24 YO Male Double Jaw Surgery (Surgery First Approach) for Class 3 Malocclusion Crossbite - Taipei, Taiwan

-Intro- Never did I think I'd actually have this...

Never did I think I'd actually have this procedure done overseas, especially not on this particular summer trip to Taiwan, yet here I am typing my experiences from my relative's apartment in Taichung. It all started when I was randomly reading a forum on orthognathic surgery reviews and cost estimates (much like this forum here) when I found a post that recommended doing the procedure overseas since pricing in the states is quite high. They also recommended Dr. Hsieh, the orthognathic surgeon who did their surgery, who resided in Taipei, TW. Seeing how I was already in the country, I thought vising the center and finding more about it couldn't hurt. Not that I ever thought I'd actually get the procedure done, not on this 3 month trip. I mean, don't I need at least a year's worth of braces before the surgery?

Well, that's what I thought. Turns out Dr. Hsieh's center does a surgery-first approach, which means putting on the braces first but only a week prior to the surgery. Once the surgery is complete, then the rest of the wiring for the braces is installed, and then it's all up to the orthodontist to straighten the teeth into perfection. The key is for the Orthognathic Surgeon and the Orthodontist to be in constant and close communication with one another in order to understand the surgeon's procedure and how to go about finishing the straightening process. Luckily, the center has both, so they work hand in hand.

After two consultations, I was confident with the center and decided to undergo the procedure. Less than a month later, the surgery was done. I was there overnight and the nurse who accompanied me throughout the night was fantastic. She helped me with everything I needed (feeding me with a syringe of ice-cold chocolate milk, making sure I haven't fainted, icing my face, etc) and even things I didn't know I needed help with (like standing up). Overall, the surgery left me with no real pain, just a lot of mild discomfort when I woke up (due to not being able to breathe through my nose, not eating, not being able to talk), but all of this is part of the process.

-Week 1-
The first week of recovery was the hardest. I was on pain killers and antibiotics the whole time. Swelling was at its WORST on day four. But out of all the hardships, the worst part was definitely eating... I couldn't. I was on a strict liquid diet of juices and Ensure nutritional milk. Breathing through my nose was also impossible since it was deeply congested with snot and blood. Had a pretty bad nose bleed once too. Blood in general kind of just continuously trickled down my nose throughout that week, so I had to keep a bundle of gauze taped below my nostrils to capture it. Sleeping wasn't too bad. In fact, napping came really, really easy since my body was so fatigued from the surgery and the subsequent recovery process.

-Week 2-
After week two, I was able to eat a slightly more chunkier liquid diet (like congee), but a liquid diet nonetheless. Ensure was still an integral part of my diet to "ensure" (ha) I was getting all my nutrients for the day. Breathing through my nose was still hard, so mouth breathing was the only option left. Face was still swollen and energy levels were still low, but I could feel myself slowly regaining more and more energy day by day.

-Week 3-
And now I just hit the week 3 mark. I just started working out again, so that's been refreshing. I still can't chew due to my teeth not clamping down correctly, but it'll correct itself overtime (or so I'm told). Until then, I'm still on a liquid diet. The blender has been a godsend. Overall, I'm pleased with how the surgery went, the doctors, the nurses, the center, and the recovery process. The only thing that worries me is that my face is still swollen even after 3 weeks. I've read that it can take up to 3 months, and I hope that's true. My biggest fear is that my cheeks will forever be this protruding and puffy.

Weak 4

Today marks my 4th week post-op, and the ride's been smooth-sailing so far aside from a couple of minor issues.

Swelling has gone done a bit although the puffiness is still recognizable. The difference in size between last week and now isn't very noticeable but it's there. Slowly but surely, right?

Still numb from the lip down and on my upper jaw palate - it sort of feels like I'm perpetually wearing a retainer that's not really there. On the bright side, the numbness intensity has been decreasing, so I'm slowly starting to feel the faintest of sensations when the numbed areas are pressed. Drooling is still a problem, although it gets better with each and every day.

I noticed that I can chew again, albeit only really, really soft foods. Glad to know that my teeth are now touching at least! But I'm still not ambitious enough to try anything harder than congee and pureed stews, not yet anyway.

-Dental Hygiene-
i noticed between the cracks of my teeth that they're starting to faintly yellow. It must be due to my improper brushing, but brushing between the wires of your braces is quite tough especially when you're in a rush. Definitely will start spending more time brushing and in different angles in hopes that it'll mitigate the issue.

-Jaw Popping-
My left jaw started popping out of nowhere in the middle of this week. Large jaw movements such as yawning or chewing would trigger it. There was no pain, but it just came as a shock to me. The doctor said it wasn't too big of an issue and that he'd explain it to me in person next time I see him. It hasn't happened since those two days, and hopefully it won't come back.

Week 4 TYPOS!


