1st consult with surgeon

I had my first consultation with the oral surgeon on November 23, but didn't have the chance to post about it until now. His name's Dr. Gotaas and he's the same surgeon that removed my wisdom teeth a few years ago. Everything went well during that procedure so I'm hoping all goes well this time too!

The consult was really informative, and Dr. Gotaas spent about an hour explaining the procedure to me, including the risks involved, and answering all my questions (I had a lot!). He even referred to a model of a skull with movable jaw sections to show how the bone will be cut and moved around, as well as the kinds of plates and screws that'll hold everything together. It was really interesting, but I also got this horrible weak-in-the-knees feeling when I thought too deeply about the situation. Soon it'll be my jaw that he's cutting into and moving around with those hands! Sometimes ignorance really is bliss.

Dr. Gotaas then spent several minutes measuring every angle and distance between the features of my face, from the length and width of my nose, to the amount of tooth I show when my lips are relaxed. Now that my face has been so thoroughly documented I feel like there's no turning back!

I'll be having upper and lower jaw surgery. Bone will be removed from my upper jaw, and the jaw will be moved upward as well as forward a little bit. This'll move my upper molars out of the way and allow my lower jaw to close properly as well as fix my gummy smile. My lower jaw will then be moved forward to match the position of my upper jaw so that all my teeth fit nicely together. No more open bite! I've also been advised to have a sliding genioplasty done at the same time, which'll involve separating the leading segment of my chin and sliding it forward to enhance my profile. I've seen some amazing results of other jaw surgery patients that had their chins done, but I'm also apprehensive. I don't want to wake up looking like the daughter of Jay Leno! I'm probably just being silly. I haven't seen anyone end up with a chin that looks too big for their face. I guess this is where the element of trust comes in. My surgeon has had much more experience with cases like mine than I have! Nevertheless, I'll be sharing my concerns with him the next time we meet and maybe he can explain more about the procedure. The entire surgery will be done through the inside of my mouth, and I'll have an incision from molar to molar on both the upper and lower jaw where my gums connect to the inside of my lips. I'll also have a splint in when I wake up to ensure my jaws remain in their proper positions, and elastics connecting my top and bottom teeth to stabilize everything.

Dr. Gotaas also referred to a couple of recent x-rays that were taken before I got my braces on. He pointed out that my upper teeth slope upwards towards the front of my mouth, as well as upwards towards my molars. My orthodontist, Dr. Major, will be attempting to straighten them out before surgery, but if he's unable to do so for whatever reason then Dr. Gotaas will do it surgically. If that's the case, then he'll not only separate my upper jaw from my skull and move it into position (yikes!), but he'll also cut it into three pieces and move the pieces separately to create a proper bite. That's a lovely thought, isn't it? Let's hope my teeth cooperate and do what they're told!




The left side of this image corresponds to the right side of my face, so imagine
that I'm looking out from the screen in order to get the orientation correct.

I've heard that one of the most common risks of jaw surgery is permanent facial numbness, often in part of the chin or lower lip. When I asked Dr. Gotaas about this, he said that about 50% of patients regain all their feeling. This is more than I expected! I pray that I'm in that 50%. The numbness is a result of damage to the main nerve that runs through both sides of the lower jaw. During lower jaw surgery, the bone is cut on both sides and moved into position while attempting to keep the nerve that runs through the bone intact and undamaged. He made the analogy of the nerve in the jaw as being like a noodle within a stick, and the goal is to separate and move the stick without disturbing the noodle. Apparently, this is possible about 50% of the time. I'm glad this isn't my responsibility!

I also asked Dr. Gotaas about how my nose will change after surgery. I've heard that having upper jaw surgery can significantly change the shape of the nose. He said that it's likely that the base of my nose will be wider, and the tip will be more upturned. Also, the amount of nostril that's visible from the front may change. I've noticed that my nose is currently pulled downwards when I talk, probably because my lips are straining to meet, and that before my jaw problems developed I had more of an upturned nose. I also have a rather narrow nose, so the proposed changes don't bother me a great deal. However, they are changes, and I'll have to get used to them along with the rest of my new face.

I've been put on the surgery waiting list for May 2012, so now it's just a waiting game. I catch myself thinking about surgery all the time and I'm trying not to let it dominate my thoughts, but it's harder than it seems! The first thing I notice about a person now is their profile and the shape of their chin! I can't do anything to make the surgery come or go any faster, so my only option is to trust that God is orchestrating everything according to His plan for my life. I pray that He gives me patience, as well as the strength needed to endure what's to come.