SARPE Surgery

[avy]

I really want your advice on this --

I had my SARPE on June 16th, 14 weeks ago, and I still look CONSIDERABLY swollen. I talked to my OS about this last week, and he said that it could be the RPE appliance making my face appear swollen (I have a bulky plastic RPE appliance in my mouth now) and that I should take it off and see how my face adjust and then see if it doesnt adjust, see if its an infection.

Can i DEMAND my OD take off the appliance? I know he's very resistant to it. I am miserable with this thing and I"m scared that my face is permanently ruined. Can I ask him to remove it and put in a TPA? I can't go on like this -- its over 3 months and people constantly comment on what's wrong with my face.

Please advise. I'm thinkng about just walking into his office and demanding he take it off.

I had SARME done 2 days before you and my swelling is pretty much gone, although it did take about 2 months for it to go down. I was really swollen for the 2 months and thought to myself I would never look normal again! My nose has spread out slightly and my mouth is definitely alot bigger so that could possibly be adding to you seeing alot of swelling, even though there may not be alot still there. Infection is a possibility and I would definitely get that checked out. I can understand your OS and ortho not wanting to take out the RPE as your bone hasnt fully healed yet and you would have a good chance of replapse. I dont think the smaller device is as strong as the RPE either? - but I'm not 100% on that.
A CT scan will show up any fluid or mass in your sinuses so that might be a good idea. Let us know how you get on.

[chicago29]

colorpurple,

I think avy's advice is really good. I know it stinks to hear, but I can't imagine the expander causing this, and it is TOO EARLY for you to have it taken out. You run a very considerable risk of relapse if you take it out now.

If you don't trust your OS's assessment, go to an EENT (eye/ears/nose/throat) doctor and get their assessment. They are likely going to recommend a CT scan of the sinus area as well. That may be the only way to see what's going on. Are you in any sort of pain?

I was VERY swollen for the first 10 days (day 2 and 3 were insane), and it went down considerably after that. I'd say it was completely gone around the 1 month mark. To have noticeable swelling at the 2 month mark certainly warrants evaluation by an oral surgeon or specialist.

Best of luck to you, and hang in there!

-Chicago29

[glenncoyle]

and the count down is now.

get my expander on in 1.5 hours, and waiting for the hosp to call for my surgery time tomorrow...

its an arvo (aussie slang for afternoon) operation wish it was morning iprefer to get his stuff out the way.

GC

[crazybeautiful]

Good luck! You might feel a bit at a loss as to how to function with that expander for a couple of hours, but it should pass.

When I got mine it was silly- I had to go to my local hospital to get it fitted and shown how to use it from my ortho, then I had to go straight to the hospital where my surgery was being performed to get my bed because for some reason they wanted me the a day before (maybe because I'm young? I don't know). I tried to eat a sandwich straight away but couldn't manage to, and after that it was just horrible hospital food. Suffice it to say my stomach was more than empty enough for the surgery the next day

[chicago29]

Best of luck, glenncoyle! Let us know how it goes...

[glenncoyle]

cheers people.

the expander has been fine, i had a few of the boys laugh at me at cricket training last night, trying to give advice when you can barely say a word is very frustrating. all in all it wasnt to bad

just waiting on the cab now to take me to the hosp.

ive quickly updated the blog, sorry bout any spelling or grammer, just in a hurry (and its not my strong point)

http://sarpe-and-braces.blogspot.com/20 ... is-in.html

ill be back home later tonight, so ill guess ill see you all on the other side

[colorpurple]

hey guys

just to follow up on my case, i talked to my ortho about the apparent swelling, and he's convinced that its the bulky appliance in my mouth. he is removing it in 2 weeks (thank god), exactly 16 weeks post-SARPE. i think my jaw overexpanded, so there is enough room for slight relapse.

what was it like getting the appliance removed? also, how soon after you get braces do the gaps close?

[colorpurple]

hey guys

just to follow up on my case, i talked to my ortho about the apparent swelling, and he's convinced that its the bulky appliance in my mouth. he is removing it in 2 weeks (thank god), exactly 16 weeks post-SARPE. i think my jaw overexpanded, so there is enough room for slight relapse.

what was it like getting the appliance removed? also, how soon after you get braces do the gaps close?

[zeira]

Hi everyone! Things have been going well with the expander. The gap is down to less than 2mm from about 5mm, so I can go to school without being all worried about it. It's a bit disappointing that it looks so natural now that people don't even ask what happened anymore

Anyway, I had a question for you. Did anyone else get SARPE/SARME as well as premolar extractions? It's a bit different in my case because I'm already missing an upper premolar that was impacted, so my ortho wants to achieve symmetry. But I really don't want to give up three other teeth. I'm glad I didn't go with the other ortho who did not even consider surgery, because then I would have ended up with a narrow looking smile, but I'm worried about the changes due to the extractions. I feel that the surgery was a bit for nothing if I still need that many extractions.

On a better note, one of my canines (you can see my fang canines in my link) has been moving and lining up with my other teeth due to the space formed. It's really fascinating to see how fast teeth move.

Oh, and I have a brace date for my uppers for November 20th, they said 6 weeks, but they're really busy until then. I think because of my overbite I'll keep wearing the retainer on my lowers for a couple of months.

[crazybeautiful]

hey guys

just to follow up on my case, i talked to my ortho about the apparent swelling, and he's convinced that its the bulky appliance in my mouth. he is removing it in 2 weeks (thank god), exactly 16 weeks post-SARPE. i think my jaw overexpanded, so there is enough room for slight relapse.

what was it like getting the appliance removed? also, how soon after you get braces do the gaps close?

