Tuesday, April 23, 2019

Jaw Surgery Q&A

Hello all,

I can't remember the last time I logged in here. I've been wanting to post a Q&A of some of the questions I get often just so it is easier for anyone to find the answers as sometimes when people try to contact me it gets lost in translation. I've changed over so many social media accounts that I don't think I even have access to all my old emails.



1. Who was your surgeon and where are they located?

I had my jaw surgery in Toronto, Canada. My surgeon was recommended by my orthodontist but I had already known about him through my own research and was interested in meeting with him for a consultation. I highly recommend meeting with him if you live in Ontario and are looking for a surgeon. I have met a few of his previous patients and their final results were functional and aesthetically pleasing. I couldn't imagine having had a better surgeon.

Here is a link to my surgeons bio and the website for the clinic he works through:
My surgeon

I am not sure if they take patients from out of the country, but my best advice is to do your research and find out as much as you can about surgeons in your area and also try to get in contact with their previous patients.

2. How much did your jaw surgery cost?

The cost of my jaw surgery is a good representation of what Canadians living in Ontario will pay through OHIP, but will probably not be much help if you are from a different province or if you are from a different country.

The jaw surgery itself and my time spent in hospital was all covered by OHIP, Ontario's health insurance plan as although my face changed, it was not done for aesthetic purposes but for functionality. I had many associated costs that were not covered.

Braces: $7,000
Consultation: $200
Planning fees: $3,500
Wisdom teeth: Somewhere in the range of $500-$1000 (It's hard to remember all these years later).

Braces are required for surgery but as they are considered cosmetic, it is highly unlikely to have them covered unless your private dental plan includes some sort of coverage. I had pretty straight teeth but I needed to have my jaw decompensated (teeth moved to align with the bone structure) since I had braces previously. They are also required for holding the jaws in place and shut after surgery.

If you are having lower jaw surgery then it is likely you will require wisdom teeth removal as they tend to cut the jaw below where the wisdom teeth are.

Planning fees were fees paid to my surgeon through his clinic for preparation and planning for my in hospital surgery. As his clinic is private, these types of fees are not covered. I had sliding genioplasty as my chin have grow in angle backwards as part of my convex profile so planning for that was also included in the fees.

The best bet of what it will cost you is to check with your insurance company and try to get in contact with other people in your area who have had the surgery.

3. Do you have permanent numbness? How do you deal with it?

This is a question I get often and it is something people are terrified of. I have permanent numbness, which is a risk but it is more likely you won't have it than you will. My chin and lower lip are pretty much numb and the best way I can describe it is sort of like rubber.

After four years it is safe to say the feeling is gone. At first your entire face is numb and the feeling slowly comes back over the course of weeks or months. I did have little pins and needle feelings here and there in that area but the feeling sort of came back outwards in and then stopped.

It has been four years and I can confidently say that the numbness does not have an impact in my day to day life in any way. I actually go months without it even crossing my mind. I tend not to drool when eating, and I can speak perfectly fine. It really is not a big deal at all.

The only time I think I really thought about it was when I last had dental work. It was strange having areas of my mouth numb, but nice at the same time that I had less sensitivity than another person might.

4. How long is the recovery? When can I go back to work or school?

My surgeon told me I would be good to return to university after two weeks. I would strongly suggest against this if you are having double jaw surgery and genioplasty. For one, I still looked mangled, very swollen, and had very little mobility in my face, or energy to get through the day. Also, I found that I still hadn't recovered enough to return to normal activities. I still had bad days with a lot of pain, and was still learning to sleep without putting any pressure on my face.

5. Does jaw surgery hurt? 

Surprisingly, no. At least it didn't for me. I found it was more annoying than anything. I had no pain post op. I was completely numb in the face for a long while. the worst part is throwing up post op, which is common, since your stomach will likely be filled with old blood. I also found it really hard dealing with feeling returning to my face because it was constantly twitching and tingling. I had some joint pain as I continued to recover, but most of my pain was manageable with medication. I was on some pretty heavy painkillers that first week, and actually ended up needing a sedative to sleep. I was very uncomfortable.

6. How long does the swelling last? 

I want to be honest and say that the residual swelling takes about 6 months to a year to go away. The first 6 weeks are the worst. My face looked very uneven during that time. After that I could get away with going out in public and not looking like my face was a rubber mask. That was the first time I took a photo of myself and felt somewhat normal. This will vary for everyone. Overall though it is a long road.

