I know I say this a lot in my posts, but hot damn does time fly. Two years post op from revision. April will be 4 years post op from my first surgery. So...where are we at for the two year mark?
Function: This has gone so much better than I thought it would. I think it's gone better than my providers have anticipated too. I just followed up with my orthodontist about 6 weeks ago and he just looked happy as a pig in slop and can't believe how perfect my bite is still. So much so that he even talked about releasing me from check ups (so long as I promise to check in with him if I have the slightest hunch something is going off the rails). Dr. Karas is feeling good about everything too, making similar comments on how solid the bite is still. ZERO relapse, which is crazy good news! Pretty much zero skeletal or dental relapse from what I understand. My front teeth are still hanging on for dear life. Tooth 7 is still the most noticeably loose and heeby jeeby feeling, but by the grace of the tooth powers that be, it's still hanging in there and not any loser than it was after it firmed up again after ortho, which is super great news. I am chewing on both sides of my mouth for the first time in half of my life. It feels odd still, but I'm slowly getting used to it. I'm still on the #SnoreNoMore team. My snoring/apnea is gone thanks to my rotation and jaw advancement.
Are there a few lingering issues on the function side? For sure. Obvious first one is the ticking clock left on these front teeth. So far so good, but who really knows how long I have left on them. My jaw still tires. Not as quick as it did the first few months from surgery, but for sure noticeable. If I eat gummy bears I definitely can only take so much before my jaw fatigues. My opening is slightly more limited than it was originally. And again, if open too long or clenched too long, I get fatigued/sore. I have a super weird rattle up in the upper sinus area between my actual sinus cavity and top of my pallet. Doesn't happen all the time, but when it does it's REALLY odd feeling. I had never had it until after my plates/screws were removed. It was bad immediately after that surgery and took a few months to wane to what it is now. I am wondering if that is more nerve damage causing a weird or phantom feeling than something really physically rattling up in my sinus cavity. My upper scar tissue is not perfect. My right side was slightly improved after scar revision, but we ended up missing a section on my left that bothered me AND kind of making the parts of the incision that we did get a little lumpier and worse off. One other thing I noticed recently is I do have a slight lisp still. This necessarily isn't related to any of the whacky stuff that happened to me and just could be purely the new position of my teeth/jaws I am not used to. I might benefit from speech therapy, but I don't think the lisp is bad enough to really address in that sense. My numbness is the same as it was by the 6-8 months post op mark: my right half of my lower lip/chin is pretty numb (yet oddly oversensitive too. if I brush against my chin or lip it sends mild shocks/tingles through my lower face), and same with the gums on that side. It's hit or miss patchy paresthesia. And then very recently I have noticed my right TMJ feeling funny. Both TMJ's out of nowhere are feeling tight, and I am getting the feeling like that right disc wants to slip again. I even had it lock a bit recently for the first time ever. Freaks me out, but I am hoping it's all just normal part of life now and I need to listen to my body and give my jaw a break when this happens. I'll talk with Dr. Karas about it when I see him for the 2 year check up in May.
I don't expect any of these things to be perfect. A lot of this is par for the course and the price to pay to have jaw surgeries like I had. And some of this can be attributed to the damage from my first surgery and the need for the second. Actually, most of what I have issues with are exactly because of that. And it is what it is there. Not the end of the world for sure.
Aesthetic: I feel like now 2 years out that I have settled enough and had enough time to come to a final conclusion about how I feel on all of this. I would say around 1-1.5 years post op I finally stopped waking up to feel surprised or feel like my face was foreign when I looked in the mirror. It finally became my new normal. I am definitely more confident in my smile now. I think cosmetically my favorite change is having the gummy smile gone. I still find myself posturing my lower jaw forward at times or not smiling all the way at times (to hide all the excess gum I used to have), but for the most part I have stopped. Again, this has finally become my new normal.
