Friday 15 March 2013

Surgery Plan

So just got back from my 'meeting and plan' with my surgeon - the last time i'll see him before the big day in 13 days! Before I went in I was so nervous, I couldn't sit still, and the 2 hour wait didn't help me either, I think it's because I'd changed surgeons last minute, and I wasn't sure what to expect from him, whether he was going to approach my surgery from the same angle as my previous surgeon, or whether he thought I was even ready for it! But he was beyond lovely and relaxed me instantly. From this only meeting, I have complete faith and trust in him, he made sure I was happy, and planned everything around what I wanted to change about my jaw, rather than him just telling me what he wanted to do instead!

So the surgery is so far still go ahead for the 28th March (fingers crossed it doesn't get cancelled) and here's what Mr. G is planning on doing; (apologies if this doesn't make sense, i've tried to remember as many details as I can!)

  • Top Jaw (Maxillary Impaction); The main aim of moving this is to correct my gummy smile. He said that a 'normal' jaw/gum line will display about 4mm of teeth, but I've currently got around 13mm of teeth and gums. He did say that to make this look to the usual '4mm' he would have to move my top jaw upwards around 8mm, and this is a DRAMATIC move. He explained to me that long-term, this would make myself and my gummy smile look worse. Apparently, as you age, everything 'goes south' meaning that as my jaws drop, my gums would too. (He told me that this is what has happened to the olympic athlete whose name I can't remember when she had correction of her gummy smile). In addition to this, too big of a movement can make the rest of your face 'squash up' aging it somewhat - So instead he plans to just move my top jaw upwards about 4-5mm, in all honesty, this is still a pretty big move, and will still reduce my gummy smile a hell of alot - so i'm pleased about that! He did say that usually with maxillary impaction, it can alter the shape of your nose, making your nostrils flare slightly. However I have a thin nose, and he doesn't think this would look too much of an issue!
  • Bottom Jaw (Mandibular Advancement): Simple plan to move this forward - I actually don't know the proposed measurements as he said it's something that he would have to look at during surgery, as by taking my top jaw upwards slightly, this would automatically move my bottom jaw forward, but I would still need surgery on it to move it forward that little bit more.
  • Chin (Genioplasty): This is something which may not go ahead, again, it is something that he will decide while i'm in theater, depending on how my chin looks after the new changes to my jaws - although he did say that sometimes it is better to carry this out at a later stage, if I wanted it done. 

Post-op wise, he said that he doesn't wire together his patients, instead he will use plates and screws to hold my jaws in their new position, and i'll probably just have a few bands for support. I've been told that i'd be able to eat only soft foods for a couple of weeks, and I should keep talking to a bare minimum - he also told me that i'd be extremely swollen (word for word, i'm to 'imagine the worst swelling ever, and expect far worse than that'), but pain wise should be bareable with normal pain killers combined with some local anaesthetic he'll give me whilst i'm asleep! Surgery should take approximately 6 hours, and I should be in hospital for atleast 2-3 nights, depending on how things go! He did touch on the 30% risk of perm nerve damage, due to the nerve running through the lower jaw - however, I think the benefits of jaw surgery in itself outweigh the risk of nerve damage.

After he told me his plan, he spent time telling me exactly how he's going to achieve this, where hes going to cut, and where he is going to plate. I've added a couple of YouTube videos which explain this really well..

  • Top Jaw (Maxillary Impaction);


  • Bottom Jaw (Mandibular Advancement):
  • Chin (Genioplasty):


I think if this post has highlighted the importance of anything; it's to make sure that you have a surgeon you can trust, and you feel comfortable with, even if it means waiting that bit longer, it does make all the difference!

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