Dilemma About Genioplasty

[Guest guest]

Hello Friends: I am scheduled to have a lower jaw advancement on Thurs Aug 21.

Just yesterday my surgereon suggested that I also have a genioplasty to make my

chin proportional to the rest of my face as well as allow me to close my lips

naturally.

I'm not sure whether to do it or not and I have to decide quickly. Has anyone

had the genioplasty? Any serious complications or risks? Is it worth it?

Any thoughts and input would be appreciated!

I'm feeling anxious about my surgery, but all your previous posts have been

extremely enlightening and helpful.

Thanks a lot! Pamela

[Guest guest]

Lots of folks have had the genio, but I am not one of them. Lots of

folks have also decided to let the surgeon decide, once he got the

jaws lined up. Sometimes the doc has gone ahead and done it; other

times the decision has been not to do it.

One complication is that usually the insurance company rules the

genio part to be cosmetic, meaning that you're left paying the extra

fee for it yourself, but if you need it, at least you're getting it

under the anesthesia they're paying for, and without putting yourself

through another operation.

I can tell you that if the genio were the way to fix my face so that

I could close my lips comfortably, I would do it in a flash.

Cammie

> Hello Friends: I am scheduled to have a lower jaw advancement on

Thurs Aug 21. Just yesterday my surgereon suggested that I also have

a genioplasty to make my chin proportional to the rest of my face as

well as allow me to close my lips naturally.

>

> I'm not sure whether to do it or not and I have to decide quickly.

Has anyone had the genioplasty? Any serious complications or risks?

Is it worth it?

>

> Any thoughts and input would be appreciated!

>

> I'm feeling anxious about my surgery, but all your previous posts

have been extremely enlightening and helpful.

>

> Thanks a lot! Pamela

>

>

[Guest guest]

Hi,

I had the genio (as well as upper/lower). My surgeon suggested it,

and I also dithered about whether to have it or not as I wasn't sure

it was medically necessary. In the end, I left everything up to him

as he's the one with all the expertise and experience.

Closing ones lips naturally when it has been an effort to do so for

my whole life is amazing, and I still marvel at it. I believe it will

improve the health of my gums. I know I'm breathing better using the

natural filter that I was born with (my nose) rather than my mouth.

Yes, there is more numbness with the genio, but it's a good trade-

off, and the numbness doesn't last forever.

Good luck with your decision!

[Guest guest]

Hello!

I think a lot of doctors and dentists are uneasy with the money part

of their business (which it is) and don't want to deal with it

directly with patients. THAT's weird, to me, but I have found it to

be true with many. Not with mine, thank goodness.

And many times I have read of docs who do indeed work out a " deal "

for patients who are not covered by insurance. That also seems a bit

strange to me, but I never tried to practice medicine nor dentistry.

I have heard of others having jaw surgery without braces. Usually

what's happened is that they get something called arch bars, which,

best I can figure, are metal wires, or bars, that are wired to the

teeth, and the wiring for support of the jaws, or the rubber bands,

is attached to those. They aren't particularly pleasant, from all

accounts.

Would it make you feel any better to hear that my surgeon told me he

has not wired anybody shut in a decade or more? I was neither wired

nor banded after my lower advancement in June 2002. I did have a

splint wired into my upper brace, though. (Unlike you, there was not

the least doubt that I needed considerable orthodontic work before

the surgery. Sigh.)

If I were presented with what you've been told, I'd ask how the

rubber bands will be held in, what they'll be attached to...

Best,

Cammie

> I'm in Manhattan where everything is more expensive I guess. I

told

> the surgeon today I thought $4K was unreasonable, and he said he

was

> going to check with his " billing department " to see if he could get

> me a better deal... I feel like I'm haggling with a vendor at the

> flea market!

>

> Just as a side question, I was told I don't need orthodontics,

won't

> have a splint, won't have my jaws wired shut, and will only have to

> wear rubber bands for a couple weeks maybe. I understand that

> everyone has a different situation, but since I'm having lower and

> upper (plus probably genio) done, does this sound weird to anyone?

