What type of surgery do I need? Please look at my pics

Message

#1 Post by **prettyteeth83** » Wed Jul 14, 2010 5:44 pm

Hello everyone!

I have been reading this forum for about four years now because I feel I need orthognathic surgery and I think now I am finally ready to go ahead with braces and surgery. I have been feeling really ugly and horrible about my appearance and I am sick of feeling this way, that is why I want to finally correct my jaw. I do not just want to do this to look better. I can’t chew food right; it takes me forever to eat anything. I can barely breath out of my nose. I have headaches all the time, and my face hurts just closing my lips, so I walk around with my lips open all of the time.

I am hoping getting surgery will help me look better also. My cheeks are sunken in, which makes me look way older than I am. When I smile not very many of my teeth show on the sides because my palate looks so narrow. My front teeth touch each other, like they directly touch each other, I am not sure if this is considered an under bite or not. My face looks flat and long . I have been grinding my teeth at night for years, I am assuming from my bad bite and this has caused my molars to become massively shortened.

My teeth and bite have bothered me my whole life and I am sick of feeling bad about it. I feel like people think I am ugly and they don’t realize I am actually a pretty girl, I just have a bad jaw. All of my ex-boyfriends have made comments about my appearance and seemed to only like my body because they would never look at my face.

Even one time at the store someone walked by me and said, “Excuse me sir” and their wasn’t any men near me, so I am pretty sure they were talking me.

My sisters and mother have also called ugly and my parents got my sisters teeth fixed when they were younger but they didn’t get my teeth fixed because they didn’t want to spend the extra money.

I called the orthodontist and made an appointment to discus how to fix my teeth but I was wondering if anyone can look at my before pictures and tell me what they think I need to get done, to fix my teeth and jaws. I understand that only an oral surgeon will know for certain what surgeries I need but I am just looking for some advice.

http://s825.photobucket.com/albums/zz18 ... rgury%201/

Thank you and I look forward to meeting you all!

Lolly

#2 Post by **sadpanda** » Wed Jul 14, 2010 6:37 pm

Hi -

I know I'm not going to really help you because I cannot tell what a surgeon needs to do to your jaw, or if only one needs to have surgery or both upper and lower. But at just a glance, upper and lower braces will be necessary and the ortho would probably make you wear an expander to widen your narrow arch, even before surgery. The whole process takes a while, so it's good to get started as soon as possible. You'll be glad when everything's done because you'll feel so much better and in less pain. You'll probably feel better from just the initial straightening and bite-correction from braces. Even if it seems like it's not the time to do it, you'll regret not doing it sooner. It sounds like you've suffered a lot. Do something good for yourself despite the cost. I've made some bad decisions by waiting and making excuses and everything just got worse, not better. In fact, waiting made me have more complications and I've been through a lot of severe pain in my life. And I waited to get braces until I was 29 (well, I just got them). Good luck!

#3 Post by **tdawg7669** » Wed Jul 14, 2010 9:58 pm

Well to be it looks like you have a vertical growth pattern. If surgery is the answer for you, I am guessing maxillary impaction will be part of the treatment plan, along with widening the maxilla.

That all being said, you might not even need surgery. Go to an orthodontist and see what he says. There are ways for them to deal with any problem you might have without surgery, while attaining good results(this includes appearance). That is if the problem is mild enough, which looks to be the case for you(there doesnt seem to be a large discrepancy between your upper and lower jaws horizontally)

Then again I am nowhere near being an orthodontist or oral surgeon. You really need to get checked out by one to know the best course of action for you. Everybody is different and only they can take x-rays and molds to locate where your problem lies.

I would also like to say that you are a pretty girl, and I am sure you will look great at the end of whatever treatment is decided for you.

#4 Post by **braceface23** » Thu Jul 15, 2010 1:07 am

Best thing you can do is see an ortho, they will do a ton of pictures/ x rays/ impressions and give you an outline of what needs to be done to achieve what you want.. If they think you need surgery they will refer you to an oral surgeon.. best of luck, I have my surgery in less then a month and it'll be the best decision ive ever made.

#5 Post by **I want to smile!** » Thu Jul 15, 2010 6:05 am

Hi there,

Your post really struck a chord with me. Everything you've described applies to me too! My teeth no longer bite, I have a long narrow face that always looks sad, my lips don't close, my cheeks look sunken etc etc. Oh, and I have a very strong/long chin too so at school the kids used to ask if I was related to Bruce Forsyth - very funny...

Anyway, I currently have braces top and bottom with a view to double surgery some time next year. I think the plan is to impact the upper jaw (ie cut out a wedge that is deeper at the back than the front), also to cut it in half (so in a straight line running back from behind my front teeth) so that it can be widened, and then to extend and rotate the lower jaw so that my teeth will all meet. Then I should be able to bite into food for the first time in years, chew it properly and even close my mouth without getting wrinkles all over my chin (nice!). It's by no means an easy option - just having braces means it's even harder than ever before to eat and close my mouth (and did I mention the drooling when I sleep - ha ha!!) - but it is tried and tested and from what I can gather off of this forum it's pretty much guaranteed to give great results. I haven't come across anyone who regrets having it done.

That said, there are non-surgical alternatives that I've come across such as these screws that somehow push your molars back into the jaw so that you can achieve a better bite. No one offered me this treatment though and I figured that even if it worked it probably wouldn't alter the facial appearance as much as surgery. I tried two NHS dentists, a private dentist, a private ortho, NHS ortho and a maxillo-facial surgeon and they all gave me the same verdict and recommended the treatment I just described. Every case is different though so just get as many opinions as you can.

And ask too about the long-term affects of not having treatment. In addition to any aesthetic concerns there could be functional problems that crop up later in life that will mean you end up having to pay for treatment that could have been avoided. Good luck with it all!

