Metal Mouth Message Board

So I'm in a confusing situation and I don't know what to do.

Basically, I'm a 19 year-old (20 in September). I don't have braces on right now. I will need to get braces puts on + undergo orthodontic surgery to fix an underbite. I currently have an orthodontist which I'm comfortable with. I've been to his office, met him and have read a bit of reviews on him. There is barely any review written on him online, but for what there was, it was good things being said.

However, here's where things get tricky. My orthodontist referred me to a surgeon he worked with often, and I've been to his office once already. I'm not sure if I'm very comfortable with him. The positives are, he is said to be very experienced, and he has a website with some videos of patients he's worked on, unlike some other surgeons. The negatives are, I've read several bad reviews about him online where people have said he only cares about money, or they can't even tell the difference after their surgery. These are things with scare me. I've met him and he did seem like he was trying to make the surgery seem less severe than what it really is, saying there are no risks, and that the surgery only takes about a half an hour depending on the case, whereas other surgeons have told me different.

I told my orthodontist that I'm not very comfortable with him, and I found a different surgeon and went to a consolation. The problem is, this second surgeon was taking some time to get back to my orthodontist after my consolation, and my orthodontist wants to do this approval process as soon as possible. He asked me if I can go to the first surgeon's office (the one with the bad reviews), because the process of getting approved for the surgery will take much quicker. He said if I don't want to have surgery under the first surgeon, nobody is forcing me to, and I can find a different surgeon to go under the actual surgery once it's time for the surgery, but I should go to his office so he prepare documents for my orthodontist that he needs to send out to the Board of Health.

So basically, to make a long story short, I'm about 2 years away from going under the actual surgery, and my orthodontist told me that once it's time to undergo the surgery, I can switch surgeons to somebody I trust and get it done.

Does this make sense to you guys?

The one thing I don't understand is, I've heard that when doing this type of surgery, the orthodontist and the surgeon have to work together. The orthodontist puts the braces on, and the orthodontist and surgeon keep in touch with each other to make sure things are going as planned as you prepare for surgery. I'm not sure how that will be possible... I am very confused and will have to ask me orthodontist I suppose.

benzorlb wrote:... However, here's where things get tricky. My orthodontist referred me to a surgeon he worked with often, and I've been to his office once already. I'm not sure if I'm very comfortable with him. The positives are, he is said to be very experienced, and he has a website with some videos of patients he's worked on, unlike some other surgeons. The negatives are, I've read several bad reviews about him online where people have said he only cares about money, or they can't even tell the difference after their surgery. These are things with scare me. I've met him and he did seem like he was trying to make the surgery seem less severe than what it really is, saying there are no risks, and that the surgery only takes about a half an hour depending on the case, whereas other surgeons have told me different.

... So basically, to make a long story short, I'm about 2 years away from going under the actual surgery, and my orthodontist told me that once it's time to undergo the surgery, I can switch surgeons to somebody I trust and get it done.

Does this make sense to you guys?

HALF AN HOUR FOR SURGERY???!!!

I think you're absolutely right to keep looking. I was lucky in that I went to two surgeons, had pre-surgery models and work-ups done, and then decided. My surgery took ~ 2 1/2 hours. It is not the riskiest surgery in the world, but both surgeons walked me through two pages of potential complications. The surgeon I chose, because I liked him better, explained the risks AND the likelihood of each. (I.e., "death" was near 0% likely, but temporary numbness was almost 100% likely, and some permanent numbness was about 5% likely, etc.) You need to know all of this.

The surgeon I chose had done 3,000+ of these. He explained the liquid diet timeline and how the healing process typically happens. They have a 24-hour line where you can ask non-emergency questions.

Also, there are different procedures that are collectively lumped under "jaw surgery". I would recommend you get a few diagnoses and opinions as to exactly what you need. In my case, I got the identical diagnosis for both surgeons (and two orthodonists), so I was comfortable that the surgery planned was necessary.

