Worth It - Cost $22,000 - Boca Raton, FL

In 2009 my dentist finally convinced me to see an oral surgeon. My gums were receding and I was wearing down my teeth due to my cross-bite. He told me I would end up with dentures which would be difficult to fit. I was only 48!!! I had a team, my orthodontist, dentist and oral surgeon and they outlined a 4 step plan. 1). Gum grafting to fix recession (2010). 2). Braces to worsen my bite in preparation for surgery (10/2011) 3). Surgery (10/2012) and 4). Replacement of crowns and possible veneers for lower front (2013-2014).

Stitches upper and lower - brushed with a Burt and Ernie toothbrush........rubber bands held it all together. Liquids for the first two weeks and then soft foods, eggs, oatmeal, pasta....added more food as I felt comfortable. Had my braces off 5 months after surgery. Continue to exercise jaw to open wide.......still under care of orthodontist and oral surgeon and in the process of step 4.

Awe, a Burt and Ernie toothbrush?! That's cute! :) But my goodness, 48 seems too young to have to go through all that.

I love the way you laid the plan out.  Keep updating us so we can hear how your healing and ability to open progress.

I'll be hoping the crowns and veneers come out gorgeous. I would love it if you would post a review for your crowns and veneers as you go through that process so we can follow your entire story. :)

Almost at my one year anniversary 10/31 and I'm doing well. I start the final phase this week for replacement of crowns which my previous bite destroyed. I will post pictures soon. Have you decided to do the surgery?

Hi, I'm curious but at your age how did you heal? Did you regain most nerve function?

That's funny "at my age" I healed exceptionally well. No nerve loss and no pain. I bit of cracking at the movement of the jaw but I always had that.....and to improve the mobility of the jaw I stress the exercises and hot compresses very early on in recovery.

Also I have to reiterate the most important step is to research the doctor! If you are in Florida there are only two doctors that routinely do this surgery. Dr. Stephen Rimer (my doctor) in Boca Raton and Dr. Garri in Miami. Some may say they do it (had 4 other surgeons tell me on the phone they did the surgery 10-15 times a year when in reality they did LESS THAN 6 or ZERO in the last 2 years confirmed by data collected by a state agency.

wish i'd have read this before....but my insurance i'm sure does n't cover dr Rimer or Garri im sure. Damn HMO. I"m now screwed with debilitating nerve pain.

how do i look for data? I am in Miami and need this surgery. I am considering dr Yoh Sawatari. Did anyone have surgery with him?

I'm having surgery with Dr. Sawatari in two months. Message me privately and we can share what we know!

Hi, I am also considering Dr. Sawatari in Miami. Can anyone offer any feedback? Or any other referrals to good oral folks (oral surgeon, orthodontist, cosmetic dentisit) in Miami? Thanks

The only doctor my surgeon mentioned was Dr. Garri in Miami, never heard of Dr. Sawatari. I will find the information for the state agency and post next week. If your insurance will cover the costs or money is not a concern, I recommend Dr. Rimer in Boca Raton. Believe me you want someone who is experienced and routinely does this type of surgery.

Thank you Dca1961!

I will have my surgery with Dr Sawatari in December so will keep you updated. So far still in braces. What are you having done? email me

I had the surgery at 48 just 4 weeks ago and I can tell you I am miserable and still in a lot of pain. I would not recommend this surgery to anyone over the age of 30. I have heard over and over again from my doctor how easily one recovers from this surgery when they are young. So far I am very unhappy with my decision to go forward with the surgery because I have been in agony since i awoke from surgery.

Carol sorry to hear about the pain you are in. What does your doctor tell you about the pain you are experiencing. Has tritom commented because she was 52. If you don't mind if I ask who was your surgeon and where in the country do you live. Where is the pain? I have not had the surgery because an oral surgeon where I live would not do the surgery because he took an MRI and found articular joint disease. My daughters teacher had the surgery over 40 and she is doing great (this is at least 10 years ago). I am quite familiar with nerve pain because I had neck liposuction, chin implant and when my wisdom teeth were removed in 1982 the oral surgeon cut the lingual nerve to my tongue so half my tongue is in a semi state of numbness. I would contact an oral surgeon who specializes in nerve regeneration and get his opinion. Let me know what happens best to you.

If you have the opportunity to meet with Dr. Rimer I would do it. In my opinion he is the best surgeon around. It sounds like you had a lot done all to initially avoid the surgery based on your reply to carol jake. I'm sad to hear about her pain but I can honestly say I had VERY LITTLE PAIN. my appearance on the other had for 3 - 4 weeks was a different story :). Make the appointment, if there is one thing to say about Dr. Rimer, he is a perfectionist and he will be honest about what can be accomplished. My bite is perfect and holding. Keep us posted.

Anybody out there fearful of orthognathic surgery should consult with a cosmetic dentist. I did yesterday and she said that I could get a great aesthetic result without ortho or surgery. I am older and do not want to risk chronic pain, relapse, and debilitating nerve damage. If I were in my teens, even 40's I would definitely risk it if I could do it over again.

I'm only 33 and those things seriously worry me too, not to mention a loss of perfectly good youth. I'm considering TADS and braces instead. Not an option for everyone but should work for me.

