Pursuing Revision - Advice and Psychological Support

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jawbreakermtl
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Pursuing Revision - Advice and Psychological Support

#1 Post by jawbreakermtl »

Hi everyone,

I'm a 21 year old female who had DJS this past summer to correct an overbite. This surgery is something that I had thought long and hard about since beginning orthodontics at age 8 (yes, that young), and last year I finally decided to commit. I got my surgery with the goal of correcting my bite as the main motivational factor - I spent all day pushing my lower jaw forward so I could talk, eat, and smile properly. In photos, I always pushed my lower jaw forward, and was so excited by the prospect of not having to do this anymore following my surgery. When I went for consultations with surgeons, I was so surprised to hear that I needed upper and lower jaw surgery, as I knew I would be happy and have my goals met by just operating on the lower jaw.

Unfortunately, being young and naive, I blindly followed my surgeon's plan, in we we would "slightly" impact the upper jaw as well as align my bite by moving forward my lower jaw, and have been left with damaging results. My upper jaw was impacted a whooping 7mm, brought forward 4mm, and my lower jaw brought forward 8mm. While I am so glad my bite is finally correct, I am devastated by the physical and aesthetic results of the surgery. My nose width has doubled in size, and I show no teeth when I talk, and only the bottom half of my teeth when I smile. This surgery has taken away "me" - I cannot recognize myself and am so angry that the movements were done without my consent. If I knew the exact surgical plan, there is no way I would have agreed to get this surgery, as I loved my old face and would never have wanted to change it that drastically.

As for the physical damage, my lower jaw is completely asymmetrical, largely bulging out on the left side. My sinuses are completely ruined, and each time I breathe in my teeth shake, almost as though my upper jaw is not attached to my skeleton. I have tingling sensations on my upper lip which seem to be affecting the muscle. I cannot fully smile or laugh naturally without experiencing pain in my nose, almost as though it will break if I move the muscles up too high. Worst of all, my nose is completely asymmetrical now, with the right side looking yanked to the left, almost as though I am having a stroke. I saw an ENT who believed this is all as a result of over impaction.

My surgeon has already offered a revision surgery to downgraft my maxilla by 2-3mm but I truly feel as though I need a bigger downgraft, as well as a cant correction, and a potential reoperation on my lower jaw. I am getting other opinions within the next few weeks but am fearful that they won't offer a revision on someone who did their first surgery with someone else.

Obviously, all of this has been incredibly difficult on me physically, as well as psychologically and emotionally. I feel like I have been violated and that I will never get my body back. I. have had to take time off of my university studies and move back home to live with my parents as all of this has played out, and am just feeling so hopeless. I worry that a revision surgery will only make things worse, however I cannot bear to think of looking and feeling this way forever. I just want the old "me" back, but with an aligned bite.

Does anyone have any words of wisdom or revision success stories they can offer me in this challenging time? I am so desperate for something positive.

bbsadmin
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Re: Pursuing Revision - Advice and Psychological Support

#2 Post by bbsadmin »

First of all, I'm sorry that your surgery didn't turn out well.

I've never had jaw surgery, but reading your story, my first thought is this: do you really want to trust that original surgeon with a revision? If I were you, I'd get many surgical consultations and seek out the absolute best oral surgeon in your area to do the revision surgery.

I don't know whether some surgeons don't want to revise another surgeon's work, but i would think that a really good surgeon would take on your case and try to help you. In many other types of surgeries, people who get something botched by one doctor often get it corrected by another doctor. I can't imagine that jaw surgery would be much different.

You are a young adult. Do you have older adults to help you in this process? Are you going to the consultation appointments alone, or are you accompanied by an older adult who can advocate for you?
I'm the owner/admin of this site. Had ceramic uppers, metal lowers ~3 years in my early 40's. Now in Hawley retainers at night!

jawbreakermtl
Posts: 6
Joined: Mon Jan 25, 2021 1:05 pm

Re: Pursuing Revision - Advice and Psychological Support

#3 Post by jawbreakermtl »

Hi bbsadmin,

Thanks so much for your reply. Both of my parents are incredibly angered and disturbed by what happened to me and deeply regret not playing a larger role in the process of planning for my original surgery. They are both going to be part of every appointment going forward and are going to advocate for me in any way they can.

I’m meeting with a top surgeon next week, and another one next month. I’m really hoping I’ll get some answers and some positive news about next steps.

snapdresser
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Re: Pursuing Revision - Advice and Psychological Support

#4 Post by snapdresser »

Well, it sounds like now you know exactly what you want! That said, a revision downgraft and associated revision to the mandible won’t fix all of the issues you mentioned, so you need to manage your expectations. It likely won’t fix nerve damage, and may in fact make it worse, though the nerves take a year or so to fully heal to whatever their final state will be. Some of the crookedness in your nose and jaw also probably won’t be fixed 100%. It’s hard to predict how your soft tissues would change from your original surgery and it’ll be hard to predict that for a revision too. Also, your bite may not be perfect after a revision. I say all this to prepare you for your future appearance should you go forward with a revision. You won’t look perfect, you may just look somewhat better than you do now. It’s important that you go into it with that expectation or you’ll never be happy with your results.

That said, a revision is probably a good idea for you IMO, and I think you should talk to another surgeon if you can afford to. Some specialize in revisions, but your original doc may give you a discount on the revision that another surgeon would not. Good luck and keep us posted on how things progress! I don’t think any of us were properly prepared for the mental aspects of orthognathic surgery, so regardless of which way you decide to go, therapy is probably a good idea.
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jawbreakermtl
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Re: Pursuing Revision - Advice and Psychological Support

#5 Post by jawbreakermtl »

@snapdresser thanks so much for the kind reply. I started therapy 4 months post-op and it has been a great help during this challenging time. Do you happen to know if anyone has had successful downgraft revision experiences? Revision no doubt comes with risks, and I would really appreciate hearing of success stories before committing to more surgery.

snapdresser
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Re: Pursuing Revision - Advice and Psychological Support

#6 Post by snapdresser »

A number of people on here have gotten down graft revisions. You can probably search some up. Often times they’re still not happy and may or may not end up having a second revision. If you know exactly what you want and convey that articulately to your surgeon, and approve their surgical plan before going under the knife, I think there’s a decent chance you’ll be happy with the results. I would recommend using a surgeon that uses VSP (Virtual Surgical Planning) to ensure a perfect bite. Good luck!!!
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jawbreakermtl
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Joined: Mon Jan 25, 2021 1:05 pm

Re: Pursuing Revision - Advice and Psychological Support

#7 Post by jawbreakermtl »

Update: I finally got a second opinion who said I was definitely impacted way too much - in fact, he may not have touched my maxilla at all! However, he really strongly urged me against doing a downgraft revision, saying it never turns out well and always has complications. This was very disheartening to hear. Does anyone have any knowledge about this? I'm tempted to pursue a downgraft revision with my original surgeon to correct her mistakes, but am worried of having potentially worse results and complications. Any advice would be greatly appreciated!

snapdresser
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Re: Pursuing Revision - Advice and Psychological Support

#8 Post by snapdresser »

As I mentioned, many people on here are not happy with the results of their downgraft. I would recommend searching some up.
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jsurgerya
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Re: Pursuing Revision - Advice and Psychological Support

#9 Post by jsurgerya »

I am struggling with the same issue. I was impacted a lot when I only had a bit of gummy smile when I laughed very hard.

Did the second surgeon go into detail about how he could tell you were over impacted, or why revision downgrafts result in issues? Considering a lot of people have upper jaw down grafts to correct a face that is too short, I don’t know why a revision downgraft would be problematic.

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