SARPE Surgery

[goofylook]

Finally I got some time to write this update.. So I went to the Ortho for my 2nd appointment last Wednesday 3/27 and here are the changes he made:
1. Put thinker wires on upper and lower (I guess more push/pull)
2. Put a chain on the upper incisors to close the gap.
3. Tied the upper left teeth together to make sure the right incisor is the one moving to the left and hold the teeth on the upper left side still.
4. Put elastics on upper canines to lower canines and molar next to it (triangle with base on lower teeth) on both sides to bring the upper teeth inward. He said that with the expansion the teeth are expanded as well. Now he wants to bring them back in.
5. Next appointment in 3.5 weeks and "wait-for-it" he's gonna take out the RPE (.. YEAH BUDDY!) and replace it with that wire that goes across the palate (forgot the name of it)

I m extremely excited for the next appointment but weird enough that I kinda got used to the RPE - probably gonna miss it after it's gone. Other than that, the gap is now at about 5mm instead of 9.5mm so it has been closing - I wish that can close faster thu. Ortho said it should close 1mm per month!! That's it seriously!!

Anyways, any questions I can answer?

Even though I m excited about the next appointment I cant help it wonder if 3.5 months is enough time to take out the RPE?! Sometimes I feel a little (very mild) stress on the broken palate bones, but it doesnt last for long before it's gone.
Any tips are greatly appreciated..

Cheers,
Goofy

[katsface]

There is hope! Your gap might start to close faster than 1mm a month. Though I should say, take my experience with a grain of salt and proceed with cautious optimism.

They put a powerchain between my incisors 3 days after I finished expanding, and installed a fake tooth in the gap with 1 or 2mm of extra space so the teeth could start to come together. It took less than a WEEK for the 1 or 2 mm gap to close. I'm hoping they continue to come together that quickly as they shave the fake tooth down to give the incisors more room to come together.

I did email to let them know when the gap was almost closed, b/c I wanted to go in to have the fake tooth shaved down before my next appointment, but an assistant told me not to come in. (I'll be complaining about that on my next visit as I want this gap to close as fast as possible and I will have wasted a week of potential progress.) They'll shave the fake tooth down to give the incisors space to move on my next visit (April 03) and I'm going to ask that they leave extra space b/c they only want me to come in every 2 weeks to have the tooth shaved, and I don't want to have another week of wasted time.

[john123]

I got my braces and my RPE on! And my oh my is my expander noticeable. It extends down so much more than my teeth so when I laugh it looks like I'm missing my front teeth. It's a beautiful sight. I hope I get used to the feeling of constant pressure against my teeth and my lips. Other than that I'm kind of enjoying the attention of having ceramic braces. However, I'm sure that'll wear off within about 3 weeks and I'll be wishing for them to be off instantly. Oh well. I think I can make it a year in a half if it means I'll have a smile that I'd actually be proud to show off!

[katsface]

I got my braces and my RPE on! And my oh my is my expander noticeable. It extends down so much more than my teeth so when I laugh it looks like I'm missing my front teeth. It's a beautiful sight. I hope I get used to the feeling of constant pressure against my teeth and my lips. Other than that I'm kind of enjoying the attention of having ceramic braces. However, I'm sure that'll wear off within about 3 weeks and I'll be wishing for them to be off instantly. Oh well. I think I can make it a year in a half if it means I'll have a smile that I'd actually be proud to show off!

Haha glad you're in good spirits! I'm trying to imagine how your expander is situated to make it look like you're missing teeth. Mine is very low in my mouth, but you still can't see it unless I open up and tip my head back. I would love to see a picture

Do you have a surgery date? Good luck!

[katsface]

Also, I might disagree here with katsface that the expansion is controlled by the ortho and not the surgeon. The surgeon job is only to loosen the bones and make sure no complication from the surgery, bleeding, recovery, etc. However the ortho decides what type of expander to use, how much to expand, and how frequent.

Just noticed this and I agree

I totally agree that the expansion is controlled by the ortho. I guess I was feeling a little indignant at the time as I was finishing up a long expansion process, because I took the wording literally when john asked if the ortho would know to only expand one side. I think my mind set was "My ortho didn't expand jack. I did. He just glued this speech impediment device in my mouth." Lol, sorry! My attitude has since sweetened

What I meant was, the orthodontist doesn't turn the expander, so he's not actively expanding your jaw, and there's nothing he can do before or during expansion to make you expand on one side only (this is from my surgeon who could be wrong). Since the RPE expands from the center outward to both sides, no matter which kind of expander he chose, I was thinking it would be the surgeon's job to only release one side of the bone if that was necessary. From my experience that's something they would both talk about and decide on, but I know some ortho/surgeon teams have the ortho make a plan and the surgeon just follows it.