Leave any further questions in the comments and I will answer them. Also, I'm going to try to save the most frequently asked questions I get and make a youtube video.

Terra



























Saturday, July 2, 2016

How to choose an orthognathic surgeon

Hi everyone,

I haven't posted in age, but I still get a lot of questions regarding jaw surgery and I thought over time I'd try to update my blog a bit and add some more information for commonly asked questions.

I feel like a lot of the reason why my jaw surgery experience was so positive and why I got the results I was hoping to achieve is really due to my surgeon. It's not easy putting your life in someones hands but it makes it a lot easier if you feel comfortable with that person and you do your research.

I have cancelled surgeries for other things in the past because I didn't feel comfortable with the surgeon. I've had breathing difficulties and a lot of other medical issues related to my jaw issue in the past. But I'm glad that orthognathic surgery was my final decision.

Here are the steps I took before deciding my surgeon was right for me: '

1. Look and their previous work

I went online and tried to get into contact with as many people as possible who went to my surgeon. Jaw surgery is a combination of functionality, but a part of it is aesthetics. Every surgeon seems to have a different style as to what end result looks good. I noticed with my surgeon that I really liked the way both the nose and the chin ended up post op. It can be common to have your surgery combined with a genioplasty which is having your chin moved. This can be necessary when you have a convex profile or your either have too much bone or too subtle of a chin. Those issues may become exaggerated depending on how your jaws are moved. If you can't find any before and after pictures from your surgeon, call their office and see if they can provide you with any. Also, don't really use their digital imaging of what you will look like as a deal breaker because mine looked nothing like how I look now.




2. Research reviews, blogs, and forums to find out anything you can about your surgeon.

I checked all the reviews I could and I could only find one negative review and it was someone upset because my surgeon refused to do surgery on them altogether. Some surgeons will not do revisions. My surgeon does not do revisions from other surgeons as far as I know. If this is a first time jaw surgery for you, you'll have a easier time finding a surgeon than if you had jaw surgery and experienced complications or relapsed and then tried to go to a different surgeon. Also, forums and blogs will give you a good idea as to how that surgeon treats their patients throughout the process. I was so scared to have a surgeon similar to my orthodontist who was extremely welcoming during the consultation and then turned into a total ass who couldn't care less about my progress after they got their payment. My surgeon and all his staff were extremely professional, friendly, and were there for me throughout the entire process.

3. Use your gut instinct.

If you get a really bad vibe off of someone it might be a good sign that you need to go elsewhere. With my surgeon, I felt comfortable from the start with both him and his staff. Jaw surgery is a big decision and you need to be 100% committed and prepared for a long road ahead of you. Don't let the slight possibility of complications scare you. I had some complications after my surgery which resulted in an infection that required more surgery and a week with a drainage tube in my face. I would still do it all over again. The recovery is such a small time compared to spending the rest of your life without all the issues you had before surgery. I still don't know how I went so long with constant jaw pain and breathing issues. Not to mention the fact that I was slowly grinding my back teeth down to the point where I will never be able to properly chew certain foods from the damage.


Useful links regarding jaw surgery:

Archwired forum  This is probably the post helpful forum I have come across. They have a section on orthognathic surgery which was extremely helpful.

Jaw surgery forums   Another super useful forum that I believe started up doing the time I was going through my process.

Facebook pages and groups - just do a general Facebook search for jaw surgery.

You can also check out any of the links on your right  -----> I tried to link as many jaw surgery blogs as possible. Some may no longer be active as this was a few years ago.


How to choose an orthognathic surgeon

Hi everyone,

I haven't posted in age, but I still get a lot of questions regarding jaw surgery and I thought over time I'd try to update my blog a bit and add some more information for commonly asked questions.

I feel like a lot of the reason why my jaw surgery experience was so positive and why I got the results I was hoping to achieve is really due to my surgeon. It's not easy putting your life in someones hands but it makes it a lot easier if you feel comfortable with that person and you do your research.

I have cancelled surgeries for other things in the past because I didn't feel comfortable with the surgeon. I've had breathing difficulties and a lot of other medical issues related to my jaw issue in the past. But I'm glad that orthognathic surgery was my final decision.

