Upper Jaw Advancement and Chin Setback (Lefort 1 and Genioplasty) - Costa Rica

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I had jaw surgery about four weeks ago in Costa...

I had jaw surgery about four weeks ago in Costa Rica. My surgeon was great and worked well with my NYC orthodontist. They are old friends so it was not nearly as crazy as it sounds. The private hospital was super nice.
As far as the surgery, it was smooth. Upper jaw was moved forward 6mm and chin moved back 4mm. I stayed one night in the hospital.

SWELLING: Being swollen and tender is always a weird feeling of being painful but painless at the same time.
There are two types of swelling with this. There is the drainage swelling, which shows in your cheeks for 10 days following surgery.
The second type of swelling is the swelling in the areas the bone was cut. For me, that is my front cheek area and chin. It's numb. The area above my upper lip is thick feeling. I never realized how much you use your upper lip! My dog's name is Maddie, but I have to call her Vaddie now. I occasionally drool, can't tell if my lips are touching closed sometimes, and am really gross to watch eat. I swear that my face has not reduced in this type of swelling, and I look the same as I did at 2 weeks post-op. It is really testing my patience. Still, I guess my speaking and eating has improved because I ate yesterday in public.

DIET: The diet is doable if you don't mind repetition. People talk about blending pizza or chicken, and I never got that desperate. I would rather swallow big chunks than do that.
I was banded shut maybe from day 3 to day 9. That was annoying because I thought I was prepared with oatmeal, Cream of Wheat, and chicken soup. NOTHING but liquid would fit through my banded mouth.
Right now, I just have two rubber bands to "remind" me not to use my teeth too much when eating. I am on a soft food diet up to week 6 post-op. Also, I probably have not lost weight.

OTHER THINGS: During the first three weeks, there will be clicking and shifting around when you make certain facial expressions or open your mouth. It's freaky. Your jaw bone is not fused together, and all that is holding it there is titanium. I was irrationally worried that every time it clanked, I was restarting the healing process.
Bones start by swelling around the fracture and reconnecting blood vessels, then a second stage of binding collagen to repair the fracture, then a third stage of hardening that bond. What is cool is that in week 3, the noises totally stopped. I can only assume that the bone is somewhat sealed in place.

NERVES: Obviously, there is at least temporary nerve damage. At first, it works in your favor. The nerves are traumatized so you face is numb. This means no pain! I got my face sawed apart and was unable to feel pain from it.
During recovery, not feeling your mouth is gross. You are disgusting to watch eat. You can't swallow saliva efficiently with a bulky and numb mouth, so I woke up in the night a lot hacking because I must have inhaled it into my lungs. This is in addition to getting a super dry mouth at night from breathing with it open.
As time passes, I feel crawling on my face and have to make sure it isn't a real spider or something. There is tingling as your nerves wake up. This week, I started getting some aches and zaps. It's as if my feeling is returning and I am feeling the pain that was there all along.

NOSE: Tubes are put in the nose during surgery so there are some heavy nose bleeds for the first couple days. My septum is VERY, VERY deviated now with the upper jaw nudging my nose forward. Also, my nose looks a little wider and is crooked. This is all a work in progress because the nose is situated right in the middle of all the swelling.

APPEARANCE: The difference in my appearance is minimal. Be prepared for that possibility. After seeing so many drastic before and after pictures, I almost look like nothing was done. Still, I look less stern and am glad I look like myself.

EMOTIONS: I had been needing this for so long that I could not turn back. I mostly liked my appearance before but had a mid face deficiency and small underbite. People would think I was depressed or mad if I wasn't smiling or animated. More importantly, my teeth were chipping and gums receding from my terrible bite. There was not enough room above my palette to breath, even after having my adenoids surgically removed to make more room. Needless to say, I had several medical reasons. It still did not make it any less elective of a procedure when you put yourself in this position voluntarily.
Keeping a diary was a good way to deal with the doubts during recover. Some days I feel this is not worth it. Other days, I realize it is not a difficult recovery, just a long one. Sometimes, I am depressed at the year more I have braces before seeing final results. I worry my nose is wider and I will have to live with it for six whole months. There are just a lot of ups and downs that come with the waiting. However, through all of that, I never got too down.

Almost Nine Months Post-Op

I am going to make this pretty quick but wanted to update for anyone currently researching this surgery. It has been quite a bit of time post-op. All symptoms of recovery are long gone. I feel like my bone may never be as secure as it was before surgery. I can sort of wiggle my top jaw. There is no pain, it's just weird. If I am being really rough on my jaw chomping down on a lollipop or something, I might feel an ache for a moment. It doesn't happen often, and I have probably sampled every type of food in these past nine months. It's really nothing.
In the initial post, I said my nose looked deviated and asymmetrical. That went away with the swelling. --- My breathing has not really changed at all...oh well. --- I also was still numb after writing the first post. They say whatever feeling you have at 6 months is probably permanent. Everything pretty much went back to normal. Maybe I have less feeling on the roof of my mouth. The one spot I lost sensation in was a on my bottom lip. Sometimes it just feels numb and rubbery; movement is not affected. That nerve damage was from the chin bone procedure I had.

I'm living in Pittsburgh, and my orthodontist is in NYC. I have had so many things (unrelated to this) going on since getting back that I have not been back for post op treatment. That is probably horrible, but I feel like it will be fine. I really need to get on that.

Overall, my expectations were a lot higher than they should have been. I was not very deformed, so it makes sense that my transformation would also be subtle. My real insecurity was ALWAYS my nose, and the only reason I became aware of my jaw deformity was because two or three rhinoplasty surgeons told me to fix it before getting a nose job. They were right; the midface deficiency was half the problem. This surgery has made my face much more average, which is a good thing! Ultimately, if your surgeon does an adequate job, I think anyone can get through this.

Final Result!

There isn't much to update. My braces came off after about 5 months of treatment, which was a pleasant surprise because I was told to look forward to a full year in braces post op. My teeth look more beautiful than I ever thought they could. My chin still projects a little too much, and I am considering a cosmetic procedure in the future for it. Otherwise, I am thrilled.
Dominican Republic Plastic Surgeon

I rated Dr Jairo Vargas of Costa Rica. I did not rate this doctor and this review cannot be deleted

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
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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