Double Jaw Surgery - waiting list

[jawing]

Hi everyone, I'm new here and hope I'm posting this in the right spot! I'll start with a little background info to my situation:

I'm officially on the waiting list to begin orthodontic treatment leading up to my double jaw surgery (NHS). Yesterday I had an appointment with my orthodontist and was introduced to (who I'm assuming will be) my oral surgeon. I'm a 20 year old female and have never been 100% happy with my appearance, but it only clicked for me in the last two years or so that it was my jaw alignment that was the cause of my unhappiness.

Basically, I have a crossbite and had braces on my upper teeth between the ages of 12/13-15 (I can't quite remember, it was so long ago!) Anyway, I was told back then that if I wanted my bottom teeth done, I would have to have jaw surgery carried out otherwise my crossbite would worsen. Young and naive, I declined, not fully understanding why it was needed/how it contributed to my appearance. To be honest, I wish back then someone had gone into more detail about what was "wrong" with my appearance and bite, because I'm now having to go through this in my twenties... hey ho.

My appointment yesterday has left me with a few questions, as it was after that I thought of more things I could've asked. I did ask how long I would need braces on prior to my surgery, and was told two years (followed by 6 months braces post-op). I was wondering whether anyone has any stories of being ready for jaw surgery sooner than your orthodontist/surgeon predicted? The thought of having braces until I'm 23/24 has left me with a heavy heart, although I know it is probably for the best to expect two years so as to not have my hopes ruined.

As well as this, when asked what I disliked about my appearance I mentioned that I did not appear to have a very big, "toothy" smile, which after googling today, have realised is because I have a narrow upper palate. I had an appointment before my one yesterday, in November, with another orthodontist who mentioned I may need my palate expanded again (I had it done the first time round, but again, was never actually told what the purpose of this was!) When I mentioned my lack of a toothy smile to my surgeon yesterday, I added that "you can't see my bottom teeth when I smile" (thinking this was the cause of why I didn't have a toothy smile, not that I had a narrow palate). He just responded, rather dismissively, that "most people don't show their bottom teeth when they smile", rather than address the narrow palate? He also said that he thought my smile was normal, even though I was smiling excessively to try and show how forced it looks almost, not that I usually smile so big! I'm a bit worried that my concerns about my narrow smile haven't been taken on board. Will there be a chance for me to address this when I am finally on the top of the waiting list and am awaiting orthodontic treatment?

To be fair, my surgeon didn't go into that much detail about what was the plan, so maybe he still needed further deliberation with my orthodontist after I had left, to discuss the notes she had taken? (I'm pretty sure she wrote down that I was unhappy about my smile).

Sorry this is so long. I have become rather obsessed with this whole thing since yesterday and it's all just so much information to take in and mull over, I've already had the waterworks haha. I appreciate any responses!

[snapdresser]

Hi everyone, I'm new here and hope I'm posting this in the right spot! I'll start with a little background info to my situation:

I'm officially on the waiting list to begin orthodontic treatment leading up to my double jaw surgery (NHS). Yesterday I had an appointment with my orthodontist and was introduced to (who I'm assuming will be) my oral surgeon. I'm a 20 year old female and have never been 100% happy with my appearance, but it only clicked for me in the last two years or so that it was my jaw alignment that was the cause of my unhappiness.
...
As well as this, when asked what I disliked about my appearance I mentioned that I did not appear to have a very big, "toothy" smile, which after googling today, have realised is because I have a narrow upper palate. I had an appointment before my one yesterday, in November, with another orthodontist who mentioned I may need my palate expanded again (I had it done the first time round, but again, was never actually told what the purpose of this was!) When I mentioned my lack of a toothy smile to my surgeon yesterday, I added that "you can't see my bottom teeth when I smile" (thinking this was the cause of why I didn't have a toothy smile, not that I had a narrow palate). He just responded, rather dismissively, that "most people don't show their bottom teeth when they smile", rather than address the narrow palate? He also said that he thought my smile was normal, even though I was smiling excessively to try and show how forced it looks almost, not that I usually smile so big! I'm a bit worried that my concerns about my narrow smile haven't been taken on board. Will there be a chance for me to address this when I am finally on the top of the waiting list and am awaiting orthodontic treatment?

First off, welcome to archwired! There's a lot of people on here that have been or are going through exactly the same thing! Your anxiety about your appearance and your treatment plan vs your desires is totally normal. Doing your own research and "steering" your doctors in the direction you want to go can be a bad thing if it's just not good medicine, but in my case I had a great experience with it in terms of making sure my appearance was approximately what I wanted, so you might consider being vocal about what exactly you want done and see what your orthodontist and surgeon say about "why not".

