On Sept 4th, I underwent a handful of procedures with Dr. Michael Yaremchuk. My other experience with my cheeks is reviewed elsewhere, but this is a review of the "revisional" procedure he performed after a sliding genioplasty 10-14 years ago. My chin is even more crooked than I started with. Not only that but the doctor has stopped all communication with me as I've tried to get a hold of him after learning that he put a bridge on one side only, thus ensuring the two sides would never be similar. I didn't know why only one side had been operated on, but when I had consulted with a maxillofacial surgeon years back, he had talked about using a tiny amount of bone filler on the right. It was my honest belief that perhaps I was only being impatient and when swelling subsided and muscle function returned, of course no surgeon would operate in a way to make a certain facial feature even more crooked. However, roughly a month after the original procedure, I learned that was indeed what happened, and now the doctor won't reply to any of my emails. There is a huge crooked scar on the bottom of my chin now as well. The scar is external and highly visible. Shouldn't some attempt to make it appear straight at least have been made?
More Crooked: Revision Genioplasty Chin Jaw Implant by Michael Yaremchuk - Boston, MA
bulge at site of implant
same view, better or worse? permanent nerve damage also present and evident in person
one more pic, taken recently
the sweet spot
Medpor is highly problematic, but I only found out about Medpor being used on me after the fact, and I wasn’t sure if it needed to come out right away or if I needed a second unwanted jaw implant so at least the two sides would be more similar again. All I can say is, THANK GOD, only one side of my jaw was touched. I’ve been reading more online since my initial posts, and what happened, I think, might be that he disrupted the pteryomasseteric sling on the inferior border of my jaw, causing the soft tissue to sag. It wasn’t evident at first with the swelling, but it’s quite evident now.
When I had to go back to Dr. Yaremchuk to get the medpor out of my midface, I specifically asked whether my smile was all crooked because he had created some underlying structural change by only operating on one side of my face, thus causing the muscle to lay differently on one side. He had talked about there being a step off on both sides, and yet he only operated on one side. I mean, in the past I had been told by a maxillofacial surgeon that a tiny amount of bone filler to the right would ensure better symmetry based on the x-rays. Dr. Yaremchuk never took any x-rays, yet I reasoned that whatever he did was in a way that both sides were going to end up more similar because obviously no plastic surgeon would operate in a way to make a person’s face even more crooked, right? Wrong. And I ended up with a full out jaw implant on one side of my face.
Anyways, I was told by Dr. Yarmechuk that my crooked smile had nothing to do with structural change and was only temporary from a pulled nerve and swelling. He said he “retracted” the muscle, but that my smile would go back to normal (even with the jaw implant) and if it didn’t, than I would be the very first patient of his with this permanently raised lower lip. (Well a simple google search dispels the notion that Dr. Yaremchuk has never had a patient with permanent nerve damage, and actually there appear to be quite a few.) A week or so later, after having the midface medpor removed, I start doubting what he told me because my entire experience with him has been frought with issues that had created a lack of trust, so I consult with another physician who tells me the implant is already integrated at this point. I also receive input that what Dr. Y did is “strange and odd” so I attempt to contact him to at least even out the two sides since the Medpor is all bound into the tissue on the right at this point, and easy removal is no longer an option. He stopped replying to me for the most part, which in retrospect turned out to be a good thing, otherwise I possibly would have two damaged sides with sagging tissue/bulges on the back side of the jaw instead of just the one.
Dr. Eppley, who has a lot of experience with medpor, didn’t want to touch it with the nerve damage and also the fact that removal and resuspension might not even correct the bulges and could make things worse. At least he actually treated me like a human being and gave me valid professional advice instead of silence or lies. Well, just recently I finally was able to see a neurologist 5 months post op, who draws me a diagram of the implant on my jaw changing the dimensions of the overlying muscle and explaining how that alone could cause the crookedness, which is the exactly what Dr. Yaremchuk said wasn’t a factor, back when there was still a chance for easy removal w/o all kinds of collateral damage to the soft tissues. Once Dr. Y had placed the medpor and damaged the nerves, there basically weren’t any good options left. (see new pics.)
Miracle worker: Dr. Mark E. Richards of Bethesda, Maryland
I trusted this doctor completely and it has been perhaps the biggest mistake of my life, more so for what he did to my face than the "revision" performed on my chin. The nurses at the center are great, but the actual doctor cared more about taking keeping my pre-deposited money than actually acting in my best interest and committing no harm.