Metal Mouth Message Board

The first picture with dark blue background is the Before Surgery picture.
The secong picture with brown and multi-colored background is After Surgery, Day 6.

My son's surgery was on April 6, so today is Day 6. The surgery itself went well, and at first things were swollen so we were optimistic. But as the swelling is going down and reconfiguring, we aren't really seeing the change in the jaw we were expecting.

The procedure was BSSO with chin implant. The jaw was supposed to be brought forward, and a chin implant put in.

Am I worrying needlessly? Can anyone tell me if this is normal and things could change? To all of us here, except for puffy lips and cheeks, etc. we can't see much difference. We're getting a bit concerned, because this is a lot of money, pain, hassle, etc. if the end result is no difference!

I guess I am hoping that I am just being silly and there really is a change, and that maybe I'm just looking so hard that I'm missing something. My DS and DH both feel the same way. DS is starting to think he is going through all of this for nothing.

i hate to say it.. but it definitely seems like the surgeon didnt do a great job as far as aesthetically balancing everything. when you told me he had a chin implant as well, i would imagine the projection would at least be normal proportions [lower lip in line with edge of chin].

The lip popping out [swollen] will definitely make it look better when it heals.. but im honestly just not seeing that much of a movement of the lower jaw [forward]. Odd...

on second thought:

http://www.youtube.com/watch?v=XXYrfV4x3dk

my video here when i turn my head, it looks like my lower jaw is still really far back. but its definitely swelling. right now its pretty balanced. ill post another video so you can see on Tuesday.

I would give it a bit more time. It has only been 5 days, and he still has a lot of swelling. My face kept undergoing changes for months afterwards.

Monarch, first of all I understand your anxiety and I am with you in spirit. I am praying that all is well and it is just early days.

However... you will lose nothing by going back to the surgeon sooner rather than later and expressing your concerns - so my advice is to please do this asap. Why? Well we were told that the best time to re-do a surgery is 4-6 weeks post op - before the bones knit together. As you may know my daughter was 'lost' in the system and didn't get a follow up appointment with a surgeon in time for this to happen. So please just go back and ask what they intended to do in terms of movements and if this is what they actually achieved - ask for an xray if possible - to compare pre and post op, and ask when the surgeon would expect to know if he/she had achieved the desired outcome. If you're not happy or do not understand any aspect of the explanation, then ask to be referred right away - immediatley - for a second opinion. In fact, I would do this in any case if you are in any doubt at all. I am no expert but I've learned a lot about being proactive as a result of what we've been through this past 4 months. I will be praying for you and your son - keep strong and positive as things will work out in the long term. God bless Jane x

Perhaps you've answered this in an earlier post that I haven't seen, but just curious -- why did you opt for an implant instead of a genio? Or was that the surgeon's decision?

I haven't had my bi-max surgery yet, and I'm well over a year from it, so take my advice with a grain of salt. Those that have been through the bi-max procedures can probably offer more solid advice.

My first reaction in looking at the photos was that the advancement was not achieved. However, I looked in greater detail and in the second (post-op) picture, the head is tilted forward more...which is going to impact how things look in the chin/lower jaw area. If you move your forehead down, your chin moves in towards your body. I think that may be masking some of the advancement.

And, there is clearly a lot of swelling. But may I add that he looks pretty good in the swelling department. Looks like he may be one of the lucky ones.

Bottom line, give it at LEAST 2 to 3 weeks before you form any opinions. That being said, speaking with your OS now as opposed to later is advised. I agree with Jane here...if there is any doubt talk to the OS, and don't hesitate to get another opinion if you feel it is necessary. You are entitled to know what the planned advancement was, and what advancement was achieved.

I hope everything turns out OK...He looks very good for just having surgery and appears to be recovering well, so don't lose sight of what really matters.

Good Luck, and keep us all posted.

-Chicago29

I would voice concern to the surgeon but please keep in mind, its been a week! He will undergo drastic changes over the next few weeks and months. People often post here freaking out at how they look when they are still well in the healing phase. Please have a look at my recovery photos on http://www.thisisjustwrong.com and see how different my profile looks from week to week.

Again, good to ask to ease your mind, but I wouldn't freak out yet.

Pre-Surgery...............................................Day 7 Post-Surgery

Thank you everyone for all your help and thoughts and concern! This board helps me so much, because I feel like I'm not alone.

I re-posted the original pre-surgery picture, taken the day before the surgery, so you can compare side by side with the picture taken today. This time I didn't block out as much of his face, neck, etc. so that you can see the jawline better. My DS wants his identity protected, so I hope I'm not showing too much of him.

The Day 7 picture is from today. Not too much change. I asked him to hold his head higher for the picture, so the angle would be more the same, I hope.

Karl, thanks for the links to your pictures...it was good to see your progress....you turned out fantastic!.....but I did notice that even during the puffy stage, your chin came out further than my son's....

Brendan, thanks for the link but when I tried it, it said this video is no longer available?

I am trying to stay positive....

Hey-

He is still holding his head lower!

Have his nose the same as in the picture so you can see better.

Unless he had his septum shaved down a bit???

Nope, no septum-shaving, LOL. The BSSO + chin implant was enough procedures for us!

I'll try tomorrow to get a picture with him holding his head higher. It's kind of hard because he still has pain, especially on one side.

Can you tell anything more now that you see more of the jawline?

I can't tell. He is still way to swollen! My oral surgeon and his assistant says that you just have to give it time. Many of their patients dont like their results untill 6-9 months after the surgery.

Thanks for more comments. So far, all of your opinions are giving me a little bit more hope....maybe he is just too swollen to be able to tell.....although I still don't know how his chin could hypothetically start to stick out more later...???

Suetemi, the chin implant was the surgeon's decision. I had asked if he could do a sliding genio instead, but he said no, he had seen some that didn't work well, and he thinks the implants work better, and the bone forms around it, etc. He no longer performs genios. So, we didn't have a choice.

I have to say that I do really like our surgeon. He is a good guy and very meticulous in his work. He genuinely seems concerned about us, and all of his patients. I just wonder if maybe we didn't communicate our hopes to him well enough? Like, maybe it is all functionally correct now (which is definitely a good thing! ) but maybe the surgeon was just focused on function, and not too much on the cosmetic side of it.

I just re-read what I wrote...and it sounds like we were doing thiis only for "looks", LOL! Of course the functionality of his bite was the number one concern, and our surgeon says he has achieved that. DS just really was hoping his looks could be improved at the same time, which we thought was what would happen.

I know where you are coming from. I am the same way. I can't wait till I can bite into an apple like a "normal" person....but then again....I hope my looks also improve. So no worries!