Zero Tooth-Show ... Revision Maxilla Down-graft
Posted: Wed Oct 18, 2017 2:09 am
Hello. Some of you may recall my story from a year ago, but briefly ... I had a SARME in 2014, and Bi-Max in 2015 and a subsequent revision Lefort 1 in 2016! The Bi-max in 2015 left me with a severely crooked nose and a mid-line-shift almost one entire tooth-width to the left (think Tom Cruise). However, despite the crooked nose and mid-line issues, I genuinely liked the look of my new face - it just needed some adjustments to get it right. At first when I tried to talk to my surgeon about my concerns after the bi-max, he became extremely emotional and defensive and flatly refused to rectify the situation. I felt completely helpless and suffered from considerable depression during that time. It took a whole year of my life to finally encourage my surgeon to perform a much-needed revision ... which he later conceded to both myself and the registrar "needed to be done" because - quote "we couldn't exactly leave you looking like that"!!!
The revision in 2016 was top jaw only as we decided a redo of the mandible would be too risky at my age. This time my surgeon managed to get my nose almost straight, and my mid-line almost centre (which was close enough for me). That would have been fine ... however for some reason also decided to remove an enormous amount of vertical excess and impacted me so much that I now have a much shorter face, a flat mid-face, wide nose and absolutely no tooth-show! Zero! I don't need to tell most of you that these changes have the potential to create the 'perfect storm' in terms of making a woman look unattractive! I look angry all the time and I look like I have no teeth.
In early 2017, I gathered my courage and went to my surgeon and told him how disappointed I was, and asked him why he had removed so much vertical excess and impacted me so much? My surgeon is a master of saying a great deal without actually saying anything at all. He concluded that I should get plastic surgery to fix the things I didn't like. I have, over the past 12 months, considered plastic surgery. The problem is that because he has removed so much vertical excess, my face has lost a considerable amount of length. If I getting nose jobs and lip lift, it's simply going to create a very centralized and concentrated grouping of my features in the centre of my face, when what I want is greater mid-face length and more tooth-show.
I simply want a maxilla down-graft, however when I went to speak with my surgeons registrar today I was informed that it is not possible to have a maxilla down-graft without bringing the lower jaw forward also (in other words, a bi-max) because the down-graft movement would force the mandible to rotate backwards.
Could anyone please advise if this is, in fact, true? If they could give me a LeFort I last year to to remove (too much) vertical excess, can they not simply reverse this movement in a revision down-graft surgery. I ask as I am an older patient and have significant nerve damage and numbness in my lower lip and chin after the bi-max and would prefer to not to take the risk of another lower jaw surgery.
Thanks for reading. I hope this all makes sense and that someone may be able to offer some advice/perspective etc. I am so angry and sad.
It has been a tough four years and feel as though I am watching each year slip away without any progress or forward movement.
The revision in 2016 was top jaw only as we decided a redo of the mandible would be too risky at my age. This time my surgeon managed to get my nose almost straight, and my mid-line almost centre (which was close enough for me). That would have been fine ... however for some reason also decided to remove an enormous amount of vertical excess and impacted me so much that I now have a much shorter face, a flat mid-face, wide nose and absolutely no tooth-show! Zero! I don't need to tell most of you that these changes have the potential to create the 'perfect storm' in terms of making a woman look unattractive! I look angry all the time and I look like I have no teeth.
In early 2017, I gathered my courage and went to my surgeon and told him how disappointed I was, and asked him why he had removed so much vertical excess and impacted me so much? My surgeon is a master of saying a great deal without actually saying anything at all. He concluded that I should get plastic surgery to fix the things I didn't like. I have, over the past 12 months, considered plastic surgery. The problem is that because he has removed so much vertical excess, my face has lost a considerable amount of length. If I getting nose jobs and lip lift, it's simply going to create a very centralized and concentrated grouping of my features in the centre of my face, when what I want is greater mid-face length and more tooth-show.
I simply want a maxilla down-graft, however when I went to speak with my surgeons registrar today I was informed that it is not possible to have a maxilla down-graft without bringing the lower jaw forward also (in other words, a bi-max) because the down-graft movement would force the mandible to rotate backwards.
Could anyone please advise if this is, in fact, true? If they could give me a LeFort I last year to to remove (too much) vertical excess, can they not simply reverse this movement in a revision down-graft surgery. I ask as I am an older patient and have significant nerve damage and numbness in my lower lip and chin after the bi-max and would prefer to not to take the risk of another lower jaw surgery.
Thanks for reading. I hope this all makes sense and that someone may be able to offer some advice/perspective etc. I am so angry and sad.
It has been a tough four years and feel as though I am watching each year slip away without any progress or forward movement.