sagittal split mandibular osteotomy
I found a lot of "I had to have this done and couldn't find anything online so I'm gonna make my own" type of blogs about my surgery, so I thought I'd jump on the band wagon and make one of my own.
This has been an incredibly long process that is hopefully coming to an end quickly. I remember the first time going to a new dentist and they freaked out over a bite that I thought was just an "overbite" that didn't need fixing. Turns out I had an open bite and my jaw was off line causing all the pressure to be placed on two teeth. Because the pressure wasn't distributed evenly, there was a high chance of multiple complications in the near future (root canals, etc). They told me about this probably around the time I was 18 I would say, before I got my wisdom teeth out. My dad and I went and met a couple orthodontists and Dr Loetscher in Norcross who wound up being my surgeon. We also chose Dr Jordan in Alpharetta to be my orthodontist. I had the braces put on in January and had an expander placed in March. Mid-March, I had the rapid expansion surgery done (by Dr Loetscher) which gave me a beautiful gap in my front teeth. Months passed, that healed, and I just had the second surgery done in December. This was the sagittal split mandibular osteotomy, and they did a lot of work here. They included bringing my chin forward as a separate part of the surgery to give more definition to my face. They just cut the tip of my chin off and pulled it forward. It's more effective than a chin implant because it pulls the muscles along with it. Also, my upper jaw was angled down so they wound up basically removing my upper jaw and chiseling off a layer to make it sit flat. Then they unhinged my lower jaw making cuts in the sides so they could slide my jaw forward. My mom said it was 3 centimeters they moved it, but I honestly don't know the right amount. But they did slide it forward. All bone cuts were set with titanium pins that look like little dumbbells. I have at least 10 in my face I think, but possibly close to 16. That's another fact I'm not so sure about.
Well the surgery took 2 and a half hours and went really well. He said there were no complications and he didn't have to go back to reset the jaw or anything - it all lined up perfectly the first time. My jaw is not wired shut. It was only wired shut during surgery but they removed the wires before they woke me up again. I went back a week later and everything has been healing properly.
The first two days after surgery were good for swelling. I didn't swell too badly. My cheeks were a bit chubbier but there wasn't a drastic change. They had warned us though that the third day is normally the worst, which proved to be true. By then, I had taken all the steroids prescribed and the other medications had been wearing off, and my face blew up like a balloon. I swelled from under my chin to right under my eyes and my lips especially got really big. The pain was bad too. The first day, it was nearly impossible to swallow. It was difficult at first because my tongue and roof of my mouth were both numb so I couldn't feel when I needed to swallow. My tongue gots its feeling back rather quickly, but it started to sting and ache when I tried to swallow. That pain only lasted about a day. All the other pain was from aching and discomfort, which is normal. The numbness also gives a strange sensation which I really don't find comfortable, so that added on extra frustration. But the swelling only stayed for about 2 days and went down considerably in a single day. I also had to wake up every 3 hours for the first week to take medicine and sleeping was a hassle. Once I stopped waking up every 3 hours, it was hit or miss if I would sleep through the night. Many times I woke up in pain or discomfort, but I found that taking medicine right before bed helped too. I also didn't bruise too badly. They messed up on 2 IVs so I have a pretty nasty bruise on my left hand that's about 2.5/3 inches long, but I didn't bruise much on my face at all. There were some yellowish colored bruises under my chin but they mostly went away with the swelling. But I have heard of other people turning purple and black from bruising so I can't say that you'll get off easy with this surgery.
Tuesday will mark 2 weeks after surgery. My chin is still completely numb and tingles whenever I touch it or talk and the roof of my mouth is numb as well as the area around my nose and upper lip and my gums. I have feeling in the rest of my face though. The pain has almost completely gone away, although I can definitely tell when I've talked too much or worked my mouth a little more than I should have. It gets sore kind of like after a workout. That was another thing - eating the first couple days took so much more energy than I imagined. I slept most of the time. And if you have ever sucked in cold air through your bottom teeth and felt that kind of pain, that's what I feel pretty much all the time now. I also get tingling sensations in my cheeks and lips, but they said that would be the numbing medication wearing off.
The biggest problem is that I'm on a 6 week soft food diet. I can't chew anything harder than macaroni and cheese. I've been trying to find some type of diet list that will give me ideas for meals. The same thing gets really old really fast. So here is a list of what I have been eating. If you have any suggestions, I'd love them and I hope this could possibly help someone else.
*As if a soft food diet wasn't hard enough, I'm also lactose intolerant and don't like seafood. But the surgeon did say that some fish was good to eat because it is softer, as well as scrambled eggs
-macaroni and cheese
-mashed potatoes/sweet potatoes (or baked potato or fries, as long as they are soft)
-pureed carrots (guess you could puree anything)
-creamed corn
-hashbrowns
-ice cream/milkshakes
-smoothies
-fruit (bananas, berries, peaches, mandarin oranges)
-soups (but ask your surgeon. they told me not the first couple of days because of sodium)
-ambrosia (marshmallows, mandarin oranges, coconut)
-ravioli (chef boyardee or the white cheese kind you can boil) or any pasta
-peanut butter and jelly is actually soft without the crust and cut into bite size pieces
-oatmeal
-chili
-spaghettios
-fried bananas
-cherries, but only buy canned cherries or seedless ones
-pudding or yogurts
-vegetable pot pie
-some breads are ok, like sandwich bread
I'll try to post some pictures of the progress. I still have a little way to go with the swelling and I can't chew until February, but I'm still truckin. And last I heard, I'll have braces 4-6 months after surgery, but I have a dentist appointment on tuesday so he'll probably be able to give me a more accurate time frame. So hopefully by this summer I'll be completely through with this whole process.
