you are healthy and in decent shape, you will most likely come out of it with minimal issues, and maybe even none post surgery.

It is a risk, but in my opinion one worth taking. I'm so glad I went through with it. I was scared but the results have more then made up for any worries I had. The most important thing is to be sure your surgeon knows what he is doing and that you go into all of this knowing what to expect. It doesn't mean anything bad is going to happen, but you should definitely be aware of the risk before hand.

Don't be afraid to research your doctor either, or ask questions. It's your jaw, you have to be proactive in what is going to happen to you so that your experience can be a positive as possible.

Good luck!

Brandy

#3 Post by **dubnobass** » Fri Jan 11, 2008 1:27 am

I'd got for option 2. You might as well try to get the best possible result out of all this, and in terms of recovery, I don't think it makes any difference whether you have both jaws done or just one. I had both done, and was back to work after 1Â½ weeks. I was offered the option of having just the lower, or both, and chose to have both.

It is true that you do run a higher risk of nerve damage with both jaws being done, but most patients recover eventually. I can't find the papers I dug out on this but I think the incidence of permanent numbness is something like 5%, and even then, most patients learn to live with it and still think the surgery was worth the numbness.

#4 Post by **chrisk** » Fri Jan 11, 2008 3:17 am

Hi Paul,

My advice is to go for option 2. I had upper and lower jaw surgery, and genioplasty in August 2006, to correct a 15mm overjet (reduced to 10mm by my braces) and a cant in my top right hand jaw. I had 4mm up and out on my top jaw, 9mm on my bottom jaw, and 6mm on my chin, so I had substantial movements.

I still have numbness in my chin and right hand lower teeth and lip but it is very liveable. It feels like a thick patch and I am still confident that I will eventually get full feeling back, as I still feel that it is oh so slowly improving. My top teeth also have a tight odd feeling to them but again, this is also gradually improving.

I would do it all again tomorrow if I had to, since the improvement in my dental health, self esteem, and profile has been worth the small disadvantage of differing sensations in my lip and chin. To be able to eat apples and corn on the cob properly, and bite and chew food without tearing it off has been wonderful.

#5 Post by **smileyone44** » Fri Jan 11, 2008 8:26 am

I would go with option 2 also. You might as well only have to do one surgery now rather than follow-up ones later for the same problems if you can avoid it. Plus, it looks like the disadvantages to option 2 are only "possibilities" and the advantages are much greater.

Also, for Chrisk--I also have a cant in my upper jaw and I was wonderng if if you noticed any changes to your nose after the cant was straightened?

#6 Post by **Paul** » Fri Jan 11, 2008 8:55 am

Thanks for all the quick and helpful replies.

Ive made up my mind, Iam going to say I would like to have both jaws done.

To be honest, even if I do end up with permanent numbness, which I know isnt that big a risk, I think I could live with it compared to only having my bite half-corrected.