What is TADS? I could not get an orthodontist to recommend braces without the surgery even though I had braces as a teenager. If I were your age I may consider the surgery if I could find a surgeon I was sure was good. I was told by OMS that over 50 I would have >50% chance of numbness may not be total numbness but partial which I could deal with if I had a great smile. But I don't think I could deal with chronic pain or a constantly shifting bite. However, he said I would've been much better off having it 11 years ago when I had a great surgeon, and insurance coverage. I would even cross state lines to find a surgeon today if I had too! Good luck and think positive. Dca1961 is right if you research a surgeon and find out everything there is to know about the surgeon you stand a really good chance that you will smile with confidence for the rest of your life.

TADS = "Temporary anchorage devices". They're modern day headgear, where a mini screw is inserted into the jaw bone to serve as an orthodontic anchor. I have a 1.5mm open bite so they can intrude my molars a bit and perhaps extrude my incisors some to close the bite. The screws are then removed so that the bone and soft tissue can heal. No surgery hence none of the risks. It only works in my case because my open bite and malocclusions aren't too off. Stability isn't well understood but a recent study I looked up suggested its 80% and perhaps higher with retention in the first year. It will not, however, fix my sleep apnea :( Then again, my airway is already 16mm so it's not clear that advancing my jaws will do it either. Jaw surgery has risks too of course, in relapse and final result. I don't know about "much better off having it 11 years ago". I found a study at one point which examined incomplete nerve regeneration by age. It was something like 30% in 20s, 40% in 30s, 50% in 40s, and 60% in 50s. So, yes, the odds get worse with age but there's not a cliff that you passed over. A quick skim of the jaw surgery forum and you'll see a few anecdotal cases of people who are very young with those problems too. Some of it is skill of surgeon, some of it is ability to heal, and some of it is amount of correction necessary. They say being in shape, eating well, and getting good sleep makes a big difference so it's possible that much of that risk is in fact not age per say but rather the condition people who happen to be those ages. In other words, you're much more likely to be overweight with diabetes or other chronic disease at age 55 than you are at 35. If you're not, then keep in mind that those odds take into account those people so your odds might actually not be so bad. Hope this makes you feel better :)

The best analogy I received for braces vs surgery was a traffic light. Do nothing = Red; Braces = Yellow; and Surgery = Green. Good luck.

Do you know who else is a candidate for TADS? Do you mind telling me what state you live in? What test did you have that told you your airway is 16mm? Do you wear a cpap at night? Is your BMI within normal limits for your age? Sorry you don't have to answer all these questions. I am asking because I was intubated during plastic surgery and told it was very difficult....I do not have sleep apnea that I am aware of. I know that there are many stories of people with not so good outcomes....but many people are so happy with their smiles they can tolerate some of the downside as long as its not debilitating. I know this because I have numbness in jowls and neck from chin implant and lower facelift (things they don't tell you about). I tolerate it because I don't have a straight line from my chin to my neck anymore. I think you're doing the right thing for you but just remember as we get older our choses are fewer. It doesn't sound like your case is that bad that you would need surgery. I have much more difficult case. I could not get an ortho or OMS to take my case even though I am in upper 1% of health and fitness for my age group. I still do not fully understand it but I may have to accept it or go out of state for consultations. I am considering cosmetic dentistry as I way to improve my bite and TMJ issues, and the look of my teeth.

TADS is just orthodontics really. They provide an anchor point that would otherwise be provided by headgear. They allow you to move teeth in the jaw but you won't change the jawlines itself. However, moving teeth can change the appearance of the jaws. Only way to know is to see an orthodontist who uses them. My surgeon has only done about 10 such procedures so far. I live in TX. My surgeon just did a panoramic x-ray I think and then measured it from the x-ray. I wear a CPAP at night and it helps most of the time but sometimes I don't think any pressure will really keep my airway open. I am of healthy weight (for any age) and when I was diagnosed I was actually close to underweight actually. No one seems to know why I have OSA, much less a case as severe as mine. Closest I've heard is that my open bite is allowing my tongue to fall back and block the airway. My surgeon thinks that my bite problems are just throwing off all the muscles in that area. I don't really care about the aesthetics. I'd just like to eliminate some chronic muscle pain and generally think about other things. I know surgery will get less and less attractive but OTOH I'm risking less at a later point and generally you expect less as you get older.

. My surgeon and neurologist tell me it is the nerves regenerating. It cerainly does not feel like anything positive. This feels more kin to a jelly fish sting or fire ant bites. The pain is entire chin and bottom lip. In addition to this the inside of my mouth is rubbed raw with the braces. since my chin and lip are numb I keep finding my lip is being biten but my nerves are not telling me so. I had the surgery in Ft Lauderdale near where I live through NoVA school for maxillo facial surgery because I have [RS bleep] health care coverage-HMO. nO one else would take my insurance. Sorry to hear about your tongue. Thanks for the tip to get some one who specializes in nerve regeneration.

um, this makes me seriously nervous. what do you know about jaw surgery and debilitating nerve damage? This is what I feel like I am going through and I had NO warning this is a possible outcome of surgery.

Call Arnettgunson and Gunson in Santa Barbra and see if you can get phone consultation. They are best in country and they can tell you what you can do. Let me know how it goes. You only have small window of time if there is anything they can do.