This has been an incredibly long process that is hopefully coming to an end quickly. I remember the first time going to a new dentist and they freaked out over a bite that I thought was just an "overbite" that didn't need fixing. Turns out I had an open bite and my jaw was off line causing all the pressure to be placed on two teeth. Because the pressure wasn't distributed evenly, there was a high chance of multiple complications in the near future (root canals, etc). They told me about this probably around the time I was 18 I would say, before I got my wisdom teeth out. My dad and I went and met a couple orthodontists and Dr Loetscher in Norcross who wound up being my surgeon. We also chose Dr Jordan in Alpharetta to be my orthodontist. I had the braces put on in January and had an expander placed in March. Mid-March, I had the rapid expansion surgery done (by Dr Loetscher) which gave me a beautiful gap in my front teeth. Months passed, that healed, and I just had the second surgery done in December. This was the sagittal split mandibular osteotomy, and they did a lot of work here. They included bringing my chin forward as a separate part of the surgery to give more definition to my face. They just cut the tip of my chin off and pulled it forward. It's more effective than a chin implant because it pulls the muscles along with it. Also, my upper jaw was angled down so they wound up basically removing my upper jaw and chiseling off a layer to make it sit flat. Then they unhinged my lower jaw making cuts in the sides so they could slide my jaw forward. My mom said it was 3 centimeters they moved it, but I honestly don't know the right amount. But they did slide it forward. All bone cuts were set with titanium pins that look like little dumbbells. I have at least 10 in my face I think, but possibly close to 16. That's another fact I'm not so sure about.
Well the surgery took 2 and a half hours and went really well. He said there were no complications and he didn't have to go back to reset the jaw or anything - it all lined up perfectly the first time. My jaw is not wired shut. It was only wired shut during surgery but they removed the wires before they woke me up again. I went back a week later and everything has been healing properly.
The first two days after surgery were good for swelling. I didn't swell too badly. My cheeks were a bit chubbier but there wasn't a drastic change. They had warned us though that the third day is normally the worst, which proved to be true. By then, I had taken all the steroids prescribed and the other medications had been wearing off, and my face blew up like a balloon. I swelled from under my chin to right under my eyes and my lips especially got really big. The pain was bad too. The first day, it was nearly impossible to swallow. It was difficult at first because my tongue and roof of my mouth were both numb so I couldn't feel when I needed to swallow. My tongue gots its feeling back rather quickly, but it started to sting and ache when I tried to swallow. That pain only lasted about a day. All the other pain was from aching and discomfort, which is normal. The numbness also gives a strange sensation which I really don't find comfortable, so that added on extra frustration. But the swelling only stayed for about 2 days and went down considerably in a single day. I also had to wake up every 3 hours for the first week to take medicine and sleeping was a hassle. Once I stopped waking up every 3 hours, it was hit or miss if I would sleep through the night. Many times I woke up in pain or discomfort, but I found that taking medicine right before bed helped too. I also didn't bruise too badly. They messed up on 2 IVs so I have a pretty nasty bruise on my left hand that's about 2.5/3 inches long, but I didn't bruise much on my face at all. There were some yellowish colored bruises under my chin but they mostly went away with the swelling. But I have heard of other people turning purple and black from bruising so I can't say that you'll get off easy with this surgery.
Tuesday will mark 2 weeks after surgery. My chin is still completely numb and tingles whenever I touch it or talk and the roof of my mouth is numb as well as the area around my nose and upper lip and my gums. I have feeling in the rest of my face though. The pain has almost completely gone away, although I can definitely tell when I've talked too much or worked my mouth a little more than I should have. It gets sore kind of like after a workout. That was another thing - eating the first couple days took so much more energy than I imagined. I slept most of the time. And if you have ever sucked in cold air through your bottom teeth and felt that kind of pain, that's what I feel pretty much all the time now. I also get tingling sensations in my cheeks and lips, but they said that would be the numbing medication wearing off.
The biggest problem is that I'm on a 6 week soft food diet. I can't chew anything harder than macaroni and cheese. I've been trying to find some type of diet list that will give me ideas for meals. The same thing gets really old really fast. So here is a list of what I have been eating. If you have any suggestions, I'd love them and I hope this could possibly help someone else.
*As if a soft food diet wasn't hard enough, I'm also lactose intolerant and don't like seafood. But the surgeon did say that some fish was good to eat because it is softer, as well as scrambled eggs
-macaroni and cheese
-mashed potatoes/sweet potatoes (or baked potato or fries, as long as they are soft)
-pureed carrots (guess you could puree anything)
-creamed corn
-hashbrowns
-ice cream/milkshakes
-smoothies
-fruit (bananas, berries, peaches, mandarin oranges)
-soups (but ask your surgeon. they told me not the first couple of days because of sodium)
-ambrosia (marshmallows, mandarin oranges, coconut)
-ravioli (chef boyardee or the white cheese kind you can boil) or any pasta
-peanut butter and jelly is actually soft without the crust and cut into bite size pieces
-oatmeal
-chili
-spaghettios
-fried bananas
-cherries, but only buy canned cherries or seedless ones
-pudding or yogurts
-vegetable pot pie
-some breads are ok, like sandwich bread
I'll try to post some pictures of the progress. I still have a little way to go with the swelling and I can't chew until February, but I'm still truckin. And last I heard, I'll have braces 4-6 months after surgery, but I have a dentist appointment on tuesday so he'll probably be able to give me a more accurate time frame. So hopefully by this summer I'll be completely through with this whole process.