Pre-Jaw surgery anxiety! SARPE, then Le Fort I

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Ercmicwil
Posts: 10
Joined: Mon Feb 22, 2021 1:47 am

Pre-Jaw surgery anxiety! SARPE, then Le Fort I

#1 Post by Ercmicwil »

Hello,

I’ve been wanting fix my teeth since I was about 16 years old. Now at 41 years old I’m finally in a place where I can afford the braces and the one, but possibly two, surgeries required. SAPRE first, then braces, then Le Fort I to correct cross bite if necessary in the final stage.

I’m scheduled for SARPE on April 1st, 2021, and I am scared. I’m not gonna lie. I’m just plain anxious about the entire damn thing. I haven’t had a chance to build trust with my surgeon, and every visit to their office has been a bit strange. I blame COVID to some extent for creating barriers to normal interaction, but I just feel like their attitudes towards my concerns are so dismissive, like this is just no big deal, people get jaw surgery everyday! (I don’t!)

I know it would be helpful for me to hear or read positive affirmations from others experiences with SARPE or upper jaw surgery.

Some questions:

Did any of you who’ve had jaw surgery of any kind get prescribed a sedative the night before or morning of surgery? I feel like this might ease those final moments. I know I’d have to clear it with my anesthesiologist.

For SAPRE, I read something about how the surgeon should not cut the pterygoid plates because it increases bleeding risk without benefit. Is this an absurd thing to ask my surgeon about? I feel so ridiculous. I’ve already asked a lot of questions, of my orthodontist, and two or three oral surgeons over the years.

I’m worried about absurd things, like bleeding to death, or having a stroke, or not waking up from the anesthesia. None of those outcome are desirable! I recognize and have been told they’re extremely unlikely. But when you’re scared, statistics are of little comfort to your lizard brain!

Despite my somewhat irrational fears I’ve been moving this process along and getting things scheduled. It’s just so real all of a sudden. It’s on my calendar!

I’m a pretty healthy guy for 41, but I did just find out I do have mild sleep apnea despite being lean. I’m hopeful the surgery can help widen my sinus cavity for better nasal breathing. I’ve been medically cleared for surgery, but still it’s gonna be a long 5 weeks of waiting if I don’t find some ways to put my mind at ease before surgery.

Anyway, if you’re sensing what I’m going through, and have any advice on how to cope. I’d love to hear it! Thank you so much!

snapdresser
Posts: 996
Joined: Wed Feb 18, 2015 7:31 am

Re: Pre-Jaw surgery anxiety! SARPE, then Le Fort I

#2 Post by snapdresser »

What kind of movements are you looking at for the LeFort I? I would caution you against impaction at your age. Regarding the anxiety, I would just say that by the time your surgery date rolls around it’ll just feel like you’re floating through the days if you’re anything like me. But the anxiety just gets worse and worse until you reach that point. I guess try to substitute excitement for the anxiety if you can? Good luck and welcome to the forum!
No braces
1-piece LeFort I + BSSO + Sliding Genio on 10 JUNE 2015!
Partial hardware removal 14 SEP 2018
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Ercmicwil
Posts: 10
Joined: Mon Feb 22, 2021 1:47 am

Re: Pre-Jaw surgery anxiety! SARPE, then Le Fort I

#3 Post by Ercmicwil »

Thank you for your thoughts. What exactly is impaction? I can only find info on impacted teeth when I google it. And why do you think age increases the risk?

The orthodontist thinks I’ll need the Le Fort I for a slight rotation to correct for crossbite, and possibly come forward a millimeter or two. But we won’t know for sure until my upper pallet arch is widened and my teeth are close to fully corrected.

I totally agree with you though. I’m trying very hard to replace the nervousness with excitement for the results. I know I can handle the pain and discomfort afterwards, it’s just my fretting over the procedure! But I get a little more excited each day. I’ll just need to manage that last 48 hours really well!

snapdresser
Posts: 996
Joined: Wed Feb 18, 2015 7:31 am

Re: Pre-Jaw surgery anxiety! SARPE, then Le Fort I

#4 Post by snapdresser »

Impaction refers to a movement of your maxilla that surgeons sometimes make during LeFort I operations, specifically when they cut out a section of your maxilla and move it upwards towards your nose. You can search “over impaction” on this forum to read people’s complaints about what happens when surgeons move the maxilla up a little too much. “Millimeters are the miles of the face” or whatnot. The reason I’m warning you is because soft tissues sag as you age, and many (most?) of the older patients on this forum complain that they have little tooth show and look much older after they were impacted. Unfortunately after it’s done there’s little they can do about it and most just end up living with the consequences.

Your challenge, I suspect, will be 1. Getting the info from your surgeon ahead of time regarding how much they plan to impact you, if at all, and 2. Getting your surgeon to listen to your concerns and alter their surgical plan accordingly. I’m sure you’ll be motivated to handle these challenges after you read some of the horror stories about over-impaction on this forum though. Good luck!
No braces
1-piece LeFort I + BSSO + Sliding Genio on 10 JUNE 2015!
Partial hardware removal 14 SEP 2018
Image

Ercmicwil
Posts: 10
Joined: Mon Feb 22, 2021 1:47 am

Re: Pre-Jaw surgery anxiety! SARPE, then Le Fort I

#5 Post by Ercmicwil »

Wow! Thanks for explaining that. I did ask my oral surgeon about that. He said that I would not need that procedure because I don’t have a gummy smile. If anything I would benefit from moving my palate down, but that might include a lower jaw adjustment.

I did ask him about the Pterygoid plates and he said he does plan to operate on those because it’s difficult to get symmetrical movement from SARPE without making a separation there.

I guess this is a controversial topic in oral surgery. I feel look I should trust him, but at this point I worry that I’m just over informed and looking for things to be afraid of.

snapdresser
Posts: 996
Joined: Wed Feb 18, 2015 7:31 am

Re: Pre-Jaw surgery anxiety! SARPE, then Le Fort I

#6 Post by snapdresser »

That’s great to hear! And your surgeon sounds like they have a better bedside manner than both. Good luck!!
No braces
1-piece LeFort I + BSSO + Sliding Genio on 10 JUNE 2015!
Partial hardware removal 14 SEP 2018
Image

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