24 YO Male Double Jaw Surgery (Surgery First Approach) for Class 3 Malocclusion Crossbite - Taipei, Taiwan

-Intro-
Never did I think I'd actually have this procedure done overseas, especially not on this particular summer trip to Taiwan, yet here I am typing my experiences from my relative's apartment in Taichung. It all started when I was randomly reading a forum on orthognathic surgery reviews and cost estimates (much like this forum here) when I found a post that recommended doing the procedure overseas since pricing in the states is quite high. They also recommended Dr. Hsieh, the orthognathic surgeon who did their surgery, who resided in Taipei, TW. Seeing how I was already in the country, I thought vising the center and finding more about it couldn't hurt. Not that I ever thought I'd actually get the procedure done, not on this 3 month trip. I mean, don't I need at least a year's worth of braces before the surgery?

Well, that's what I thought. Turns out Dr. Hsieh's center does a surgery-first approach, which means putting on the braces first but only a week prior to the surgery. Once the surgery is complete, then the rest of the wiring for the braces is installed, and then it's all up to the orthodontist to straighten the teeth into perfection. The key is for the Orthognathic Surgeon and the Orthodontist to be in constant and close communication with one another in order to understand the surgeon's procedure and how to go about finishing the straightening process. Luckily, the center has both, so they work hand in hand.

-Surgery-
After two consultations, I was confident with the center and decided to undergo the procedure. Less than a month later, the surgery was done. I was there overnight and the nurse who accompanied me throughout the night was fantastic. She helped me with everything I needed (feeding me with a syringe of ice-cold chocolate milk, making sure I haven't fainted, icing my face, etc) and even things I didn't know I needed help with (like standing up). Overall, the surgery left me with no real pain, just a lot of mild discomfort when I woke up (due to not being able to breathe through my nose, not eating, not being able to talk), but all of this is part of the process.

-Week 1-
The first week of recovery was the hardest. I was on pain killers and antibiotics the whole time. Swelling was at its WORST on day four. But out of all the hardships, the worst part was definitely eating... I couldn't. I was on a strict liquid diet of juices and Ensure nutritional milk. Breathing through my nose was also impossible since it was deeply congested with snot and blood. Had a pretty bad nose bleed once too. Blood in general kind of just continuously trickled down my nose throughout that week, so I had to keep a bundle of gauze taped below my nostrils to capture it. Sleeping wasn't too bad. In fact, napping came really, really easy since my body was so fatigued from the surgery and the subsequent recovery process.

-Week 2-
After week two, I was able to eat a slightly more chunkier liquid diet (like congee), but a liquid diet nonetheless. Ensure was still an integral part of my diet to "ensure" (ha) I was getting all my nutrients for the day. Breathing through my nose was still hard, so mouth breathing was the only option left. Face was still swollen and energy levels were still low, but I could feel myself slowly regaining more and more energy day by day.

-Week 3-
And now I just hit the week 3 mark. I just started working out again, so that's been refreshing. I still can't chew due to my teeth not clamping down correctly, but it'll correct itself overtime (or so I'm told). Until then, I'm still on a liquid diet. The blender has been a godsend. Overall, I'm pleased with how the surgery went, the doctors, the nurses, the center, and the recovery process. The only thing that worries me is that my face is still swollen even after 3 weeks. I've read that it can take up to 3 months, and I hope that's true. My biggest fear is that my cheeks will forever be this protruding and puffy.

Today marks my 4th week post-op, and the ride's been smooth-sailing so far aside from a couple of minor issues.

-Swelling-
Swelling has gone done a bit although the puffiness is still recognizable. The difference in size between last week and now isn't very noticeable but it's there. Slowly but surely, right?

-Numbness-
Still numb from the lip down and on my upper jaw palate - it sort of feels like I'm perpetually wearing a retainer that's not really there. On the bright side, the numbness intensity has been decreasing, so I'm slowly starting to feel the faintest of sensations when the numbed areas are pressed. Drooling is still a problem, although it gets better with each and every day.

