New here, have anxiety/doubts about my surgery!!!!!!!!!!!!!!

[Nathaniel]

Hi everyone ,

My mom always browsed this site for me and now I've finally decided to participate in it. I think it took a while simply because I felt as though I wouldn't be scared and stuff but really I am. Actually, now that we've had the consultations and first surgery scheduled I am questioning my reasons, I am wondering if I can live with what I have since I have been so far, and I question if it's just going to stay the same and no real problems would come about from *not* doing it.

The *original* reasons why I wanted to do this, which has been about 6 years or so, is because I felt shy about smiling, didn't like the way I had my gums showing, having a narrow smile, and having what looked to be a big bottom face. Aside from the looks, eating pizza/burgers or anything that had layers or was thin was somewhat of a challenge, but I managed to use my tongue a lot to help out and I'm so used of it now.

Fast forward to today - I'm confident in myself; I don't mind smiling, I don't have any shyness towards talking to someone or what not, really I feel extremely comfortable in situations. Now and again I don't like to smile in pictures, just because I find I "look better in real life" so to speak. Eating is no real problem, but the only thing that still makes me want to do this is just knowing I have a nice smile for photos, the prevention of spitting when talking (only happens sometimes), and fixing my teeth/jaw alignment. My top jaw is still narrow, but you can't really tell unless I smile. Also, I am wanting to do it because I think it may help my oral health later on, i.e. teeth degradation/mouth breathing.

From what I'm told, I have an Open Bite with a really, really minor case of Underbite. Like, really minor, but the Open Bite is quite big, along with a narrow upper jaw.

What I'm getting done:
- SARPE Procedure; RPE turning for about 3 weeks; 8mm expansion. 3 Wisdom Teeth Removed. (Round 1, Feb. 8th)
- Maxillary (Upper Jaw) LeForte I Osteotomy; Mandibular Sagittal Split Osteotomy; Genioplasty

I'm really, REALLY scared. And I'm wondering if I should do this still, I'm only thinking I should do it because health reasons/teeth care later on down the road. I can live with sloppy eating and spitting while talking otherwise. I think this forum will be a real big help!

Hope to talk to you all as I go through this and if I do end up going through with it all I will be forever helpful to everyone who does it after me, because I want people to feel as comfortable as possible, especially people who have anxiety like me.

Cheers!!

[Nathaniel]

Here's some pictures taken from my orthodontist, maybe people here can actually convince me that it's a good idea to have it done!

[hduggan]

We went through a similar period of doubt over the summer. My son (the patient ) had gotten pretty good correction of his open bite with his braces, and we no longer felt we had a pressing functional/cosmetic reason to go through the surgery.

But, when we talked to our orthodontist, he told us that my son's bite, although much better than it had been, was still so off that he would end up losing his back teeth by 40 and then start going through implants and having those fail. Also, he told us that, without surgery, we would lost much of the orthodontic correction.

Your situation may not be the same as ours - my son's bite was really, really bad before orthodontics - but it would be worth revisiting the question with your orthodontist and surgeon to figure out what the surgery is meant to help with.

I have to say, having had the surgery, we are *very* happy about having it done. My son had managed to compensate for his bite so that it wasn't too obvious, but having "normal" proportions restored for his face has been an amazingly good change and he's beyond delighted with it.

[hduggan]

(just looking at the pictures) Yeah, it looks like you have a similar situation to my sons, where all of the stress of eating is falling on a few teeth in the back. That's what led our orthodontist to tell us that my son would start losing teeth without the surgery. But, our experience is no substitute for what your orthodontist and surgeon have to say.

[Nathaniel]

Hi hduggan, thanks for your response! I greatly appreciate it. My parents and I are going to be going to my orthodontist tomorrow to revisit him and speak with him. I want to know what alternatives I have with no invasive, I asked him before and I remember he didn't suggest much but I still think I would feel better to just ask one more time.

You're right with your judgement, all my food is mainly chewed on with the back teeth, specifically the left back side.

How much time has gone by since your son's surgery? Has there been any complications/relapses of the teeth/permanent nerve damages?

[chicago29]

First off, the nervousness is totally understandable. In fact, I'd be concerned if you WERE NOT worried. Jaw surgery is scary stuff, and I think every patient needs to take the time to determine if it is the right course of action for them. And, once they've done that, you still have to find the right orthodontist and oral surgeon that you feel comfortable with. It is a long and challenging road, for sure.

That being said, I think you're the classic surgery case. By the looks of it your teeth aren't necessarily bad, but you do have a severe open bite and a narrow arch. I take it you are over the age of 16...and if that's the case the only way to fix this in a stable manner is through surgery. You may also potentially consider extraction of one of the premolars (one in each quadrant), but there is a lot of debate on whether that's the "right" thing to do long term for a case like this.

