I had lower jaw surgery with metal plates and screws to correct an underbite 11 years ago. I have never been happy with the outcome, as I am a petite female and now my jaw sticks too far out and is lopsided. I used to have a feminine jaw and now I believe it's too strong and looks manly. I don't like to smile because it really emphasises the lopsided-ness.
This is a question for those who've had revision surgery. I am just wondering: How do I go about correcting this? Do I have to go back to an Orthodontist and wear braces for two years again? Do I go to an MD and request a Maxilofacial surgeon. Basically, how do I start the process?
I originally had it done by Kaiser Permanente in Oakland, CA. Not there anymore, but should I go back to Kaiser?
I'm going to purchase health insurance with the intention of choosing the best type of plan to route me to a revision surgery.
Open to any advice, recommendations and suggestions.
Thanks all, peskywabbit
Lower jaw surgery with lopsided outcome, How do I fix?
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peskywabbit
- Posts: 40
- Joined: Thu Oct 14, 2010 10:19 pm
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peskywabbit
- Posts: 40
- Joined: Thu Oct 14, 2010 10:19 pm
Hi peskywabbit,
Just curious. Even after correction of an underbite, you still feel that your jaw appears too prominent? Did you have genioplasty to extend your chin?
I had surgery at Kaiser, too, but it was to correct an overbite. I now have a slight underbite, pronounced lopsidedness, and an overly prominent profile, too. There is more, but I won't go into that here.
In your case, I would first consult with orthodontists with lots of surgical experience. It might be best to see at least 3 or 4. These consultations are usually free of charge, so you will invest only your time. I failed to do many consults, and so I ended up with some pretty lousy orthos. An old and wise ortho once told me that nearly half of the orthos these days don't know what they are doing, so surgical patients need to be especially choosy, IMO. I have been under the care of one good and three bad ones, so his assessment doesn't seem too far off, at least in my experience.
Once you find a good ortho, s/he will determine whether surgery is your best option and will then refer you to a surgeon. I'm guessing that that surgeon will depend on the insurance plan that you choose. You will likely need braces in preparation for surgery. How long you'll have them on will really depend on you current bite and how much movement is needed for the surgery and aftercare.
I cannot give you recommendation for a max fax surgeon in the San Diego area, given my bad surgical experience, but I'm sure that there are some good ones around town. Maybe someone else here can give you a good lead.
Currently, I'm in splint therapy with orthos McLaughlin & Upatham to determine where my bite will ultimately end up. Compared to the others I have seen, they are by far much more thorough. McLaughlin has written journal articles in his field and co-wrote a facial aesthetics textbook with Dr. Arnett (Santa Barbara surgeon). Time will tell, though, how well they will be able to successfully treat my complicated case. That being said, I would add them to your list of local orthos to consult with.
Good luck!
Just curious. Even after correction of an underbite, you still feel that your jaw appears too prominent? Did you have genioplasty to extend your chin?
I had surgery at Kaiser, too, but it was to correct an overbite. I now have a slight underbite, pronounced lopsidedness, and an overly prominent profile, too. There is more, but I won't go into that here.
In your case, I would first consult with orthodontists with lots of surgical experience. It might be best to see at least 3 or 4. These consultations are usually free of charge, so you will invest only your time. I failed to do many consults, and so I ended up with some pretty lousy orthos. An old and wise ortho once told me that nearly half of the orthos these days don't know what they are doing, so surgical patients need to be especially choosy, IMO. I have been under the care of one good and three bad ones, so his assessment doesn't seem too far off, at least in my experience.
Once you find a good ortho, s/he will determine whether surgery is your best option and will then refer you to a surgeon. I'm guessing that that surgeon will depend on the insurance plan that you choose. You will likely need braces in preparation for surgery. How long you'll have them on will really depend on you current bite and how much movement is needed for the surgery and aftercare.
I cannot give you recommendation for a max fax surgeon in the San Diego area, given my bad surgical experience, but I'm sure that there are some good ones around town. Maybe someone else here can give you a good lead.
