Anyone else's surgery results not as planned?

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#1 Post by **mp921** » Tue Dec 15, 2009 2:53 pm

Just as I'm sure has happened with most of you, my Ortho reviewed my surgical molds with me. He showed me the position of my bite at that time and the expected movement and resulting bite that was to occur with surgery. It was perfect! He had everything lined up to fit like a puzzle piece.

So here I am, 4 months post-op. My overbite is much better than it was prior to surgery, but I still have somewhat of an overbite. My midline was absolutely perfect until 5 weeks after surgery and then something shifted. I don't know if it was due to my joints, the infection, a bone shift or what because even 4 months later I can't get an answer from my surgery or ortho about what happened. They both dance around it, like neither wants to point blame or take responsibility. Now I'm left with a midline that's almost a bottom-tooth-width off, a significant crossbite on the right side and an open bite on the right side. My bite feels forced and no where I bite feels correct.

I'm in elastics for the crossbite and open bite, but after 2 months nothing is changing. I've worn the elastics as told at all times except when eating and cleaning.

It's hard to tell what my smile & bite would look like if the braces were taken off today (ha...he won't even discuss a debanding timeframe). Maybe it wouldn't be as noticeable without them, or maybe it would be even more noticeable. Either way it's definitely a bummer, especially considering the fact that I can't count how many times I heard my ortho and OS tell me how straightforward my surgery would be! I've joked (although I might halfway be serious) about needing some counseling from the emotional trauma I've been through with knowing there has been a problem the entire time but being unable to get my doctors to discuss it with me.

I imagine it would be like having a knee surgery gone bad. Replace a kneecap and the doc tells you that it'll feel natural and you'll be walking great again. Only to find out that it doesn't feel natural and you have a limp that will never go away.

Anyone else? What was done?

#2 Post by **cvn** » Tue Dec 15, 2009 3:11 pm

That's basically what I felt like after my surgeries. I didn't know where to rest my teeth and nothing felt right and my midlines were off, and the surgeon swept it under the rug. Fast forward a few years and a failed redo surgery and another decade of dental work and I'm worse off than where I started by a longshot. You should probably think about getting an outside opinion and/or raising hell with the current surgeon because I'd hate to see people in my position.

I've had bad experiences so I tend to be an alarmist, but if your bite is changing then it has been my experiences and my mother's experiences that the surgeon probably didn't fully seat the condyles during the surgery and this should be addressed sooner rather than later. Hopefully your problems are easily fixed.

#3 Post by **mp921** » Tue Dec 15, 2009 3:23 pm

cvn, I am sorry to hear of your troubles. I know what it's like to have a failed initial surgery. I can't even begin to imagine the trauma from a failed second surgery! What is wrong with your bite at this point? Is there anything that can be done?

My surgeon has always been very kind and caring, until I told him I knew something wasn't right. I mean, it's clear to absolutely anyone who looks into my mouth and knows nothing about teeth that there is a problem. It doesn't take a rocket scientist to see that it looks as if my bottom jaw is now shifted to the right a good bit! My OS was very quick to tell me that everything would turn out okay and that there was NOT a problem with the bone or joints. I brought this up at 3 different appointments and he literally brushed the problem off each time. He just keeps saying that he thinks I'll be happy with my new bite once the Ortho is finished. There are other surgeons in with him, but that is the only practice in my city that performs orthognathic surgery. It infuriates me because my Ortho explained that all of the work he was doing in preparation for the surgery was to ensure that everything would fit together perfectly as soon as the jaw advancement was done. Not so much!!

#4 Post by **ORTHO12** » Tue Dec 15, 2009 4:45 pm

I hate the way they lightly explain the surgery like it's just something they do and then you go and live a happy life.

All I have noticed is that they do not appreciate your personal opinion with regards to how you look, how you smile, how you like your teeth and they move your teeth and disregard everything else.

If you try moan about anything or even address it rationally they disregard it.

I had a 1mm open bite, face was symetrical no under/overbite and was very happy with my appearance. They said they were moving my teeth they moved my whole face, dimensions, features and left me with teeth that close but a crooked face. When I say about my face now being longer on one side than the other, they keep saying my bite is perfect...and??

#5 Post by **chicago29** » Tue Dec 15, 2009 7:51 pm

This thread disappoints me because I get upset when I hear that patients say their doctor doesn't listen to them. That being said, I think we all need to realize that the "perfect result" is, in some ways, a myth. Orthodontics and Jaw Surgery, no matter how hard people try, is not an exact science and I personally think it is unrealistic to go into it and think everything is going to be perfect in the end.