>

..yahoo.com

[Guest guest]

Hello, I just saw your post, sorry to butt in. You're going to have

upper/lower and genio and go back to work in a week? Do you test

mattresses for a living? or does somebody pay you to sleep all day?

(if so, I want your job)

You need at least 3 weeks off for this type of surgery. I always say

take as much time as you can, you won't regret it, and you really

only get once chance at a decent recovery from this.

I also had upper/lower & genio. I am Superwoman, I thought I could go

back to work after two weeks, but thankfully I listened to my cranial

therapist and took more time off (she suggested a month). My surgeon

would have signed me off for 8 weeks " that's how long it takes for

the bones to heal " , the insurance company approved 6, and in the end

I went back after 5 weeks. I am a very high energy person, but my job

is somewhat stressful and I found out the hard way that you really do

need to take time, that you won't have full energy for awhile.

As for pain, zero pain, as promised by my surgeon. It is surprising

to find that after they wean you off demerol (for me, 1st morning

after surgery because I blew my IV) that you can manage quite nicely

with childrens' tylenol and codeine every 3 hours. Pain is not common

as you are usually very numb (I was numb from behind my eyeballs to

the tip of my chin, which was a VERY weird feeling). It's more like

discomfort, think sore muscles, your face will be sore (they do hold

your mouth open WIDE for about 3 or 4 hours, after all).

I had two lower wisdoms out (1 impacted) and had way more swelling

with that, also a bit of pain, but nothing that tylenol 3 couldn't

fix. This surgery has more challenges in terms of being able to eat

and open afterwards, but it shouldn't be painful. If so, they have

heavy duty drugs for it!

Good luck!

> Thanks for the reply! Maybe my case isn't severe enough to warrant

> the splint and being wired shut. I found out yesterday that my

upper

> jaw is 3 mm off, my lower is 5 mm, and my chin is 8mm. I don't

> really know enough about the surgery to know if this is a terrible

> case or not. I'm scheduled for surgery on 11/11 right now, and I'm

> starting to get a little freaked out. Was this the most terrible

> pain you've ever been through? Having my four wisdom teeth taken

out

> didn't hurt at all, but I imagine this is going to be 50 times

> worse. Were you able to go back to work in a week?

[Guest guest]

A. it is not a terrible case at all.

B. Severity of the case, I think, has little to do with what your

surgeon does. I believe he/she will use the techniques that work

best, in his/her experience... Think about it. Isn't that what you

really want????

I would bet that you will not have big time pain. A few folks do, but

most do not. A bigger problem may be numbness, or swelling. There are

things to do for the swelling; and one big one for the numbness --

patience. None of it is easy. But usually, it doesn't hurt that much.

> Thanks for the reply! Maybe my case isn't severe enough to warrant

> the splint and being wired shut. I found out yesterday that my

upper

> jaw is 3 mm off, my lower is 5 mm, and my chin is 8mm. I don't

> really know enough about the surgery to know if this is a terrible

> case or not. I'm scheduled for surgery on 11/11 right now, and I'm

> starting to get a little freaked out. Was this the most terrible

> pain you've ever been through? Having my four wisdom teeth taken

out

> didn't hurt at all, but I imagine this is going to be 50 times

> worse. Were you able to go back to work in a week?

>

>

>

[Guest guest]

My doctor is telling me I should be able to go back after a week, but

I almost feel like the guy is making it sound like it won't be bad so

I'll go through with it. I talked to my boss about it last week and

she told me that I could work from home if I needed to (I'm an

editor, so I basically sit around in a cubicle in front of a PC all

day).

Why is the recovery time so long if the painisn't the problem? Is it

just because the swelling is so awful? I'm really starting to think

that either my surgeon is magic, or he's minimizing the seriousness

of the surgery. As I mentioned before, he told me no orthodontics,

no splint, no having my jaws wired shut, and completely recovered in

a matter of few weeks (back to work in a week). If he's able to pull

all of this off, I'm going to start doing infomercials for this man

because it sounds a lot better than what everyone else is having to

go through!

Thanks for responding, I'm glad to hear your perspective on it!

