Strongly considering orthognathic surgery

[39_braces]

Hey everyone,

My orthodontist was originally going to just extract two upper bicuspids and shorten the upper arch to correct my overbite. The reason he was planning on this is because I'm somewhat leery of surgery. After some consideration, I'm thinking of going for the lower jaw surgery to properly correct things. My lower jaw is most definitely retruded and I think that extending it would not only improve the look of things, but it may even help me breathe easier.
My main concern about the surgery is the potential for extreme pain and any complications that may develop (eg. - loss of nerve function).
Can anyone who has been through this offer me advice one way or the other?

[smylex]

My main concern about the surgery is the potential for extreme pain and any complications that may develop (eg. - loss of nerve function).
Can anyone who has been through this offer me advice one way or the other?

There is risk in loss of nerve function. Going by what my orthodontist has advised me (I'm looking at having orthognathic surgery for my underbite), most people experience trauma to the nerves resulting in numbness and tingling to the lower jaw. In many ways, this works to their advantage - since they're numb for days/weeks/months after surgery, they don't need to take the pain medication they're given. Not me, I love those drugs!

[39_braces]

There is risk in loss of nerve function. Going by what my orthodontist has advised me (I'm looking at having orthognathic surgery for my underbite), most people experience trauma to the nerves resulting in numbness and tingling to the lower jaw. In many ways, this works to their advantage - since they're numb for days/weeks/months after surgery, they don't need to take the pain medication they're given. Not me, I love those drugs!

Thanks for replying. I'm with you about the medication. If I go through with this, I'll be sure to have all prescriptions filled and lined up next to my bed before I even go into surgery!

[mikeg]

Go for it... surgery with braces is bcoming more and more common to get the results patients need and there are a lot of good surgeons avail now...

Now if we could get insurance companies to view a bad bite as a medical condition

[Sunny]

Mike surgery will only be done if the problem is a bone one. If it's dental problem, surgery is not needed and only a dodgy surgeon would operate on a person in this situation.

Surgery of any kind includes risks and when it's being done to an area that is so 'obvious' to others, it really has a huge impact. Nerve damage can be temporary ... and it recovery from this damage can be as quickly as a few weeks, to as long as years. Some nerve damage can be permanent.

Relapse can still happen after surgery ... there are not guarantees. Some people find that they can't live with the steel and bolts and need additional surgery to have these removed. Others find their bite is still not right and either have to choose to live with it like it is, or have more surgery.

It's important to visit several surgeons until you're confident with their approach. Next make sure you're well prepared with the many bits and pieces that will make life post surgery that much easier for you.

Good luck with making your decision 39!

[Aisling]

I had two of my upper teeth taken out when I was 15 and they are the one next to my front teeth. They were pegged. Any way I'm in my 30's now and trying to have the Orthognathic surgery. I went through a couple of dr.'s and wound up at an ENT who referred me to an orthognathic surgeon. (I have sleep apnea and problems swallowing air, not fun) Well I was told that I have a retrognathic mandible. This mean my jaws grew down wards, a weak chin. So when I was in my teens with almost 5 years of braces trying to fix my overbite. I am now faced with something I never knew I had. For me I would not recommend taking out your teeth. Surgery may sound scary but in the long run it may have other benefits for you, like breathing properly. Hope this helps.

Anyone know about insurance and if it takes a couple of times to approve the surgery? I have blue shield of CA, PPO. Thought it was good. I will have to appeal. Not fun.

[smylex]

Anyone know about insurance and if it takes a couple of times to approve the surgery? I have blue shield of CA, PPO. Thought it was good. I will have to appeal. Not fun.

I went through my physician first. She gave me the referral to the surgeon when I showed her the x-rays that I had and the history of medical problems my underbite is presenting, especially sleep apnea and severe malocclusion. Since the medical group knows that I need to have the surgery, they said they're more likely to approve it which should cause less of a fight with Blue Shield (HMO+).

Good luck.

[39_braces]

Well, I went to one oral surgeon who said I shouldn't bother with the orthognathic surgery. He thinks it's more trouble than it's worth at my age.
I went to another surgeon and he was the opposite, telling me I need both lower AND upper surgery. He said just doing the two bicuspid extractions will make my nose look bigger and not correct the problem. Despite this, he said they still have to be extracted (?!). I did, however, get the distinct impression that the guy was just out for money. He quoted me a price of $3000.00, which I can't really afford after paying for the braces.
I don't know what to do at this point.

