I saw my surgeon on Monday and got the answers to my many questions. I was really impressed that he took the time to answer each of my questions and then some. I deal with many surgeons in my job and can say that most are not this patient and willing to take the time necessary to make you feel comfortable. I also had to fill out the hospital intake forms which really made things more real!
Here are the answers he gave to my questions:
What do you recommend? BSSO and genioplasty, upper jaw surgery not required.
Do you think my teeth (gaps) will be ready by March 28th? As long as OD feels teeth are in suitable position.
How much overjet do I have now(measurement)? He does not measure, moves teeth into best position for bite. From what I have measured myself I would say 8-10mm.
Asymmetry? Yes, there is some but will not be changed with this procedure.
How much movement (and what kind) do you expect? Again no measurement but will move forward lower jaw as much as able and angle slightly if needed to ensure best bite position.
Will BSSO be sufficient to correct bite? Yes, ortho to finish positioning postop.
Does amount of movement increase risk of permanent numbness? Yes Age? Can't change it so doesn't matter.
Discuss hardware used to stabilize. Titanium plates and screws.
Any long term risks? Hardware... 5% of patients need hardware to be removed at some point can be done in office with freezing if necessary.
Previously mentioned open bite...front/back? No open bite now so will not be open postop.
Can I expect a perfect bite post-op/post-braces? Will move mandible forward to align jaws, ortho to finish aligning teeth/bite.
Any incisions to face or intraoral only? Oral incisions only.
Bleeding? Always a risk for bleeding but should be minimal.
About how long will the surgery take? 1.5 to 2 hours. Be there at 6:45, surgery at 8:45.
Will it be you or a resident performing the surgery? Surgeon with resident assisting, follow ups will be with resident.
Will I be banded or wired? Not wired, elastics only.
Splint? No.
Surgical hooks? Yes, ortho to apply.
Swellling...Ice good or bad? Ice x 24 hours then heat after that.
Manual lymphatic drainage (massage)? I didn't ask about this but have training in this area and plan to do self-massage to promote drainage, very light massage technique will not cause any harm.
What changes can I expect in my face? Cannot be predicted accurately, even if twins had the same surgery they would likely look different.
Do you have software that can show me potential profile and front view pictures? No.
How will surgery effect lip competence? Should improve with genioplasty, without genio lip competence will not dramatically improve.
How will surgery effect mouth breathing? Should improve.
Does genioplasty increase chance of permanent numbness with increased traction on the nerve? Yes, anything that involves the nerve can cause numbness
Opinion re: need for genioplasty? Recommended but not mandatory. I was previously strongly leaning towards no genio as I like the shape of my chin viewed from the front, I just don't want to end up with a 'big' chin. He said surgeons usually prefer bigger chin, maybe I can negotiate a medium sized chin??? This is worrying me the most at the moment. As of right now I won't see him again until the surgery date but I may call about this.
Can I expect to be free of jaw related headaches after? May not resolve if related to clenching. I honestly think at the moment my jaw pain is more muscular and related to my worsened bite from the braces/extractions as I don't really recall having this pain in the past.
What are my chances of relapse? Up to 25% experience some relapse. 1-3 mm not usually noticeable, if 4mm or more further surgery may be recommended.
Supply list? I think I will follow my fellow bloggers suggestions on this front.
Diet info? Will see dietician in hospital postop. I plan to stock up on liquids, soups, puddings etc
Vitamins (Calcium, D, B)? Protein powders? I plan to take vitamins and high protein shakes.
Postoperative meds? Pain medication and prophylactic antibiotics.
Chronic nasal inflammation...post-nasal drip, swelling, breathing, prior injury to nose? Not much will change in this regard...if ongoing problems could see ENT.
Preoperative physical? Yes, need forms returned 1 month prior to surgery.
Should I stay in the city overnight? Inpatient? YAY! He will arrange for me to stay in hospital overnight since I live 2 hours away.
Sleep positions postop? Whatever is comfortable. I'm planning to sleep in a recliner downstairs.
When is first follow up office visit? Timing of other visits to plan for travel/work. One week, two weeks, fpur weeks, three months, six months, one year.
Time off work? 1-2 weeks. I'm planning for 3 weeks just in case as my job involves ALOT of talking with patients and other hospital staff. If feeling ok I may go back sooner but don't want to feel rushed.
Cosmetic suggestions re: bonding canines post-braces, who to see?He can give me a list if my ortho doesn't have a local recommendation.
What if I get hit by baby/dogs? Avoid for 6 weeks....hmmmmm. Again this one worries me, seems to happen on a daily basis. Here's hoping I can avoid this :S
Yikes, that's a lot of questions (and answers) but I'm sure he's used to it. Sorry for the gigantic post, it will also help me remember all of the answers too. His last piece of advice was to try to think about the surgery as little as possible from now until then, not sure if that will happen. Though I do think my two week Mexican vacation will help with that (16 more sleeps!)...can't wait!!!
That's all for now. Will post about my adjustment and new pics later :D
