Gummy Smile and Weak Chin - Jaw Surgery

Hey Real Selfers, I am 30 years old and in my...

Hey Real Selfers,

I am 30 years old and in my third round of braces. My first round was when I was 12 yrs old and then again at 18yrs because they relapsed. My orthodontist told me around 18 years old at the second round of braces that I could do jaw surgery if I wanted to, but that it would mostly be cosmetic as they could fix my bite with the braces alone. At 18 years old I didn't really notice my weak chin or gummy smile and never pursued jaw surgery. Looking back maybe I should have? Now I am 30 years old with braces on again.

Back in March 2016 I went to a new orthodontist complaining of my gummy smile and weak chin. My orthodontist told me the only way to fix it was upper jaw surgery (lefort 1 osteotomy) and potential sliding genioplasty. She mentioned that sometimes when they impact (move up) the upper jaw (maxilla) it rotates the lower jaw (mandible) outward and thus correcting my weak chin. This would be ideal because then I would not need the sliding genioplasty.

I am currently scheduled for surgery on November 19 2016. I live in Canada and the surgery itself it covered by provincial health care. I had to pay for the braces ($8,500) and the preoperative 3D planning and molds at the surgeons ($5000). So in total this whole thing costs me $13,500 out of pocket, peanuts compared to the cost of the surgery which I believe is anywhere from $50,000 to $70,000. Thank you universal health care and thank you Canada!

I've had 3 consultations with 3 different oral and Maxillofacial surgeons. Spent endless amounts of time researching the procedure and my surgeon. And of course reading reviews on this site and the World Wide Web, which is a really scary place. I've read reviews on both sides of the spectrum, from truly horrible, disfiguring surgeries gone wrong, and to beautiful, life-changing surgeries gone perfect! In the end I believe the combination of the simplicity of my surgery and the fact I am a young and healthy person with reasonable expectations my surgery will go as planned. At least that's what I tell myself everyday or else I'd probably back out and run for the hills, lol.

The name of my orthodontist is Dr. Jennifer Smith. She has been amazing and has held my hand throughout this entire process (I've needed a lot of handing holding, lol).

The name of the surgeon I've chosen is Dr. Simon Touchan. He has also been amazing, I had a small breakdown last week and almost considered abandoning my whole treatment after reading too many bad reviews. I called his office and they got me in to see him on Friday. He sat and listened to my entire speech I had written out about all my concerns without rushing me or making me feel stupid. He spent close to an hour going over in great detail all the questions and concerns I had. And not once did he stumble or scramble to debunk any of my preconceived notions or skepticisms of the surgery. He was confident without being too confident and never made me feel stupid for asking millions of questions (I'am sure some of them were silly). Most importantly thought I believe my surgeons vision is the same as my vision.

Will update post surgery!

5 days to go

In my initial review I typed my surgery date wrong. It's actually Nov 18 2016. I am going to get all my blood work and an ECG tomorrow after work. I see my orthodontist this Thursday at 10am for my final appointment with her before surgery. She will be adding some surgical hooks onto my brackets that morning in preparation for the surgery. The hospital will also be calling me Thursday at 1045am for a pre admission consult over the phone. At that time I will be given instructions about when to stop eating and what time to be at the hospital for, surgery time etc. My surgeon will be performing two surgeries that day, so I will either be the morning surgery or afternoon. Finally, I will either be meeting my surgeon Tuesday or Wednesday morning at his office in order for him to show me all my surgical molds and pictures with predicted outcomes. He will then be able to tell me how many mm he predicts he will be moving my maxilla upwards and wether or not I'll need the sliding genioplasty. I will update after that visit, and hopefully have some of the pictures/molds for you guys. Hope everyone had a nice long weekend.

3D planning

I consulted with my surgeon this afternoon and after he completed his planning with the engineers he has told me that he will be impacting my maxilla 7-8 mm. As a result of the impaction my mandible will autorotate and given me more chin projection. My surgeon still would like to do the genioplasty though by advancing it another 2mm but will have to decide in the surgery room.

Surgery was a success!

Where to start, so many things to say. Everything went as planned, no hiccups and my recovery was great. When I first woke up from anesthesia I felt pain 5/10 and slightly nauseous. The nurses gave me lots of anti-emetics which helped right away. So I didn't puke once. I had trouble going pee for awhile after too which was from the anesthetic. But eventually my muscles relaxed and I was able to pee. My doctor had me on IV antibiotics and IV dexamethasone to prevent infection and reduce swelling. But regardless I am swollen! My surgeon said it will take 3 weeks for the swelling to really normalize and a full 8 weeks for it to completely reduce. He ended up performing the genioplasty and I am already thrilled about it. I finally have a chin!!! My lips and nose are super swollen and he did a special kind of suture to prevent me from losing my top lip and my nose from getting too wide. So right now they look VERY funny, but my surgeon assured me they will look very good once the swelling goes down. I stayed in the hospital for 2 nights, but my surgeon said I could go home after one. I chose to stay cause I was just not ready and really had amazing nurses who made me feel safe. I'm wearing tight elastics right now so eating is hard. I basically just squirt soups and protein smoothies through the front of my teeth. I'm so hungry! Haha. I've already lost 3 lbs. I'll keep everyone updated over the next week. Probably only do an update once a week since swelling will be slow to reduce. I see my surgeon on Monday and will update then.