The truth is nobody knows what the future holds - Nobody can tell you with certainty your teeth will degrade, or that you'll develop TMJ, or all the other scary things. However, having an unstable bite like this can lead to these things...we know that much. I've seen people with worse bite's that are fine...so one truly never knows.

It comes down to what YOU want. I accept the fact that you're scared, but I challenge you to forget about that for a while. Think about what your doctors have told you and think about the benefits you'd get from the surgery. Then, make a decision in absence of the fear.

There are hundreds (maybe thousands) of people on here that were all in your shoes at one point...myself included. We were scared senseless, but we all got through it. I know you can do the same if that's what YOU want to do...

Best of luck, and I encourage you to stay involved with this message board as you go through your journey...

Best Regards
Chicago29

[hduggan]

How much time has gone by since your son's surgery? Has there been any complications/relapses of the teeth/permanent nerve damages?

We're still in the early days - 5 weeks out tomorrow. The only major issue we had is that we sort of bungled the release from the hospital and took off without dealing with either his nausea or his anxiety (both of which he's prone to). That gave us one really bad 24 hours, but no serious issues past that.

For my son, I think I never realized how deformed his bite made him feel. With it repaired, he feels "normal."

Because we only did the LeFort, we have a lower risk of the permanent nerve damage. I think that's mostly a lower jaw thing. I'm a natural fret-er, so I'm sure I'll continue to worry whether he'll run into problems with a non-union or a relapse for awhile still, but there's a pretty low risk of either of those.

[Nathaniel]

Hi Chicago and hduggan, thanks again for your time.

I sometimes wonder if doing all of this, wearing a permanent retainer and having the risk of relapse is worth it all to avoid some teeth degradation down the road (that may or may not happen).

I want to ask my Ortho if he believes only getting the top jaw surgery is enough (spreading the teeth wider on the top, then the LeForte I after that to fix the open bite, and maybe just have braces on the bottom jaw to straighten them out and things.. Do you think that could work?

I’m scared the most about the bottom jaw I think, where I have a greater risk of nerve loss and possible need for a chin modification. I feel as though the top jaw is "easier" because it's more "common"? Also, I read that the wisdom teeth removal is more painful than the LeForte I and RPE. Any opinions on that?

[chicago29]

First off, a permanent retainer is NOTHING. I just got mine "installed" and you won't even notice them. Don't let that be a consideration at all...

As for upper vs lower, both surgeries have very different risks. The thing is they often need to be done together, and you should speak with a board-certified oral surgeon to evaluate you. At the end of the day your upper and lower jaw must meet correctly, and you often need to move both jaws to achieve this.

Numbness for lower surgery is common - although it is in most situations only temporary. I am one of the lucky ones...I don't have any numbness in my lower jaw, although I have some spots of "altered sensation".

Your final point...is wisdom teeth more painful than upper surgery. The pain is usually totally under control...It would be very rare for you to be in uncontrollable pain. However, in my experience I say jaw surgery is worse simply because of the swelling and altered eating arrangements you'll need to follow for 4 to 6 weeks. Jaw surgery takes a lot out of you and you aren't back on your feet in a few days. It takes a few weeks. But if you realize that, plan for it, and accept it...you'll be FINE!

[sarahorsomeone]

Firstly I want to say that I had upper and lower jaw surgery about four months ago, and for me it was a completely life-changing experience for the better. My confidence has increased dramatically, and the function of my bite has improved in ways I didn't even expect (I don't think I realised just how much trouble I had chewing until it was fixed...).

Also... although I wouldn't like to guess which is easiest (not being a surgeon); I do know that the Le Fort I osteotomy generally takes much longer than the sagittal split osteotomy. Before I had my operation my surgeon predicted that the whole operation would take about four hours, and only half-an-hour of that would be spent on the lower jaw.

As for nerve damage, that can happen with both surgeries. I have no lasting numbness, but the only numbess I ever had was in the top part of my face (on one side in particular) and that was from the Le Fort I osteotomy, not the saggital split osteotomy.

Pain wise... I experienced very little pain from my surgery. The swelling was a bit horrible for a few days, but it was definitely worth the end result.