SO this "big toothy smile" thing. I have some mixed feelings about that. Your surgeon was right in saying that most people don't show their bottom teeth when they smile. If people show too much of their bottom teeth when smiling, it makes them look old (told to me by my surgeon and confirmed by people here whose upper jaws were moved up too much). The "aesthetic ideal" is to show 1-2mm of upper gum when you smile your biggest. Now there's this whole deal with the WIDTH of your smile. You may say you like a big, wide one but that look doesn't suit everyone's face. Check out this link:
http://0.tqn.com/w/experts/Oral-Surgery ... arison.jpg
This guy was complaining that after all the effort and surgery he went through, he actually looks WORSE! That's a guy who had a faaaairly narrow top half of his head. He certainly didn't have a broad face/forehead before, at least, and as you can see, simply straightening his teeth or maybe a very slight palate expansion would have probably ended up looking better. I had a narrow palate going into all this too, but I didn't have my palate expanded because cases like that guy made me realize that my general pre-op appearance wasn't suited for that. Do I appreciate a big wide smile? Absolutely. It looks really great on a lot of people. But it's not for me. I have a narrow head and fine features and a big wide smile just wouldn't look good. Just my 2 cents

Good luck!!! I'll be interested to see how everything develops with you

[jawing]

Thank you so much for replying snapdresser!

I'm in a lot better place today, yesterday was very hard as I was frantically carrying out further research and questioning whether it's really all worth it. The hard part is ultimately (as I'm sure is the same with everyone), I'd rather not go through this whole process, but I know I'll regret it when I'm older. It's just such a long process, I'm scared of going through all this and not noticing the improvements. So yeah just feeling pretty anxious about it all, but reading through other topics on here has made me feel a lot better and the support everyone offers each other is lovely.

You're right about the bottom teeth, and I did believe him when he said it. It's more he didn't provide any further explanation as to what a "toothy" smile entails, and sort of sidetracked my concerns about a wide smile. I don't know, it probably has been taken on board, I'm just a massive overthinker and the whole thing drives me crazy haha.

Whoa, those pictures are an eye-opener. I do think he suited the narrow palate more actually! But different people will see different beauties, and have different preferences. I will definitely take this on board when I meet with my surgeon in the future. That's eased my mind a lot actually.

Just another question though, did you (or anyone else reading this), ever get provided with any computerised images of what you might look like post-op, or at least were you given a very detailed idea of what you would look like? With the appointment I had there wasn't much discussion of what changes would actually be made to my appearance, rather it was just me vocalising my dislikes. I sort of wish I could wind back time and have it all over again, because I would've been a lot more thorough in my dislikes but I was quite nervous and didn't want to come off as obsessed with vanity, so I held back a bit.

[Dureena]

I'm on the NHS as well, had the braces on for a few month now. The initial orthodontic preparation will just be up righting all your teeth, they'll get down to the final detail nearer the time.
You may not see your surgeon again until the orthodontist think's you're ready for surgery.

The two-years is just the standard answer. Keeping appointments, looking after you brace etc will all help. What's the name of the surgeon?

If they're saying you've got a toothy smile you'll get an impaction of you upper jaw. If they move you jaw forward I think that will widen your smile.

[snapdresser]

I'm just a massive overthinker and the whole thing drives me crazy haha.

You might want to search the posts on here for comments about the mental aspect of this surgery. It's VERY difficult mentally and overthinking everything isn't going to help You're going to have a new face, and there will be days that you don't like that new face, that you wish you had never gone through with it. Those days get more and more rare as time goes on, but they happen for everyone, even people with amazing results, because it's a new face and it seems strange and wrong and for some reason we feel the need to unfairly pick it apart.

Just another question though, did you (or anyone else reading this), ever get provided with any computerised images of what you might look like post-op, or at least were you given a very detailed idea of what you would look like? With the appointment I had there wasn't much discussion of what changes would actually be made to my appearance, rather it was just me vocalising my dislikes. I sort of wish I could wind back time and have it all over again, because I would've been a lot more thorough in my dislikes but I was quite nervous and didn't want to come off as obsessed with vanity, so I held back a bit.

I did get to see a computer simulated image (basically a photoshop) of what a surgeon expected me to look like post-op. It was just a profile picture, not from the front, and he warned me that the soft tissues are very unpredictable and they may be different than in his simulation. That pic was from a surgeon who charged me $500 for my initial consult. I ended up not going to him because he wasn't in-network for any insurance plans, but that $500 consult was more than worth it because of what he provided me, including that picture. The surgeon I ended up going with didn't provide any simulated pictures at all but she did send me her Virtual Surgical Planning (VSP) .pdf which showed 3D images of my pre- and post-op skull. Not super useful when trying to establish what I'd look like afterwards I think most people on here never got a picture of what they were going to look like afterwards. Feel free to photoshop one yourself tho!

Oh yeah, and I made sure I gave my surgeon the impression that I was obsessed with vanity and I don't regret that one bit! I wanted to make sure that she put aesthetics high on the list of concerns when developing my treatment plan