Day 10-15: Photos of Weeks 1 & 2

Hello! Recovery is getting a lot easier now! Zero pain, some discomfort… but mostly I am just waiting for my swelling to go down and my bones to heal so I can finally chew (and get this damn splint out of my mouth).

Aches

The muscle situated near my left temple aches quite frequently now. Very annoying. Feels like someone is pounding on the side of my head with a sledgehammer. My surgeon said it is because my muscles are trying to move in the old way but my elastic bands are resisting this movement. She also mentioned that it is nothing to worry about but it is such a PAIN IN THE ASS.

Swelling & Bruising

I am still puffy around my cheeks and upper lip. Especially the latter, because that is the area where they slit me open. But the swelling has gone down to the point where a stranger would just think I have a chubby face. Discolouration of my neck and chin is mostly gone! Yay!

2nd Post-Op Appointment

On Day 14, I went to meet my surgeon for the second appointment after surgery. She removed the stitches from the surgical sites, which was uncomfortable and stung quite a bit (quite a bit of blood in my mouth after that). I was really dreading it because I thought it would hurt a lot but it wasn’t that bad I guess, and I feel a lot less stiff now that the stitches have been removed.

My surgeon reduced the number of elastic bands from two on each side to one on each side, and also taught me how to change them. I’m advised to change the bands every other day and to brush the insides of my teeth. With the elastic bands on I can open one finger width. I haven’t replaced the bands yet so I have yet to measure how much I can open my mouth without bands.

Next appointment will be exactly a month after surgery AND I WILL BE REMOVING MY SPLINT!!!!

MUGSHOTS

I AM BARING MY SWOLLEN FACE FOR THE INTERNET. These are portraits taken almost everyday in the first 2 weeks. I’ll add Day 1 when I get it from my mother’s phone. Unfortunately, I forgot to take a picture on one of the days so… opps.

Before

Before

Day 2

Day 2

Photo on 2014-01-12 at 14.14

Day 3

Photo on 2014-01-13 at 18.23

Day 4

Photo on 2014-01-14 at 11.53

Day 5

Photo on 2014-01-15 at 15.51 #3

Day 6

Photo on 2014-01-16 at 19.04

Day 7

Photo on 2014-01-17 at 20.48

Day 8

Photo on 2014-01-18 at 18.06 #2

Day 9

Photo on 2014-01-19 at 18.34 #7

Day 10

pufferfish

Day 11

Photo on 2014-01-21 at 16.48

Day 12

Photo on 2014-01-22 at 21.45 #5

Day 13 – Hairbun = Replacement for Hair Curler

Photo on 2014-01-23 at 19.10 #3

Day 14

Photo on 2014-01-25 at 00.45 #2

Day 15

Collage

I don’t think the pictures accurately show how chubby I really am in real life. There is more volume around my cheeks and upper lip in reality. In a 3/4 profile shot, my swollen cheeks have overtaken my cheekbones as the most prominent facial outline.

Overall

I am getting my energy back, and am less frequently plagued with less negative thoughts now. Finished all my medication, and I have no need for extra painkillers. I can open my mouth wider, which increases my food options. Not a fan of the texture of blended food, so I have been opting for very small pieces of normal food that I swallow without chewing. I also tried blending fried chicken as I said I would and the texture is disgusting so… don’t do it. The hardest part is definitely over and all that’s left is waiting for my bones to heal and swelling to go down.

Was this surgery worth it? Too early to say, really. My two main reasons for going through with this surgery are to improve my chewing and pronunciation. The splint is still in my mouth so I can’t pronounce properly, and I haven’t tried chewing either. Also, I am not completely satisfied with my appearance right now because I really don’t like the whole ‘chubby cheeks’ business going on with my face. I LOVE my side profile though. But this is not my final face so there’s little I can conclude about appearance at this point.

I’ll answer this question again in the near future, when I am able to judge how much my pronunciation and chewing have improved due to an aligned bite. As of fifteen days post-op, I am not regretting the surgery, and I am optimistic about things. For now, it’s a good position to be in!

FINAL Appointment with my Surgeon

Yesterday’s 2-hour appointment with my surgeon was veryyyyy eventful. She spent an hour informing my mother and me about the exact procedures involved and explaining the recovery process, and another hour measuring my face.

Basically, I am diagnosed with a ‘dentofacial deformity’ (how blunt), specifically a Class III Malocclusion. My surgery will involve Lefort I + bilateral sagittal split osteotomy (BSSO) + KIV genioplasty. That is surgeon-speak for double jaw surgery with a possibility of chin advancement if the surgeon decides during the surgery that it is necessary. The surgery is planned to be five hours, although with all the pre- and post-op preparations, I will be in the operating ward for a total of around eight hours.

Risks & Complications

She was very thorough in going through every single risk and assessing the possibility of things going wrong. These include:

  1. My body rejecting the blood that is given to me
  2. Severe blood loss
  3. Tiny foreign instruments getting left behind in the open wound (when the tip of the instruments break off, or if a surgical hook falls out)
  4. Damaging some facial nerve that will result in a lopsided smile
  5. Something going wrong on the day after the surgery such that I need to go for a second surgery
  6. Developing an infection
  7. Permanent residual numbness
  8. Relapse

In short, many many many things could go wrong.

