maxillofacial surgery

[ggina]

Hi,

I'll be having maxillofacial surgery during the fall because it's a recommendation (or rather, a definite must) for me prior any kind of FFS work.

This is the one where they cut some length out of the upper jaw to make it shorter and then re-fix it with metal plates and screws. They call it Lefort I. osteotomy. Serious stuff. I have a very long middle face which shows in a gummy smile of about 5-7mm with an upper lip length of 20mm and this surgery will eliminate the visible gum. The nose-lip distance then will be shortened by 5mm with a lip lift but that will be another session later.

If anybody have some experience or knowledge regarding the jaw-procedure, please reply. It's not a common thing to do and the resources on the net are rather scarce about it.

Thanks,g

[ggina]

nobody? I guess you're lucky then, not having the problems I have

g

[Cruelladeville]

Your best bet is to join yahoo groups ffs Gina but its really a clique....place!!

And I got binned off, executed with no warning, just because I backed another newbie that was p#ssed for constantly being moderated....

However there was member there that was in a terrible mess post jaw work through the Agave clinic, just before it went bust. She had a detached jaw muscle and was in danger of loosing teeth....

So I'd recommend only a surgeon that has a 'fabulous' track record with this type of face work...

Take care and best-o-luck when you go for it....

[ggina]

Cruelladeville, thank you for the good wishes

As for your concerns, I think I've found a very good surgeon, I've seen some of his previous work done on much worse cases than I am and was amazed by the results, so I should be only a piece of cake for him. Not to mention it's only upper jaw which is usually much less problematic than the lower one.

Yes I think I was a member of that yahoo group some time ago but they weren't really friendly, to me at least. I like this place much better

g

[bibilinda]

I have had major maxillofacial surgery involving facial bone (Chin Surgery – Genioplasty)

All I can tell you is that it involves general anesthesia, and if yours does too, prepare for maybe about a week of a miserable feeling in your throat (because of the a tube they place into your air pipe, or trachea, it really hurts it a lot, there's lots of inflammation, it hurts for a week like hell, the first couple of days it's difficult to swallow, from the third to almost a week, it hurts so much, even swallowing liquids hurts a lot...  so if they are going to use general anesthesia, I'd beg the m to be super-careful with your throat, since as you're put under during the procedure, you can't complain of their hurting you... And the real results of procedures involving bones in the face, you can see from the 6 month on,you see maybe 50% a couple of weeks after, the rest will be seen gradually month by month. I would advise you to take a picture/video right before the procedure and one after, and an orthopantonography or any other mandible bone X-ray image before the procedure would be very useful for you, to compare it against the results 6 months after and if there's any wrongdoing by the surgeon, you can prove it with the images...

Well, that's what I can tell you now about my experience... So, if you'll be on general anesthesia, be prepared to have a mostly liquid diet with very soft food included, for about a week, and lots of painkillers to be able to stand the major pain you will feel in your throat!

Bibi

Hi,

I'll be having maxillofacial surgery during the fall because it's a recommendation (or rather, a definite must) for me prior any kind of FFS work.

This is the one where they cut some length out of the upper jaw to make it shorter and then re-fix it with metal plates and screws. They call it Lefort I. osteotomy. Serious stuff. I have a very long middle face which shows in a gummy smile of about 5-7mm with an upper lip length of 20mm and this surgery will eliminate the visible gum. The nose-lip distance then will be shortened by 5mm with a lip lift but that will be another session later.

If anybody have some experience or knowledge regarding the jaw-procedure, please reply. It's not a common thing to do and the resources on the net are rather scarce about it.

Thanks,g

[ggina]

Thank you Bibi for the advices. Judging by your avatar your chin is very pretty so you probably went to the right surgeon I too will need some chin work done but that's another time. Some surgeon suggested the sliding genioplasty you've had but I'm not yet sure.

As for anasthesia, I've already been through several (not T-related) procedures which involved local, spinal and general anasthetics as well so I'm expert in the field Don't remember any throat pain and didn't take painkillers but maybe I had luck or I'm the toughest chick in town

g

[Cruelladeville]

I've just had two GA's in 14 days...

First for 3hrs and second for 5hrs..... both took only 48hrs to get over, and because of my throat op done back in the 90's a smaller tube was used....

I would say there have been no post-op problems due to GA at all, though it pays to be uber-fit pre any procedure I was..... the only issue I have is bowels re all pain drugs antibiotics et al.....

And you only feel bad groggy if you don't get enough fluids in while down, though you need a brill anaesthetist....Dr. M used Dr Best, who's worked with him for decades....they're a kool team you can trust while you're down...

