Jaw Surgery - Orthognathic surgery

[oral b]

1) Anyone been through this surgery?
2) Able to brush teeth?
3) Able to open mouth naturally, eat and brush?
4) What is your diet immediately 7 to 14 days after the surgery?

 

[been there]

Hi,

I went for this surgery in Feb 2003 after wearing braces for about 8 months. After the surgery, you need to keep wearing braces for another 6-12 months, before u switch to retainers.

you are not able to brush your teeth for the first week after operation. In fact, you can't open your mouth, as your upper and lower jaws will be tied together. you have to take a special kind of milk using straw. imagine drinking milk for a week. i can still remember the taste...

after 1-2 weeks, u are able to switch to soft diet, eg. porridge, nestum, cereal. probably after 3-4 weeks, you can take solid food, but not too hard. it all depends on how fast u recover. my doc said i'm quite fast. btw, there will be a huge swelling of your cheeks after op. u will be given 3 weeks of MC.

u can refer to internet for some info. i even saw 1 page with photos of the op itself.

 

[oral b]

Hi Been There,

Thanks for your reply.

Couldn't open your mouth for a week, so how do you clean your teeth and mouth?

Yours is upper or lower jaw or both?

How did you prepare yourself mentally and physically before the surgery?

How did you feel after waking up from your surgery? What was your first reaction?

 

[crayonshinchan]

hi Oral B,

my sis went for the op some yrs back.. when she came out from the op, her cheeks were really bloated.. hahhaa..my mum and i cried when we saw her... cos we had nv seen her sooo bloated before... i think u really have to be very very prepared mentally... my sis cldnt talk and she cld only cry to express her pain... actually was quite sad for her... even after she was discharged, she cried alot... think it was really very painful for her... and like wat been there said, she had to take milk for a wk... imagine.. more than 3 times a day... but i think the op was worth it.. she look so much better now...

 

[oral b]

Hi Crayonshinchan,

Thanks for the mail.

The clinic assistant feedback that one of the patient did not feel any pain after the op or through out the recovery period. That was really good for he or she.

Really don't know what to expect in term of the pain after the op.

 

[been there]

Hi Oral B,

You'll be asked to buy a small toothbrush so that you can brush your teeth when they are bound together. but can't do thorough cleaning. the doc will give u a antiseptic mouth rinse. you may have to inject the mouth rinse and milk using a syringe.

i did both upper and lower jaws. there's a yahoo group called orthognathic, where people posts comments on their op and their progress. you'll feel encouraged by reading those messages. gives u sort of a moral support. after the op, i was thinking why the hell did i put myself under this op. the cheeks are bloated and eating is a big problem. I did not feel any pain cos you'll still be under the anesthetic effect. but after this initial phase, you'll feel u made the correct decision as u'll look so much better.

just a warning. as the surgeon has to cut through the nerves for your upper and lower jaws, you lose the sensation of your chin and maybe the area above your mouth. I did not have the latter problem. but i still suffer from the after-effects of the first problem. especially the first few weeks after the op. you may not know that some food is stuck on your chin as u can't feel it. i got to constantly wipe it with my hands to ensure i don't cause an embarassment to myself. i carried a mirror and looked at myself after meals to ensure there's no food stuck on my chin. Till today, i reckon I have only recovered 50-70% of the sensation. my doc said some people may not regain it forever. but that's rare.

the other problem is that you got to get used to your new chewing action as the jaws are newly aligned. that proved to be a problem for me but I've gotten used to it.

Hope the info helps. When are u having the op?

 

[oral b]

Hi Been There,

Very comforted by your mail. At least, I have gathered more information.

How do I go to this, yahoo group called orthognathic?

A Thousand Thanks.

 

[been there]

Hi Oral B,

go to http://groups.yahoo.com
Sign in if you are a registered user, or create an account
Search for the group Orthognathic surgery support
you'll find loads of useful information and lesson to learn.

 

[oral b]

Dear Been There,

Hope u r still around. Did u have a white layer forming on your upper n lower lips? Did u try using cotton bud to remove the white layers?

Did you form a layer of dried skin on your lips?

Was both sides of your lips stiff, very much wishing to open but not able to?

How long before your doc actually remove the banding for you?

How did you you survive through the immediate post op period and e first week after discharged?

Did u actually couldn't recognise yrself when u first look at the mirror?

How did you overcome it?

So many q to ask you, hope u can patiently answer all of them.

Million thanks.

 

[seabreeze]

Hi OralB ....

Me did this surgery 2 years back .... although it was a very difficult period .... but I must say that its very worth it .... although my diff wasn't too drastic ... but I must said that it did make me feel more confi ....