Here are the steps I took before deciding my surgeon was right for me: '

1. Look and their previous work

I went online and tried to get into contact with as many people as possible who went to my surgeon. Jaw surgery is a combination of functionality, but a part of it is aesthetics. Every surgeon seems to have a different style as to what end result looks good. I noticed with my surgeon that I really liked the way both the nose and the chin ended up post op. It can be common to have your surgery combined with a genioplasty which is having your chin moved. This can be necessary when you have a convex profile or your either have too much bone or too subtle of a chin. Those issues may become exaggerated depending on how your jaws are moved. If you can't find any before and after pictures from your surgeon, call their office and see if they can provide you with any. Also, don't really use their digital imaging of what you will look like as a deal breaker because mine looked nothing like how I look now.

This is my before and after. In all photos my face is in resting position with my teeth fully closed. 



2. Research reviews, blogs, and forums to find out anything you can about your surgeon.

I checked all the reviews I could and I could only find one negative review and it was someone upset because my surgeon refused to do surgery on them altogether. Some surgeons will not do revisions. My surgeon does not do revisions from other surgeons as far as I know. If this is a first time jaw surgery for you, you'll have a easier time finding a surgeon than if you had jaw surgery and experienced complications or relapsed and then tried to go to a different surgeon. Also, forums and blogs will give you a good idea as to how that surgeon treats their patients throughout the process. I was so scared to have a surgeon similar to my orthodontist who was extremely welcoming during the consultation and then turned into a total ass who couldn't care less about my progress after they got their payment. My surgeon and all his staff were extremely professional, friendly, and were there for me throughout the entire process.

3. Use your gut instinct.

If you get a really bad vibe off of someone it might be a good sign that you need to go elsewhere. With my surgeon, I felt comfortable from the start with both him and his staff. Jaw surgery is a big decision and you need to be 100% committed and prepared for a long road ahead of you. Don't let the slight possibility of complications scare you. I had some complications after my surgery which resulted in an infection that required more surgery and a week with a drainage tube in my face. I would still do it all over again. The recovery is such a small time compared to spending the rest of your life without all the issues you had before surgery. I still don't know how I went so long with constant jaw pain and breathing issues. Not to mention the fact that I was slowly grinding my back teeth down to the point where I will never be able to properly chew certain foods from the damage.


Useful links regarding jaw surgery:

Archwired forum  This is probably the post helpful forum I have come across. They have a section on orthognathic surgery which was extremely helpful.

Jaw surgery forums   Another super useful forum that I believe started up doing the time I was going through my process.

Facebook pages and groups - just do a general Facebook search for jaw surgery.

You can also check out any of the links on your right  -----> I tried to link as many jaw surgery blogs as possible. Some may no longer be active as this was a few years ago.


How to choose an orthognathic surgeon

Hi everyone,

I haven't posted in age, but I still get a lot of questions regarding jaw surgery and I thought over time I'd try to update my blog a bit and add some more information for commonly asked questions.

I feel like a lot of the reason why my jaw surgery experience was so positive and why I got the results I was hoping to achieve is really due to my surgeon. It's not easy putting your life in someones hands but it makes it a lot easier if you feel comfortable with that person and you do your research.

I have cancelled surgeries for other things in the past because I didn't feel comfortable with the surgeon. I've had breathing difficulties and a lot of other medical issues related to my jaw issue in the past. But I'm glad that orthognathic surgery was my final decision.

Here are the steps I took before deciding my surgeon was right for me: '

1. Look and their previous work

I went online and tried to get into contact with as many people as possible who went to my surgeon. Jaw surgery is a combination of functionality, but a part of it is aesthetics. Every surgeon seems to have a different style as to what end result looks good. I noticed with my surgeon that I really liked the way both the nose and the chin ended up post op. It can be common to have your surgery combined with a genioplasty which is having your chin moved. This can be necessary when you have a convex profile or your either have too much bone or too subtle of a chin. Those issues may become exaggerated depending on how your jaws are moved. If you can't find any before and after pictures from your surgeon, call their office and see if they can provide you with any. Also, don't really use their digital imaging of what you will look like as a deal breaker because mine looked nothing like how I look now.

This is one of my before and after pictures. Theses are both with my face in resting position and teeth fully closed. 