Currently, I'm in splint therapy with orthos McLaughlin & Upatham to determine where my bite will ultimately end up. Compared to the others I have seen, they are by far much more thorough. McLaughlin has written journal articles in his field and co-wrote a facial aesthetics textbook with Dr. Arnett (Santa Barbara surgeon). Time will tell, though, how well they will be able to successfully treat my complicated case. That being said, I would add them to your list of local orthos to consult with.
Good luck!
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peskywabbit
- Posts: 40
- Joined: Thu Oct 14, 2010 10:19 pm
Dear Twitberry,
Thank you so much for all your advice. I had an underbite and the doctor corrected it, however, she also advanced my chin because she though it would look good I think. Anyway, in advancing my chin, she must have slightly tilted it as well, and I think it just looks wierd. I was really trying to avoid orthodontics, as I am 41 now and actually my bite is fine. It's just the aesthetics. Was hoping I could just have the plates and screws taken out and shave the chin a bit to soften and even things out. I don't know if it's possible, but will try to find out. I'm sure if I go see an ortho, he's gonna suggest orthodontics, but really I feel I don't need them. Like I said, my teeth, bite are absolutely fine.
Once again, thanks so much for all your help.
Thank you so much for all your advice. I had an underbite and the doctor corrected it, however, she also advanced my chin because she though it would look good I think. Anyway, in advancing my chin, she must have slightly tilted it as well, and I think it just looks wierd. I was really trying to avoid orthodontics, as I am 41 now and actually my bite is fine. It's just the aesthetics. Was hoping I could just have the plates and screws taken out and shave the chin a bit to soften and even things out. I don't know if it's possible, but will try to find out. I'm sure if I go see an ortho, he's gonna suggest orthodontics, but really I feel I don't need them. Like I said, my teeth, bite are absolutely fine.
Once again, thanks so much for all your help.
Hi Peskyrabbit,
That seems so much easier. No need for an ortho if all is well with your bite. I would call max fax surgeons directly and consult with as many as possible. You may have to travel to find one that is experienced with reductions, as I've been told that the procedure is tricky in terms of post-op soft tissue slackness. Good luck!
That seems so much easier. No need for an ortho if all is well with your bite. I would call max fax surgeons directly and consult with as many as possible. You may have to travel to find one that is experienced with reductions, as I've been told that the procedure is tricky in terms of post-op soft tissue slackness. Good luck!
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peskywabbit
- Posts: 40
- Joined: Thu Oct 14, 2010 10:19 pm
Re: Lower jaw surgery with lopsided outcome, How do I fix?
Saw Dr Robert Relle today. Wonderful man. Is gonna help me. Not shave it, but move it around a bit. Ok, so here we go. Round two, Aug. 22. Thanks all.
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Bullfighter
- Posts: 201
- Joined: Sun Mar 20, 2011 1:20 pm
- Location: San Diego, CA
Re: Lower jaw surgery with lopsided outcome, How do I fix?
Pesky,peskywabbit wrote:Saw Dr Robert Relle today. Wonderful man. Is gonna help me. Not shave it, but move it around a bit. Ok, so here we go. Round two, Aug. 22. Thanks all.
I'm in San Diego as well and had BSSO/genio done by Joel Berger with excellent results (so far -- still healing).
One thought on your first post: it seems possible that advancing the lower jaw can accentuate an existing lopsidedness -- i.e., if the upper jaw isn't perfectly symmetrical, then the surgery on the lower jaw might not have created any new asymmetry but just made the existing situation more noticeable.
Anyway... good luck in August. I would certainly go with chin surgery over jaw surgery.
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peskywabbit
- Posts: 40
- Joined: Thu Oct 14, 2010 10:19 pm
Re: Lower jaw surgery with lopsided outcome, How do I fix?
Yes, bullfighter, turns out in the original surgery, I should have had upper jaw surgery as well, as my left TMJ is really flat and arthritic due to a previous traumatic injury as a child. The first surgeon never even thought about checking my TMJs as being an underlying problem, despite some torsion to my face. But the lower jaw surgery itself was such a big deal, plus I've had a couple nose jobs to fix the torsion in the nose and I'm just so exhausted with big surgeries and am actually looking half normal now. Even if fixing the chin doesn't completely straighten my face, I'm happy enough with how it looks. I'm not looking to be a model at age 42, just normal. 