You can drop me a mail at [email protected] k .... than we can 'chat' in more details =)

 

[kaitlynn]

Hi Been There & Seabreeze

How long were you on MC after the op? During the first week, were you given painkillers? If yes, how do you take them since your jaws are tied together? I am so scared as I am allergic to quite a few painkillers. (
Seabreeze, how long did you have to wear your braces after the op? I am scheduled to go for the op in May. My wedding is end of the yr...time is sooo tight!! (

 

[oral b]

Hi Kait,

Not much painkillers will be given as u will be under antiseptic.

U will be discharged 1, 2 days after e op if everything is ok.

Your jaw will be tied together for at least 3 weeks.........

 

[seabreeze]

hi kaitlynn,

me was on mc for 3 weeks to 1 month ...

wasn't on painkiller but was on anti-biotics ... so what I did was that I had to mix the anti-biotics with the milk (your food) and drink it down ... that was the most horrible part of all ... other than that ... me just stay at home and surf net ... read book ... just that can't tok ... so me usually just SMS and write down my tots ...

 

[kaitlynn]

Hi Oral B & Seabreeze

My surgeon had mentioned staying for 5 days in the hospital. All this time I had thought my jaws will be tied together for only ONE week! Am I mistaken for both instances?
Hmmm will the antiseptic get rid of the pain? I am beginning to panic now.....less than 4 wks to go before surgery...OMG!

 

[seabreeze]

Hi Kaitkynn,

How major is your op?? only lower jaw or??

Mine was only the lower jaw and considered as a minor op ... stayed in hospital fo 3 days ... removed band abt 2 or weeks later ....

Dun worry lar ... you dun feel much pain just discomfort cos you can't eat and talk ... so now eat everything that you ever wanted to eat ....

 

[passing by]

hi.. there are different kinds of orthognathic surgery.. It could be a BSSO or just reduction of the lower jaw or it may involve the upper jaw as well. I think you should be mentally prepared that this is not a very minor operation and expect a fair amount of swelling and discomfort post op.. I think the first week is the worst.. being unable to eat and open the mouth... the swelling will go down after 5 days and tubes removed... It is an uncomfortable op but the results will be well worth it.. your appearance will be drastically altered for the better... Think of the way you will look after the op and I think you will feel better..

 

[oral b]

Hi Kait,

Don't worry too much abt the pain factor, is more a case of discomfort in not able to open your mouth n not able to eat.

5 days is just an estimation, day 1 u check in, day 2 u op, day 3 if ok, u will be discharge.

Yrs is lower jaw only or both upper and lower?

Passing By,

U a Been There or just a onlooker?

 

[kaitlynn]

Hi All

Honestly not sure what exactly will be done. Meeting with the surgeon tomorrow and ask more questions. One thing for sure, I know I will be moving the upper jaw forward. I have spent the past 15 mths in braces - making my alignment worse (pull my upper row of teeth back. Orthodontist said this is to prepare my teeth for the surgery in order to obtain optimal results.

 

[passing by]

Oral B.. I am a dentist

 

[kaitlynn]

After speaking to my surgeon, I am doing a Le Font I & BSSO. I believe this will be rather major? Anyway got a few doubts clarified already.
Tks alot for all the advice!

 

[ger]

Hi All,

I would like to know where did u gals did ur ops?

 

[oral b]

Hi Germ,

If your surgeon is from NDC, you can hv it either at SGH or CGH.

 

[ger]

Hi Oral B,

How is the surgeon there? Which 1 would u recommend?

 

[kaitlynn]

Hi Germ

Have you started your treatment of orthodontics yet? I think it would be best if you meet up with one first as orthognathic surgery should work hand in hand with braces. Your orthodontist will also need to communicate with your surgeon to decide on the best treatment.
I saw a private orthodontist and my surgeon is from NDC.

 

[ger]

Hi Kaitlynn,

Its actually for my friend...she juz went for her wisdom tooth extraction and the dentist actaully recommended her to go for a jaw surgery...her extraction from NDC is not very well done..so she is not very confident with surgeon from NDC. She would like to know of other alternatives place or surgeon that she can go to.

 

[passing by]

Jaw surgery should be done by an oral surgeon.

You can check out the Singapore Dental Council website for a list of surgeons and they should be affiliated to a hospital. The other places would be NUH and Mt E.

I recommend Dr Winston Tan in private practice.. Dr Ho Kee Hai at NUH is good too.Their work is quite nice..

Germ:

At NDC, you may be seen by a dental officer(GP), an oral surgeon trainee or an oral surgeon
(specialist) for the extraction. If it is for a jaw surgery, the NDC surgeons are ok, but you must make sure you get an oral surgeon and not one of the oral surgery trainees. Dr Teh LY, Dr Poon CY (Senior consultants)are not bad. Little post op complications and they are gentle.