Anyway, I know it's a moot point now. But I wanted to let you know I agree with Goofy.

[john123]

I got my braces and my RPE on! And my oh my is my expander noticeable. It extends down so much more than my teeth so when I laugh it looks like I'm missing my front teeth. It's a beautiful sight. I hope I get used to the feeling of constant pressure against my teeth and my lips. Other than that I'm kind of enjoying the attention of having ceramic braces. However, I'm sure that'll wear off within about 3 weeks and I'll be wishing for them to be off instantly. Oh well. I think I can make it a year in a half if it means I'll have a smile that I'd actually be proud to show off!

Haha glad you're in good spirits! I'm trying to imagine how your expander is situated to make it look like you're missing teeth. Mine is very low in my mouth, but you still can't see it unless I open up and tip my head back. I would love to see a picture

Do you have a surgery date? Good luck!

Thanks! A picture would be so unflattering that I'm just not sure I could put one up. The less people that can see it the better haha.

No exact date yet but it'll definitely be around the end of May since I'm still in school for another month.

[john123]

Also, I might disagree here with katsface that the expansion is controlled by the ortho and not the surgeon. The surgeon job is only to loosen the bones and make sure no complication from the surgery, bleeding, recovery, etc. However the ortho decides what type of expander to use, how much to expand, and how frequent.

Just noticed this and I agree

I totally agree that the expansion is controlled by the ortho. I guess I was feeling a little indignant at the time as I was finishing up a long expansion process, because I took the wording literally when john asked if the ortho would know to only expand one side. I think my mind set was "My ortho didn't expand jack. I did. He just glued this speech impediment device in my mouth." Lol, sorry! My attitude has since sweetened

What I meant was, the orthodontist doesn't turn the expander, so he's not actively expanding your jaw, and there's nothing he can do before or during expansion to make you expand on one side only (this is from my surgeon who could be wrong). Since the RPE expands from the center outward to both sides, no matter which kind of expander he chose, I was thinking it would be the surgeon's job to only release one side of the bone if that was necessary. From my experience that's something they would both talk about and decide on, but I know some ortho/surgeon teams have the ortho make a plan and the surgeon just follows it.

Anyway, I know it's a moot point now. But I wanted to let you know I agree with Goofy.

Ahh I get it now. I had no idea that the surgeon could release only one side. That makes me feel a whole lot more confident about the procedure and everything. Thanks a bunch!

Yeah seriously the worst part about braces so far is the awkwardness when trying to talk. I feel like such a dweeb trying to swallow my spit before speaking so I don't shower the person I'm talking to. It's rough, very rough. Here's to hoping it gets better!

[katsface]

Also, I might disagree here with katsface that the expansion is controlled by the ortho and not the surgeon. The surgeon job is only to loosen the bones and make sure no complication from the surgery, bleeding, recovery, etc. However the ortho decides what type of expander to use, how much to expand, and how frequent.

Just noticed this and I agree

I totally agree that the expansion is controlled by the ortho. I guess I was feeling a little indignant at the time as I was finishing up a long expansion process, because I took the wording literally when john asked if the ortho would know to only expand one side. I think my mind set was "My ortho didn't expand jack. I did. He just glued this speech impediment device in my mouth." Lol, sorry! My attitude has since sweetened

What I meant was, the orthodontist doesn't turn the expander, so he's not actively expanding your jaw, and there's nothing he can do before or during expansion to make you expand on one side only (this is from my surgeon who could be wrong). Since the RPE expands from the center outward to both sides, no matter which kind of expander he chose, I was thinking it would be the surgeon's job to only release one side of the bone if that was necessary. From my experience that's something they would both talk about and decide on, but I know some ortho/surgeon teams have the ortho make a plan and the surgeon just follows it.

Anyway, I know it's a moot point now. But I wanted to let you know I agree with Goofy.

Ahh I get it now. I had no idea that the surgeon could release only one side. That makes me feel a whole lot more confident about the procedure and everything. Thanks a bunch!

Yeah seriously the worst part about braces so far is the awkwardness when trying to talk. I feel like such a dweeb trying to swallow my spit before speaking so I don't shower the person I'm talking to. It's rough, very rough. Here's to hoping it gets better!

Sorry, to be clear, I don't know that the surgeon could, or would, release only one side. I think I might have read someone in this SARPE thread that had something like that done, but I might be imagining that.

[john123]

AWW MAN. Nah, I actually think you may be right.

[andygoodyear]

Vantwins - like yourself I have recently been through a SARME that I'm convinced didn't go completely as planned. I've been bottling up a lot the last week or two so hopefully this is not too much of a ramble.

