reason for your orthognathic surgery

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#1 Post by **jayye** » Sat Jul 11, 2009 10:12 am

What was / is the reason for your orthognathic surgery?

Are most people here because of pain / health / unable to chew reasons? Im wondering as my reason for 'wanting' to go through this is cosmetic. Looking back through some older posts I saw someone else who was here for cosmetic reasons and some other people said to him/her that they wouldnt go through all this just for cosmetic gain.

I hope Im not judged as shallow, I absoloutely hate my profile and have spent my whole life since I knew how ugly it looks trying to hide it. Ive always pushed out my jaw when possible, worn my hair long and down to try and cover my profile etc. Im not a good night sleeper and breather due to my short recessed jaw but this alone would not make me go down the orthognathic path. Now age 36 I am ready (?!) to do something about it. I see my ortho next week and I hope he can help me. Would you / have you done this for looks alone? Do you think it is right / wrong for me to do this? Thanks

Sat Jul 11, 2009 11:09 am

Welcome aboard arch wired. I personally believe that if you feel something needs to be done then I think you should go for it. some people may say "why are you doing this? and "Do you know what you are getting yourself into". I think If you really want to do this and you are willing to commit to treatment then I think by all means you should go for it. While its true there are alot of people on here that are doing it for non cosmetic reasons I'm very sure that you are not alone. The lack of sleeping at night and breathing issue sounds like it could be a medical reason but you would have to talk to your ortho about this and see what he or she thinks.

Congratz on taking the plunge on deciding on getting to get braces!

#3 Post by **crazybeautiful** » Sat Jul 11, 2009 11:56 am

I know exactly what you mean about wearing your hair down to cover your profile. I do the exact same thing. Actually until recently I always had very long hair, as if that would somehow work as a better disguise

It's a difficult one to judge, because personally I think things like having boob jobs, etc are silly. However the underlying issue with any jaw problems is just that- a problem with your jaw. It shouldn't be that way and therefore if it's bad enough then we shouldn't have to cope with it.

Esteem is greatly effected by malocclusions in a lot of cases, and I think really everyone who undergoes these procedures would agree they look somewhat better afterwards.

What I think is important to consider aswell is that we live our whole lives with bad bites, and therefore are habituated to 'work around' the problem and cope with chewing differently or biting down differently, etc. It is the norm for us, so it's not something we actively think about. But our appearance is another kettle of fish. You can't escape seeing yourself and your jaw, and so this is more constant in our minds, and we think about this more often. We notice our problems and focus on them, and eventually this accumulates into low confidence. So when we come round to having surgery to treat it, we only think of what we will look like, because the other issues we have already coped with for our whole lives.

I don't think it's shallow if the problem is bad enough. Sure if it's a tiny issue and not really anything to have a just reason for being bothered about it, then I would call that vanity. But if it affects eating, sleeping, breathing, etc then the esteem issue will most likely than not also be an issue. And I think it's perfectly acceptable to feel like this (not obviously welcomed, but natural). It's about wanting to have a normal jaw and appearance. And if your malocclusion is so bad, then why should you live with it? The rest of the population don't

#4 Post by **OzzysMom** » Sat Jul 11, 2009 1:32 pm

Welcome Jayye! The first two answers are wonderful.
I just would like to add one more thing. I had my surgery last Oct at age 48. At age 42 I started getting almost constant tension headaches which nobody could diagnose. It turned out it was because my jaws had to work so hard to close my mouth to swallow a couple thousand times each day. After my surgery, I no longer have headaches. There were several other functional issues that are much improved since my surgery.
At one of my dr visits, I was told that often younger people will have it done for cosmetic reasons but usually older patients will have it done for functional reasons. I guess what I'm trying to say is that it could become more of a functional problem as you get older. I personally think it's probably a functional problem even for young people, it's just that when we're young, we adapt easier.
Best wishes with whatever you decide to do!

#5 Post by **Twinjoy** » Sat Jul 11, 2009 2:21 pm

As OzzysMom stated I truly believe that while you may think it is purely cosmetic just wait until you see the orthodontist. I bet that he will tell you of several issues that you may already have or may have later in life. If by some miracle he doesn't diagnose any issues I would probably still go through with it because it is a huge possibiliy of causing issues down the road.

#6 Post by **archangel689** » Sat Jul 11, 2009 3:35 pm

This is true, you MAY defiantely have functional issues you are not aware of quite simply because you have never experience a correct bite.

But if you are presented a situation like I was where i would get like .5 mm more projection in the midface in exchange for a sesame of pain and nerve damage that comes with a lefort I....dont flower do it, it aint worth it and you wouldn't notice a damn difference anyhow.

#7 Post by **AF104** » Sun Jul 12, 2009 12:04 pm

You shouldn't care what we think of you. If you're concerned about how you look then opt for surgery. I would suggest that you see a plastic surgeon at a major(university) medical center as opposed to an oral surgeon though. Plastic surgeons will focus on an optimal aesthetic outcome whereas oral surgeons most often try to normalize the skeletal relationships without regard to the cosmetic outcome.

