SARPE Surgery

[sauerkraut]

My ortho never sealed anything?!

I really wouldn't worry about it. My ortho put plastic sealant over the expanded screw part of the expander once I was done expanding. Even as he did it he told me it wasn't strictly necessary, and I think many orthos don't bother.

Glad to hear the pressure has eased now.

[likemysmile]

From my understanding I think the wide variation in cost is all dependent on whether the surgery is a "pure" SARPE or if it is a SARPE with a LeFort. A true SARPE is less invasive than a SARPE with a LeFort. If you google SARPE+surgery+diagram the fourth of fifth site down will be a book titled Introduction to Ortho. It explains the various types of surgeries and explains how a LeFort is a "segmental" surgery while a SARPE is not. I suspect this why some of us recover from a "SARPE" quickly with few ill effects and others, those with a SARPE and some type of LeFort, need a lot more time to heal.

I had a SARPE without any LeFort on Oct 28 and the cost was $1800 and the anesthesia was $494. Thankfully my insurance covered 80% because it was considered "medically necessary" in my case. Although the statement I received states LeFort I Osteotomy I did not in fact have a LeFort. When I anxiously asked at my pre-surgery appointment about my recovery, my surgeon specifically told me he wasn't doing any LeFort. He explained how, because my surgery was only a SARPE, my recovery would be easier than some of the arduous experiences I had read about here. It seems the terminology is used a little loosely when it comes to a LeFort. From what I gather, LeFort is used generally to refer to any type of upper jaw surgery.

Hope this information is helpful.

I'm considering having the SARPE surgery next month. Like you, my insurance will not cover the procedure - we asked, they said no!

My insurance did, however, cover the cost of the consultation, so that's $92 I don't have to pay.

If I have the procedure, it's going to be roughly $3,000.00. I don't have the severe crowding you describe, so I wonder if you'll need surgery beyond just the SAPRE? As I've trolled various blogs, there are so many different types of orthognathic surgery, the only way to really know what you'll need and what it'll cost is to see an OS.

Hey everyone! I'm new & have questions for one of you pros, or anyone who's had SARPE. I'm 24 & have SEVERE upper crowding (severe is an understatement- I actually have one of my front teeth on the roof of my mouth) due to apparently a tiny upper jaw/palate. I found out a few days ago at my 2nd ortho consultation that I'd need to expand that puppy to make room for all my teeth & this happens with surgery & an key expander. I'm so excited to finally know what I need to do to fix the teeth that have long made me feel super insecure, and gave me a bit of a lisp (due to "alien" haha tooth on roof of mouth I'm guessing). But I'm also TERRIFIED as I read most are. After days of reading on this forum, I feel as comfortable as I'm going to about the post-op condition I'd be in. The main thing frightening me is cost! I finally know what to do to fix my teeth & don't know if it's going to happen all of a sudden, b/c I was only prepared for the expense of braces- not an additional surgery. My orthodontist said that'd be something I had to talk to the OS about & wouldn't even begin to ballpark a figure. However, I've read that some people are looking at a $250+/- consult fee just to meet w/the OS's. Having no idea if this surgery is even financially attainable, I don't want to shell out a huge consult fee, only to find out the surgery is waaay outta my means. My current health insurace doesn't cover orthognathic surgery, so it'll be allllll out of pocket for me (as the braces will be as well). So I can't even figure out if this is a $20,000 surgery or a <$5,000 surgery?! I feel so clueless & can't come up with any successful google hits!

Can someone please help me out? I'm sure it varies widely depending on surgeon, hospital, geography, etc, but I'm just going for a vague ballpark... Any idea how much the sarpe surgery generally costs?

[Foxface]

Sigh. Any other updates from you folks? I'm still expanding and wishing that my SARPE had not been done as a LeFort, since my upper jaw is still moving all over the place. It doesn't really hurt, but I still have a hard time closing my mouth. Feeling everything shift around in there is completely unnerving. For those of you who had that type of SARPE, how long did it take until the bones fused back together and you had some more stability?