My SARME was only four weeks ago and I'm still expanding, but I noticed as soon as I came out of surgery that one tooth looked slightly lower than the other. I mentioned this to my surgeon when I say him three days after surgery, and he did say that as the SARME incisions are made all the way around, it could sometimes be slightly off angle. Also, the same side of my jaw did already have a slant to it (just one of my wonderful abnormal jaw deformities) and the surgery and widening is just making it look bigger and bigger. That said I'm still upset. The wider the gap is getting, the lower down the tooth looks. I telephone my ortho yesterday who said he did notice it at my last appointment (so why he didnt mention it to me I'm not sure) - but it just looks ten times worse now. My gap is now 11mm but I don't actually care about the gap, I care about the slant - I think I look like a <insert derogatory description> now.

Anyhow I'm back to see the ortho on Monday and I'm hoping he will put my mind at rest. I do still feel very confident with the ortho and the surgeon, I just feel like I need a little more reassurance from them.

With your SARME being un-even, how did they say they would fix it? I know you said your new ortho will fix immediately - but what exactly will they do?

[andygoodyear]

And thanks everyone for your information on here - this is such a great support network. I wish I found it eariler!

[goofylook]

andygoodyear, welcome to this thread. I m not sure about the details of your case but mine expansion was more on the right side than the left side, which is good for me because the cross bite was on my right side. Also, my incisors kinda came down more after the surgery. I asked my ortho about it coz I was worried they will fall off (lol) and he said that was normal. I think you are doing the right thing following up with your surgeon and ortho.

Can you post some pics of your teeth to highlight this slant? My right incisor was slanted as well. It was slightly slanted before the surgery but after the expansion it looked horrible!!! The ortho has fixed that pretty easily and now my incisors are pretty much straight again and closing together.

Good luck,
Goofy

[s214111]

I had my SARPE surgery, not Lefort I surgery last week. Before that had taken place, I had written up 20 questions to my surgeon; that is, based on information I had gathered based on research studies I had found via on-line. Questions ranged from minor to major complications and what to expect during post-op. My overall experience was fair during the pre-op and one person I was eager to speak with was the anethstheologist. I asked him a few questions and one was being parlyized during the operation. I found that I was going to be during the intubation only. Not long after that, I was given a sedative and ushered to the OR. I then awaken in the post-op there and immeadeatly started vomiting blood - it sounds worse that it actually is. However, the nose bleeds were terrible. It seems nasal intubation is given during this type of surgery - this something I expected but was worse than I expeccted. That doc bruised the inside of my throat and it became especially sore. Overall, it took about 4 days for the swelling to go down and the bleeding to stop. Since my bottom wisdom teeth were removed, extra swelling did take place. So, I'm still recovering and on liquid/semi-solid food diets. I've lost 6 pnds so far in the first week. All this hasn't been too bad compared to my bi-lateral inguinal hernia surgery I had a couple of years ago. Also, I'm surprised the expander painless operation. I don't feel discomfort from it until about an hr after it's turned. Then, it only feels moderately uncomfortable for a few hrs - pain killers do help all this.

[goofylook]

Congrats on your surgery. Glad you are feeling better. It should be down hill from there.


An update on my gap, it has been closing freakishly fast. The ortho said it should close 1mm a month but it is closing 1mm every 1-2 weeks. I most now little less than 4.5mm from all high 9.5mm.


Cheers,
Goofy

[Vantwins]

Hi all! Sounds like everyones treatment is coming along well! John, how did it go getting the RPE in? That thing is no fun!

Kat - I don't know why the original surgeon and ortho didn't refer me to a perio. Just more reason that in hindsight, I think they were crappy doctors! If I need any more expansion after the botched SARPE, my new surgeon will deal with it during my next jaw surgery. I had my 2nd gum grafting on Friday, so I'm healing from that. Had my 2nd (new) ortho appt on Monday and got a stronger wire on my top teeth. It seems to be doing a good job of evening out my teeth. He said when I go back end of May he'll start working on closing the gaps, thank goodness! When I started all this, I never imagined I'd have a gap for 6+ months!!! I am sort of used to it by now though, but will be happy when it's gone!

Kat, I hope your bill gets sorted out! I got a very unexpected bill for 15k+ as well. The surgeon is appealing it. As he should - there's no way I'm paying him for the crappy job he did, so if he wants to get paid, he better work it out with insurance.

Insurance also denied my gum grafting, which I've already spend about 11k on. Argh. Thinking of the amazing vacation I could be taking instead of messing with my gums! Or the tummy tuck I'd much prefer!

Vanessa