#8 Post by **HokieTay** » Sun Jul 12, 2009 12:57 pm

AF104 wrote:You shouldn't care what we think of you. If you're concerned about how you look then opt for surgery. I would suggest that you see a plastic surgeon at a major(university) medical center as opposed to an oral surgeon though. Plastic surgeons will focus on an optimal aesthetic outcome whereas oral surgeons most often try to normalize the skeletal relationships without regard to the cosmetic outcome.

That's horrible advice. There are many stories of people who went to plastic surgeons not knowing that they had a functional issue. Then the plastic surgeons correct the cosmetic aspect, but the functional issue is the same, if not worse. It's like putting a band aid on a gun shot wound.

#9 Post by **crazybeautiful** » Sun Jul 12, 2009 1:33 pm

HokieTay wrote:
AF104 wrote:You shouldn't care what we think of you. If you're concerned about how you look then opt for surgery. I would suggest that you see a plastic surgeon at a major(university) medical center as opposed to an oral surgeon though. Plastic surgeons will focus on an optimal aesthetic outcome whereas oral surgeons most often try to normalize the skeletal relationships without regard to the cosmetic outcome.
That's horrible advice. There are many stories of people who went to plastic surgeons not knowing that they had a functional issue. Then the plastic surgeons correct the cosmetic aspect, but the functional issue is the same, if not worse. It's like putting a band aid on a gun shot wound.

I would agree. Plus oral surgeons don't disregard aesthetics. They're making serious changes to our faces, so I think they care just a bit about how those faces turn out in the end

#10 Post by **AF104** » Sun Jul 12, 2009 1:44 pm

Plastic surgeons aren't going to destroy the face functionally. They're also well qualified in orthognathic surgery. The principle concern in this case is cosmetic and not functional. Sure there could be functional problems too but that's mere speculation.

#11 Post by **OzzysMom** » Mon Jul 13, 2009 2:11 am

I know that some orthognathic surgeons are trained/qualified in plastic surgery.
However I don't think the statement that plastic surgeons are "well qualified in orthognathic surgery" is true. Other than performing a genioplasty, I don't think most of them are qualified to do any of the surgeries that we need. I could be wrong though.

Bottom line is that if it's a skeletal issue involving the maxilla/mandible, an orthognathic surgeon is the only one I would trust.

#12 Post by **AF104** » Mon Jul 13, 2009 4:38 am

Craniofacial surgery is a large part of a plastic surgeons training. They perform every type of facial reconstruction. Most plastic surgeons who operate in academic medical centers have also completed an extra year of fellowship training in craniofacial surgery. At those centers they see the most challenging cosmetic and reconstructive cases in the world. They are also the undisputed experts of soft tissue reconstruction. So, seeing a plastic surgeon in this case would be wise where the persons concerns are cosmetic("my reason for 'wanting' to go through this is cosmetic") Their is no official title of "orthognathic surgeon". Here's a great orthognathic article by a Chicago based plastic surgeon: http://emedicine.medscape.com/article/1279747-overview.

#13 Post by **AF104** » Mon Jul 13, 2009 4:41 am

The "." I included at the end of the sentence became a part of the link so here it is again:

http://emedicine.medscape.com/article/1279747-overview

#14 Post by **fromjersey** » Mon Jul 13, 2009 7:12 am

In 1956 I saw a plastic surgeon in Newark, N.J. I was age 28. All I knew was I had an awful profile, receding chin,deviated septum and protruding teeth, also no self-esteem. I had no idea mouth breathing or nasal obstruction was related to my Class II malocclusion and neither did the plastic surgeon. Where on earth would I get such knowledge? I should have been referred to an orthodontist and a max/facial surgeon. This guy did a chin implant of diced cartilage when I actually needed Lefort, BSSO and genioplasty, also orthodontic treatment. I was temporarily elated, then the implant was absorbed over the years. By the time I had the nerve and knowledge and money to do anything, I was 79. Getting the works was not possible because of mandibular joints and I settled for sliding genioplasty and gum surgery. I still have a midline shift about as serious as Tom Cruise's. That plastic surgeon in 1956 did not do his job and I can't speak for those of today. I do think most of us here need max/facial surgeons.
Helen

#15 Post by **kahootz** » Mon Jul 13, 2009 8:46 am

I would have to agree that MOST plastic surgeons don't know anything about the jaw, palate, etc. I went to a well known plastic surgeon for my rhino/septoplasty. He kept insisting that he fixed my deviated septum and didn't believe me that I can't breathe any better than before. Well I found out from a oral/maxillofacial that I never would because of my high palate; my passageways are just too narrow. I had lower jaw surgery, when I should have actually had upper and lower. My orthodontist keeps saying that I should go to a plastic surgeon to see if he can do some soft tissue work to lengthen my upper lip. I told him that I've never even seen good lip injections that didn't look like "trout pout," so why would I let a plastic surgeon touch my lip. I said "If you ever see a good result from this type of surgery, let me know."

Of course, all this being said - my original OS was an idiot and didn't look at my facial balance, just my bite.