[shari]

Foxface - I'm pretty sure I had the same kind of surgery. I only found out after when I went to see my surgeon 3 days after the surgery. He took an xray and show me the 'break' line above my teeth and said the the break was nice and straight. I don't remember anything feeling unstable, but there was alot of discomfort during the whole time I was expanding (30 days post op). It's been 2 months since my surgery and in the last week I've been making lots of progress with the swelling and the discomfort. Hang in there, it does get better!

[Foxface]

That sounds encouraging, shari. (although I'm slightly jealous you're already a month ahead of me! ) I hope I'm done expanding soon, I'm in the middle of the 2nd week (1 more to go, I think. Yuck. ).

The good thing about my treatment plan is that I get to do all the really icky stuff first. The braces will not be fun and the 2nd surgery will be worse than the first, but the expanding / healing / speaking with expander while working full time portion of the plan has to be worse than being at home for 5 weeks while waiting for your jaw to heal. So by the time the new year rolls around, I'll know some of the worst stuff is behind me.

[shari]

That sounds encouraging, shari. (although I'm slightly jealous you're already a month ahead of me! ) I hope I'm done expanding soon, I'm in the middle of the 2nd week (1 more to go, I think. Yuck. ).

The good thing about my treatment plan is that I get to do all the really icky stuff first. The braces will not be fun and the 2nd surgery will be worse than the first, but the expanding / healing / speaking with expander while working full time portion of the plan has to be worse than being at home for 5 weeks while waiting for your jaw to heal. So by the time the new year rolls around, I'll know some of the worst stuff is behind me.

You'll find that as the swelling eases speaking will become easier. My prononciation is much better now. I am having my braces put in on December 2nd, but there is no second surgery for me!
I remember counting the days when I was expanding...seems so long ago now. Take the time to heal. I had originally taken 2 weeks off and took and extra week plus 2 weeks at 3 days a week. Had I been better informed I would have taken 5 weeks as well.

[Foxface]

That sounds encouraging, shari. (although I'm slightly jealous you're already a month ahead of me! ) I hope I'm done expanding soon, I'm in the middle of the 2nd week (1 more to go, I think. Yuck. ).

The good thing about my treatment plan is that I get to do all the really icky stuff first. The braces will not be fun and the 2nd surgery will be worse than the first, but the expanding / healing / speaking with expander while working full time portion of the plan has to be worse than being at home for 5 weeks while waiting for your jaw to heal. So by the time the new year rolls around, I'll know some of the worst stuff is behind me.

You'll find that as the swelling eases speaking will become easier. My prononciation is much better now. I am having my braces put in on December 2nd, but there is no second surgery for me!
I remember counting the days when I was expanding...seems so long ago now. Take the time to heal. I had originally taken 2 weeks off and took and extra week plus 2 weeks at 3 days a week. Had I been better informed I would have taken 5 weeks as well.

I was actually referring to the 2nd surgery, which might be either just upper jaw surgery or a BSSO. For the SARPE + Lefort, I took about 10 days off, which is not much, but I cope (better than staying at home obsessing about your jaw). About the speaking, I can only hope so - my lishp is pretty bad right now.

[sauerkraut]

If I had a brain I’d be dangerous. I am finally waking up to the fact that not everyone has all their jaw bones “loosenedâ€

[AtLast]

BraceFace36-

I'm not sure how much research you've done, or if you have time to do this, but I've found many people have posted (on various websites) that they've fought to prove SARPE as medically necessary to get it approved. In my case my orhto referred me to an ENT (who I haven't seen yet) & feels confident that this surgery will make a huge improvement in my ability to *breathe*, lol...It's funny b/c I always thought all the breathing through nose (or lack of the ability to do so well) was NORMAL until my ortho asked a bunch of questions like "do you sleep w/your mouth open?" (my answer was yes, of course). We'll see what the ENT says but my upper jaw is apparently exceptionally small, so I'm hoping to prove medical necessity. Even then from what I've read it will be a fight w/my ins. company, but I've read some people have gotten these medically necessary procedures (considered by ins to be cosmetic- ha) by basically harrassing the ins. co. My benefit booklet specifies that these "cosmetic" proceedures should be exceptions when medically necessary.

