It's always a good feeling when you walk out of your surgeons office feeling his absolutely beaming vibe. That is the only way I can describe it-- he's beaming. Same vibe I get from my ortho. Like a sense of relief and genuine happiness, and hopefully some pride in the job they've done. I am sure seeing a good result after all of the hard work and planning is super fulfilling for them, so I hope they are feeling energized off of this good result! And they should!! Seriously-- I know I've said it a few times, but I was (am) a TOUGH case, and these guys should be damn proud of their work! Anywho, the guy was smiling ear to ear when he walked in the door and saw me. He again is happy with the way I look visually and reminded me that I am actually still quite puffy and shouldn't be in a hurry to see that go away any time soon, especially since this was a revision. He said especially on my left side I am still more swollen (you can def tell in the picture/video updates with this post that my left side is bigger, but it's not awful). I reminded him that I am in no rush, and based on what happened last time, I am in for the full year of waiting for things to slowly get better and settle and I definitely won't be banging down his door in a month asking, "are we there yet?!" So, same as the last few appointments, he took a look at everything and said I am healing nicely. I am at the point where I can start being a little more aggressive with my chewing. He was quick to remind me what I already knew from last time, it won't be easy for the first 4-6 months. Remember that whole robot jaw thing I was talking about in the post where I got the splint off? Well, yeah, something like that. It takes a whole year for the joints to remodel and muscles to build up and function fully in their new home, so it takes a while to get that chew force back. Timing sounds about right, because I think it was around 3-4 months post op last time when I was able to fully chew something like a chicken breast. Regardless, I remember it's a slow process to feel normal chewing again, so I am in no rush the next few months while things continue to settle.
My bite is looking great. He said my right side is already closed up nicely thanks to the work of my ortho. He wants me to get out of the bands a little more and start doing some stretching exercises he gave me. He's happy with my opening (a bit more than 2 fingers, which is pretty good at this point when 3 is about normal opening), but said I can definitely start getting to work on it a bit more to get back to 3 fingers soon. The last week I've noticed that my joints are giving a little crunching noise here and there again. I had this happen last surgery too for the first 3 months, so I wasn't worried about it. But the other night it felt like my right joint totally slipped for a hot second. I don't want to say it fully dislocated, because it wasn't loud and it wasn't super painful....more just awkward and took me by surprise. Dr. Karas was a little intrigued, but not super worried since it wasn't painful/locked/popped. He said that side was under some decent stress from the torque of my jaw being swung out the other way for the last 2 years, and it also saw the biggest change from surgery to bring the joint back to where it should be, so it's going to take time to settle and the inflammation to come down in the joint and the tissue around the disc. So, this is all probably just normal aches/pains of healing again. So, cleared to slowly integrate more than soft chew, and cleared to get back to some normal light exercising (sans my impact activities where I could take a hit and mess up the joints remodeling over the year, so no road bike for at least a few more months, and still plan to be out of skydiving and stuff through the spring/summer....and seriously considering the rest of the year to really be sure my joints fully remodel in the right place without being smacked and ruining all of the hell I've been through to fix this!). I am in good enough shape to go on my own the next 6 weeks before another appointment. He wants another xray to check up on everything then. Otherwise I am released to my ortho for him to do what he wishes now.
Speaking of the ortho... I did stop in after seeing my surgeon. Right away he asks what I think of everything. I told him I wasn't going to say anything to see if what I thought was going on what actually what was going on. Sure enough, it was! Ha! He basically just smiled and said, "this is why I left it up to you to know when to stop by between now and your next appointment." So, like I thought, I do have a smidge of overjet popping out, and the bands closing my right side are actually causing my left to open up a tad and my midline has floated off a touch to my left. BUT, we're still way OK. With the future band configurations he's going to do and the work to correct the tooth size discrepancy on my top teeth and bring them back in together, he's got this planned out to where it should all come together. I can tell he knows exactly what he wants to do, and I fully understand his plan and know it what we should be doing, so I am 100% not worried about this. I see the ortho again in two weeks for my first post op wire change and I am sure he'll update my bands. For now he took me out of the triangle and the up/down bands on my right and just put me in straight up class II config on both sides (see pictures and video update-- just one band on each side going from lower molar to upper K9). So, my rubber band jail has been loosened for the time being. Yay!
