29 Yo Double Jaw Surgery for Cross Bite and Hemifacial Microsomia - Geelong, AU

I have always considered myself unnattractive, particularly my lips and jaw which I thought were masculine. I also noticed from photos and corner mirrors that my face was very asymetrical. I initially approached my orthodontist to correct a turned lateral incisor, I then found out that I had a cross bite and only chewed with one side. After having 4 x extractions of all 2nd premolars I had my braces placed and the ortho achieved an excellent bite after 12 months. However my face was still crooked and there was nothing she could do to fix that. She gave me a referral for an maxillofacial surgeon who found that each side of my face had grown unequally, we're not sure if it is hemifacial microsomia or hyperplasia. My orbits differ vertically by 5mm but the surgery to correct this is far too invasive to correct a cosmetic problem. The surgery I had was to bring both jaws foreward, a maxillary impaction to even the jaws up and a genioplasty.

I had my surgery on the 6th of March 2015 and all went well, other than going 90 minutes longer than expected (total of 5 hours). I didn't have any elastics to begin with so I was able to comfortably vomit (a few times in the 1st 24 hours) and drink my meals. The only criticism of my recovery in the hospital was not enough pain relief. I had to ask the nurses repeatedly for endone (I had expected patient controlled IV morphine). This is possibly related to not having much numbness, only around the chin and the gums themselves. The swelling in the first week was enormous but it quickly went down during week 2. I am currently 33 days post op and still have some swelling around the nose and cheeks. My surgeon is keeping an eye on it as my left cheek is more swollen than the other which could mean some bone not healing correctly or a loose fragment, but there's no temp or excessive pain. I've has 4.5 weeks of intensive elastics to bring my maxilla forward as I left surgery with a crossbite, my bite is now perfect and we are just waiting for the muscles to learn the new movement.

Overall I am very happy with the results. While my nose and soft tissues are still uneven due to the swelling I can see that my bone structure is even. I have a much improved jaw line and my slightly gummy smile has been fixed. My bottom lip projection has improved and I think my top will as the swelling reduces. My mouth is still full of braces and elastics so that is throwing things out as well. Once the swelling goes away I will be getting injectables to get the look that I'm aiming for.

Pain wise I have been very uncomfortable and needed endone/oxycontin as well as paracetamol and diclofenac. It took me a while to get the balance right so I wasn't waking up in the morning or at night with 6-7/10 pain. Things seem to be improving and I am trying to get by just on the diclofenac and paracetamol/codeine, but have endone on hand just in case. The pain is worse in the morning and at night. I also have constant right sided TMJ pain which can flair up to 8/10 levels. I have returned to work as a dispatcher and have found speaking/chewing aggravates it.

I'm down to fortnightly reviews! The surgeon is just about ready to hand the reins back over to my orthodontist to get my teeth perfect. I'm still taking pain relief every other day but some days can get by with nothing. I have some extra swelling in my left cheek but that is because I'm "cheek biting" according to the surgeon, not sure what can be done about that but I'm seeing my ortho today so maybe there's a wire sticking out or something. A word of warning - your teeth will get gross, they're really hard to clean properly and if you're like me and drink a lot of sugar to get the calories in they're not going to look pretty. I'll try and get a scale and polish done next week.