Jaw Surgery Forums » Post-Surgery and Recovery Questions

About your treatment plan & surgeons

(10 posts)

  1. May89
    Member

    2 weeks ago, I had upper jaw advancement and lower jaw pulled back to fix my underbite, crossbite and asymmetrical face. I remained in hospital for total of 6 days.

    Now that I'm reading everybody's blogs, forums and checking out videos... and realizing everyones treatment plan is so different.

    I had the waiver (splint) for 5 days then had it removed and got 2 elastic bands. I got the greenlight to start having soft diet 6 days after my surgery. Today, I'm given the option to remove my bands whenever I'm eating and brushing my teeth then to put it on back and sleep with it. I can open my jaw around 1 finger and a half.

    According to my surgeon, after 2.5/3 weeks I might be able to chew on soft food.

    Physically I'm doing well. My swelling is going down each day. I got full sensation of my lips, chin (slightly tingly on the left side). I'm still a bit too puffy, but otherwise not doing too bad. I'm still waiting for my piggy nose and upper lip to shrink but apparently that will take some time. I've lost 11 lbs so far.

    I have no bruises except for a little around my neck and very light on my jaw.
    The only real issue I have here is that I had TMJ before surgery and had arthrocentesis procedure 2 years ago. Today I'm getting clicking/popping sounds and my joints get sore every now and then whenever I swallow or talk.

    So I'm wondering, did any of you had such a-somewhat smooth route to recovery and how come I'm not wired shut or am allowed to remove bands and have soft diet so early on? I consulted 5 other surgeons in his department and they said I shouldn't overthink it and that my surgeon knows what he's doing. So pretty much just going with the flow and seeing what happens.

    Posted 5 months ago #

  2. coffeecups
    Member

    There are two techniques to lower jaw surgery: a BSSO and IRVO. In general they go like this:

    A BSSO uses plates/screws which means your jaw is immediately fixed into it's new position, thus allowing a soft food diet pretty much as soon as you feel up to it. Sometimes elastics are used to guide the new bite, which varies from person to person.

    An IRVO (which is only used to set back lower jaws) uses no screws at all, and relies on wiring the lower jaw to the upper jaw so that the bone can heal without any movement whatsoever. (Sort of like putting a broken leg in a cast.)

    So don't worry about that ^^

    Posted 5 months ago #

  3. May89
    Member

    :O Thanks!! Makes alot of sense!!!

    Posted 5 months ago #

  4. RachelM
    Member

    I wasn't wired shut and only had two loose bands either side from week 2 that I could remove to eat and clean my teeth. I was able to 'eat' soft food so long as I didn't chew for six weeks, I was then allowed to eat whatever I felt I could manage (which was very soft stuff for at least three months)
    It's different for everyone. I had plates and pins so there was no need to wire me shut. Something I feel very lucky to have had done as so many people seem to struggle when wired shut.
    I'm not sure why different surgeons use different techniques but don't worry, you've had the same as lots of people on here and the same as me and six months on, I've had no problems at all and am delighted with my final result!
    All the best with the rest of your recovery. be patient as it does take time for thigns to get back to 'normal'

    Posted 5 months ago #

  5. OmarMarro
    Member

    i didnt know about two different procedures but it would be great if the second one was erased from the map being jaw wired shut is a nightmare jajaja

    Posted 5 months ago #

  6. OmarMarro
    Member

    i was trying to find the difference between these two procedures and finally i found this let me know what you think:

    Whether you get banded or wired shut depends on the procedure used to move your lower jaw. The two most popular techniques are Bilateral Sagital Split Osteotomy (BSSO) and Intraoral Vertical Ramus Osteotomy (IVRO).

    In a BSSO, the surgeon cuts your jaw roughly below where your wisdom teeth sit and slides your lower jaw backward (or forward). In a IVRO, the cut is further back, roughly where your jaw starts curving up, and the lower jaw tilted backwards.

    The BSSO cut goes right through the path of a major nerve that runs along your lower jaw. A IVRO is far enough back in the jaw where it can completely avoid this nerve. This nerve is connected to the chin and the lower lip, so since the IVRO cut doesn't go directly through the nerve, it reduces the risk of numbness.

    However, with an IVRO, the cut is in a position where the surgeon can't see very well. It is also in a structurally awkward position at the end of your jaw bone, so they can't use plates & screws to fix together the two sides of the cut jaw bone. Instead, your entire jaw is wired in a fixed position until the bone heals - which takes several weeks. The BSSO on the other hand cuts in the middle part of the jaw bone, where the surgeon can access more easily and screw a plate across the cut. This keeps the two sides of the cut jaw bone together, meaning you don't have to be wired shut.

    There are also some minor aesthetic differences, mainly that an IVRO creates more of a square jaw angle than a BSSO.

    So in summary, a BSSO has a greater chance of nerve damage than an IVRO, but has a much easier recovery time since you don't have to be wired shut for six weeks. Also most surgeons perform many more BSSOs than IVROs, so they will be much more familiar with the former. Either way, I would talk with your surgeon about what is best for you.

    http://www.archwired.com/phpbb2/viewtopic.php?f=15&t=35199&view=print

    Posted 5 months ago #

  7. May89
    Member

    Oh wow, that's very interesting.

    I think I might have got BSSO but I'll ask my surgeon during my next appointment. As far as nerve damage, no numbness whatsoever now. Only slightly tingling on my chin.

    So in the end of the day it seems like the surgeon chose what's best for me. It helps having loose bands, I can brush my teeth easily now. I get slight achey feeling around my nose area but my surgeon said it's fine and I shouldn't worry about it. Something about bone tissue.

    I still have a feeling my jaw might just drop if I don't put my elastic bands on hahaha...

    Thanks for the info Omar!

    Posted 5 months ago #

  8. gottadothisiguess
    Member

    wow, thanks for that info omar. i think im going to talk to my surgeon about IRVO instead of BSSO now. I really would like a shorter face, and more square gonial angle (looks more masculine imo). Plus less risk of numbness is a huge plus. 6 weeks of wired shut though, its not that bad in my opinion I think I could manage on ground up foods and blended items through a syringe.

    Posted 5 months ago #

  9. coffeecups
    Member

    I would definitely recommend an IRVO if possible, I had 100% numb-free straight after surgery. It's definitely a million times worth the wired-shut period.

    Posted 5 months ago #

  10. OmarMarro
    Member

    yeah it sound better i think i had a IRVO cause im being wired shut 45 days jajaja it sucks im starting to feel my chin again after 4 weeks but that is because i had a genioplasty also so need some patience here jaja i hope it is useful

    Posted 5 months ago #

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