Sunday, 30 October 2011
Let's start with the most important news from the appointment...I'm not gonna be having surgery for at least another 9 months!!! I was quite disappointed, but strangely not as disappointed as I would think I would be, if that makes sense. Maybe it's because deep down I'm terrified about having it done, so it still being 9 months away makes me less scared. I just don't see what else there is to do?! They said that my wonky no-bracket tooth is now ready to be brought forward. I felt like saying 'Just do it now while I'm here then!' but obviously they won't, and I've got to wait til my next appointment on 23rd November to get that done. But apart from that I don't really understand what else needs to be done. I think I'll ask my ortho next time I see her.
On a slightly more positive note, my surgeon did say that the longer you have your braces on pre-surgery, the less time you have them on post-surgery, so I suppose that's good...but he also said that I'm not even 1/3 of the way through this whole process yet :(
But anyway, I'm still glad I had the appointment. I got to ask him lots of questions. I'll summarise the things he said in bullet points:
- He agreed he'll do my upper and lower jaws - he said they'll impact my upper jaw by about 5mm. It was quite scary cos he was showing me a model skull and showing me where/how they cut it, and showing me all the things they have to be careful of, such as cutting my septum and giving me a wonky nose! But I suppose it's good that they're aware of these things and will try to stop them happening!
- He also said that they'll be careful not to impact my top jaw too much because it could turn my 'slender' face into a bit of a 'podgy' face :s But he did say this is probably something I wouldn't even notice, but as it's his job he would and it would bother him that he hasn't got it perfect
- I said to him about my cant and wonky midline - he didn't seem too concerned about this and acted a bit as if I was worrying about things that aren't really a big problem, but he said it would be fixed in surgery
- He said that he thought I was being sensible with regards to my approach towards the genioplasty by waiting until the jaw surgery is out of the way and then assessing whether I think I want the genio, but I said that at the moment I don't think I will. He agreed and said that, in a perfect world where you're trying to make the perfect face, you might want to bring the chin forward a bit, but I said I'm not aiming for perfection, I'm just aiming for my jaws in the right place
- He said that they have a 'hierarchy of stability' for the different jaw procedures, and that the two types of surgery I'm having are pretty high up the hierarchy, and therefore very stable, and more safe and predictable than other types, so that was reassuring
- I asked about my nose getting wider, and he basically in a polite way said that if anything the surgery will improve the appearance of my nose. He said it will make me show less nostril, and that it would get rid of my 'bobbing tip' - apparently the end of my nose moves up and down when I talk because my top lip is pulling it down because my top lip has so far to go to meet the bottom one. I never knew I had this, but getting rid of it will be a bonus I suppose!
- He said their rate of permanent numbness at my hospital has decreased from 8% to 5%, so again that's reassuring
- I asked how common it is that someone has to be taken back into surgery to correct something, and he said that he hasn't done that for a very long time, and that when he did it was nearer the beginning of his career - however, he did say that there are often complications with jaw surgery and 'any doctor who says they don't have any is lying'
- After surgery you have your train-tracks (i.e. fixed braces) for around 3 - 4 months (this was less than I thought it was) and then a retainer that you wear all the time, and then just a retainer you wear at night
I think that's pretty much what he said. So it seems likely that I'll be getting my surgery next summer, around August hopefully. Also I now need to have my top wisdom teeth out, so I'm having them out on 15th December. Having these teeth out is nowhere near as bad as the bottom ones, so I'm not too worried, but I don't like the fact that it's only a local anaesthetic and I'll be awake! It's annoying because both the surgeon (who I think took the bottom wisdom teeth out) and my ortho don't know why the top ones weren't taken out when I had the bottom ones out! Never mind!
So although I'm a bit disappointed about it still being at least 9 months away, I know I shouldn't complain because I'm so lucky and so grateful to be getting this done at all. This really hit home when I saw on the Orthognathic Surgery Facebook page that it cost someone $58000 to get just their upper jaw done. I really am so lucky that the NHS are doing this for me for free, so I promise there will be no more moaning about it! I'm incredibly grateful to be having it done at all.
They said that the progress would be slowed down by any breakages and by not keeping it clean, so I was wondering whether it's worth investing in a Waterpik now? I don't really know much about them. Any advice on this would be appreciated!
I will post some 7 month photos later, although I'm sure they're not much different from the 6 month ones!
Sunday, 9 October 2011
I had a hospital appointment on Thursday 6th October. I had my wires changed, they seem to be a bit thicker now. Apparently I still need another mm of movement before she can bring forward my backwards tooth with no bracket, so I had a new spring put on. My teeth have been a bit achey so hopefully that means they're actually moving.
It was meant to be just a normal check-up appointment, but as I was the last patient of the day my ortho started talking to me a bit about my surgery. She started looking at my face and said what she thinks they'll do during the surgery. She confirmed that I do indeed have a cant, which I was pleased about because I was starting to worry that I'm just being completely over paranoid and analytical of my face.
She re-took some of my photos because she said they were a bit blurry. Then she got another man who I think is a surgeon to come and have a look at me. He kept getting me to push my jaw forward and do a really big smile so that he could see the extent of my gummyness and cant. He said that I should definitely have both jaws on, and said to me and my ortho that I should make sure I push for the surgeon to do both jaws because I won't get as good a result from just having the lower jaw done. He also said that he thinks I should have a genioplasty. This isn't something I've considered before, but he said that I do have a 'diddy' chin. But he said that this is a secondary procedure and that they would do this after the jaw surgery, which means that I can see what I think of my appearance after the surgery and decide whether or not I want the genioplasty. At this stage I don't think I will, as I don't think I'll want to put myself through more surgery, and I don't want to risk my chin looking too big. But I'll worry about this after surgery. They also said that my midline on my top jaw is 2mm to the right so my top jaw will have to be moved 2mm to the left. This isn't something I've noticed before but now she's pointed it out I can see it.
Then my ortho showed me my x-ray on the computer and showed me what they'd do in my surgery and what effect it would have. She clicked the measurements that they would move each bit by on the computer, and as she clicked each mm it moved my x-ray to show how it would look. So I've seen a rough idea of what my new profile will look like.
When the ortho and surgeon were talking to each other about me, the surgeon was weighing up whether a bi-saggital split osteotamy or a Lefort 1 would be better. I don't know what a Lefort 1 is...I'll have to google it. But I'm a bit worried because he said that one of them had 'lower morbidity' than the other. I don't really know what that means but I'm a bit worried because the only meaning of morbidity I know is death...but I'm sure he doesn't mean that...I hope not anyway.
Here is a very rough guide to what they will do during the surgery:
- Upper jaw moved forward 2mm
- Upper jaw moved up about 5mm
- Greater impaction of the upper jaw on the right side than the left to correct the cant
- Upper jaw moved 2mm to the left to correct midlines
- Lower jaw moved forward - probably about 8mm at a guess
I never realised I had so much wrong with my top jaw. The reason I got into all this was because I hated my bottom jaw being too far back, but it turns out I actually have much more wrong with my top jaw!
Here are some photos I took today...I look very ugly as I have no make-up on, so please excuse my ugly face lol. I can really notice my cant in these pictures.