Just my 2 cents worth

 

[ger]

Hi Passing by..

Dr Winston Tan is in Mt E rite? Do we need referral letter from gov clinic to see a specialist in private hospital? My friend condition is not very serious..its juz that her lower jaw are slightly longer than her upper jaw. You can't see from the side that her jaws are like that...so as a prof point of view..do u think she should do it?

Thanks

 

[passing by]

Yep, Dr Winston Tan is at Mt E.

No,you do not need a referral from a government clinic. The referral from the government clinic is to get a subsidy for treatment with a government related institution. For treatment by someone in private practice, there is no government subsidy, so the referral for subsidy is not necessary..

As for whether it is necessary, I can't give an opinion without seeing.. But if it is an issue of aesthetics, then it is a personal decision.. A jaw reduction surgery is not a simple one with the related risks and complications. But I stand by the fact that looks are almost always improved after the surgery. So it is whether you think it is worth the while to go through the surgery to improve the way you look..
Perhaps you can get a consult with an oral surgeon?

 

[kaitlynn]

Hi Germ
I am seeing Dr Poon at NDC. I must say she is extremely meticulous and professional. My time for completion of treatment is very rushed due to wedding at the end of the yr. Dr Poon has been very understanding to try to accomodate my surgery into her busy schedule but only after giving me ample warning about possible undesirable results due to rushed treatment.
I had also been recommended Dr Poon by my private orthodontist.

Hi Passing By
Seeing your comment on less post-op complications by the senior consultants at NDC was so reassuring. I guess I am more prepared for the surgery in less than 3 wks...) Tks!

 

[oral b]

Hi Kait,

When did you first starting seeing Dr Poon, like 6 months or 1 year ago to with e op in the pineline?

 

[kaitlynn]

Hi Oral B
I saw Dr Poon prior to my actual putting on of braces which is more than a yr and half ago. My private orthodontist had communicated with Dr Poon on my case and I was sent to Dr Poon for my extraction of wisdom teeth.
I went back to seeing Dr Poon only about 3 wks ago I think.....although there was still a gap in my upper row of teeth. Orthodontist dun usually send patients to see the surgeon until the teeth is ready but I have no time to wait anymore( Understood that appointments for surgery usually required at least 2 mths advance booking. I was lucky to be able to get a surgery date about one mth away then.
I have seen Dr Poon twice since they gave the go-ahead for surgery.

 

[oral b]

Hi Kait,

Getting mentally prepared for your coming op?

All the best to you.

Cheers

 

[kaitlynn]

Hi Oral B
Its 4 days more to my op!! Nervous definately! Thank you for your concern. Shall post my experience here once I am discharged )

 

[smilezzz]

Hi kaitlynn

No worries, I did the op on my lower jaw 6 years ago. With God's grace, I didn't feel pain at all and my recovery was very smooth. I just took porridge and everything else thru a straw! I was even able to pop in chocolates

The only side-effect that I experienced was the numbness, til now I only recovered 50-70%. But I am glad that I went for the op, it definitely increased my self-confidence and I can smile bravely now. All the best for your op!

 

[oral b]

Hi SmileZzz,

How long was it before you had 50-70% of the recovery?

Until now still on milk and porridge diet, very very unbearable.

How on earth did you manage to pop in those hard, chucky chocolates? You are really incredible!

Kait,

Await for your discharge.

Cheers!

 

[smilezzz]

Hi Oral B

It took me almost 6 mths before I got back 50-70 of the sensations of my chin... and til now it stayed that way. I took M&M, they are quite small and I just stretch the rubber bands a little

Other than chocolates, I pop in much more, especially tidbits, cos lots of cravings so just cut everything into very small pieces and stuff myself.

Actually, for me I didn't feel much pain after the op but I remember it was when they put in the retainers and 'wires' before the op that almost killed me! I hate the anaesthesia injections into the gums... it is so painful! Which is why when I had to remove the retainers, I told Prof Ho (Ho Kee Hai, NUS) to just cut the wires and pull... dons't bother with the inject me with anaesthesia and just cut and pull. It's actually less painful. At least to me...

BTW, Prof Ho is very very good and experience!

 

[oral b]

Hi SmileZzz,

Wow! 6 mths to gain back 50%-70% of your sensations? My doctor said the most obvious recovery will be the first 3 mths. Meanwhile, require to do the re-education exericse for at least 12 months. A lot of times, I touch my chin and it just feel so odd, like it doesn't belong to mine. Very weird feeling.

