Metal Mouth Message Board

I've tried to search this on here and haven't quite found anyone who addressed it.

I just had my consultation with kaiser at the beginning of the week and was not prepared at all to be told I could have upper OR lower jaw surgery!!! I've had an underbite my whole life. I had a headgear when I was younger which helped a lot. But i still had this bigger lower jaw with a pretty good size chin that definitely bothers me. Right now after 2 years of Invisalign my teeth are ready for surgery and he says I only need about 4mm done. My side profile definitely shows an underbite. My bottom lip sticks out farther than my top by a lot and my whole chin protrudes. My surgeon said the problem with moving the lower jaw back is the tissue and getting "turkey neck" as I get older (I'm 28) although I've only seen good things with before and after pics. He said he could also move the top jaw forward which will make my nose poke just a tad bit upward. I guess I don't know how I feel or which I would like better. Pulling my upper jaw forward would it make me just look like I have a huge face since I have a jaw a little bigger than normal? Has anyone had lower surgery and it not looked THAT much difference? ( I saw one before and after that seriously didn't look different!) it scared me!

And lastly does my opinion even matter when it comes to the treatment plan with the drs? If I can do either can I decide which one I'd like?

For me it was kind of odd; my initial referral from my ortho was for lower surgery. It's a logical choice; my jaw is so crooked that on x-rays my chin is comically shifted significantly towards the right. (As an amusing side-note, seeing that x-ray helped explain why it was so difficult to trim my goatee evenly... I keep my goatee on-center, even though my chin isn't; it actually does a great job) When I went for the consult with the surgeon, I was instead offered either upper or upper/lower. Lower-only was never even on the surgeon's list; there was a problem with the width and position of my upper jaw not fixable with SARPE... lower would have been just cosmetic.

I chose upper-only because the recovery from upper/lower is significantly more difficult. Since my lower was not fixed, my upper midline was shifted to match my offset lower midline, which I know really bugs my ortho. But that's just a cosmetic quirk; functionally my ortho, general dentist, and oral surgeon all think the final result is really good.

sirwired wrote:
> For me it was kind of odd; my initial referral from my ortho was for lower surgery.
> It's a logical choice; my jaw is so crooked that on x-rays my chin is comically
> shifted significantly towards the right. (As an amusing side-note, seeing that x-ray
> helped explain why it was so difficult to trim my goatee evenly... I keep my goatee
> on-center, even though my chin isn't; it actually does a great job) When I went
> for the consult with the surgeon, I was instead offered either upper or upper/lower.
> Lower-only was never even on the surgeon's list; there was a problem with the width
> and position of my upper jaw not fixable with SARPE... lower would have been just
> cosmetic.
>
> I chose upper-only because the recovery from upper/lower is significantly more difficult.
> Since my lower was not fixed, my upper midline was shifted to match my offset lower
> midline, which I know really bugs my ortho. But that's just a cosmetic quirk; functionally
> my ortho, general dentist, and oral surgeon all think the final result is really
> good.

Hey thanks for responding! Do you wonder what you would have looked liked just doing the bottom? How drastic was the change? I guess deciding to do this at 28 years old is a big deal for me. I've always hated my lower jaw...I guess I feel like doing the upper jaw will only make me look worse and I'll still have this chin. So they said only doing lower was cosmetic? Did they say that from the first consult? Or once they start the 4 week pre-op they start deciding truly what would work? I go in for my braces consultation Monday and then have to call my surgeon back and schedule am appt for surgery. Still trying to do research on all of this...don't really know as much as i'd like.

Because I have a thick goatee, it hid/hides my lower asymmetry very well. (Although I can't say I ever noticed it (pre-goatee) until I knew it was there... I can now see it in old photos.) That means I suppose my "cosmetics" technically had a setback, as I went from just a lower asymmetry I couldn't see to keeping that lower asymmetry, and adding an upper midline shift to it also.

However, neither one of my cosmetic "problems" is/was readily apparent to a casual observer. It's the sort of problem that's easy to spot if you know it's there or are looking for it, but nobody just talking with me would ever notice. I expect that significant front/back jaw issues would be readily noticeable, so it's a completely different situation than what I was in.

Hotset,

did the surgeon give you the option of doing both jaws? It's usually the better option if you are concerned with aesthetics. I had very small movements but my surgeon still recommended moving both jaws and genioplasty for aesthetics. It's a face you're going to have to live with, why not get it done right the first time? What's the point of only doing one jaw to cut a few weeks of recovery time off when you can do both jaws and probably be more happy with the results.