> > Thanks for the reply! Maybe my case isn't severe enough to

warrant

> > the splint and being wired shut. I found out yesterday that my

> upper

> > jaw is 3 mm off, my lower is 5 mm, and my chin is 8mm. I don't

> > really know enough about the surgery to know if this is a

terrible

> > case or not. I'm scheduled for surgery on 11/11 right now, and

I'm

> > starting to get a little freaked out. Was this the most terrible

> > pain you've ever been through? Having my four wisdom teeth taken

> out

> > didn't hurt at all, but I imagine this is going to be 50 times

> > worse. Were you able to go back to work in a week?

[Guest guest]

Thanks, you guys are making me feel a lot better!

> > Thanks for the reply! Maybe my case isn't severe enough to

warrant

> > the splint and being wired shut. I found out yesterday that my

> upper

> > jaw is 3 mm off, my lower is 5 mm, and my chin is 8mm. I don't

> > really know enough about the surgery to know if this is a

terrible

> > case or not. I'm scheduled for surgery on 11/11 right now, and

I'm

> > starting to get a little freaked out. Was this the most terrible

> > pain you've ever been through? Having my four wisdom teeth taken

> out

> > didn't hurt at all, but I imagine this is going to be 50 times

> > worse. Were you able to go back to work in a week?

> >

> >

> >

[Guest guest]

You're having genio only? That may be different from surgery on the

jaws.

I had movement of the lower jaw only... advancement and sideways.

My trouble post-op was not pain, nor was it swelling. It was just

that I was so bleeping exhausted. As in, try to sit on the couch and

watch teevee, and be asleep within two seconds.

I hope that you will have a different adventure. I was 56 when I had

this done, and I think my advanced age did not help with the

weariness.

Best,

C,

> > > Thanks for the reply! Maybe my case isn't severe enough to

> warrant

> > > the splint and being wired shut. I found out yesterday that my

> > upper

> > > jaw is 3 mm off, my lower is 5 mm, and my chin is 8mm. I don't

> > > really know enough about the surgery to know if this is a

> terrible

> > > case or not. I'm scheduled for surgery on 11/11 right now, and

> I'm

> > > starting to get a little freaked out. Was this the most

terrible

> > > pain you've ever been through? Having my four wisdom teeth

taken

> > out

> > > didn't hurt at all, but I imagine this is going to be 50 times

> > > worse. Were you able to go back to work in a week?

[Guest guest]

My suspicion antennae go up when any person specializing in this

stuff starts belittling another. That doesn't mean to me that anybody

is right or wrong, just that I would want more opinions.

Good wishes to you. Surely there are also orthodontists and oral

surgeons in Germany who can give you their opinions, as well.

Best.

Cammie

> His name is Monesabian. I went to get a second opinion based on

some

> advice from someone at work, and was told by an orthodontist that I

> could have my problem resolved non-invasively within two years.

The

> problem is, my fiance is German, and we're moving to Europe at the

> end of next year. I can't wait around for two years, and the type

of

> treatment this guy recommends isn't traditional orthodontia. The

guy

> who gave me the second opinion told me that surgery should be my

last

> resort and that my surgeon is just trying to get money out of

me...

> The thing is, how do I know whether to trust the second guy,

because

> he's trying to win my business too?

>

> Anyway, my surgeon is really nice, he performs the surgery a lot,

and

> if it goes as well as he says it will, I'll be thrilled.

>

>

[Guest guest]

My ortho told me that he doesn't tell his patients everything that

might happen to them because it might not happen. I found out anyway

through these sites.

I don't know what being an editor entails, but I didn't feel like

spending hours at the computer post-op. I slept a lot for the first

week - my surgery was on Tuesday, I went home on Thursday, by

Saturday the weariness hit big-time. I couldn't read books or watch

movies as my concentration levels just weren't there. I normally fall

asleep watching movies anyway, this was a lot worse - I would fall

asleep within minutes.