Otherwise, things are coming along. Still puffy. I pretty much have almost all of my feeling now in my upper face. Upper right lip is desensitized but on it's way back. Lower lip and chin is slowly improving. Almost all of my nerve healing and feeling has come back in exactly the same pattern it did last time. So, I have a feeling the left side of my lower lip and chin is going to make it's way back first and then slowly shrink in to the strip that was left numb from the first surgery. Could that numb strip actually improve? I don't know. I haven't asked my surgeon because it's honestly not at the top of my priority list in terms of things to be concerned with at this point. If the nerve was pinched off from the old hardware or a piece of bone and that source of impaction is now removed, then yeah, I guess I could get full feeling back, but it's definitely not anything I am close to expecting. Whatever I am left with, I am left with and will be the cost of doing business to get my jaws and face straight again.
Here are a few shots from the last week or two. Still learning how to smile again. Things will be stiff for months, but even outside of the stiffness, learning how to smile with your new jaw position is a totally weird feeling. You're so used to smiling a certain way or posturing your jaw a certain way to mask whatever discrepancy you had that it's weird to NOT have to do that. Takes a while to break the posturing habits, which in my case was not smiling all the way to avoid showing more gum in my gummy smile, and then sliding my lower jaw forward to make it look like I didn't have buck teeth. I put the 2013-2016 progression pictures together last night to respond to a thread online where somebody was asking for before/afters. I'll have to update that when I get new progress photos at my surgeon and ortho, but for now I took ones yesterday and put them at the end for my after revision pictures (at least for now, even though I am still plenty swollen at this point). Weird looking at the progression though. I know there is a lot left to settle, but I am not sure I am a huge fan of some of the aesthetic changes from the front. I mean, my face is just different and maybe not different in a bad way, but it will just take some time to get used to. Could also just be swelling still. And then the nose getting wider. I wasn't a fan of that after the first surgery either, but I think overall it's actually been brought in again a little and the width I am seeing now is swelling still around my nose. So again, that will take time to settle for sure, so no rush there. Either way, I am OK with whatever is left. I made it very clear to my surgeon that I was willing to trade a few aesthetic things I didn't like if it meant functionally fixing my bite and making my overall jaw/tooth health better. So, it is what it is, but still interesting to see how it evolves. I do like my side profile better. Definitely look less class II finally! Scary thing is... I kind of look like my little sister now, which is definitely OK at the end of the day because she is the cute one in the family! If you want to see a larger photo, right click on one in the gallery and hit "view image," and that will open it up a little bigger for you. The one like the progression pictures comes up a little small in the weebly gallery viewer and I am too lazy to code something different myself ;)
My bite is looking great. He said my right side is already closed up nicely thanks to the work of my ortho. He wants me to get out of the bands a little more and start doing some stretching exercises he gave me. He's happy with my opening (a bit more than 2 fingers, which is pretty good at this point when 3 is about normal opening), but said I can definitely start getting to work on it a bit more to get back to 3 fingers soon. The last week I've noticed that my joints are giving a little crunching noise here and there again. I had this happen last surgery too for the first 3 months, so I wasn't worried about it. But the other night it felt like my right joint totally slipped for a hot second. I don't want to say it fully dislocated, because it wasn't loud and it wasn't super painful....more just awkward and took me by surprise. Dr. Karas was a little intrigued, but not super worried since it wasn't painful/locked/popped. He said that side was under some decent stress from the torque of my jaw being swung out the other way for the last 2 years, and it also saw the biggest change from surgery to bring the joint back to where it should be, so it's going to take time to settle and the inflammation to come down in the joint and the tissue around the disc. So, this is all probably just normal aches/pains of healing again. So, cleared to slowly integrate more than soft chew, and cleared to get back to some normal light exercising (sans my impact activities where I could take a hit and mess up the joints remodeling over the year, so no road bike for at least a few more months, and still plan to be out of skydiving and stuff through the spring/summer....and seriously considering the rest of the year to really be sure my joints fully remodel in the right place without being smacked and ruining all of the hell I've been through to fix this!). I am in good enough shape to go on my own the next 6 weeks before another appointment. He wants another xray to check up on everything then. Otherwise I am released to my ortho for him to do what he wishes now.