I still don't think the RPE is the problem because it can only be bulky internally, not externally. But maybe it is just the over-expansion

Anyway, the removal of the expander was fine for me. Except it was a tiny bit smelly and gunky

The gap is all relative to your individual situation. My gap closed on its own pre-braces, and for others it takes longer. You just need to wait and see, really

[colorpurple]

hey CB, i have a special type of RPE. it's a bonded RPE and has bulky acrylic on the outside of my teeth (labial) that push my lips out.

http://www.aztecortholab.com/bonded%20rpe%20lg.JPG

i hope this is the problem

do you think 7 weeks is too early to take of the expander? i had a SLOW expansion -- surgery on 6/16, turned every other day till 8/11 for 32 turns, and removal 7 wks later. i'm guessing bc it was a slow expansion, the bone was healing AS i was expanding. i also didn't get a big gap. now my gap is as about 1-2 mm. i have spaces on my lateral incisors tho.

[crazybeautiful]

Aaah, that would probably make a difference then. I thought you just had a 'normal' RPE

Well I think a conservative RPE removal is around 6 months post op. Some people get it taken out sooner, but the bone does take a long time to fully heal and stabalise. But with slower expansions I suppose that would make a difference to healing. Just trust your ortho, but I would follow what he/she says rather than try to push for the removal. The swelling still could just be normal, and more than that it might just be magnified because your jaw is now wider, giving the illusion of more swelling.

I'm just speculating so I don't know, but good luck anyway. If you have over-expanded than a slight relapse is fine anyway

[glenncoyle]

hey alll

just thought id let you know how it went.

the surgery was fine and the first 24 hours were pretty easy. got a heap of swelling days 2,3,4 and i mean a heap, top lip is what is annoying me the most.

some movements feel funny, and scare the crap out of me, but other than that im all good.

its day 5 now, a lot of the swelling has gone down. i think i have some bruising, but cant see, im taking this oppertunity to grow a beard (ill walk into the first day of work and will get laughed at )

i started turning the expander the day after the op. 2 turns one day, and 1 the next. so far ive expand 7 times (with the 8th tonight). a very slight gap is starting to form, but you cant notice unless you relly look, i gather i 1/5 the way through, if it gets 5 times bigger than now, id be stoked

have my frist ortho apt on wed (two days) and then a catch up with the surgeon on monday.

ill update the blog with some pics on wed to show the progress

[Braceventura]

The following summarizes my experience to date:

I had my SARPE on July 22nd, 2009.

I was instructed to start turning the RPE 2 turns, 2x/day - once on the morning and once at night - beginning 3 days after surgery.

I executed 42 turns in total and generated an 8mm gap by day 10.

My orthodontist said I could stop turning on August 4th, 2009.

When I had a check up with my orthodontist on September 15th, 2009, he said everything looked really good. My gap had closed down to just 2mm on its own. No swelling. No remaining pain -- unless I bite into something hard. All traces of the stitches under my upper lip, except for the slight bumps where they had been, are gone.

I am scheduled to have the RPE taken out on October 27th. It will be replaced with a TPA and ceramic braces.

I feel as if I had a normal experience based upon all the blogs I've read. I was swollen for the first couple weeks. I still can't really feel my upper gums very well but they do seem to be getting more feeling in them.

I am able to eat most things at this point -- except for the more dense foods (e.g. nuts, apples, etc.).

I still sound somewhat like Sylvester the Cat (Sufferin' succotash, etc.) and I look a little goofy since all my upper teeth seem to be moving around into the new space but I'm slowly feeling like I'm going to come out of this on the positive side!

For all the 'discomfort' (aka pain), I think the results are going to be worth it. I get to keep my teeth (apparently I was losing bone from my upper jaw because my upper teeth failed to occlude my lower teeth correctly; if you don't use bone you lose it ( as in 'weight bearing exercise').

And, my teeth now fill out to the edges of my mouth when I smile. So, once they are all placed into their nice comfy new homes, it should look a lot better.

I waited until I was 50 to do all of this due to the fact I just never 'had the time' in the past. I wish I would have done this 30 years ago but I'm not sure they even did this back then.

Finally, I do believe that all the blogs people who have written on this topic have been extremely helpful. Being able to measure my progress against others (e.g. Graham's SARPE blog -- he photographed/video recorded his entire experience from week to week) was far better than any physician's advice/commentary -- few of them have been on the receiving end of this experience!

[na2r4]

Hey Ziera, thank u for the warm welcome back.
Luckily, i only had the SARPE, although before surgery they had told me, i would need both top and bottom surgeries done about 6 months apart, but my Orthodontist worked REALLLLLLLLY hard to make sure i wouldn't have to go through it. He knew i was really worried about having to go through it and did an amazing job.
Here are pics of my impressions and again, i think my story is on page 46 or 47 of this topic, where u actually see some of the befores (after SARPE) and during.
I actually held my horrible looking "before" impression next to my 5 yr old daughters open mouth and noticed mine was even smaller than hers!!!! It actually had an impacted tooth that had come through just before the impression into my palate. Not a good look!!!














Front tooth discoloured a little, needs root removal after trauma.

During treatment: Here, my top jaw has now been expanded, but my bottom two teeth were being very defiant.




And now i'm done and loving my retainer.
Good luck everyone with your treatment, and i'd be more that happy to give you my orthodontists name if you reside in NY.