2. Research reviews, blogs, and forums to find out anything you can about your surgeon.

I checked all the reviews I could and I could only find one negative review and it was someone upset because my surgeon refused to do surgery on them altogether. Some surgeons will not do revisions. My surgeon does not do revisions from other surgeons as far as I know. If this is a first time jaw surgery for you, you'll have a easier time finding a surgeon than if you had jaw surgery and experienced complications or relapsed and then tried to go to a different surgeon. Also, forums and blogs will give you a good idea as to how that surgeon treats their patients throughout the process. I was so scared to have a surgeon similar to my orthodontist who was extremely welcoming during the consultation and then turned into a total ass who couldn't care less about my progress after they got their payment. My surgeon and all his staff were extremely professional, friendly, and were there for me throughout the entire process.

3. Use your gut instinct.

If you get a really bad vibe off of someone it might be a good sign that you need to go elsewhere. With my surgeon, I felt comfortable from the start with both him and his staff. Jaw surgery is a big decision and you need to be 100% committed and prepared for a long road ahead of you. Don't let the slight possibility of complications scare you. I had some complications after my surgery which resulted in an infection that required more surgery and a week with a drainage tube in my face. I would still do it all over again. The recovery is such a small time compared to spending the rest of your life without all the issues you had before surgery. I still don't know how I went so long with constant jaw pain and breathing issues. Not to mention the fact that I was slowly grinding my back teeth down to the point where I will never be able to properly chew certain foods from the damage.


Useful links regarding jaw surgery:

Archwired forum  This is probably the post helpful forum I have come across. They have a section on orthognathic surgery which was extremely helpful.

Jaw surgery forums   Another super useful forum that I believe started up doing the time I was going through my process.

Facebook pages and groups - just do a general Facebook search for jaw surgery.

You can also check out any of the links on your right  -----> I tried to link as many jaw surgery blogs as possible. Some may no longer be active as this was a few years ago.


Friday, January 9, 2015

I Corrected my Tongue Thrust - Without Speech Therapy

A tongue thrust is basically poor tongue posture which causes you to push your tongue against the inside of your teeth instead of up on the roof of your mouth. Everyone is born with a tongue thrust and almost everyone learned proper tongue posture on their own, without any assistance. Tongue thrusters do not. A common result of this is an anterior open bite where none of the anterior teeth meet and an opened appears.


This was my anterior open bite prior to double jaw surgery and prior to decompensation. It wasn't nearly as bad as I had braces at a younger age to attempt to fix the bite. With no attempt to fix the tongue thrust I just kept tongue thrusting and ended up relapsing to the point I was developing sleep apnea and TMJ disorder. I also had speech issues, chewing issues, mouth breathing, and other things that were out of the norm.

I believe two things fixed my tongue thrust.

  1. Persistence to fix my tongue posture: I didn't go to speech therapy during this process, but I researched tongue thrust correction and used many youtube videos to help learn ways to correct my tongue thrust. It was very annoying, and at first you will start thrusting the second you stop thinking about it. Be persistent. It is a very difficult habit to break. 
  2. Jaw surgery: When I had my jaw surgery I had both jaws moved and my chin moved. It was a big surgery to go through with a very tough recovery. I also had cysts removed from my nasal airway. Being able to breathe properly through my nose was a huge factor in correcting my tongue posture as it allowed me to keep my tongue at the top of my mouth while using my nose to breathe. 

I know a lot of people have relapsed after having jaw surgery for an anterior open bite. I had my surgery over two years ago and so far my bite as remained the same as it was post op. I will always try to be aware of my tongue posture and one day I will see a speech therapist to assure I am doing everything I can to avoid a relapse.

This is my bite post op:



Terra



Back To Toronto

It is cold, really really cold. I didn't realize how warm in was in Vancouver until I arrived in this deep freeze hell that is Toronto. I'm back in school and after two days of classes I now have three days off, which I will not complain about at all.

I got back in late although the flight was making good time. The arm that connects the gate to the plane was having issues and we had to wait for that to get figured out. Then my luggage got jammed on the ramp coming into baggage claim. I had to wait an extra 15 minutes before it started moving again and my hard shell luggage had a huge dent in it which I managed to bang out with my fist. I didn't take a lot back with me as I am moving out west and wanted to leave everything I could there. To be honest it's so cold here I would happily wear pjs and sweatpants the rest of the winter.

I hate flying. It's one of my most hated things. Not out of fear. I actually have no fear of the actual flight, I just hate jet lag and I get motion sickness. I usually force myself into a drugged up coma and try to numb the pain with reruns of whatever horrible sitcom they have available on those little screens. I watched Back To The Future and old episodes of Fraiser. That about did it for the flight.