That being said, now I can say what I am not a fan of, and it's actually things that bothered me right off the bat. My nose is still REALLY wide for me. If I were to go back and do a correction with a cosmetic procedure, it would be for my nose. Unfortunately I get a lot of surgery because of my joint issues, so I have a hard time forcing myself in to a surgery that isn't for functional limitations and is purely cosmetic. I also feel like skeletally I am still slightly class II, especially when my mouth is kind of relaxed hanging open or partially open and my lower jaw is not all the way autorotated up/closed. And part of me feels like this has gotten worse in the last year, so maybe that is some kind of muscle relapse or something. Who knows. I am also not a huge fan of my general face shape right now. I feel like the CCW rotation and lower jaw advancement gave me more of a square/masculine look, and overall I feel like this has all aged me a little. Who knows, maybe I am just in a time of my life where I would have noticeably aged anyway. Because of the lopsided twist I was left with after my first surgery, that has caused a slightly noticeable bulge on my left side vs. my right, and it's caused a dimple on my left side vs. no dimple on my right still. This for sure is not high on my list of "what bugs me the most," but it's worth mentioning. I hate to say this, but outside of my gummy smile, I prefer to have all of the old features of my pre-surgery face. I am kind of OK if this was the price to pay to get my teeth in better shape though. I'm chewing better, things are keeping cleaner MUCH easier, no cavities or other whacky issues like I used to be plagued with, my sleep apnea is gone, and my bite is class I. I am thankful for all of that, and if dismay over my post p nose is what I have to live with for it, then so be it.
One last note that is related to this surgery, but kind of not at the same time-- my hair never really recovered from all of this. I lost a lot of hair after both surgeries. I cut to a pixie cut after revision to let it all reset and grow back out, but I am still REALLY thin up front around my crown/face area. I have noticeable bald spots when I put my hair up. Bummer, but not much I can do. I take a TON of supplements and do all the right things..... but I feel like this is what it is here.
So.... what are the plans from here? I see Dr. Karas in May for a check up. I am not 100% sure what he'll do with me after that. Normally he would have released patients by now, but I am glad he's keeping tabs on me with all the issues and relapse risk to watch out for. He might go in and do some steroid shots on the left side of my scar tissue that is still kind of "meh," but I am inclined to leave it all be at this point. My orthodontist will check in on me around the same time. I think if all looks well at this appointment he is going to officially release me and I just need to call for an appointment if I need something or think something is off and want him to take a look. I still see my prosthodontist 3 times a year for cleanings. He likes to check on everything, keep tabs on my shrinking roots, make sure everything is tidy and well. When it comes time to finally address those front teeth, he and my surgeon will get together and plan again. Lets hope that doesn't happen for a long time!
Finish with a recent picture to show where we're at....ps: GO EAGLES!
Function: This has gone so much better than I thought it would. I think it's gone better than my providers have anticipated too. I just followed up with my orthodontist about 6 weeks ago and he just looked happy as a pig in slop and can't believe how perfect my bite is still. So much so that he even talked about releasing me from check ups (so long as I promise to check in with him if I have the slightest hunch something is going off the rails). Dr. Karas is feeling good about everything too, making similar comments on how solid the bite is still. ZERO relapse, which is crazy good news! Pretty much zero skeletal or dental relapse from what I understand. My front teeth are still hanging on for dear life. Tooth 7 is still the most noticeably loose and heeby jeeby feeling, but by the grace of the tooth powers that be, it's still hanging in there and not any loser than it was after it firmed up again after ortho, which is super great news. I am chewing on both sides of my mouth for the first time in half of my life. It feels odd still, but I'm slowly getting used to it. I'm still on the #SnoreNoMore team. My snoring/apnea is gone thanks to my rotation and jaw advancement.
Are there a few lingering issues on the function side? For sure. Obvious first one is the ticking clock left on these front teeth. So far so good, but who really knows how long I have left on them. My jaw still tires. Not as quick as it did the first few months from surgery, but for sure noticeable. If I eat gummy bears I definitely can only take so much before my jaw fatigues. My opening is slightly more limited than it was originally. And again, if open too long or clenched too long, I get fatigued/sore. I have a super weird rattle up in the upper sinus area between my actual sinus cavity and top of my pallet. Doesn't happen all the time, but when it does it's REALLY odd feeling. I had never had it until after my plates/screws were removed. It was bad immediately after that surgery and took a few months to wane to what it is now. I am wondering if that is more nerve damage causing a weird or phantom feeling than something really physically rattling up in my sinus cavity. My upper scar tissue is not perfect. My right side was slightly improved after scar revision, but we ended up missing a section on my left that bothered me AND kind of making the parts of the incision that we did get a little lumpier and worse off. One other thing I noticed recently is I do have a slight lisp still. This necessarily isn't related to any of the whacky stuff that happened to me and just could be purely the new position of my teeth/jaws I am not used to. I might benefit from speech therapy, but I don't think the lisp is bad enough to really address in that sense. My numbness is the same as it was by the 6-8 months post op mark: my right half of my lower lip/chin is pretty numb (yet oddly oversensitive too. if I brush against my chin or lip it sends mild shocks/tingles through my lower face), and same with the gums on that side. It's hit or miss patchy paresthesia. And then very recently I have noticed my right TMJ feeling funny. Both TMJ's out of nowhere are feeling tight, and I am getting the feeling like that right disc wants to slip again. I even had it lock a bit recently for the first time ever. Freaks me out, but I am hoping it's all just normal part of life now and I need to listen to my body and give my jaw a break when this happens. I'll talk with Dr. Karas about it when I see him for the 2 year check up in May.
