Just had NHS consultation - thoughts??

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#1 Post by **Gavin12345** » Tue Jun 30, 2009 5:32 am

I had x rays taken and I would need an upper jaw advancement to correct my bite.
Now previously I said my main motive for having surgery was the fact that I had a slight lisp and that affected my confidence. I also added that when I eat food that uses the back teeth it aches a lot.

What I did NOT mention is that I also really dislike the way my face looks, I was scared that if I mentioned that he would think I only wanted the surgery for cosmetic reasons and I would be denied?

Was this a mistake?

He explained that I'd need braces for at the most 2 years with surgery in between. He said I should get another appointment towards the end of the year to meet with the surgeons, so they could discuss whether surgery would actually help my lisp or not as obviously they could not guarantee this.

The way he spoke it was almost as if he was hoping i would say another reason for surgery?

Should I mention my looks also affect my confidence with the surgeons or keep quiet??

Also has anyone else had any experience at Morriston hospital Swansea?

thanks.

#2 Post by **bubsy08** » Tue Jun 30, 2009 8:19 am

I said i was not happy with my the look of my jaw and they said that was fine. If it is causing you physical problems as well they cant deny you treatment.

I am having treatment in prince charles hospital in merthyr tydfil, just had my first joint appointment with surgeon and ortho, gotta wait 16 weeks til they start the treatment which has pissed me off. It will be a year since i mentioned to my dentist about my problem to me starting treatment, not much I can do.

#3 Post by **changes09** » Tue Jun 30, 2009 2:06 pm

I told my OS that I did not like the way my face looks. And he was fine with it. I actually that my doc and his techs are more excited then I am to see what my new face will look like. The keep telling me that I am going to be so happy with the results. The oral surgeon is concerned with the function of the bite and the asthetics of the face also.

#4 Post by **irishlady1980** » Sun Jul 26, 2009 3:51 am

I am NHS and my ortho and surgeon both know that the main reason im getting this done is cosmetic because of my lack of confidence and i find it helps that they know they understand me and i feel i can tell my ortho when im feeling nervous we have a great relationship because she understands it all from my side so i think it helps

#5 Post by **crazybeautiful** » Sun Jul 26, 2009 4:05 am

I think our orthos have the insight to know about the effects these things have on our confidence and self-esteem. Like I said on the thread about going to an oral surgeon vs an orthognathic surgeon- the OS's don't disregard aesthetics just because outwardly it's not a 'cosmetic' procedure. I think they will all have experience of patients who dislike how they look and know that it matters. Like changes09 said, function and aesthetics are both of interest to our orthos and oral surgeons. And I wouldn't say you could have one without the other because if you jaws are right it follows that your face is, right? (simple, but that is the essence of it surely)

#6 Post by **AF104** » Sun Jul 26, 2009 7:25 am

If your jaws are "right" your face isn't necessarily aesthetically "right". For example mandibular hypoplasia is associated with cheek prominence. Making the mandible "right" would make the face look WORSE. There is no one-size-fits-all cosmetic advice for the jaws. Each situation is unique.

#7 Post by **crazybeautiful** » Sun Jul 26, 2009 10:32 am

But then what is an 'enhancement' to just 'normal'? Surely our issues lie in the fact that we have a malocclusion, not merely that we just don't like how we look. If your problem is fixed then both issues must be (that is, your bite and your facial harmony), because the 'problem' is both issues combined. If you no longer have a malocclusion, you no longer have any concerns regarding such malocclusion do you?

There is no one-size-fits-all cosmetic advice for the jaws. Each situation is unique

Exactly. So what kind of oral surgeon would disregard aesthetics for their patients?

#8 Post by **AF104** » Sun Jul 26, 2009 9:19 pm

You assume that normal "facial harmony" provides optimum aesthetics. That's not true. There's many people with perfect dento-facial relationships that aren't attriactive.

#9 Post by **AF104** » Sun Jul 26, 2009 9:29 pm

*attractive

#10 Post by **crazybeautiful** » Mon Jul 27, 2009 6:11 am

But you're missing the point. If a person has a malocclusion and dislikes the way the look because of it, then the linear relationship is malocclusion = lowered self-esteem and dislike of appearance because of malocclusion. It's about cause and effect.