But post Lipo work, which I've had..... 2.5ltrs apparently easily came out of my torso waist, so I'll get my better hip to waist ratio back....though they do put in fluid agents to kill the fat zones... and this will take a week or so to work out!

But back to faces....

I'll have consulted with Dr Bart van de Ven, Dr Meltzer, Yaremchuk and Di Maggio with a final decision based on recommendation, reputation, success rate and finally what I've got as a budget for this procedure.... and last but not least location.... as hotels, private nurses and flights are elements you need to factor for...

[ggina]

I've just had two GA's in 14 days...

jeez, that seems just tooo much although it's good to know that it's possible because I'm planning on a similar schedule.

I'm fit as hell, train regurarly so this was probably one reason that I haven't had any complications during my previous procedures. But come to think of it, Bibi must also be fit (well at least she WAS fit back in the day ) so this might not be a factor at all... ehhh. We'll do it anyway, won't we?

btw Cruelladeville, what do you mean by "this procedure"? You'll be getting ffs i suppose?

Yes I agree there many factors to consider but what counts for me first and foremost is the manners of that specific surgeon. I somehow like when they're a little bit arrogant because that usually means that they know their job and that they're professional and won't get emotionally involved with the patient meaning that they'll handle me as an object, just a task to be done when I'm lying on the table And that is good, a surgeon should always operate that way. I somehow always get suspicious when a doc is way too friendly towards me Nurses, yes, but docs, no.

g

[Cruelladeville]

I'm a veteran of procedures Gina....

The first round done in my early thirties when uber-able and young enough to recover fast and within months of completing the 2 year RTT, tough going but twas all key for my successful life to date.......but now I'm heading through another year of procedures 3 down one to go...I'm even more careful with prep and how it goes being a 52 year old bint!

Age+ = more time+ it takes to heal.... (simples)

So yep my schedule pre all this...was gym x 3 nites a week, weekly club level tennis and frequent 8m hill/mountain hikes at weekends....but then having an athletic approach to all this means you can do this surgery stuff with a better % chance of pulling it safely off....lol

Also best diet possible, no alcohol and key additives as necessary.....

Here's the list of what we (me & docs) have achieved so far....

Procedure: Thyrochondroplasty - Surgeon Mr. Cheesman, FRCS. Date: 1992
Procedure: Rhinoplasty - Surgeon Mr. Dai Davies. Date: 1992
Procedure: SRS Surgeon - Mr. Michael Royle. Date: 1992
Procedure: Breast Augmentation - Surgeon Mr. Dai Davies. Date: 1993
Procedure: Dental/oral teeth surgery – Dr. Belá Batorfi Date: 2010
Procedures: SRS revision labiaplasty, body contouring liposuction and buttock lift - Dr. Toby Meltzer Aug/Sep 2010)

And yep I aim to finish off for good this year, no more elective enhancement stuff ever again....(the time investment alone is just too enormous)......when my FFS, Lip enhancement and face-lift rejuvenation surgery is complete come Nov/Dec....or Jan that will be truly it....

And I want my old life back, i.e. PAYE full-time exec level ops work and my stealthy joy packed girlie life again....

Looking ab-fab for my age obviously.....*s->-bleeped-<-s*....

As I will.... no I'm not being smug.....but the investments do bring rewards...... the truth is out there in any magazine, film TV show to see.... as are horror stories if you do too much or pick doctors unwisely....

[ggina]

yet the Dr did not shave off anything to make it pointy, he limited himself to cut bone

That's most unfortunate. I thought doctors are supposed to tell you what exact things they'll be doing and what results can you expect. And if he says he can only give you 5mm, then you look for another doc. From what you write here it seems like the doc said a blunt 'yes' to all of your needs and then did what HE wanted to do on the table. If this was the case, it's just not fair and I would've wanted my money back

g

[ggina]

what they ALWAYS tell you is: "I can promise you YOU WILL IMPROVE YOUR LOOKS

well, about the particular surgery I'm going to have, I asked my doc how much he can move the upper jaw and he said 6-7mm. That's a pretty exact answer And I've heard some docs can show you the 3d image of a planned rhinoplasty which I don't really believe exists, but why not?

What I was talking about is it does matter whether he can reduce your chin by 5 or 10mm. I'm not talking about exact numbers, it can be 4 or 6 or 9 or 11, whatever, but a 100% difference is too much to put it on pure guessing, he should be able to tell that beforehand. Or, if he says he's going to cut but not shave, even that's more than nothing.