I don't expect any of these things to be perfect. A lot of this is par for the course and the price to pay to have jaw surgeries like I had. And some of this can be attributed to the damage from my first surgery and the need for the second. Actually, most of what I have issues with are exactly because of that. And it is what it is there. Not the end of the world for sure.
Aesthetic: I feel like now 2 years out that I have settled enough and had enough time to come to a final conclusion about how I feel on all of this. I would say around 1-1.5 years post op I finally stopped waking up to feel surprised or feel like my face was foreign when I looked in the mirror. It finally became my new normal. I am definitely more confident in my smile now. I think cosmetically my favorite change is having the gummy smile gone. I still find myself posturing my lower jaw forward at times or not smiling all the way at times (to hide all the excess gum I used to have), but for the most part I have stopped. Again, this has finally become my new normal.
That being said, now I can say what I am not a fan of, and it's actually things that bothered me right off the bat. My nose is still REALLY wide for me. If I were to go back and do a correction with a cosmetic procedure, it would be for my nose. Unfortunately I get a lot of surgery because of my joint issues, so I have a hard time forcing myself in to a surgery that isn't for functional limitations and is purely cosmetic. I also feel like skeletally I am still slightly class II, especially when my mouth is kind of relaxed hanging open or partially open and my lower jaw is not all the way autorotated up/closed. And part of me feels like this has gotten worse in the last year, so maybe that is some kind of muscle relapse or something. Who knows. I am also not a huge fan of my general face shape right now. I feel like the CCW rotation and lower jaw advancement gave me more of a square/masculine look, and overall I feel like this has all aged me a little. Who knows, maybe I am just in a time of my life where I would have noticeably aged anyway. Because of the lopsided twist I was left with after my first surgery, that has caused a slightly noticeable bulge on my left side vs. my right, and it's caused a dimple on my left side vs. no dimple on my right still. This for sure is not high on my list of "what bugs me the most," but it's worth mentioning. I hate to say this, but outside of my gummy smile, I prefer to have all of the old features of my pre-surgery face. I am kind of OK if this was the price to pay to get my teeth in better shape though. I'm chewing better, things are keeping cleaner MUCH easier, no cavities or other whacky issues like I used to be plagued with, my sleep apnea is gone, and my bite is class I. I am thankful for all of that, and if dismay over my post p nose is what I have to live with for it, then so be it.
One last note that is related to this surgery, but kind of not at the same time-- my hair never really recovered from all of this. I lost a lot of hair after both surgeries. I cut to a pixie cut after revision to let it all reset and grow back out, but I am still REALLY thin up front around my crown/face area. I have noticeable bald spots when I put my hair up. Bummer, but not much I can do. I take a TON of supplements and do all the right things..... but I feel like this is what it is here.
So.... what are the plans from here? I see Dr. Karas in May for a check up. I am not 100% sure what he'll do with me after that. Normally he would have released patients by now, but I am glad he's keeping tabs on me with all the issues and relapse risk to watch out for. He might go in and do some steroid shots on the left side of my scar tissue that is still kind of "meh," but I am inclined to leave it all be at this point. My orthodontist will check in on me around the same time. I think if all looks well at this appointment he is going to officially release me and I just need to call for an appointment if I need something or think something is off and want him to take a look. I still see my prosthodontist 3 times a year for cleanings. He likes to check on everything, keep tabs on my shrinking roots, make sure everything is tidy and well. When it comes time to finally address those front teeth, he and my surgeon will get together and plan again. Lets hope that doesn't happen for a long time!
Finish with a recent picture to show where we're at....ps: GO EAGLES!
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