[Van'braces]

I just had sarpe surgery and wisdom tooth removal. I was scared silly for the preceding 3 months; I'd never experienced surgery before. Honestly pain/discomfort wise it was totally fine, the only issue I had was with severe nausea, and there are amazing anti nausea meds out there! I cant believe how different my bite is now, 8 weeks after surgery and the only minor inconvenience is cleaning the palatal expander, my gap is nearly closed and Im so glad I did this! I cant comment on the lower jaw surgery but Id say if you're risking having a ton of dental work in later years because of cracking/weak teeth from an incorrect bite, it may be worth having the surgery. One thing I would say is having confidence in your Surgeon is important,I had no doubts about my surgeon as my surgery was a relatively "minor op" for him as he deals with a lot of complex cleft palate cases and facial reconstruction much more involved than mine.

[freakyteeth]

I too am terrified. I worry about stroke, nerve damage, blood clots, etc. I've been through a similiar surgery and so I understand the swelling.
I am left with no alternative. The teeth are falling out of my mouth and I cannot chew anything.

I think of it as short term sacrifice and discomfort for long term gain.

THose post surgery - would you do it again? Was it worth it?
I think there may be an earlier thread on this.

[Tuxkeeper]

I am going through the same things mentally as you are! I'm supposed to be getting the upper jaw done to fix an open bite. We've been going back & forth with my insurance company and finally last week I got the approval letter, so it's becoming more real to me now that things are really moving forward. I don't have a surgery date yet, but that is coming soon. I'm scared & I have the same thoughts of anxiety & worry. I wonder if it's worth it. I've lived with the open bite for so long, that it's second nature, so would it really be the end of the world if I just didn't do the surgery? Then I think of how much better my smile AND my bite will be once it's over. The discomfort & the inconvenience will only be temporary (is what I'm trying to remind myself...over & over ). Almost everyone who's had a surgery like this done seems to think it's well worth it. My ortho told me that once I have it, I'll wonder why I didn't do it sooner. I hope he's right! Do you have a surgery date yet?

[Nathaniel]

How much time has gone by since your son's surgery? Has there been any complications/relapses of the teeth/permanent nerve damages?

We're still in the early days - 5 weeks out tomorrow. The only major issue we had is that we sort of bungled the release from the hospital and took off without dealing with either his nausea or his anxiety (both of which he's prone to). That gave us one really bad 24 hours, but no serious issues past that.

For my son, I think I never realized how deformed his bite made him feel. With it repaired, he feels "normal."

Because we only did the LeFort, we have a lower risk of the permanent nerve damage. I think that's mostly a lower jaw thing. I'm a natural fret-er, so I'm sure I'll continue to worry whether he'll run into problems with a non-union or a relapse for awhile still, but there's a pretty low risk of either of those.

Congratulations to you and your son on everything! What's a non-union relapse, and also, do you know how severe "normal" relapses are?

Thanks for taking the time to post!

First off, a permanent retainer is NOTHING. I just got mine "installed" and you won't even notice them. Don't let that be a consideration at all...

As for upper vs lower, both surgeries have very different risks. The thing is they often need to be done together, and you should speak with a board-certified oral surgeon to evaluate you. At the end of the day your upper and lower jaw must meet correctly, and you often need to move both jaws to achieve this.

Numbness for lower surgery is common - although it is in most situations only temporary. I am one of the lucky ones...I don't have any numbness in my lower jaw, although I have some spots of "altered sensation".

Your final point...is wisdom teeth more painful than upper surgery. The pain is usually totally under control...It would be very rare for you to be in uncontrollable pain. However, in my experience I say jaw surgery is worse simply because of the swelling and altered eating arrangements you'll need to follow for 4 to 6 weeks. Jaw surgery takes a lot out of you and you aren't back on your feet in a few days. It takes a few weeks. But if you realize that, plan for it, and accept it...you'll be FINE!

Hi Chicago29! thanks for your post and time. Congratulations on the recent removal of your braces! I wish you all the best and a life filled with big smiles! Do you plan to stay around these forums for a while? I really like where the community is at during this point, and feel it's going to be a big factor in my process, I'd be disappointed to see these familiar and informative "faces" to disappear. I know it eventually happens, but I'm just wondering on your plans.

Thanks for your time to post!

Firstly I want to say that I had upper and lower jaw surgery about four months ago, and for me it was a completely life-changing experience for the better. My confidence has increased dramatically, and the function of my bite has improved in ways I didn't even expect (I don't think I realised just how much trouble I had chewing until it was fixed...).

Also... although I wouldn't like to guess which is easiest (not being a surgeon); I do know that the Le Fort I osteotomy generally takes much longer than the sagittal split osteotomy. Before I had my operation my surgeon predicted that the whole operation would take about four hours, and only half-an-hour of that would be spent on the lower jaw.

