Upper jaw is "off" after surgery

Message

#1 Post by **moth** » Sat Apr 11, 2009 6:28 pm

Hi everyone,

I had Lefort I, BSSO, and genioplasty done on the 6th. Everything went okay at first, and then my lower jaw shifted and 1 day later, they noticed that my lower jaw seemed to have shifted even though the xrays looked okay. I went in for a second surgery the next day to fix the lower jaw and secure it more, as my surgeon made some small incisions through my cheeks and readjusted things. The lower jaw seems to be sitting just fine now. My concern is now the upper jaw, which is off. My teeth do not sit centered under my nose, they are shifted to the right (by about the size of one whole front tooth, if that makes sense). When the surgeon was doing the surgery, he said that when there was no swelling, and when my mouth was entirely relaxed, everything was perfectly in position. It was only afterwards, once swollen again, that the position was off.

He didn't seem to be concerned about the shift because he doesn't normally wire/band people shut right after surgery, he says it's too uncomfortable for patients. Instead, he puts the bands on about a week later. He said to me that since my bite was sitting perfectly when he set it and when there was no swelling, that the bands he puts on will shift it back into place. I have much more swelling on the left side of my face which would seem like it makes sense, as my upper jaw is shifted to the right.

Has anyone had this happen? I'm concerned because the upper jaw looks so off... and I don't understand how if it's screwed into place, how swelling can push it out of place so much. Can bands shift things back into place this much? I also have significantly more pressure on the right side of my face and ear (the direction into which it shifted). I'm really not hoping for a third surgery!!!

Thanks!

#2 Post by **moth** » Sat Apr 11, 2009 6:33 pm

Forgot to also mention that among other things, my surgery corrected an asymmetric bite which leaned towards the right. The left side of my jaw grew longer. The surgeon said that the way my muscles used to be will affect the swelling, and that my upper jaw also looks "off" right now because of the muscle memory.

#3 Post by **Emaciated** » Sun Apr 12, 2009 10:11 am

My jaw(s) shifted slightly too, by a few millimeters at least. My midlines were perfectly aligned but after a few weeks of chewing the bite settled with my midlines slightly off, maybe by 1mm. My teeth still fit well and its not noticeable to anyone but me, but the shift clearly took place after I had already started healing, like you're describing. I blamed it on chewing but I suppose it could've been due to swelling too. From the distance you're describing it sounds like you must be pretty swollen if that IS the case.

#4 Post by **peggysue** » Sun Apr 12, 2009 10:16 am

Hi Moth,

I had a Lefort I on the 25th of Feb and went through something similar to you in terms of the mid-line not meeting up straight away. When my surgeon checked my mouth a few hours after the op my teeth didn't meet properly and I was a bit concerned about it. He assured me that during the op they had aligned them and double checked by wiring the top and bottom jaws together. The swelling made it seem like they jaws were off but they definately weren't.

I was sent home without any bands and saw my surgeon a week later to be tightly banded. I'll be honest with you...it was probably the toughest part of the whole procedure! The four days it took for my mid-line to shift into its correct position were very hard...they best way to describe it is like tectonic plates moving! Not painful but the tension and pressure I experienced was immense. This part just takes time, as it takes a while for the muscles to give in to the new position...my mid-line would slowly shift into the right position, then jump back in the space of a few hours but after a few days it'll settle, and the results will be there for you to see!

After getting through that tough spot I went to my ortho who changed my elastics for lighter ones that I can take out for eating and cleaning. It was such a relief!

I'm nearly 7 weeks post-op and still wearing them (and its wise to keep an eye out for any movement during this time just in case)but everything is looking good so far!

Good luck, I'm sure you'll be fine...and it'll all be worth it in the end!
x

#5 Post by **Emaciated** » Sun Apr 12, 2009 10:23 am

Here are some related threads too if they make you feel any better or are helpful at all:

Post surgery, midline's off
viewtopic.php?t=26973

midline asymetry
viewtopic.php?t=22884

#6 Post by **moth** » Sun Apr 12, 2009 11:39 am

Thank you both *so* much for the information!

I feel much more relieved... was hoping not to go in for a 3rd surgery haha

#7 Post by **brendan** » Sun Apr 12, 2009 6:52 pm

I just checked mine

In between my middle teeth, the line is a few MM off from the center of my nose. its also titled a bit [my whole bottom and top teeth are too] by about 2 mm. Kinda weird.. not sure if its swelling or the fact i lifted about 130 lbs up a flight of stairs the other day... [dumbass idea]

#8 Post by **moth** » Sun Apr 12, 2009 7:30 pm

Haha! Hmm.. interesting. I guess I expected everyone to come out of surgery looking straight but I suppose not!

I measured the distance of my shift, it's not quite as big as a full tooth - it just looked like it. I should've measured first, lol. I keep feeling my ears pop/crackle throughout the day when I swallow, my right ear is ringing really loudly and hearing is really muffled. Have what feels like alot of pressure on the jaw joints. When I move my head to different positions, it feels like things "shift" a bit, I can hear little cracking sounds. Guess that's normal though. (hopefully

)