Metal Mouth Message Board

My surgeon briefly mentioned that sometimes it is difficult to secure the plates on the mandible and so in some cases they must literally drill through your face to screw in the plate. I have a co-worker who had orthognathic surgery 10/15 years ago and he had little marks on each side of his jaw. How common is this????

I had the same thing. A small incision on each cheek. I think it is fairly common for lower jaw surgery.

I have tiny little incisions on each side of my mandible. It looks like only about 3 stitches or so each cut. I didn't even notice them until 2 days after surgery.

Wait, so this is fairly common? How noticeable are the stitches about 7-8 days after surgery?

This is very common, especially if your surgeon doesn't use plates on the bottom jaw. If they use screws only, this is how they place them. They are called "punch incisions".

I think guys have it a bit easier here...Generally speaking us guys don't have flawless skin like a lot of women out there, so you can barely notice them. Plus, we could always grow facial hair if they were noticeable (which, I can almost promise you they will NOT be noticeable).

I'm 6 weeks out and you'd have to absolutely go looking for them to spot them.

Good Luck!
Chicago29

yeah i have a stich on each cheek. Its a really tiny incision, I'm pretty sure if it leaves any mark it won't be worse than a zit scar really! Anyways that's what concealer is for right?:)

I don't have any marks on my cheeks; but I do have a small horizontal scar, about 3-4mm long, between my eyes. It's from where a screw was drilled into my forehead to take measurements from. I must say I was rather surprised to find stitches at the top of my nose when I woke up! It's barely noticeable, and even at four weeks out of surgery it's already starting to fade a little.

dvdrdiscs wrote:Wait, so this is fairly common? How noticeable are the stitches about 7-8 days after surgery?

it really depends on your surgeon. none of the surgeons in my area still do this, but apparrently elsewhere it's very common. It depends on the type of fixation he uses on your lower jaw.

Interesting! Thanks everyone! I will definitely put this on my list as something to talk to my surgeon about again! I scar very easily and hope he will use a fixation that does not require this.

i have 2 small incision scars (one on either side) just under my jaw line that no one can notice..

chicago29 wrote:This is very common, especially if your surgeon doesn't use plates on the bottom jaw. If they use screws only, this is how they place them. They are called "punch incisions".

I think guys have it a bit easier here...Generally speaking us guys don't have flawless skin like a lot of women out there, so you can barely notice them. Plus, we could always grow facial hair if they were noticeable (which, I can almost promise you they will NOT be noticeable).

I'm 6 weeks out and you'd have to absolutely go looking for them to spot them.

Good Luck!
Chicago29

I'm rather confused by what you're saying. Assuming someone gets BSSO, they will definitely get their jaws fixated by plates. Those plates are held together by screws. So what do you mean if the surgeon doesn't use plates and screws only?

dvdrdiscs,

No, not all surgeons use plates for a BSSO. I have screws only, and there have been others on here that have had the same. In fact, I posted about this right after my surgery in September.

I asked my OS about this as I thought plates were a sure thing. He said that when the movement is on the low end, using plates is not necessary.

In addition, he said that at an OMS conference he just attended, more and more surgeons are using screws only and avoid the plates altogether. The reason for this is the higher rate of infection with plates. That's proven itself on this message board as the number of people that end up with plates removed seems much higher than the "4% or 5%" that you'll see in literature.

Anyway, I hope that clears up my original post.

-Chicago29

By the way, screw fixation for a BSSO is called "bicortical screw fixation". Anybody interested in it can Google it for more details. It seems to be very popular and has been around for quite some time, but admittedly I didn't know about it until after I saw I only had screws on my xrays.

I see. Is the reasoning for having to make an incision then because the screws used are longer when there are no plates? Sorry, I know these are all questions that I should be asking my surgeon but if you've read some of my posts, my surgeon is not very people friendly.

The screws are actually behind the back teeth...up more on the ramus. It is hard to describe. They aren't in the same location you'd typically see plates.

I really can't say I know exactly how the BSSO cuts are done. I've tried to figure it out, but I really haven't. I know it is a much longer cut than I thought...but that's all I really know.

And you should tell your surgeon to be nice and answer your questions...You are paying them a lot of money!!!!