#6 Post by **chipmunkcheeks** » Thu Jul 15, 2010 9:59 am

I don't see how your bit could be fixed without surgery because it looks like your upper jaw is narrower than your lower jaw. The only way to fix this is a SARPE in order for your lower jaw to fit into your upper. This would probably fix the aesthetics of your "sunken cheeks". It also looks like you have a slight underbite, which would become more pronounced wtih braces. So a second surgery to set your lower jaw a bit back might follow. This could soften your lower jaw and give you a more balancd lower face and chin; more feminine. I am no expert, but this is what I can see from pix. Once your OD takes films and does measurements, s/he will know better what makes sense for you. Good luck! It was very much worth it for me and I hope for you too!

#7 Post by **tdawg7669** » Thu Jul 15, 2010 10:12 am

Actually it might be possible to fix everything without surgery. There have been plenty documented cases of non surgical expansion on this forum with pictures. Regardless SARPE expansion and non surgical expansion doesnt noticeably alter facial appearance from the photos I have seen.

As for facial height, that is only something an orthodontist will be able to tell you. It depends on the cause of the facial height and the severity of the problem. For mild cases there are ways to control the posterior excess without surgery, giving the same aestethic results by autorotation of the mandible.

However if you also have a skeletal underbite than a need for surgery is more likely. How do your molars line up?

#8 Post by **prettyteeth83** » Thu Jul 15, 2010 2:37 pm

Thanks to everyone that replied for your advice!

Hopefully they will only need to widen my palate because the other surgeries sound really scary to me.

I will let you all know after my appointment what they suggest to fix my problem

Thanks

#9 Post by **prettyteeth83** » Thu Jul 15, 2010 3:00 pm

tdawg7669 Thank you for your input!

I have a question, what is a vertical growth problem? Also what is a maxillary impaction, is that when they move your upper jaw forward or up or both, is that what a lefort 1 is?

For my facial height problem you say, “there are ways to control the posterior excess without surgery, giving the same aestethic results by autorotation of the mandible.” Could you give me for information on what you mean by this? Are you saying that they could fix the facial height problem with just braces and that would fix my appearance as much as getting it fixed surgically?? Sorry I am just sort of confused

I am also concerned that if I only get the SARPE surgery, that my cheeks will still look sunk in

So I am gathering that my problem is my upper palate is too narrow and this would be fixed with SARPE, that I would also need a lefort on my upper jaw to move it forward and or up and possibly need my lower jaw moved back, Is this correct?

I think I only have a slight under bite because my bottom teeth aren’t in front, like pushed out from my top teeth, my teeth just directly touch each other. Like my top teeth don’t cup over my bottom teeth, like a lid on a jar does, if that make sense.

Oh, my molars line up but the top molars on the right side don’t directly line up with the bottom molars, so I think that means I have a cross bite from what I read.

Sorry for all of the questions. I have just been reading trying to figure out how to fix my problem for years

Thanks!

#10 Post by **tdawg7669** » Thu Jul 15, 2010 5:16 pm

A vertical growth pattern is where the maxilla grows down instead of out. Usually(as in the case with me) this results when the tongue isnt in constant contact with the roof of the mouth for whatever reason. So the teeth and maxilla grow down, instead of around the tongue which is normally supposed to act like a natural palate expander. Usually when a narrow palate is fixed the cheeks appear slightly more prominent. However this might also be due to weight loss adding definition in the face. Personally the only difference I can tell in people who have undergone palate expansion is a wider smile.

As for controlling facial height, there are ways to do it without surgery. For example take a look at this page:
http://www.angle.org/doi/full/10.1043/0 ... 2.0.CO%3B2

Look at the photos of the adult patient at the bottom. By intruding the posterior teeth into the bone, the mandible naturally rotated up and forward because the disturbance(overgrowth) in the posterior segment was removed. This results in a shorter lower third of the face.

As for how the molars should like up. http://www.onedollardentist.com/images/mal3.jpg

Look how the molars line up in those occlusions and compare it to your own.

I hope I have helped a bit. Remember I am just some guy on the internet who has researched this because I have my own dental problems that are being fixed. You definitely need to get looked at by a pro for any real answers.

#11 Post by **tdawg7669** » Thu Jul 15, 2010 5:56 pm

I forgot to answer one of your questions. A maxillary impaction is where they basically shave off some of the excess maxilla. Usually in the case of the open bite where its just the posterior that developed too much they shave more off in the back than they do in the front. In the case of gummy smiles they shave off an equal amount in posterior and anterior segments. It is usually done as part of a lefort. Basically impaction moves part of or the whole maxilla up. Then the surgeon can also move it forward or backwards as needed.

#12 Post by **Emmauk** » Fri Jul 16, 2010 2:13 am

I have a very narrow upper jaw, i cant even touch the front part of the roof of my mouth anymore with my thumb as my thumb is too wide. It used to be thumb width but has since got even narrower. I have not been told i need to have SARPE surgery, my OD will widen a bit but not much as he is worried i wont have enough gum to cope.

Dont get hung up on what people have said they are only sharing there experiences and giving there opinion.

I think where you are will also impact on what your offered and how, let us know what your OD tells you, when is your appointment?

#13 Post by **joebraces** » Sat Jul 17, 2010 3:55 pm

From what I can tell you should look into getting your upper jaw expanded (widened). That alone with braces would probably fix your problem. I haven't even looked at the other comments, I'm making this purely off looking at your photos. Anyway, you really should tell an orthodontist exactly what it is you don't like about your smile/teeth/jaw/face and he will tell you what can, and maybe even what "should" be done (some people get offended by comments even if it is constructive or asked for)....

Goodluck

I'm having upper jaw surgery so I get how you might feel with your teeth/jaw issues here.