I wanted to do a little jaw update since something weird happened when I got to Vancouver. My first day in I spent revisiting my lunch over the toilet, now a common ritual after flying and then spending 30 minutes in a car on ever changing elevations and winding roads. I pretty much avoided all food and stayed in bed when the nausea would pass. Once I got up I was enjoying a healthy lunch of skittles and my jaw did something really weird. I opened my mouth and got a really sharp pain not in the TMJ but a little in front of it. It was a really awful sharp pain like something cracked. Every time I opened my mouth I would get this sharp pain and cracking noise. I have no idea what it was. I pretty much avoided chewing and tried not to open my mouth and hoped it would go away. I have a history of having jaw issues arise when I am many thousands of kilometres away from my surgeon. I should call my surgeon about the plate and bring this up too. I'm getting pain in all the upper plate now. Not horrible pain, but still uncomfortable. I don't feel any sort of infection, but if I lean forward, or move my face a certain way I will feel an uncomfortable pressure in the plates in that area.

All the plates on my upper jaw are close to the surface and can be felt through the skin. There are three plates in my upper jaw. I had four but one was removed when I had a reoccurring infection in my sinus area. The surgery wasn't for plate removal, but it was removed while my sinus was being cleared of any material that got lodged in there. Jaws are such weird things, and it's crazy all the metal used to hold it all in place after surgery.

Oh I almost forgot. Weird breathing thing. So I had a lot of sleep apnea symptoms prior to jaw surgery. I would sometimes wake up in the night with my throat collapsed, unable to breathe at all. This all pretty much went away after jaw surgery. My fiancé woke me up a few nights ago because I was gasping for air in my sleep after struggling to breathe through my nose. Or so he says. If this is the case then I am really happy I am breathing through my nose in my sleep as I had a very bad tongue thrust. It took years, but I managed to force my tongue posture so often that it somehow stuck. I'll do a separate post on this.


Well I'm off to bed. It's midnight Vancouver time and 3:00 am Toronto time, which seems like as good a time as any to sleep.

Terra

Friday, September 19, 2014

Will Jaw Surgery Change Your Nose?

Hey guys and gals, A lot of people have asked if jaw surgery changes your nose. It depends. My surgery involved a lefort I osteotomy. This did change my nose. My maxilla was brought forward which widened my nose and change the curve of the nose a little bit. My surgeon assured me it wouldn't be a noticeable difference. To be honest I'm glad my nose changed. As you can see pre op my nose was extremely narrow and not only did it look weird but it wasn't very functional. These pictures are before, 6 weeks post op, and over a year post op.

 

Wednesday, July 9, 2014

Permanent Numbness

Hey readers,

I notice that I get a lot of questions about permanent numbness and about numbness in general resulting from jaw surgery. I will post a video about permanent numbness soon.

I had my surgery close to two years ago. I knew that there was a risk of permanent numbness when I agreed to have double jaw surgery and genioplasty. I knew this was a risk.

I have permanent numbness in my lower face. It's mainly on the left side of my face, the chin, lower lip, and gums.

Was it worth it to have this numbness? Absolutely.

To be honest, after living with numbness in my face this long I can confidently say that it hasn't had any effect of my life. The whole overreacting about numbness that everyone who is pre op makes isn't even worth it. I thought permanent numbness would make it impossible to eat normally and I thought it was something that would constantly be on my mind. To be honest I have never had food on my face that I didn't know about. The motion in your face doesn't change. Unless you usually eat and get food all over yourself, the numbness won't cause you to suddenly have all your food fall onto your chin.

Do I notice it? No. The only time I notice that I have permanent numbness is if I purposely poke at my face or if the temperature changes suddenly. I don't think that saying it feels like when you go to the dentist is accurate. When you get your face numbed at the dentist you have a hard time moving your face and this hasn't been an issue at all with permanent numbness. I can move my mouth normally and I can smile normally.

Does it change the way kissing feels? At first it does, but at first jaw surgery altogether will change this.  You're learning all over again how to move your face so everything involving your mouth is going to feel weird until you've recovered.

Honestly, ignore the people who go on and on about permanent numbness but haven't even had surgery or haven't fully recovered. You adapt to it and you get to a point where it just feels normal.