I had my orthognathic surgery consult with Dr. Arnett in Santa Barbara back in July and thought I'd share a bit about my consult for those that are interested.
I had braces as a teenager and while they did "straighten' my teeth, they did not correct my bite issues and actually made other problems worse. I went into this consult primarily for cosmetic issues regarding my retrognathic profile, but I came out knowing so much more about my underlying problems...
My issues are 5-fold:
- my face declined as a result of braces pushing backwards on my upper incisors to (unsuccessfully) correct my class II malocclusion.
- I have an open bite and a narrow palate that will both need to be corrected with a multi-segment Lefort I osteotomy.
- My TMJs are almost completely arthritic.
- I have grinded my teeth so much over the past 10 years when I sleep that I will need to get many of them bonded to their proper heights before I get braces again.
- My airway is only 3mm wide.
So...this consult was a complete eye opener to all that I have going on functionally.
Here is the proposed Cephalometric Treatment Plan (red is my post-treatment structure):
![Image](http://farm3.static.flickr.com/2652/3910406949_baf002ae3d_o.jpg)
Dr. Arnett wants to do a 9.5mm multi-segment Lefort I advancement and a 20.3mm bilateral saggital split osteotomy (BSSO) advancement. While advancing my upper and lower jaws, he is also rotating them so that my "occlusal plane" becomes completely flat thereby putting less stress on my TMJs and creating chin projection without needing a genioplasty. My airway will also increase in diameter from 3mm to 13mm.
For pure cosmetics sake, he will also be doing hydroxyapatate cheekbone augmentations and an upper lip reconstruction to increase the vermilion height (red portion) of my upper lip.
I am extremely excited to go ahead with his plan, but the cost is astronomical and will have to wait a few years. I may stand a chance at some insurance coverage but even with all of my functional issues, Dr. Arnett is not a provider on any insurance plan so coverage will be minimal and this will most-likely be (almost entirely) out of pocket.
Anyway, I just wanted to vocalize my concerns and tell about my consult in case any of you were interested. I will keep everyone updated on my journey and feel free to ask me any questions at all!!
-Dan