[justjenn]

I saw an oral surgeon about 2 months ago about my overbite. I'm 28 and growing up, I had bad TMJ. Before my orthodontist would even consider putting braces on, he wanted to see if my overbite could be corrected. I wanted to find out if BCBS of AL would cover it. It took about 4 weeks to get approval. Obviously they approved it cause I'm now starting week 3 with braces. I can't wait to get my jaw surgery. My lower will move 6-8mm and that will be huge. I'll finally be able to use my front 4 teeth.

[39_braces]

Well, I saw a third surgeon earlier in the week and he has a very good reputation and spent 45 minutes with me. He says if I'm to go through with the surgery, I would need the BSSO (lower) to extend my mandible and the LeFort (upper) to close an openbite tendency.
I'm just really concerned about going through with all this. It seems like such a drastic thing to have to endure to correct my appearance (and possibly open my airway more).
All sorts of thoughts are crossing my mind. Things like how stable will the bones be once they heal? Will the bones have permanent flaws in them? Will the brackets and screws ever deteriorate or cause other problems twenty years from now? Will the jaw relapse?
I feel so frustrated by the whole thing.
Any advice or comments are welcome.

[mikeg]

As an adult the chance of a relapse is very slip.

Athletes such as football players, boxers, have had this surgery done and they have been fine.

I am taking the plunge myself in about 10 months. It will be nice to be rid of TMJ, Clicking, and chewing issues.

EVERYONE that I have talked to that has had this procedure.. would do it again in a heartbeat.

I do plan on putting on some weight a couple months prior though

[Sunny]

39_braces you need to ask these questions of the surgeon as you need to be clear in your own mind what are the negatives if you don't have surgery. Most people don't have surgery ... basically they can't, due to the cost, so don't be concerned about feeling the way you do, as these types of surgeries are still very low when compared to other types of surgery.

Hopefully your surgeon will help you make this decison.

Good luck and make sure you're well informed, as this surgery has dangers, just as any surgery has ... plus it can fail.

[39_braces]

39_braces you need to ask these questions of the surgeon as you need to be clear in your own mind what are the negatives if you don't have surgery. Most people don't have surgery ... basically they can't, due to the cost, so don't be concerned about feeling the way you do, as these types of surgeries are still very low when compared to other types of surgery.

Hopefully your surgeon will help you make this decison.

Good luck and make sure you're well informed, as this surgery has dangers, just as any surgery has ... plus it can fail.

I already know what the possible negatives are of not having the surgery. I'll have to wear a permanent bonded retainer along the inside of the front lower and upper teeth. The surgeon told me my teeth will gradually move back to where they were on the sides (which would be slightly tilted inward). I'm also worried that a shortened arch may cause sleep apnea problems in the future.
If I am to go ahead with this surgery, I do have confidence in the surgeon. He has an excellent reputation and is on the staff at a world-class children's hospital near me where he performs paediatric oral and maxillofacial surgery.
I'm concerned about the long-term effects of it. Am I going to be a 65 year old man with issues stemming from the degradation of titanium plates and screws in my jaw?
Also, it seems like a lot of younger people get this surgery. Although I'm in excellent health, I'm pushing 40.

[jenfromzen]

I hear ya, I'll be at least 39 when I do mine so same thing so nice to hear from someone else my age. And mine is cosmetic so call me crazy, but I have a John Kerry/Sara Jessica Parker long head from birth and to have a long jaw and gummy smile make it look longer for the rest of my life I can't bear the thought. At least they have long head with long body, I have long head and I'm fairly short, just under 5 5. Even though I can't go back in time to enjoy being better looking in my 20s, I still think when I do this and then maybe some other more minor stuff later on, I'm going to look younger and I'm still going to have plenty time left to enjoy it. I'm very underweight though so I am concerned with being under 100 lbs when all is said and done, but hopefully I gain it back and I do own a belt, lol. Just don't want be called anorexic, I already get called tiny and find that annoying. We're close to 40, but we can do this! Well, maybe you did it already, I didn't read all the posts and your post is from July and it's Dec now. If you did it already I hope it went well.