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...

-Intro-
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.

-Surgery-
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.

10 Comments

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!
  • Reply
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?
  • Reply
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.

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-
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?

-Numbness-
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.

-Chewing-
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.

1 Comments

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!

Week 4 TYPOS!

WEEK* 4
DOWN*

I really oughta do a better job proof reading!

2 Comments

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.
  • Reply
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!
  • Reply

Week 7 Update

Pain: None!

Breathing: There's definitely a noticeable difference - a positive one. Breathing through my nose has become so much easier since the surgery! I just need to break the habit now of mouth-breathing and get used to breathing through my nose with my mouth shut.

Numbness: There's slight numbness on the upper hard palate of my mouth and on the surface of my chin, but it's definitely a lot better than it was on my last update. I no longer drool on accident anymore since my mouth muscles are becoming more and more in control, which is nice to say the least.

Talking and Eating: Outside of the occasional poking from the braces, talking and eating isn't a problem.

Swollen: It's better but I'm still not happy with where I'm at. My cheeks still look really gummy, like a chipmunks. And in the sunlight, you can really see the protrusion of the cheeks! I know it doesn't look terrible nor noticeable unless mentioned, but I'd definitely prefer if it went down! I'm keeping my fingers crossed that the healing will continue and that it's actually swelling, and that it's not how my facial structure will look from now on!

2 Comments

Nice to see that things are progressing!  I have no doubt you're still swelling, from our other community members.  And likely any swelling at all will be glaring to you.  Do you have any before pictures that are profile?
  • Reply
Yeah, I'll add them now!

A couple more before and after pictures

4 Comments

You look great! And I'm so sure your swelling will continue to improve based on my own experience...I still have weird puffy pockets (around my nose, for instance) and numbness on my chin and inside my mouth! Hopefully with time our faces will settle into a place we're happy with and then we will forget the days of Ensure and braces. :)
  • Reply
Thanks!  None of them were in profile, but I still think you look swollen compared to before.  You also look like you're wearing braces :D.  (The way it makes your lip stick out a little bit.  It even happens to me in my invisalign retainers without attachments.)  Your profile looks really fantastic now--very handsome.  I don't have any idea if it's a big change, though :).  What do you think?
Ohhh I misinterpreted what you meant by profile. I'll have to get that from my doctor. As for drastic changes - the biggest one is the bite. My teeth are actually straight and aligned now, which I really enjoy and am grateful for. But there's not much difference externally except that my chin is no longer jutting out as much it used to, which really is only something that I would notice. Most of my friends and family can't even tell that I had surgery! They know something is different, but they can't really pinpoint it. So yeah, no huge changes but all the ones that mattered to me! And thank you for your positivity and reassurance! It's making this process so much smoother.
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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