Braces at 13 and Again at 54, Followed by Orthognathic Surgery at 56! - Palo Alto, CA
After suffering with crooked and broken teeth for...
After suffering with crooked and broken teeth for 50 years in spite of 4 years of orthodontic treatment at 13, it was only after I discovered that OSA surgery could address almost all of my oral-maxillofacial issues.
I have probably always been a OSA sufferer, even in my youth. Also, I have always been very hard on my teeth because of the bite issues associated with being "edge-to-edge". It was only when my apnea worsened & I started cracking/losing teeth that I realized that I needed to get on this. I interviewed OMFS in the SF bay area, Texas, and North Carolina. Because I did not want to do a formal "BIMAX" due to my already prominent mandible, I was challenged on how best to achieve function, aesthetics, and apnea relief. I opted to have a maxillary advancement. At Stanford alone, there are 3 doctors in 2 separate divisions (plastic/oral surgery & sleep medicine) who do this procedure. I opted to use Dr. Kasey Li, M.D., DDS who was formerly affiliated with Stanford, as my surgeon. My reasoning was simple. Dr. Li is a board certified in Oral & maxillofacial surgery, ENT, and Facial plastic surgery. He operates at Stanford but is out-of-network & essentially private-pay.
It is now almost 6 weeks post-surgery, and I am thrilled with the results. As I said, I probably could have gotten more apnea relief from a much larger surgery, but I wanted a bite and better esthetics as well. To be frank, you have to have an excellent orthodontist who understands the whole surgery process. You then need a surgeon who does orthognathic surgery frequently, & who understands the interrelated nature between airways, sinuses, bites, and aesthetics. To be fair, many apnea sufferers I talked with prior to my surgery cared only for apnea relief and NOTHING ELSE.
The process is long and complicated, and not inexpensive if you live in the US. Most importantly, wait until your jaw have stopped growing, or you may be looking at a revision surgery. Try to center your providers around a large teaching hospital/medical school, if possible (though there are plenty of great "solo-providers" as well). Most importantly, remember that MOST oral surgeons do not do orthognathic surgery, but focus on less time-consuming procedures that are more profitable. You do not want your jaw repositioned by someone that does this "occasionally".
I am happy to respond to any personal requests for information. Please pm me.
Best of luck to you all!
Replies (29)
The total cost of surgery and hospital stay was about $100K. Insurance paid all of it (with contractual discount) except $695.00. My stress echo that was required by the surgeon prior to surgery cost me more out-of-pocket. This is far less than I expected.
My total cost looks like this: braces - approx. $8,000.00, x-rays, & CT scans - approximately $1300, surgeons fee - approximately $15,000. Throwing-in an additional $1500 for "miscellaneous" brings the grand total to about $26,000. Not too bad!
A couple of notes. First, I could have tried to get this done at Stanford in-network and that would have saved the surgeon's fee. I opted to go with a surgeon formerly affiliated with Stanford. He is of-of-network with all insurers, but is considered the top sleep surgeon in the world. As I mentioned in an earlier post, not every oral surgeon does these procedures on a volume basis. Trust me, you do not want to use someone who does these procedures infrequently. Too much can go wrong! Revision surgery is much more difficult!
Replies (10)
BTW, I'm told that bunion surgery is very painful with a long recovery period. As I mentioned, after leaving the hospital, I never even filled the prescription I was given. I took advil for about a day, and that was for a headache that was not related to the surgery.
In any case, you'll do great and you will love the results. Reach out to the real self community for support. Jaw surgery patients are a very close group. I think it's because we have been impacted by so much.
Please let me know how you are progressing!
I did get my braces on the first part of February. Im curious what the splint actually does... And why I need three? Do you know?
In my case, the splint was removed after the completion of the surgery. I never wore a spin post surgery. I'm pretty sure that is because my surgery was single jaw, and relatively straight-forward.
I just had my 4 month check it up with the surgeon, and the healing is almost All complete. According to my orthodontist, my occlusion and bite are just about perfect, so It appears that despite my concerns about not having a splendid, it really was not necessary.
By reading the entries of other patients, it does appear that splint can be somewhat uncomfortable and complicated. However, if that is what is required to keep the job properly positioned until healing occurs, then it is well worth the discomfort.
Congratulations on your surgery and getting insurance to cover most if not all of the procedure. That is no small feat.
Best of luck and please keep us posted as to your progress!
Thank you so much for sharing your review, and your offer to answer questions. It's great that you had a good outcome after so much time.
Like you, I had issues with an overbite my whole life. I was never given the information necessary to understand why my bite/chew/breathing were awkward and difficult. After moving to SF in 1999, I slowly began to realize the origin and depth of my problem. First of all, you are not too old for orthognathic surgery. True, most of the patients tend to be younger, but since bite issues never really abate, anyone healthy enough for surgery (old or young) can benefit from the procedure.
The best tip I can give someone is to get the most experienced orthodontist & surgeon you can find. You want someone who does these procedures weekly. That is your best assurance of a smooth procedure and recovery. Also, I had considered going out-of-town for surgery (cheaper fee) but in the end, I decided to pay-up and stick with the best. Honestly, you want access to your surgeon in case of complications. I have had no problems, but it's nice knowing that my surgeon is local. Also, he is seeing me about every 2 weeks now, so it would be impractical to fly-in & fly-out for these 15 minute appointments.
Finally, the pain from the surgery was almost non-existent. In fact, after leaving the hospital, I never even filled the prescription for the pain-killer. Now, I only had a single jaw (maxilla) procedure, but I have experienced more pain from hemorrhoid surgery. Evidently, this is not unusual. This operation is uncomfortable but not painful (according to other patient's experiences - online). I took one full week-off from work, and needed an additional week of slow-going before jumping back full-time. Six weeks out, I am feeling & looking great! Last tip, once the braces are on, your decision is pretty much final, so before starting this endeavor, be absolutely certain! Again, even at 56, you will heal fine with very little or no pain (expect some discomfort though). Again, I did the maxillary advancement only (2 jaws is a considerably bigger procedure).
Best of luck and let me know how it progresses!