Day 7

It's been a week since my surgery and I can honestly say this was the best decision I have ever made regarding my health and wellbeing. My surgeon was spot on with everything. He truly is an artist. Anyone out there who is considering orthognathic surgery I would highly recommend it. It truly has brought harmony to my face, and I haven't even seen my smile yet! The best is yet to come.

In point form this is what I've experienced over the 1st week post op:

- Still have major swelling with little to no pain
- congestion that lasted 3-4 days, now completely clear
- numbness to both cheeks, nose, palate, lips, and chin, already getting pins and needles which is a sign of nerve regeneration
- weight loss of 7 lbs (my elastics are super tight and I can only drink liquids currently)
- day 4 and 5 I really started to get my energy back and could go without napping, even started doing light Pilates again at home.
- little to no bruising (a testament to my surgeons hand???) INCREDIBLE!!!
- I'm in love with my new profile, I am so happy I let him do the genioplasty, he was right when he said he was "really good at them".
- I still have a good 4-5 weeks left before the swelling will completely resolve but each day my BF tells me he can see a difference.

Can't think of anything else. Will update after I see my surgeon Monday.

Cheers!

Appointment with surgeon

Today I met with my surgeon for my 1st follow-up. Here's what happened

- Bite is looking great. He loosened my elastics so I can open my mouth wider. Yay more soup

- can't chew for 2 more weeks. Yay soups??

- he talked about the type of closure he used under my lip. It's called a v-y closure and he said I should really like it cause it will give me more lip volume. It also aloud him to control how wide my nasal alar base gets. I told him I was a little concerned about how wide it looked. He told me I have so much swelling right now, that there is even swelling in my cartilage at the tip, thus giving me a "bigger looking" nose. He also told me that the way you determine how wide your nasal alar base should be is, you line it up with something at the eye (can't remember exactly what part) and then you know your nasal base it appropriate for your face. That made me feel better because I then knew it wasn't based off of his subjective opinion, but off of a scientific measurement. He also said the nose is the last thing to heal, sometimes the tip stays swollen for up for 10 months! Even his nurse said my nose looks way bigger than it did in surgery and I shouldn't judge it too hard yet.

- Before I went into surgery I told my surgeon, please don't OVER impact my upper jaw. As a result my surgeon told me I will have 4mm a repose as opposed to 3mm, which is ideal for women. Oh well, maybe I should of kept my big mouth shut, but I was just so worried that you wouldn't see my teeth at all at repose (rest). Either way I think things won't make much difference, we are only talking about 1mm. Ces't la vie!

- So apparently I wasn't suppose to be doing any exercise. Oops. If I raise my blood pressure too much I could possibly cause a hemorrhage. Or if I bite down too hard I could shift my jaw. So I'm only aloud to walk really for the next two weeks. Ugh. I'm gonna have no muscle left after this. I'm the type of person who weight trains 4-5 days/week, religiously, so this will be the hardest part for me, more than not chewing.

- My chin. I still can't believe I have a chin. What a difference a chin can make for the profile. Eek!! So happy.

- I LOVE my surgeon. He is so easy to talk too and I get the warmest feeling from him. He truly cares about his patients. I feel so blessed/lucky to have had him as my surgeon.

That's all I can think of. Still have to pinch myself that I'm already 10 days post op. My braces will be off before I know it!!

Take care everyone ????

I made it 2 weeks!

Here are my thoughts as of today:

1) Still quite swollen and that's expected right up to week 3-4. Feel the most swollen in the morning.

2) I hate my tight elastics. I'm suppose to wear them 24/7, but mostly just wear them at night cause they're so annoying and start to give me a headache cause I'm constantly feeling like I'm clenching.

3) Can't smile yet cause the muscles still need to reattach. My surgeon says that takes 3 weeks. So my smiles are forced.

4) Can't close my lips either. I wonder if that's because my muscles around my mouth haven't healed yet, or because of the millions of sutures I have in my mouth still. Will inquire on Thursday with my surgeon.

5) Still eating soups, porridge etc. I suck on chocolate though until it melts. All I really want is potato chips though. When I can chew again first thing I want is Ms. Vickies salt and vinegar chips, followed by Old Dutch jalapeƱo Cheddar. Oh my, I'm salivating just thinking about it. Lol.

Hope everyone is doing well. Can't believe Xmas is in 3 weeks! I'm suppose to fly to ON to visit my in laws for Xmas, but my surgeon said a change in cabin pressure might not be good for my sinuses and it will have to be a "game-time decision" wether or not I can go. Has anyone had to fly after their surgery? If so, did you have any issues?

Let me know! Chat soon ????
Calgary Orthodontist

Dr Jennifer Smith and Dr Simon Touchan: See review.

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