Sunday, 9 October 2011

6 months of braces and appointment update

So, 28th September marked 24 weeks since I got my braces. Hopefully that means I'm at least half way to surgery.

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.

You can see here that there is a bigger gap between my top and bottom teeth on the right of the picture than the left, which is because of my cant. I essentially have an open bite on one side of my mouth now because of this.

Here I can notice my cant and my midlines being off centre.

New spring and big overjet

Again you can see the uneveness of the gap between the top and bottom teeth on each side.

Wonky gummy smile.

Wonky gummy smile again

Horrible profile and open mouth


  1. Sarah,

    Congrats on your progress!

    A BSSO is when the mandible (lower jaw) is advanced.

    A LeFort I is when the maxilla (upper jaw) is moved.

    In our cases, where there is a deficiency in the lower jaw and gummy smile, the maxilla is impacted (brought upwards).

    If the Oral Surgeon you saw today said he thinks you should have double jaw surgery, then both of these procedures would probably be performed.

    I'm no oral surgeon but when I look at your photos, I think cosmetically, you would benefit from lefort I because it would eliminate the gummy smile.

    It also appears you would benefit from a lower jaw advancement (BSSO). Although in my opinion, I think you have a very lovely chin and I agree with you about holding off on the genioplasty, at least until you get closer to surgery and can really see where your profile stands at that time.

    I'm having double jaw surgery plus a genio in December. Take a look at my profile pics - I just posted a new one today. You can see I have no chin whereas you have a lovely chin.

    By the way, I think you have the cutest nose! You're so pretty! You will really love the results of this surgery, I think :-)

    When will you know about surgery? Do you think it will be in about 6 months? It will be here before you know it!!

    Take care,

  2. This was all great information shared here. It is really very important to think twice for surgery before going for it. Every coin has two side the positive and the negative so its important to get to know about the surgery, it procedure and about other factor.

    nose surgery

  3. Hi Tara,

    Thanks for your comment and for your explanations of the BSSO and Lefort. Yes I think you're right, I definitely want both jaws done so I'm sure I'll have both procedures.

    Yeah for now I'm not going to worry about the genio. I can see what you mean in your pics about you having a smaller chin than me, but I think my jaw is further back than yours so I still see my overall profile as worse than yours. But like you said in your post, we're all our own worst critics. When I look at your photos I can see your jaw problems, but I still think you're really pretty, but when I look at my own I just see the jaw problems, and no prettiness!

    In your post you said about not thinking that that's what you look like in the mirror, but I don't think that what you see in photos is necessarily what other people see. My mum took these photos for me and she said I look so much worse in the photos than in real life, so that's a relief...and a slight insult lol. I think the photos really accentuate the bad things about my face. I look a lot more assymetrical and wonky in photos than I do in real life I think...I hope!

    Thanks for your compliment about my nose but I'm afraid I don't agree! I hate my nose so much, I'm really hoping the surgery will make it look nicer. I think we will both love the results of our surgery :)

    I have an appointment on 27th October where I will see my ortho and surgeon (and any other important people) so I think that may be the day I start asking about possible surgery dates :s So scary but so exciting!

  4. Hi Sara! That's great that you had such an awesome appointment and were able to learn so much more about your particular surgery and the possible results. I think if someone is saying it would be best to have both jaws done, then I would push for that. You want the best possible outcome, and you wouldn't want to have it done again... I will have both done too, and even though it's more intense, I'm relieved because I think moving both gives the OS more flexibility in placing the bite and jaws in the ideal position.