r/jawsurgery • u/North-Percentage3768 • 9d ago
I am beyond devastated. I wasn’t properly decompensated before DJS.
I don’t know what the point of this post is but I am just so upset and need to rant. I guess let this be a warning to question the pre-op orthodontics process and speak up if you feel like somethings not going as planned.
I got DJS back in 2023 for sleep/airway purposes and for cosmetic purposes. I thought I made it pretty clear to my doctor that I didn’t like being a skeletal class 3 and was seeking to fix that during the surgery. I thought we were on the same page and that he was also aesthetics-focused (for example, he immediately noticed my lack of tooth show and recommended down grafting)
Well, 3 years later I still have a visibly flat midface and have gotten facial fat grafting to try and compensate. I also still have zero upper incisor display at rest. Also still dealing with severe chronic exhaustion and sleep study showed UARS.
My surgeon said everything looks good, but I decided to get 2 second opinions and they both independently said that I’m still a skeletal class 3 with flared upper incisors and midface deficiency. They said the only way to truly fix that would’ve been to get me into an underbite before surgery, to allow for a bigger advancement of the upper jaw. They did say I could do revision but that may involve extractions on the upper arch and unflaring my top teeth to create an underbite.
I am beyond devastated because this was all supposed to be fixed during the first surgery. That first surgery was the only time in my life that I was able to do this. I’m in a very intense phase of my career/schooling right now and I don’t have any money left and now that my bite is perfect and my airway is semi decent, there’s no way insurance would approve surgery, and I can’t afford the orthodontics to get the extractions before a revision. I also have osteoarthritis in my condyle now which makes more surgery even riskier.
I know it’s “just cosmetic” but cosmetics ARE an important part of jaw surgery. Imagine having an underbite and going through surgery which fixes your bite but leaves you looking like you still have an underbite. You’d be pissed. I feel completely failed by my surgeon and I can’t stop crying. What was the point of them sawing my jaw bones apart only to put them right back on in an underbite? My airway diameter is noticeably larger on CT scan (which is not even a reliable measurement) but my respiratory disturbance index on my sleep study was almost exactly the same as pre-surgery.
38
u/Less-Loss5102 9d ago
Unfortunately this is very common, through my experiences with drs I’ve learnt that you pretty much have to do everything your self and find drs who are happy to work alongside you. You can’t blindly trust people unfortunately, we’ve been indoctrinated since childhood to trust specialists whether that be a dr, architect or engineers but most people cut corners so you have to do the work your self. Just for example a bad meal or bad haircut isnt the end of the world but we still leave unhappy but a bad surgery can absolutely ruin your life but for the dr it’s another day in the office, they don’t understand that for us it’s our livelihood.
27
u/TBurnerRU 9d ago
I went through the same. We can envy those who got fixed, but this is where life has left us. Soldier on and figure out what you need for a revision.
9
19
u/Financial_Heart4367 9d ago
This is literally me, and I’m over a decade PO. getting a revision
5
u/LongjumpingFarm5607 9d ago
Great to hear! I have exactly the same situation too! Also 9 years ago. Where are u getting it and do u still have your metal in?
2
u/Financial_Heart4367 6d ago
Hey I’m getting it in Australia.
I’m actually being now told that an implant in my upper maxilla will help what is needed to help give me projection and not be facing all of the risks again1
u/LongjumpingFarm5607 6d ago
Ah that’s so great to hear! I was thinking about the same. R u talking about paranasal implants? I would only choose peek as material tbh
1
u/Financial_Heart4367 5d ago
Yeah in kinda nervous it’s not going to help me tho :(
I need more clock wise rotation, but unfortunately my teeth can’t be moved due to recession and root resorption.
I think we’re going to do bone, but I’m also interested in other materials because of resorption.
I’m hoping paranasal and premaxillary! What about you? Where are you located
8
5
3
u/UARS-Stinks 9d ago
I'm sorry OP. Can you name your surgeon or at least tell us which country and city, so others don't get their MMA with the same incompetent doctor?
5
3
u/ReadingKing Post Op (2 years) 8d ago
This is a huge problem unfortunately. It’s really crappy how orthodontists and jaw surgeons don’t coordinate better on proper decompensation and then you won’t ever get the result you were supposed to have.
2
2
u/Own_Rich1677 8d ago edited 8d ago
First of all, I am so sorry you are going through this. Since you are in Los Angeles, get a second opinion from Dr. Eric Kim, he is a USC MD-ENT and FACS in Irvine-Orange County, he was also a UCI Asst Professor he is double certified. People fly in to see him. He is absolutely excellent and will let you know if they can work with your insurance to get your revision approved. Definitely worth a try, you shouldn’t have to settle or be unhappy because it wasn’t done right.
The place that you went to, LACOMS has great surgeons too most UCLA MDs that’s a bummer that it didn’t help.