There is really only a couple of "factual" things I can say here:

1) Most if not all of the problems raised here seem to be related to the bite. The bite often can be fixed with braces and elastics. It is also very common for things to shift after the surgery, to some degree. In a vast majority of these situations I've heard of on this board, it seems that orthodontics can get things back to normal

2) If your doctors are not listening, why don't you find a new one? I'm not saying that is an easy decision and I understand how hard that can be. But, if you are really unhappy and you feel you are being ignored, gather your records and get another opinion. Nobody deserves to be ignored by their doctors, and if you are REALLY being ignored you owe it to yourself to find somebody else

I really hope that everybody is able to get things worked out in the end...

-Chicago29

#6 Post by **kahootz** » Tue Dec 15, 2009 11:46 pm

Well, I had a unsuccessful first surgery and can't even get another surgeon (including Gunson) so do a second do the increased risk of nerve damage. My original surgeon only moved my lower jaw forward when he should have done a Lefort 1 as well. So now I'm left with all the problems I wanted the surgery for in the first place: Lip incompetence, a recessed chin, and a jaw that never relaxes together. I also show more gum than I should, which never bothered me before - but other surgeons have pointed out.

It's not so easy to say, just find a new doctor. Dr. Gunson agrees that I need upper and lower (again) to fix my problems, but said he wouldn't recommend surgery. He said to "try other things first" which amounted to a "lip switch" procedure no once here seems to have heard of. Of course all the subsequent doctors I saw said that procedure would be a mistake. No doctor (I've been to four) wants to re-do the lower jaw.

I can relate to others here though because all along all my orthodontist can say is how great my bite looks and how happy I should be. Woo, hoo! I think the problem here is there are a lot of surgeons doing orthonathic surgeries that shouldn't be.

#7 Post by **acrobat** » Wed Dec 16, 2009 2:45 am

Here another dissapointed patient

I had lower jaw moved forward in januari 2007 and was out of braces that same year in september.
The whole treatment went great and i was very happy with the result.

And then this summer, a year and a half after surgery, the jaw started to relapse. Not much at first, but now i have an overjet of 3-4mm...

I also get the feeling that neither ortho or surgeon really knows what's happening and what to do now.
In fact, it took me three months to explain them it really was a problem. At first they were like: oh well, a little shift nothing to worry about
But it felt strange to me, and now it's getting worse...
They still claim it won't get worse, but they do admit it has changed.

Especially my surgeon doesn't want to do anything. He says a new surgery is out of the question right now.
My ortho is more helpfull, he really tries new things, but he's so vague about what it will do!
Now he will get me a posiotioner. At the same appointment he said:
1. Your lower jaw won't move further back and with this apliance we may even get it back forward again.
2. This appliance will keep the problem stable but won't improve much

So he totally contradicted himself!

I really feel like nobody can handle a 4 mm overjet because of a relapse...

#8 Post by **chicago29** » Wed Dec 16, 2009 6:25 am

I should re-phrase my statement a bit. I know it isn't easy to just find another surgeon. I guess what I mean to say is just simply don't stick it out with your current one and leave it at that. In other words, you have to try and get other opinions to find out what your options are, and don't just listen to your prior OS who is probably somebody you already don't trust.

It sounds like in some cases another surgery is not an option. That is very unfortunate, but I guess you have to trust their opinion and they are doing what they feel is best for you. If somebody like Dr Gunson felt that surgery is indicated I'm sure they would say so. And, the opposite holds true in situations where they feel it wouldn't be a good idea. You have to respect a doctor that does what he feels is in your best interests.

The statement that "there are surgeons out there that shouldn't be doing orthognathic surgery" is so very true. That's a shame, and it really bothers me. The more I learn the more I realize that this is such a very skilled surgery, and there just isn't a ton of very qualified surgeons out there. And, to make it even more complex, sometimes the surgery is a success and biology takes over and messes things up. Of course nobody can predict that sort of thing. But, even in those types of situations, many people still are better off in some regards, although problems can remain or reappear.

#9 Post by **mp921** » Wed Dec 16, 2009 7:36 am

chicago29 wrote:And, to make it even more complex, sometimes the surgery is a success and biology takes over and messes things up. Of course nobody can predict that sort of thing.