Ugly vs pretty has nothing to do with a malocclusion, unless of course a person has somewhat of a body dysmorphic disorder and they don't like the way they look generally (as in any malocclusion they have is not bad enough to warrant surgery). Then they would wish to seek out 'perfection' (whatever that might be)

I get the feeling that most patients on this board who have had surgery and disliked the way they looked beforehand feel much differently about themselves afterwards, and for the better. It's about normal facial harmony. Whether or not a person is a supermodel anyway is not the point. Otherwise everyone in the world would want cosmetic surgery, no?

#11 Post by **AF104** » Mon Jul 27, 2009 6:39 am

No you are missing the point. People care more about the facial aesthetics than the dental aesthetics. If orthognathic surgery perfects someones bite but makes them look worse aesthetically then they will more often than not have more surgery to reverse the first one even though it's at the expense of the bite.

#12 Post by **yeahyeahyeah** » Mon Jul 27, 2009 7:17 am

I never realised that there are loads of people getting surgery done in order to improve their facial aestatics.

My 2 cents: I have a bad anterior open bite, and need chin arguementation and a rhinoplastery. I also am currently suffering from long face syndrome as a result of this. I would absolutely lie to you if I said I wasn't doing this for cosmetic reasons. I strongly belief that by fixing the bite it will if anything bring harmony to my face, because atm it is too narrow, long, and lacks definition around the jawline.

#13 Post by **yeahyeahyeah** » Mon Jul 27, 2009 7:23 am

Gavin12345 wrote:I had x rays taken and I would need an upper jaw advancement to correct my bite.
Now previously I said my main motive for having surgery was the fact that I had a slight lisp and that affected my confidence. I also added that when I eat food that uses the back teeth it aches a lot.

What I did NOT mention is that I also really dislike the way my face looks, I was scared that if I mentioned that he would think I only wanted the surgery for cosmetic reasons and I would be denied?

Was this a mistake?

He explained that I'd need braces for at the most 2 years with surgery in between. He said I should get another appointment towards the end of the year to meet with the surgeons, so they could discuss whether surgery would actually help my lisp or not as obviously they could not guarantee this.

The way he spoke it was almost as if he was hoping i would say another reason for surgery?

Should I mention my looks also affect my confidence with the surgeons or keep quiet??

Also has anyone else had any experience at Morriston hospital Swansea?

thanks.

Gavin,

Even if you dont say anything they will bring it up eventually. This was certainly true in my case. Before my SARPE surgery I had a pre-op assessment with a maxomillio (sp?) facial surgeon, and she told me exactly how my face will change after bottom jaw surgery, told me that my face will become much more symmetrical and in her words "this will be a life changing experience.". Furthermore, she suggested that I get my nose fixed as it will complement my new jaw line well.

So my point is, they are fully aware of it. Personally, I wouldn't emphasis it to much, rather emphasis that you want it done because you want a nice smile instead.

#14 Post by **AF104** » Mon Jul 27, 2009 7:44 am

Maxillofacial

.......This is highly variable: "Even if you dont say anything they will bring it up eventually." Some surgeons will never mention cosmesis.

#15 Post by **kahootz** » Mon Jul 27, 2009 1:41 pm

Gavin - DEFINITELY bring this up to your surgeon. Most everything I've read on orthognathic surgery mentions facial balance being in the equation. Unfortunately, I did not bring this up with my surgeon thinking he was figuring this all in. WRONG!! I have a great bite, but also still have lip incompetence and a recessed chin. I think I'm an attracitve female and have no problem getting guys' attention, but I am sooooo unhappy that I did not get more facial balance. Orthognathic means "straight jaw." Well, I still have vertical maxillary excess and my jaw actually is still positioned downward. Yes, you can have a correct bite - even with your jaw not totally corrected. My lower jaw was moved forward to correct my overbite, but in reality I should have had upper and lower jaw surgery. I sure wish I had been more clear on what outcome I expected. Other surgeons I have gone to since think doing both jaws would have been a no brainer.

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Just had NHS consultation - thoughts??

Just had NHS consultation - thoughts??

Re: Just had NHS consultation - thoughts??