What to do when surgery fails?

[Mandy22]

Ok. So i decided to start a new topic. So, i had a surgery 3,5 months ago. Both of my jaws were moved forward 9mm. The movement was too big. I just got a second opinion from a very respected craniofacial surgeon who suggested high le fort 1 + setbeck. I have not told him i had a jaw surgery in the past, so I was a bit shocked and a bit relief that i am not going crazy and that my jaws indeed were moved forward too much. I had to pay a lot of money for the first surgery. At this point i cant afford another surgery. But i think i should not pay for another surgery. I am preapred to pay for anesthesiology fees.
What should I do? And how long should i wait for a secondary surgery?

[katsface]

Ok. So i decided to start a new topic. So, i had a surgery 3,5 months ago. Both of my jaws were moved forward 9mm. The movement was too big. I just got a second opinion from a very respected craniofacial surgeon who suggested high le fort 1 + setbeck. I have not told him i had a jaw surgery in the past, so I was a bit shocked and a bit relief that i am not going crazy and that my jaws indeed were moved forward too much. I had to pay a lot of money for the first surgery. At this point i cant afford another surgery. But i think i should not pay for another surgery. I am preapred to pay for anesthesiology fees.
What should I do? And how long should i wait for a secondary surgery?

I think you should go back to the surgeon you consulted with and tell him that you had surgery 3.5 months ago. I think there are at least two reasons he may change his mind about diagnosis.

1. It can take 6 months or more for all of the swelling to go down (even though you may feel like it's all gone), and that might make your jaws look more advanced than they actually are.

2. Surgeons often over compensate with surgery, because some amount of relapse is expected. With SARPE, for example, a 30% relapse may be expected, so treatment may involve over expanding by 3 or more millimeters to compensate.

Those two factors combined might make your face look more advanced than it will 6 months and even 2 years from now. Because there is so much going on, and so many factors, I don't think a surgeon can give a correct opinion or diagnosis without knowing all of the facts. He may even want to see pictures or X Rays from before your first surgery to decide if your result is an improvement. Also if you give this surgeon all of the information he will be able to tell you how long you have to wait to have a second surgery if you need one.

Now, he may still think you were advanced too much. In that case, you could potentially go back to your original surgeon and tell them you think they should do a re-do surgery to correct their mistake.

Were your procedures cosmetic or functional? Did you have braces too, and did your orthodontist or your surgeon decide how far you should be advanced?

[bmueller]

My surgeon told me that I can't have any work done on my face until a year has passed after surgery. This even includes work on the nose and the chin. Despite feeling/looking like you are normal, you aren't fully clear of residual swelling and healing for a year after surgery.

You do need to be honest with the surgeon and tell him what surgery you have had. That may change what types of surgery or methods he can use. It is not fair for him to assume one thing and then get into surgery, cut you open and be shocked when he finds the hardware and readjusted bones.

I know you are very upset about your original surgery and are looking for another surgery for relief, but I'm sure you really don't want to rush things, go through another surgery premature and end up with more unhappy results.

Do you think this proposed High Lefort will be covered by insurance? How confident are you in the new surgeon? Maybe you need to see someone who specializes in reconstruction because they may be able to handle a more complicated case like yours.

[Mandy22]

Hi

Yes i told this surgeon everything. And basically I am a right candidat for le fort 3. He said that i have two options basically, well three. le fort 3 to bring out my nose, cheeks and orbital rims, to undo the surgery i had and to bring out my cheeks or to leave it as it is now.
Ive decided to wait at least 3 months for the full 6 months mark, i know this will be diffucult for me but i have no other options, and then to probably undo my first surgery at least to set back my jaws for a few mm. It is more difficult for me because my whole face is/was retrusive.

[Mandy22]

Were your procedures cosmetic or functional? Did you have braces too, and did your orthodontist or your surgeon decide how far you should be advanced?

My procedure was mostly cosmetic. I have a facial hypoplasia and i am stil wearing brace (crossbite).
My surgeon said the movement will depend on cephalometric analysis and my wishes. I thought i need 9mm. And he did it. I had no idea this will have such an enormeous impact on my soft tissue. Disaster.

[bellakai]

Did he look at xrays of you? How would they not be able to tell if you've had surgery?

It seems though that any surgeon could probably try and find something wrong. I'm not saying this is always the case, but you have to remember that they ARE in business to make money even though they are surgeons.

[Mandy22]

No, i havent send my xrays. Ill wait 3 months before i do anything.
I was watching my before pictures and its just incredible how fast I forgot how i looked for the past 25 years of my life. I certenally look different now. I do not think i look worse (tomorrow i might think i look worse), i cant say i look better, just different. And i sure hope my cheeks are still swollen as i look like i just gained a whole lot of weight.