I am going out on a limb to say I think that's probably what happened in my case. Because things looked great and lined up perfectly (or so I thought) until around 5 weeks post-op. But then again I was extremely swollen and banded tightly and couldn't exactly *see* in there. That being said, it is clear that *something* happened. But my OS swears it has nothing to do with a bone shift or the joints. But what else is there that could cause the lower jaw to shift to the side a month after surgery? That's my point here. I would love for them to talk through the possibilities with me, what might have happened, what can be done if anything, etc. But they (both my ortho and OS) brush it under the rug any time I bring it up.

For instance, at my final appt. with my OS I said "Dr. ###, it is clear that something isn't right here. I'd like to know what is going on with my bite and what could have happened to cause it." He said "Let me take a look." He looks around for a second and continues with "I think you'll be really happy with your teeth once the ortho is finished with treatment. I bet you'll have your braces off in a couple of months." What?!?!?! And this is basically the same type of thing that happens with I try and talk to my Ortho.

It makes me feel as if one of them made a mistake somewhere along the line and they are both covering to avoid a lawsuit. Never ever have I come across as the type of patient that is looking to take legal action against a doctor. But I suppose in this day and age they have to be on the defense. It's extremely frustrating for the patient!

#10 Post by **ORTHO12** » Wed Dec 16, 2009 9:59 am

Hmm.... my new surgeon is doing upper and lower again for me to rotate the complex the other way in reverse to the way the other surgeon did it in the first place as it has caused a complete change in my profile that I am not happy with and did not ask for so I am having double jaw again.

#11 Post by **loveyourself** » Mon Dec 21, 2009 7:02 pm

I am so sorry for everybody who has had their surgeries go so terribly wrong. It makes me really afraid to go through with mine. I guess I have to decide what is worse, going trough life with jaw pain and not being able to chew well (or someday probably not at all) or all of the complications and bad outcomes that can happen. This is such a frustrating thing, I envy the people who just have a perfect bite and teeth, like my husband!

#12 Post by **ORTHO12** » Wed Dec 23, 2009 4:39 am

So today the truth was revealed!!

Original team "We did not move your jaws forward at all, just up"

New Team "both your jaws have come forward a great amount"

You should see my ceph, the whole bottom of my face is like it is trying to run away from the top....ape like...so far forward that I do not know how my lips are stretching that far.

Please remember this was meant to be a lower jaw set back....arrrgh.

#13 Post by **loveyourself** » Wed Dec 23, 2009 6:56 am

Oh my gosh! I can't even imagine the range of emotions you are going through! What are you going to do? I am so sorry this happened to you. How did these doctors mess it up so bad?!! I hope you will keep us updated.

#14 Post by **ORTHO12** » Wed Dec 23, 2009 7:28 am

My new surgeon said to me that pre surgery my face was so proportional and my teeth were so straight and bite near perfect apart from 1mm open at the front that he does not understand why this was done to me its like they opened me up, made sure my teeth fitted together and then stuck the actual jaws wherever they wanted.

I have had a MASSIVE change for a 1mm openbite that was edge to edge, both jaws forward 6mm and the top jaw up 6mm, my face is short and protruding... I have not seen myself for 4months now. My lips don't meet anymore and he says its like the surgeon just grabbed the skin and yanked it forward to try fit over the jaws after he moved them and my nose is so far up in the air and my chin is the furthest point forward on my face.

Ive never had lip incompetence, mentalis strain, tmj issues, or mouth breathing problems, now I have them all....HEY but my teeth close...

#15 Post by **chicago29** » Wed Dec 23, 2009 7:52 am

loveyourself wrote:I am so sorry for everybody who has had their surgeries go so terribly wrong. It makes me really afraid to go through with mine. I guess I have to decide what is worse, going trough life with jaw pain and not being able to chew well (or someday probably not at all) or all of the complications and bad outcomes that can happen. This is such a frustrating thing, I envy the people who just have a perfect bite and teeth, like my husband!

loveyourself,

You should never let anything you read on this message board stop you if:

1) You truly feel the surgery will benefit you, and

2) Your willing to commit to and understand the surgery, which means a ton of research, appointments, and asking questions to surgeons about your treatment options and the possible side effects

There are complications and unplanned results in anything we do in life. If you have #1 and #2, you've done all you can to minimize the unknown. Unfortunately that's not a guarantee for a positive result, but here comes the old cliche...There are no guarantees in life. All that you can do is #1 and #2. Everything else is not in our hands...

This message board is awesome in so many ways, but my biggest caveat is don't let anybody's story (positive or negative) sway your personal decision. If you commit to surgery, the only thing I can promise you is your experience will be unique.

Best of luck in your personal decision. I know you'll make the best one for YOU.

-Chicago29