But yeah, what if he says "you get the 10mm" and he doesn't give it to you? He won't give his signature to something like that. You can't do anything, suing is not worth it, especially not if he didn't mess up your face real bad. Probably that's why learning to be a doctor is so popular among youngsters

Anyway I've seen your frontal picture where you sit on a bed and from this distance it doesn't look all that bad so this post may be much ado about nothing. But of course if you feel it's big then it probably is

g

[ggina]

okay Bibi, I'll be careful

[lilacwoman]

the surgeon I am seeing for chin reshaping told me of horror possibilities of cutting through some big nerve and being left with a sagging drooling mouth.
So we agreed to open my chin up carefully to see if much can be cut away without leaving slobbering.

[Cruelladeville]

Before I got binned off Yahboo FFS clique site...

I saw some pics of a TG gal whom had been able to get her US insurance to pay for her FFS.... her surgeon...

Was this chappie...

http://www.dryaremchuk.com/english/surgery-patient-resource.htm

So I'm gonna do a consult with him as well, I'll have four possibles lined up for end-o-year....

There's load of useful stuff on his site for sure.... and the guy publishes loads of acadmic med papers....which is always a good sign that they ain't standing still skills wise...

[ggina]

the surgeon I am seeing for chin reshaping told me of horror possibilities of cutting through some big nerve and being left with a sagging drooling mouth.

Yes, and as far as I know this applies to all kinds of lower jaw-related surgeries as well. That's why I told my doc about this specific surgery that I don't want him to touch the lower jaw, he should move only the upper portion. I could have much better results by moving both but as I too am afraid of nerve damage and I plan on having a chin surgery sometime in the future, I thought I'd reduce the risk by only having one lower procedure instead of two. That's 50% less and it's a lot

I'll have four possibles lined up for end-o-year....

I see you're not taking anything by chance All those good surgeons, I wonder upon what'll you base your final decision before the first incision?


g

[Cruelladeville]

#1: Talent....handi-work skills...
#2: Track record and are they still delivering?
#3: Cost of procedure (including sundries/hotel travel)
#4: Location, and the local political situation....

(I leave as little to chance as possible).....*s->-bleeped-<-s*

And I'm very happy with my results so far in Arizona, though desperate to get home to some grey & rain....and missing ma b/f loads now...... 

[lilacwoman]

Yes, and as far as I know this applies to all kinds of lower jaw-related surgeries as well. That's why I told my doc about this specific surgery that I don't want him to touch the lower jaw, he should move only the upper portion. I could have much better results by moving both but as I too am afraid of nerve damage and I plan on having a chin surgery sometime in the future, I thought I'd reduce the risk by only having one lower procedure instead of two. That's 50% less and it's a lot

that big nerve runs right round the chin so any surgery in the area is a risk.
however I had my jaw broken once withoty lasting nerve damage so maybe the surgeons are playing safe.

[ggina]

#1: Talent....handi-work skills...
#2: Track record and are they still delivering?

now this first two are really the hard-to-tells I think one can never get enough objective information about these topics. Opinions don't count as they're biased and what else do we have? Academic papers? nah. He might be an awesome theorist but poor in practice...

So I basically decide on having a consultation with them and see how they talk, how they think, how rude they are to me. Might sound stupid, but being just a little bit rude is a sign of confidence and I like that. In a surgeon at least, not in everyday people

g

[Cruelladeville]

Academic papers can include procedure update photos...which can be accurate for ballpark results....and patient forum groups will tell you (if peeps are honest) what's going on....

This does shape opinion which is why many surgeons don't like you posting stuff, for the obvious reasons....

If a Dr was rude to me it would put me off (personally) as if he didn't respect me...he's not that likely to care as much about what goes on...where as if he does like me.... in a sincere way, it helps immensely!

(basic psychology).....

But fits work both ways for sure....

They might turn you down as a poor candidate..... does happen.....

[ggina]

yeah our reactions may vary... I know I don't expect too much humanity from a surgeon, I expect a machinery with lethal precision

btw, would you do a lip lift with a surgeon who has never done it before? This seems to be the case in my country, noone have done it as of yet... There are lot of talented surgeons but people don't even know that this procedure exists so the docs can't get any practice with it. I don't want to travel abroad for such minor stuff (it's at most 2 hours with local anasthetic) so I'm contemplating to be a first case for some doc here. I mean, if he's talented, then why not? But still, I have my fears...

Every doc has to have a first case, I just don't know if I want to be one

g