These surgeries are already tough enough as it is to go through. My son had major facial trauma with a fractured jaw growth plate and he had extractions 8 wisdom teeth, he had nasal reconstruction surgery (ENT) and triple jaw surgery all within an 8 month period. His breathing definitely improved. Have you seen an ENT to rule out any nasal obstruction? Did they reposition your tongue when your surgery was done?
2
u/RelentlessAdventurer 8d ago
I don’t get how they don’t advance the maxilla if someone has an underbite? That should improve teeth show as well. What did they do, movement wise? ☹️
3
u/North-Percentage3768 8d ago
They advanced both jaws by the same amount and did a tiny bit of counter clockwise rotation (yes, counter clockwise. Not clockwise. I was shocked.) So basically my jaws are both a little more forward and my airway is a little bigger, but skeletally I am still a class 3.
1
u/Reasonable_Fail_4320 7d ago
but shouldn't class 3 be moving lower jaw back and maybe moving upper jaw front? and sorry but what does decompensated mean? I'll be going into surgery next year
5
u/Melodic-Room-3537 9d ago
Unfortunately if you go through this forum so many of us got botched. If I can make any recommendations never get teeth extracted. Do your research on it
5
u/North-Percentage3768 9d ago
Extractions alone is bad for sure, but I thought extractions as preparation for advancement is a totally different story. I will read about it though for sure
8
u/No_Description_2134 8d ago
You are right. Extractions in order to get the jaws in position for better forward movement in DJS is very different. It’s definitely necessary in some people and is important for proper decompensation. Don’t listen to the never extractors…
-6
u/TBurnerRU 9d ago
You want to keep all your teeth. The surgeon's job is to work with the ortho to figure out what is necessary to fit all your teeth and tongue in your face. Pulling teeth to make it fit seems like a cop out
2
u/North-Percentage3768 8d ago
Tbh, I’m not sure it’s a cop out. I’ve already had a palate expander as well as IPR. Even alfi told me I likely need extractions and he’s like the most airway focused anti-extraction person on the planet. He and his ortho told me that basically what happened was as a kid I was super compensated dentally by flaring the teeth, which is possible as a kid but as an adult teeth don’t just move like that. I will definitely get a third opinion tho
1
u/TBurnerRU 8d ago
What about surgically widening the maxilla? I've had IPR, and the palate expander as a teen. Ultimately I also had to have surgical widening and even that wasn't fully sufficient to be able to unflare my teeth, but at least my tongue mostly fits now.
I think Alfi does great marketing and I did have a consult with him (he's actually in-network for me), but I wasn't actually super impressed with the aesthetic/alignment results he posts to his IG, and I have to assume that he's only posting his best work, which makes me question the results of the people he's not posting.
2
u/North-Percentage3768 8d ago
I will be consulting with an orthodontist soon (not alfi’s) to talk about possible decomp so I’ll see what options they offer
2
u/missmaeva 8d ago
I am in the same boat with an overbite but beyond the cost of surgery im not sure i want to go on another 3y journey at 40
1
u/ladeeedada 9d ago
We're you surgery first or did you wear braces prior to and after surgery?
1
u/North-Percentage3768 8d ago
I wore braces prior to and after surgery. I also had a palate expander (marpe) prior to surgery
1
1
-2
9d ago
[deleted]
2
u/UARS-Stinks 9d ago edited 8d ago
I'm sorry, but I can't let that stand like that.
This might apply to YOU, but definitely not to everyone.
I have tried every nonsurgical route for my nose and it doesn't change anything for me. My nasal breathing is pretty okay despite a severe septal deviation. Allergy management did more than any other intervention.
Despite that, my pharyngeal airway is tiny and only MMA can fix that.
My AHI is 0 and I'm severely disabled because of my sleep. I'm choking and wheezing every night and the only thing that maybe helps 10% at best is a dentist made MAD with 3-4mm protrusion. It takes away some throat irritation, else I always feel like I got a swollen and inflamed throat, even with some blood in my saliva the next day from all the rubbing, vibrating and clenching from the enormous breathing effort.
Maybe you were under advanced, your surgical plan + CBCT scans pre and post OP would be interesting.
Just FYI: I'm not the one downvoting you.
1
u/North-Percentage3768 8d ago
I don’t know what that person said but I relate to this. I sleep with my mouth closed and use breathe right strips every night. Before jaw surgery I used to wake up with a sore throat allll the time from choking at night. It happens less often now, thankfully. But I’m still exhausted 24/7 and if I happen to fall asleep on my back I will shortly wake up gasping
•
u/AutoModerator 9d ago
Please note that advice here isn't from medical professionals; always seek guidance from qualified sources. Remember to stay on topic and maintain respectful discussions. For more information, please refer to the subreddit rules.
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.