As for nerve damage, that can happen with both surgeries. I have no lasting numbness, but the only numbess I ever had was in the top part of my face (on one side in particular) and that was from the Le Fort I osteotomy, not the saggital split osteotomy.

Pain wise... I experienced very little pain from my surgery. The swelling was a bit horrible for a few days, but it was definitely worth the end result.

Hi sarahorsomeone!

Did you notice your face "shrink" in terms of height? I want to keep my long-like face, because it matches my tallness. Also, did you notice your lower check area more "full", because they say I have somewhat of a flat face there. Finally, did you get any chin work done?

Thanks for your time to post!

I just had sarpe surgery and wisdom tooth removal. I was scared silly for the preceding 3 months; I'd never experienced surgery before. Honestly pain/discomfort wise it was totally fine, the only issue I had was with severe nausea, and there are amazing anti nausea meds out there! I cant believe how different my bite is now, 8 weeks after surgery and the only minor inconvenience is cleaning the palatal expander, my gap is nearly closed and Im so glad I did this! I cant comment on the lower jaw surgery but Id say if you're risking having a ton of dental work in later years because of cracking/weak teeth from an incorrect bite, it may be worth having the surgery. One thing I would say is having confidence in your Surgeon is important,I had no doubts about my surgeon as my surgery was a relatively "minor op" for him as he deals with a lot of complex cleft palate cases and facial reconstruction much more involved than mine.

Van'braces, where did the nausea come from? the Anesthetic? Congratulations on your fast progression with the closing of the gap! I take it you're not doing the lower jaw surgery?

Also, I don't think I'm at risk with lots of dental work in the later years, simply because I'm so cautious nowadays that my teeth hardly ever hit eachother. But, with that low risk, would you still go through with it?

Thanks for your time to post!

I too am terrified. I worry about stroke, nerve damage, blood clots, etc. I've been through a similiar surgery and so I understand the swelling.
I am left with no alternative. The teeth are falling out of my mouth and I cannot chew anything.

I think of it as short term sacrifice and discomfort for long term gain.

THose post surgery - would you do it again? Was it worth it?
I think there may be an earlier thread on this.

freakyteeth, I've read many threads and I would say that almost all say it's worth it because they love it, but some, very few from what I came across, said that knowing what they know/experiencing what they've experienced after it was all said and done, they may not have made the choice only because the mental acceptance probably wouldn't be there.

Do you have any dates planned?
Thanks for your time to post!

I am going through the same things mentally as you are! I'm supposed to be getting the upper jaw done to fix an open bite. We've been going back & forth with my insurance company and finally last week I got the approval letter, so it's becoming more real to me now that things are really moving forward. I don't have a surgery date yet, but that is coming soon. I'm scared & I have the same thoughts of anxiety & worry. I wonder if it's worth it. I've lived with the open bite for so long, that it's second nature, so would it really be the end of the world if I just didn't do the surgery? Then I think of how much better my smile AND my bite will be once it's over. The discomfort & the inconvenience will only be temporary (is what I'm trying to remind myself...over & over ). Almost everyone who's had a surgery like this done seems to think it's well worth it. My ortho told me that once I have it, I'll wonder why I didn't do it sooner. I hope he's right! Do you have a surgery date yet?

Hi Tuxkeeper! Yea I'm always saying to myself "you don't need this, you've been fine already... you don't grind your teeth, you don't have erosion just yet"... but, I mean, when I talk to my Ortho and hear these stories about how great it is to bite with the front teeth and smile with a broad smile, it becomes more with it.. then I discount all that with "well, I enjoy eating now" and "I like my appearance already". It's really hard to convince me lol. My date is on the 8th.

I think another big hurdle for me is that, I've never done any surgery before, I haven't experienced being put to sleep for a bit... Also, the idea of doing it all TWICE, ahh!!! freaks me out. I'd rather have one big surgery where they do everything at once because if that happens, it's like every day after that is on the road to recovery, where if I just have one.. wait a year, then another, it makes the first one seem like a checkpoint of sorts, and that I'm no where near to being done.

I have some interesting and exciting insights from my Ortho though today that he wants to discuss with my surgeon on Monday, I don't want to say what it is until he tells me what's the decision because I don't want to jinx it but I'll share it with you all soon!!!

Tuxkeeper, are you going to go through with it? How old are you now too if you don't mind me asking, simply because your Ortho made the "doing it sooner" comment.
Thanks for your time to post!

[hduggan]

I think normal relapses are minor - something that can be measured, but not really felt.

A non union is when the bones don't bind together after the surgery. This is a rare event, and requires a second surgery to make it work. More common is a delayed union, just meaning that the bones take longer then usual to knit.