-Chewing-
I noticed that I can chew again, albeit only really, really soft foods. Glad to know that my teeth are now touching at least! But I'm still not ambitious enough to try anything harder than congee and pureed stews, not yet anyway.

-Dental Hygiene-
i noticed between the cracks of my teeth that they're starting to faintly yellow. It must be due to my improper brushing, but brushing between the wires of your braces is quite tough especially when you're in a rush. Definitely will start spending more time brushing and in different angles in hopes that it'll mitigate the issue.

-Jaw Popping-
My left jaw started popping out of nowhere in the middle of this week. Large jaw movements such as yawning or chewing would trigger it. There was no pain, but it just came as a shock to me. The doctor said it wasn't too big of an issue and that he'd explain it to me in person next time I see him. It hasn't happened since those two days, and hopefully it won't come back.

WEEK* 4
DOWN*

I really oughta do a better job proof reading!

Pain: None!

Breathing: There's definitely a noticeable difference - a positive one. Breathing through my nose has become so much easier since the surgery! I just need to break the habit now of mouth-breathing and get used to breathing through my nose with my mouth shut.

Numbness: There's slight numbness on the upper hard palate of my mouth and on the surface of my chin, but it's definitely a lot better than it was on my last update. I no longer drool on accident anymore since my mouth muscles are becoming more and more in control, which is nice to say the least.

Talking and Eating: Outside of the occasional poking from the braces, talking and eating isn't a problem.

Swollen: It's better but I'm still not happy with where I'm at. My cheeks still look really gummy, like a chipmunks. And in the sunlight, you can really see the protrusion of the cheeks! I know it doesn't look terrible nor noticeable unless mentioned, but I'd definitely prefer if it went down! I'm keeping my fingers crossed that the healing will continue and that it's actually swelling, and that it's not how my facial structure will look from now on!

The long await 3 month update is finally here. There's a general consensus that by this point, most of the swelling and numbness should be gone, and for me, it's mostly true.

-Numbness-
My Lips and Chin have virtually no numbness, but it's a different story for my upper gums and my upper palate. When I press my tongue to my palate, it's almost painful but not enough to be classified as so. It's just an intense numbness accompanied by an even more intense tingle.

-Swelling-
My cheeks are still swollen, or at least I hope so. If not, I'd be pretty disappointed with how I look. I feel like my face is still quite bloated, and my cheeks remain very, very round. I've read that swelling isn't completely gone until the 6 month mark, so I'll reserve my judgement until then! Would love to know if others still had swelling at their 3 month mark as well, y'know, to give me hope haha.

I returned to Dr. Hsieh in Taipei last month and had my braces removed.

As of now, there's still some slight numbness in my upper palette but its negligible and doesn't bother me at all. Everyone else, from my lips to my chin to my cheeks, have regained sensation.

The cheek bone is still a bit tender when pressed on, but nothing too serious.

Talking, eating, breathing is back to normal if not better - breathing especially. I can breathe a lot easier now when I sleep.

Overall, the surgery was a success. My teeth are straight and my bite is perfect. My only complaint is that my cheeks still seem a bit puffy/saggy. I believe it's because my skin was accustomed to my old jaw where it was longer, and now that it's been shortened, there's excess skin. So if you look in my pictures, you can see the skin on my cheeks are a bit loose/puffy. People don't really notice it, but it does bother me a bit. I'm hoping it'll tighten up with more time, but I've already past the 6 month mark so I'm not sure.

Would be happen to know if anyone has experienced their skin tightening over time after the surgery, or if it didn't, what steps are there to rectify it?

If the cheeks weren't so puffy, I'd be 100% satisfied with the operation. But other than that, it was a relative success, and the operation accomplished what it set out to do - correct my bite and straighten my teeth.

In my last review I felt my cheeks were still puffy. Amazingly they were still swollen even after 8 months. At the 10 month mark I'm finally starting to really like my bite and face in general. Numbness is completely gone. I have no pain. Sleep is a lot better. No problems eating. Surgery was a success.