Also, I found out I do indeed need multiple sugeries. Who knew my face was so out of whack, lol? Not me. Apparently I need to have my bottom jaw set back, my top jaw both brought fwd & expanded! The expansion is the most necessary, as it will have numerous medical benefits (according to my ortho) and if they don't expand they'd have to pull two teeth, which would apparently only exaggerate my too small top jaw & to big/far fwd bottom jaw. As far as moving my jaws fwd/backward where necessary- I haven't decided if I'll do it or not. I KNOW the ins. won't cover that, & even though I don't love my profile, I'm worried i'll possibly love it less after that big of a change. I'm afraid if I have all three I'll hardly recognize myself in the mirror... It also seems that perm. numbness is more common w/bottom jaw surgery & that's scary too..

So, as we go along, we'll see. At my next ortho consult. they'll upload my x-rays & superimpose them w/digital photos so we can view expected visual results & weigh more on the pros & cons on lining up my jaws appropriately vs. just making room to straighten the top teeth & breathe through the nose.

Sure wish I could go back & tell the mom of 13-year-old-me to have this all checked out, lol

Also found out at my teeth cleaning today that all four wisdoms must come out. Top teeth need space & bottom are partially impacted, so I'll plan on using the same OS for the other surgeries & maybe begin to discuss further with him...

Thanks to all for the help

[quote="BraceFace36"]I'm considering having the SARPE surgery next month. Like you, my insurance will not cover the procedure - we asked, they said no!

My insurance did, however, cover the cost of the consultation, so that's $92 I don't have to pay.

If I have the procedure, it's going to be roughly $3,000.00. I don't have the severe crowding you describe, so I wonder if you'll need surgery beyond just the SAPRE? As I've trolled various blogs, there are so many different types of orthognathic surgery, the only way to really know what you'll need and what it'll cost is to see an OS.

[nesnob]

Hi Guys,

Did anyone find that their SARPE caused an open bite, and if so was it ultimately corrected?

I never used to think of myself as a hypochondriac, but the different twists and turns on my SARPE journey do get me a little worried ...

In my case expansion was done very rapidly, with my Ortho applying 4 turns a day for a week and a half. By the end of that both sides of my maxilla appeared slightly angled out like wings, but one side was lower than the other by several millimeters. I think the expander may not have been completely horizontal when it was cemented in place, in part because even after the spacers everything was still very tight.

Things seem to have stabilized, but I now have an open bite on just one side: none of the teeth touch from front to back.

My gap is still closing slowly, and I still have the slightly-wonky expander in, so I'm hoping that once the expander is removed that this open bite can be corrected by braces and elastics alone.

Is that overly-optimistic? Does anyone else have similar experiences?

Any comments would be greatly appreciated!!

[badbite]

nesnob,

SARPE has made my open bite worse, and I know it created an open bite for many. Don't worry your ortho will take care of it. I know many of us already need another surgery. I am not too worried about the open bite yet, since I have always had one.

[Foxface]

nesnob,

SARPE has made my open bite worse, and I know it created an open bite for many. Don't worry your ortho will take care of it. I know many of us already need another surgery. I am not too worried about the open bite yet, since I have always had one.

Seconded. I'm thrilled that in the expansion process, I've gotten to the point where the molars on both sides touch. The right side is slightly lower though. But I don't expect my bite to be perfect until after the second surgery.

[nesnob]

Ah ... I was very, very much hoping not to need a second surgery, and that braces alone might be sufficient.

I think I better have a chat with my ortho.

However thank you very much for responding. And at least I have pretty good contact on one side

[badbite]

nesnob, If your only other problem is an open bite, this can be fixed without surgery in many cases. Def. ask your ortho so he can put you at ease.

[sauerkraut]

Here's another one who ended up with an open bite after SARPE .

I remember my dentist rattling her probe around in the gap and saying something like "Ooh, I wonder how the ortho's going to fix this!" It does seem to be getting better with braces, even without elastics.

And don't worry about extra surgery, nesbob. Like badbite says, it doesn't necessarily take surgery to fix an open bite. Lots of us are/were due a second op anyway, for other reasons - in my case to bring forward the lower jaw. It may well fix the open bite as well but that's more of a "side effect" than the primary purpose of the op. If you see what I mean .