[quote="sunnyD"]Hotset,

did the surgeon give you the option of doing both jaws? It's usually the better option if you are concerned with aesthetics. I had very small movements but my surgeon still recommended moving both jaws and genioplasty for aesthetics. It's a face you're going to have to live with, why not get it done right the first time? What's the point of only doing one jaw to cut a few weeks of recovery time off when you can do both jaws and probably be more happy with the results.[/quote]

SunnyD he didn't mention that...it was only my consultation. So maybe we can talk about that next appointment. I thought about it myself ever since my consult. I never thought anything was wrong with my upper jaw...but he pointed out how I don't have that full area around my nose...that bringing my upper out would get rid of the lines down the sides of my nose to my lip and fill me out. I have kaiser and I'm still wondering how easy they are. My consult was a breeze....is it an option to ask for both? Even though it's about 4mm maybe 5?

I think it really depends on the surgeon. I'm lucky to have a good surgeon who listens and understands what you end goal is for this surgery. My movements were small between 1-2mm split between both jaws. Perhaps if he did one jaw it would be 4mm? I think if you emphasize aesthetics double/jaw with genio would be the way to go but again it really depends on the case.

My surgeon was adamant doing both jaws and genio for the chin. He did ask me about leaving the chin and address it afterwards. But why would you want to go under the knife twice???? and after being 7 week post op after my surgery I would never ever do double jaw surgery again I rather keep my crooked jaw and teeth haha

In the end make sure you're happy with the plan, and comfortable with the surgeon. I've read some bad stories on other forums and I'm married to a dentist so I have a bit of inside info.

Interesting! Thanks for all the info!!!! I haven't read many with little movement needed. Would you say the 4mm made a lot of difference in your profile? Or just face in general? I was really hoping to move my chin back a good amount...when I heard 4mm I felt like it might not even change much. I've even gone as far as downloading a photo editing app and trying to alter my side profile to see what the bottom or top would look like!!! I'm def going to ask about my option for both! I have a feeling they won't just shave my chin for me like I would like! Since it's cosmetic and my insurance is kaiser.

Yes I look different. Some people say I look a lot different some don't notice a big difference. Personally I liked my old side profile better but overall I think my face does have better symmetry and balance.

Ive accepted my results thus far and willing to move forward. I wish you luck keep me updated.

During my initial consult, my ortho brought up the option of doing upper only, lower only, and both jaws and showed me computer imaging of each scenario. However after consulting with the surgeons, both sugeons I spoke with recommended lower only for me due to assymetry in my lower jaw. My movement was also about 4mm only (plus some rotation to fix the assymetry). I was told that doing the upper jaw as well will give me a fuller face, but since the movement will be so small, it was not worth the risk.

i kinda disagree with Sunny about doing both jaw if each jaw onlly needs to move 1 - 2mm. I think you really have to consider the risk v. benefits of cutting an additional jaw. In addition to having a longer recovery time, there is also more risk in terms of potential complication, infection, long term issue, etc. Will that 1 - 2 mm movement be worth the additional cosmetic benefit? Something for you to decide, obviously.

Alicia there's nothing to disagree with me about here. I am only pointing out that if you are concerned with aesthetics the surgeon should give you all the options. My point was echoed in your case because the option of doing both jaws for you would perhaps achieve a fuller face (aesthetics) but you were not comfortable with the risks compared to one jaw. Emphasizing my statement that in the end you should be comfortable with the surgeon and happy with the plan before proceeding.


Again it varies case by case. I would say the majority of surgeons would only love to move one jaw but they have to address the needs of all the patients and as patients admittedly or not we are concerned with "aesthetics". It's probably one of the primary factors why we do this.

Alicia110613 did you find a big difference in your appearance with the 4mm movement with the lower jaw? It just seems so small to me..I find myself worried that even though the surgery is for my general health of my teeth and jaw I DO want to look a little different from the surgery that it won't be much difference. Since my last orthodontist tried to move my teeth enough to do without the surgery...so now my front teeth sit almost right on too of each other

I definitely see a difference with 4mm, although it's not as drastic as people who have their jaws moved by 10mm for example (i.e. people are not going to think you look like a different person). With the lower jaw moved back, most of my friends can tell my chin just got smaller/more recessed (which helps with the profile). It doesn't change anything above the nose. Whereas if you only move your upper jaw, I'd imagine your cheekbone area will look different.

Either case, I think 4mm movement is considered relatively small when you look at the majority of jaw surgery cases. Most before/after pic I've seen tend to be in the 5 - 10mm range.

I may not have chosen my words wisely earlier, so hopefully my words did not offend anyone here. In any case, I hope you will find an option that you're happy with.

My lower jaw was moved 11 mm (BSSO advancement) but the difference in my appearance is very small. I looked pretty before the surgery and didn't had any functional issues or pain. After the surgery I have had pretty serious problems with function and pain. My surgeon didn't consider the risk v. benefits of cutting my jaw at all. My ortho and surgeon looked at the models and x-rays and the difference from normal situation was clearly huge for them but I functioned well and had no issues with aesthetics or pain.