Speaking of the ortho... I did stop in after seeing my surgeon. Right away he asks what I think of everything. I told him I wasn't going to say anything to see if what I thought was going on what actually what was going on. Sure enough, it was! Ha! He basically just smiled and said, "this is why I left it up to you to know when to stop by between now and your next appointment." So, like I thought, I do have a smidge of overjet popping out, and the bands closing my right side are actually causing my left to open up a tad and my midline has floated off a touch to my left. BUT, we're still way OK. With the future band configurations he's going to do and the work to correct the tooth size discrepancy on my top teeth and bring them back in together, he's got this planned out to where it should all come together. I can tell he knows exactly what he wants to do, and I fully understand his plan and know it what we should be doing, so I am 100% not worried about this. I see the ortho again in two weeks for my first post op wire change and I am sure he'll update my bands. For now he took me out of the triangle and the up/down bands on my right and just put me in straight up class II config on both sides (see pictures and video update-- just one band on each side going from lower molar to upper K9). So, my rubber band jail has been loosened for the time being. Yay!
Otherwise, things are coming along. Still puffy. I pretty much have almost all of my feeling now in my upper face. Upper right lip is desensitized but on it's way back. Lower lip and chin is slowly improving. Almost all of my nerve healing and feeling has come back in exactly the same pattern it did last time. So, I have a feeling the left side of my lower lip and chin is going to make it's way back first and then slowly shrink in to the strip that was left numb from the first surgery. Could that numb strip actually improve? I don't know. I haven't asked my surgeon because it's honestly not at the top of my priority list in terms of things to be concerned with at this point. If the nerve was pinched off from the old hardware or a piece of bone and that source of impaction is now removed, then yeah, I guess I could get full feeling back, but it's definitely not anything I am close to expecting. Whatever I am left with, I am left with and will be the cost of doing business to get my jaws and face straight again.
Here are a few shots from the last week or two. Still learning how to smile again. Things will be stiff for months, but even outside of the stiffness, learning how to smile with your new jaw position is a totally weird feeling. You're so used to smiling a certain way or posturing your jaw a certain way to mask whatever discrepancy you had that it's weird to NOT have to do that. Takes a while to break the posturing habits, which in my case was not smiling all the way to avoid showing more gum in my gummy smile, and then sliding my lower jaw forward to make it look like I didn't have buck teeth. I put the 2013-2016 progression pictures together last night to respond to a thread online where somebody was asking for before/afters. I'll have to update that when I get new progress photos at my surgeon and ortho, but for now I took ones yesterday and put them at the end for my after revision pictures (at least for now, even though I am still plenty swollen at this point). Weird looking at the progression though. I know there is a lot left to settle, but I am not sure I am a huge fan of some of the aesthetic changes from the front. I mean, my face is just different and maybe not different in a bad way, but it will just take some time to get used to. Could also just be swelling still. And then the nose getting wider. I wasn't a fan of that after the first surgery either, but I think overall it's actually been brought in again a little and the width I am seeing now is swelling still around my nose. So again, that will take time to settle for sure, so no rush there. Either way, I am OK with whatever is left. I made it very clear to my surgeon that I was willing to trade a few aesthetic things I didn't like if it meant functionally fixing my bite and making my overall jaw/tooth health better. So, it is what it is, but still interesting to see how it evolves. I do like my side profile better. Definitely look less class II finally! Scary thing is... I kind of look like my little sister now, which is definitely OK at the end of the day because she is the cute one in the family! If you want to see a larger photo, right click on one in the gallery and hit "view image," and that will open it up a little bigger for you. The one like the progression pictures comes up a little small in the weebly gallery viewer and I am too lazy to code something different myself ;)
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