Yours was 6 years ago so there might be changes in the procedure cos there was no retainers or 'wires' before e op, just the braces there is all along fixed on. Were you put to sleep for the op?

I must say u r a very brave gal (I suppose u r a gal) to take choco n tidbits. Very adventurous!
Me really just stick to pure liquid n soft diet cos has this thing fixed on my upper jaw so couldn't chew or bit or even use the straw. Sob sob.........

 

[smilezzz]

Hi Oral B

As I do not require braces, so the doc fixed the temp retainers for me. It's been 6 years and I sort of got use to the numbness. Yes, I was put to sleep and I am a gal...

Poor gal, guess you must have a lot of cravings now...take care!!

 

[oral b]

Hi SmileZzz,

U r absolutely right! It's both physical and mind torturing.

A lot of times just don't hv e drive to persist on.

Wonder how is Kait?

 

[seabreeze]

HI OralB ...

Hows you now? Everything okie? Can get back to your 'normal' life yet?

 

[oral b]

Hi SeaBreeze,

Really very nice to hear from you again.

Doc said mouth still not open wide enough.
Has since switched from pure liquid to soft diet but still is driving me almost crazy as it has been more than 5 weeks liao.

There r comments that I am anorexia as my flesh seems to hv totally disappear from my body so can imagine my torment.

The min I can chew n bite, I am going feast all day long and gain back whatever I hv lost and more.

 

[seabreeze]

Hur ... why so long ar yours?? Maybe it was really major ... I went back to work aft 5 weeks ....

 

[kaitlynn]

Hi All

I survived! Thank you for all your concern.

It was not a breeze for me. I had to stay in ICU and then the high dependency ward. My face swell to twice how others will swell (Small mouth doc thinks). It has been 9 days since. I am still as chipmunk faced as I can be! It was more than 5 days after the op before I could drag myself to doing sumthing. Head felt like bursting literally all the time!

Oral B, I totally agree on the eating part. I am going crazy with all the liquids. My teeth are tied shut and I doubt i can even squeeze a teeny bit of mushroom in.

Dr Poon said I could remove the rubber bands on the front by next wed. Yippie! It will be very mushy porridge from then on....hmm I wonder how long I will be like that. I have lost 4 kg in the past week...lucky i have excess fats to burn man....

How long did it take for the swelling to go down for you ladies?

Hear from you all soon!

 

[oral b]

Hi Kait,

Welcome back!

How many days were you hospitalised?
I totally understand what you are going through right now. I know is a very very difficult and tough period to get through, any thoughts, grievances, just drop a line at this forum.
Next wed, meaning how many weeks are your teeth being tied together? Mine was 3 long weeks.

It took about 2 to 3 weeks for upper lip to swell down.

 

[juz_curious]

hi gals,

is this op. for ppl wearing braces??

 

[kaitlynn]

Hi Oral B

I was in hospital a total of 4 days. Today is my 12th day after op.

I will be removing the front rubber bands on Wed which is the day after. I would be able to open my mouth slightly then i believe? So I am tied up total of 2 wks?

I dunno about the upper lip but my whole face is still quite swollen. Chipmunk face! Frens thought I had mumps just yesterday coz I sneaked out. So booooring at home!!!

Anyway how are you recovering? All your swelling gone already?

Hi Jaz_curious
This op is for anyone who needs it. However, most times, the op alone will not cure watever problem you might have and it has to work with braces. I think the best person to advise would be your orthodontist.

Cheers!

 

[oral b]

Hi Kait,

Apparently most of you hv the rubber bands removed after 2 wks compared to mine which was 3 wks. Lucky you!

Not to worry about the swollen face. Once the rubber bands are removed, e doctor will ask you to practise opening your mouth real wide and this in a way help to reduce your swolleness.

I am finally back to normal diet for about a week but till now still not really able to chew normally.

Been there, Seabreeze & SmileZzz,

Is this the case for your gals?

 

[kaitlynn]

Hi Oral B

Glad to hear you are recovering. The first taste of "real food" must have been heavenly! What do you mean you cannot chew properly? Is that due to your bite?Or you are still not used to it?

Have your looks changed dramatically? I was told some people really look different. I cannot see much difference yet coz of the swelling? Wonder how you did?

 

[oral b]

Hi Kait,

I am not too sure, maybe is that I am not used to the new position or that my jaw has not been in use for too long.

Really need to hear from the 3 gals or anyone that can confirm on this.

I look the same after after the swolleness was gone.

 

[kaitlynn]

Hi Oral B

May I know what procedure did you do?

Personally, i moved my upper jaw forward and down. My lower was moved back. Although i do not think my looks will change dramtically, my profile is definately altered. Now I can smile!!