Wired or Banded -and for how long ?

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#1 Post by **slscott99** » Tue Apr 28, 2009 10:59 am

Hi - I am the parent of an 18 year old who is about to go through a Lefort, BSSO, and genioplasty after having a SARPE last year.
We have had to change Oral Surgeons twice (long story for some other time) but now we are talking to someone who has lots of experience, is actually the department head of Maxillofacial Surgery at a major hospital so we feel confident.
However my son is freaking a bit because the surgeon is telling him he will wire him shut for 5-6 weeks. The previous OS told him 2 weeks tightly banded, followed by 4-6 weeks of looser bands and no chew foods.
So I'm trying to get a consensus / poll whatever of what most of you are hearing from your surgeons when having this type of procedure - how long are you completely shut, wires or bands, etc...etc..
You all have been very helpful to my son in the past (he does not know I am posting this) - so I appreciate all the info you could provide, and / or any advice to help me keep his spirits up through all of this !
Thanks,
SLS

#2 Post by **chicago29** » Tue Apr 28, 2009 3:47 pm

This is a great question and is something that is currently on my mind. I'm probably a year away from my bi-max, and my surgeon advocates banding and does not wire shut. That sounds great, but I admit I'm scared to death of something shifting or relapsing.

It seems to me that the "older" the surgeon, the more likely they wire you. That is just my perception based on people I've talked with on this site. If you think about it, it makes sense. The concept of rigid internal fixation is only 10 to 15 years old I think, so somebody that's been doing orthognathic surgery for years is likely to stick with procedures they know best.

Think of how we ourselves can be in resisting change. You have to believe a successful surgeon that is very confident in their skills would be the exact same way and in many regards be much worse than us mere mortals

I think a vast majority of people on here have been banded, but I know there are people that have been wired.

If I were you, I'd ask this direct question to the surgeon. Ask them why they choose wiring instead of banding, and what they believe the perceived benefit of being wired shut is.

If you do that, please post back as it would be great to have information from surgeons about this topic.

Best of luck.

-Chicago29

#3 Post by **archangel689** » Tue Apr 28, 2009 6:46 pm

How about screws?

#4 Post by **ZmaN277** » Thu Apr 30, 2009 1:25 pm

I posted this reply on my thread, which may serve useful in determining why some surgeons choose wiring over banding:

My surgeon who's doing the procedure (which is probably going to be a BSSO), is the head of the oral maxiofacial department at a very prestigious hospital, so i do trust him, to a degree.

The reason he's doing it [Wiring] is because my lower jaw deficiency is fairly severe, and he want's to prevent relapse at all costs.

I'm just trying to figure out who tight these wires actually are, and if the teeth pressing together all the time will be a constant source of pain/discomfort ):.

I do hope the wiring is for a legitimate concern of relapse, and not just because he's old-school ._.

#5 Post by **Figamentation** » Thu Apr 30, 2009 1:35 pm

I have many screws and plates from my surgery but my doctor still felt that I needed to be firmly shut so I was heavily banded (he used the term wired although it was achieved with an enormous amount of rubber bands because he was able to move them each week to adjust the placement of my jaws during recovery) for 7 weeks. Each doctor is different and each patient is different, and while I of course wish I wasn't required to have done 7 weeks hard time of zero ability to open my mouth and fully liquid diet, I understood that the doc truly felt that was necessary to maintain the integrity of the bite he created and now I'm over 5 months post op and have had no relapse.

#6 Post by **LemnzestManatee** » Fri May 01, 2009 12:12 am

I am currently completely wired after having surgery. (I had my upper molars moved up so that my lower jaw could come forward [to correct an overbite -- don't know the official medical term of that part of my procedure], and a genioplasty)
I had my surgery on April 16th of this year, and I am set to have my mouth un-wired a week from now. (a total of 3 weeks being completely wired shut)

My main surgeon is kinda old...I'd say 50-60. But my other surgeon (who worked on my mouth during the operation at the same time as him) is a rather young woman. They are partners, so they go over things together so I doubt that their choice to wire me shut has anything to do with age. They are both extremely nice and I trust them completely, so I was fine when they told me I'd be completely wired. I think that they definitely decide whether to band or wire on a case-by-case basis.

#7 Post by **Esoteric** » Fri May 01, 2009 1:56 pm

I'm going to be wired as well and I think another reason my surgeon wires is because he doesn't like using screws along with rubber bands. I have to ask again to make sure though.

#8 Post by **Thathrill** » Sat May 02, 2009 8:57 pm

I had BSSO performed and was told I would be rubber banded completely shut for 2 weeks and then get less restrictive bands for another 2-4 more weeks. What ended up happening was I was banded very tightly for a total of 5 weeks due to some complications of my midline. My jaw was very stubborn and did not want shift. It wasn't fun but its definitely tolerable. If I had to do it again, I suggest taking all that time off from work/school. I do have a plate with screws on each side of my jaw.

Now I was told that if I had chose vertical ramus osteotomy that I would be completely wired shut for 6 weeks with no options of getting them off earlier.

So for me it all depended on the procedure performed. Also know that different surgeons have different opinions on post surgical treatments.

#9 Post by **teylix** » Thu May 07, 2009 5:37 pm

my first OS told me he didnt need to band me at all. just splints but i moved to anchorage and this one seemed a bit more old school although both OSes are about the same age.

the one here wanted to wire me shut but i was greatly surprised to wake up with no bands or anything in my mouth. however my lower jaw is a bit further back than it should be so i'm going to get bands on my teeth tomorrow which is A-OK by me if it ensures an optimal bite.

just know that it sounds awful (and probably is awful) but it's really a small price to pay opposed to a 2nd surgery or a smile you are not happy with.