I really oughta do a better job proof reading!
Dr. Hsieh

Speaks fluent English. Very intelligent, professional, patient, and understanding of the patient's needs. Talked me through the entire process and answered all of my questions during our consultation. The facility itself is also very well trained and equally as patient and caring. The overnight care after the surgery was superb, and they took great care of me through that long night. My bite is perfect now, just worried about the swelling (but it's only week 3, so we'll see)

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
3 out of 5 stars Payment process
4 out of 5 stars Wait times
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Comments (13)

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Just got in a new review of a woman who got double jaw surgery for sleep apnea.  She said she had swelling for four months!  And still had numbness at 6 months.  So you could very well still be swollen.
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Really glad to hear of the improvements!  I feel like the main place I see swelling is above your upper lip.  Does that mesh with what you see?  

I also read below that you are with Kaiser Permanente.  I am, too, and they are great if you are healthy and just need little things; but boy do they fight you on the big stuff!  That said, they've been pretty good about giving my children myriad tests for Autism and ADHD.  It seems like you got great service in Taiwan, though, and the price is amazing.

Continued happy healing to you!
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Hello, thanks for sharing your story! I was still SO swollen at three weeks and continued to be swollen for several weeks after (I'm now at seven weeks and still have some swelling in my cheeks around my nose and my lower jaw line on both sides). I saw a drastic reduction of swelling in week six but I definitely feel your frustration! I was panicking I would always look like that and was definitely not pleased. And also at seven weeks my feeling is just (very slowly) starting to come back in my numb areas. My doctor told me it takes up to six months for the face to fully settle and become "you" because things do change in small ways as the muscles continue to adjust to the new jaw placement, etc. Anyway, best of luck in your recovery!
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Thanks for sharing your story as well! Would love to see an update if you ever have the time to write one :] Pictures of the drastic change you mentioned on your week 6 would cure me, and I'm sure many others, of their fears of their swelling never reducing. I guess my biggest fear is that since my doctor also rotated my upper jaw, which he said - functionality aside - would flesh out my face due to it being considered "flat" pre-op, the results are my cheeks protruding as much as they are now due to the new bone structure. As much as I dislike the swelling, I'm hoping that's the case!
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Hi! Thanks for sharing your story. Did insurance pay for your procedure? If so, how bad were your problems? Do you know how many millimeters your bite was over what it was suspose to be?
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No, unfortunately not. I have Kaiser in SoCal and I've tried multiple times to have them cover me for the procedure since it was giving me issues such as TMJ, Tinnitus, Sleep Apnea, and the occasional jaw locking. Despite my pleads, kaiser gave me a very circuitous route without any definitive answer of whether or not they could cover me. The doctors would often suggest massage therapy rather than the surgery itself, and I've disliked arguing with doctors since, well, I'm not an M.D. The 10,000$ USD was out of pocket, which isn't too bad considering a.) it's a 50,000$USD at least in the states without coverage and b.) the quality of the doctors in Taiwan. I'm not sure the exact bite differential I had but if you look closely on my first "Before" pic without braces on, you can clearly see where the centerlines are supposed to fit but do not.
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Well you look great! I hope your doing well! I will pray that the surgery solved your problems.
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Thank you! That means a lot to me. I see you're also interested in jaw surgery. I'd recommend it if it's needed! Good look with your future bite endeavors :]
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Hello, and welcome to the jaw surgery community!  Thank you so much for choosing to share your story with us.  I was looking at your pictures and I was all impressed that you'd stopped being swollen by 3 weeks.  But then I read that you're still swollen.  Saffronblossom is over a month post and she's still very swollen; whereas chariirose is about the same but has nearly no swelling left.  How are you doing in terms of numbness?
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Thanks for the welcome! I actually hope my swelling isn't done healing yet because if it has, then I'd be pretty disappointed with how my face is currently shaped. When smiling, my cheeks still bulge out, much like a hungry chipmunks Fingers crossed it's still healing, but the reduction seems to have slowed down considerably since the 2 week mark. In terms of numbness, it's still pretty bad. Can't feel much, if any, of my lower jaw down to the tip of my chin. I drool quite often without even realizing it, which can be embarrassing in social situations. Thankfully there's no pain, just tingling sensations every now and then. My jaw joints are still very stiff. I can't really open my mouth all the way, but I'm told with more massaging and heat packing, it'll loosen up eventually.
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Yeah, I think that 3 weeks is a little early to be done swelling after double jaw surgery.  In this answer from the Q&A, How Long Does Swelling from a Jaw Reduction Last? (I know, you didn't have a jaw reduction, but the doctor is answering about orthognathic surgery :), the doctor says 3-4 weeks of swelling for double jaw surgery is normal, but that it's all individual and based on lots of factors.  You may want to look up the two reviews I gave you and see whether their swelling has finished yet, but I know @saffronblossom was still swollen at a month post-op.  And she's had the same experience with numbness as well.
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I saw their progress, and it was a very good reference for me! Not only that, it was just really comforting to see other who, like me, are on this journey as well. Hopefully we can all have a speedy recovery :] And thank you for the link! Definitely a good reference as well.
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You should intro yourself, Especially to saffronblossom!  I'm sure she'd like to know that someone was helped by her review.  Also, she would likely appreciate knowing someone who was going through what she is going through :)
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