You said you've got two years. This is a big decision. I would schedule a few consultations with reputable surgeons, gather more info, get more comfortable. What you don't want is to be ready for surgery and then 'shopping' for a surgeon at the last minute.

Good luck.

benzorlb wrote:The one thing I don't understand is, I've heard that when doing this type of surgery, the orthodontist and the surgeon have to work together. The orthodontist puts the braces on, and the orthodontist and surgeon keep in touch with each other to make sure things are going as planned as you prepare for surgery. I'm not sure how that will be possible... I am very confused and will have to ask me orthodontist I suppose.

My ortho and surgeon know each other well and talk frequently about their cases.

When you talk to surgeons, they'll ask you who your orthodonist is. It's a good idea to ask whether they know each other, and how they plan to communicate during the process.

Sometimes you have to take charge. For example, I returned to the orthodontist for my second post-op appointment and they wanted to take new Panorex x-rays. I knew that I had just had those, post-op, at my surgeon's office, so I told the ortho and he called over and they emailed the digital images to the ortho -- saved me another round of x-rays.

If I were you, I'd probably find another orthodontist, mainly because I don't like the sound of him trying to pressure you into going to see the surgeon simply to get the process started. What's his rush? Are you not covered by insurance for orthodontics after 19?

I can see your orthodontist's point about switching surgeons, because you do have that option, but if you switched surgeons, you'd still have to get another insurance authorization from that surgeon's office (assuming you're in the US). I don't think I quite understand why the orthodontist needs the surgeon to get this process started. Aren't the braces and surgery two separate approvals?

The orthodontist and the surgeon do need to talk often and be in communication with each other, but if you're 2 years out from surgery, they're likely not going to be talking that frequently about you for a while.

Personally, I don't take all that much stock into online reviews, particularly when there are few reviews. I'm assuming you're looking at sites like yelp or yahoo things like it, and not the jaw surgery sites. While it's nice to have some positive things said, you never know who's posting the reviews. I think you were right in fleeing from the first surgeon based on your interactions with him.

If I were in your position, I'd probably find a surgeon that I'm comfortable with first and ask him for a few orthodontist recommendations. A good surgeon always has orthodontists that he works with frequently.

Good luck .

Bullfighter wrote:

benzorlb wrote:... However, here's where things get tricky. My orthodontist referred me to a surgeon he worked with often, and I've been to his office once already. I'm not sure if I'm very comfortable with him. The positives are, he is said to be very experienced, and he has a website with some videos of patients he's worked on, unlike some other surgeons. The negatives are, I've read several bad reviews about him online where people have said he only cares about money, or they can't even tell the difference after their surgery. These are things with scare me. I've met him and he did seem like he was trying to make the surgery seem less severe than what it really is, saying there are no risks, and that the surgery only takes about a half an hour depending on the case, whereas other surgeons have told me different.

... So basically, to make a long story short, I'm about 2 years away from going under the actual surgery, and my orthodontist told me that once it's time to undergo the surgery, I can switch surgeons to somebody I trust and get it done.

Does this make sense to you guys?

HALF AN HOUR FOR SURGERY???!!!

I think you're absolutely right to keep looking. I was lucky in that I went to two surgeons, had pre-surgery models and work-ups done, and then decided. My surgery took ~ 2 1/2 hours. It is not the riskiest surgery in the world, but both surgeons walked me through two pages of potential complications. The surgeon I chose, because I liked him better, explained the risks AND the likelihood of each. (I.e., "death" was near 0% likely, but temporary numbness was almost 100% likely, and some permanent numbness was about 5% likely, etc.) You need to know all of this.

The surgeon I chose had done 3,000+ of these. He explained the liquid diet timeline and how the healing process typically happens. They have a 24-hour line where you can ask non-emergency questions.

Also, there are different procedures that are collectively lumped under "jaw surgery". I would recommend you get a few diagnoses and opinions as to exactly what you need. In my case, I got the identical diagnosis for both surgeons (and two orthodonists), so I was comfortable that the surgery planned was necessary.