You're going to lose blood during the surgery, you won't be able to

take in enough nutrition as you normally do, you probably won't sleep

as well as you usually do. Your body will be trying to deal with the

after-effects of the anaesthesia (it can take a looooong time to

clear your system completely). You'll be waking up every 3 or 4 hours

in order to take meds. You'll be a bit weak and dizzy the first week

from the anaesthesia. I felt as weak as a newborn in some ways, and

was really grateful that others were taking care of me.

One of the unexpected things post-op for me was how tiring talking

was. I couldn't talk for more than half a minute without getting sore

and tired. The whiteboard was my friend, and my husband did a lot of

the talking for me. When I went back to work at 6 weeks post-op, I

tried to do as little talking as possible.

If you had been in a car accident, would your employer or your boss

really want you to be back at work in a week? (not to scare you, but

my cranial therapist said I'd feel like a Mack truck had hit me - I

didn't, but the message helped give me some perspective). Surely your

company can function without you for a few weeks - don't they have a

contingency plan for emergencies?

You may feel fine, as I did (I had very minimal swelling too), but

your body will have gone through a major trauma and needs you to give

it time to heal. Why overload yourself with work and recovery from

major surgery at the same time? My advice is to take off as much work

as you can without jeopardizing your job. If you can go back partial

days, you might be able to go sooner, but honestly, I think you ought

to give yourself at least 3 full weeks off at a minimum. You won't

regret it.

> > > Thanks for the reply! Maybe my case isn't severe enough to

> warrant

> > > the splint and being wired shut. I found out yesterday that my

> > upper

> > > jaw is 3 mm off, my lower is 5 mm, and my chin is 8mm. I don't

> > > really know enough about the surgery to know if this is a

> terrible

> > > case or not. I'm scheduled for surgery on 11/11 right now, and

> I'm

> > > starting to get a little freaked out. Was this the most

terrible

> > > pain you've ever been through? Having my four wisdom teeth

taken

> > out

> > > didn't hurt at all, but I imagine this is going to be 50 times

> > > worse. Were you able to go back to work in a week?

[Guest guest]

I'm having upper, lower, and genio. What I'm beginning to gather is

that I'll have to spend a lot of time beforehand putting together

documentation for my job and training my boss. The most I'll be able

to spend out of work would be two weeks because I just started in

this position in July.

Did you have advancement on your upper jaw? My surgeon told me that

the advancement will make the sides of my face look fuller. Did you

notice this?

> > > > Thanks for the reply! Maybe my case isn't severe enough to

> > warrant

> > > > the splint and being wired shut. I found out yesterday that

my

> > > upper

> > > > jaw is 3 mm off, my lower is 5 mm, and my chin is 8mm. I

don't

> > > > really know enough about the surgery to know if this is a

> > terrible

> > > > case or not. I'm scheduled for surgery on 11/11 right now,

and

> > I'm

> > > > starting to get a little freaked out. Was this the most

> terrible

> > > > pain you've ever been through? Having my four wisdom teeth

> taken

> > > out

> > > > didn't hurt at all, but I imagine this is going to be 50

times

> > > > worse. Were you able to go back to work in a week?

[Guest guest]

I think that yes, you need to educate your boss. Maybe print up some

of the posts from folks who have had rougher times here, and some

pictures from the files on oss2, of people who are immediately post

op.

That said, the recovery will probably not be as bad as you are afraid

it will be, nor as easy as your doctor and boss think it will be. It

will be easier without wiring and splinting, I would imagine. But the

general fatigue after general anesthesia (plus the steroids, which

minimize the swelling, believe it or not) will be likely to tell your

body that it needs some recovery time.

I had work on my lower jaw only. Upper, I think, is a bit harder,

because it involves (or can) the breathing apparatus, can mean more

loss of blood and can leave you with a lot of congestion. Upper,

however, can also bring more dramatic results.

Good wishes to you.

Cammie

> I'm having upper, lower, and genio. What I'm beginning to gather

is

> that I'll have to spend a lot of time beforehand putting together

> documentation for my job and training my boss. The most I'll be

able

> to spend out of work would be two weeks because I just started in

> this position in July.

>

> Did you have advancement on your upper jaw? My surgeon told me

that

> the advancement will make the sides of my face look fuller. Did

you

> notice this?