You said you've got two years. This is a big decision. I would schedule a few consultations with reputable surgeons, gather more info, get more comfortable. What you don't want is to be ready for surgery and then 'shopping' for a surgeon at the last minute.

Good luck.

Yeah, it sounded ridiculous to me. I've been told that I'm going to need to have my lower jaw moved back and my upper jaw moved forward, so I imagine that would take even longer than just moving one of them. I have a pretty severe case, I guess you would say.

I'm aware of all the complications that come with surgery. The other surgeon which I liked better told me the complications such as, sometimes you need to re-do the surgery and other stuff like that. This surgeon told me there is no major risks.

A plus is, he's said to be very experienced, as I mentioned before. He is said to have done thousands of these surgeries as well. He's an older man who looks to be in his 60's, however, I'm just not so sure.

I agree with you completely. I'm going to talk to my orthodontist and see what I'm doing. I definitely want the best surgeon possible. This is such a major surgery and I'm a person who always strives for perfection. I can't stand settling for a barber who isn't the best or something like that, there's no way I'm going to let myself settle for a surgeon who's not one of the best out there.

SLiM2590 wrote:If I were you, I'd probably find another orthodontist, mainly because I don't like the sound of him trying to pressure you into going to see the surgeon simply to get the process started. What's his rush? Are you not covered by insurance for orthodontics after 19?

I can see your orthodontist's point about switching surgeons, because you do have that option, but if you switched surgeons, you'd still have to get another insurance authorization from that surgeon's office (assuming you're in the US). I don't think I quite understand why the orthodontist needs the surgeon to get this process started. Aren't the braces and surgery two separate approvals?

The orthodontist and the surgeon do need to talk often and be in communication with each other, but if you're 2 years out from surgery, they're likely not going to be talking that frequently about you for a while.

Personally, I don't take all that much stock into online reviews, particularly when there are few reviews. I'm assuming you're looking at sites like yelp or yahoo things like it, and not the jaw surgery sites. While it's nice to have some positive things said, you never know who's posting the reviews. I think you were right in fleeing from the first surgeon based on your interactions with him.

If I were in your position, I'd probably find a surgeon that I'm comfortable with first and ask him for a few orthodontist recommendations. A good surgeon always has orthodontists that he works with frequently.

Good luck .

I think it's because I might get too old and the insurance won't cover it anymore or something like that. At least that's what I heard, that once you get older, the insurance might not cover it... is that true?

To be honest with you, I am really not sure. I have to call and ask some more questions. I think that's what I'm going to do - I'm going to call my orthodontist and figure out what exactly I'm doing.

Yeah, I know what you mean about the online reviews. They can be tricky, I remember finding some driving school and seeing hundreds of good online reviews, only to figure out that it was the company constantly putting up good reviews about themselves.

It's still scary to see anything bad about a surgeon you might consider, though.

Thank you for the advice, the thing is, I need to find a surgeon who takes my insurance... it's definitely a process and I'll keep you guys updated .

Oh yeah, it must be that you're not covered by insurance for braces after 19. My policy is structured that way, so I'm paying out of pocket for braces.

The surgeon that you liked couldn't refer to you to someone?

I would also start finding out if your insurance will cover the jaw surgery after the age of 19. I have had two different insurances tell me that they will not pay for jaw surgery or hospitalization because I'm older than 19. My surgery is in the middle of this month and I will be paying everything myself.

And I agree with other people here. You should really find an orthodontist and oral surgeon who work well together so that you can have the best outcome.

Good luck!

Experience doesn't always equal excellence. You can have someone who's been practicing the right things for 7 years or one who has been practicing the wrong things for 17.

Good luck and keep us up to date.

listen to your gut and take your time to find someone you really trust!
I have a great ortho-team and the clinic is catered to low income families, so i went for a consultation with a very pricey up-scale orthodontist, found out with who he conducts his surgeries with, went back to my orthodontic clinic and connected them to the surgeon who was very reputable etc. so I got really lucky!!!