The first 5 are highly unlikely, but the last 3 are definitely valid concerns. Apparently 10% of patients are left with permanent numbness (not total numbness, but more like a degraded sense of feeling in some spots on their chin/lips), and the risk generally rises with age. I’m less worried about that, and more anxious about the possibility of relapse, which can be as high as 50%, especially when the jaw movement is large. My movement is quite significant, so there is a higher probability of relapse. Thankfully, my surgeon stresses that the degree of relapse in most cases is negligible, and in all likelihood I will not go back to an underbite.

Fingers crossed that Murphy’s Law won’t apply to me and it will all be smooth sailing!

Recovery Timeline

  • I will spend an hour or two under intensive monitoring. The first night will be in the high dependency unit.
  • I will probably be able to check out after the first or second night if nothing goes wrong and I am comfortable with my progress. Swelling will peak on the second day.
  • Week 1: Liquid diet. This includes Ensure, juice, melted ice cream, yoghurt, strained soup, etc. Elastic bands everywhere!
  • Week 2-6: Soft food, no chew diet. If I’m not wrong, by this point there will only be one elastic band on either side of my mouth.
  • Week 4: Splint is removed
  • Week 6 onwards: Slow transition back to normality

Post-Surgical Changes

Besides being able to tear food properly and comfortably close my lips, and having improved pronunciation, my surgeon also talked about the aesthetic changes that the surgery will bring. She emphasised that this isn’t a cosmetic surgery, although it does have a cosmetic effect.

My front teeth will become much more prominent, and my profile will become convex instead of concave. There will be ‘more support’ at the mid-section of my face, where my cheeks are, so my cheek bones will become more prominent and I will probably become ‘chubbier’. My nose will be ‘lifted’, so it will become more upturned, and the base will be slightly larger. She warned me in a very serious tone that I will look girlier. I don’t know why she sounded so grave about it, really. I’m female after all, I wouldn’t mind looking girlier!

After that, she spent an hour measuring every aspect of my face. It was pretty funnily awkward to keep still and stare straight into the eyes of my surgeon as she appraised every single aspect of my facial appearance. She was very verbal about her evaluations, and some of her comments were quite amusing:

“Your eyes are very symmetrical. That’s really good, the eyes are the window to the soul.”

“Hm. Your lower midline seems to be a little off. Just a little. Actually if I tilt my head a little I wouldn’t notice it at all.”

“Your lower jaw is really long! That’s great, then you won’t get a double chin when we push the lower jaw back.”

“I think you are going to look like that woman.” *Points at model on the dental implant poster* “But don’t quote me on it.” (Sorry doc.)

She was pretty optimistic about my post-op aesthetic changes, and told me that I might need to get a new passport done. Before that appointment, I was honestly not expecting my facial changes to be very drastic, because a couple of people I know from school went for the operation and they don’t really look dramatically different. I still don’t want to expect much, because I reckon it’ll be pretty disappointing if I’m expecting significant change but I hardly get any, and aesthetics isn’t my main reason for the surgery anyway.

My surgeon sent me away with the line: “See you on the 9th of January.” Yes, the next time I see her will be on my op day! Which is just a little more than a month away. Everything is in her hands now. The only things left for me to do between now and then are an autologous blood donation on Boxing Day and just a bit more waiting.

Gosh it’s crazy how close it is.

Surgical Hooks Are In!

Had my SECOND LAST pre-op orthodontic appointment today. The last one will be in a month, and my ortho will take my final dental impressions. She put in 10 surgical hooks today, which cost SGD$80 in total! So it’s like 8 bucks a piece for that tiny metal, yeeesh.

Photo on 2013-10-31 at 21.03 #3

It seems a bit early to have these in, I think. Usually people have them installed a few weeks before the actual op, but mine are in a bit more than two months before. They are not too bad, except now food gets lodged there pretty easily so I might have to resort to carrying my interdental brush around.

Ah, these things make the operation seem so real now. I’m not thinking about it too much though, because I have a more important and imminent worry – bloody ‘A’ levels. Good god this examination will potentially decide my course of life. If only I was American and only had to take the SATs… At least I can retake that if I don’t do well the first time. If I screw my A levels up… oh I don’t even want to think about it.

Okay, I’m off to hit the books. I’ll be back on 5th December with an update on my very long and probably very eventful pre-op appointment with my surgeon!

Metal Braces & Three Months Pre-Op Pictures

Had another dental appointment today. I hate having orthodontic work done, it is SO brutal. Changing the wires can sometimes hurt. Nothing unbearable, but sometimes when it is really tight, I have to take soft food for two days or so after the day of appointment. I thought adjustments would be less painful the longer I had braces on, but they really don’t get much better.

I don’t see much progress anymore with regard to teeth movement, so I guess it’s just the waiting game now. Next appointment is in a little more than 10 days. I’m not too sure what’s on my ortho’s agenda, but she said I’d have to wait an hour or so for the mould to solidify, so sounds like it’ll be more than just an adjustment. 🙂

About Having Metal Braces

Recently, I’ve been reading quite a few orthoblogs and I realised that many don’t have the traditional metal brackets. Some have lingual braces, invisalign or ceramic brackets.

It was quite surprising. My ortho told me, in my first visit, that the only option for patients who are intending to undergo orthognathic surgery is metal braces. I guess it depends on the clinic and the orthodontist. I don’t mind it too much, actually. Not the most aesthetically pleasing, but my bite is a mess anyway so it is not too much harm done.

Also, metal braces are considerably cheaper than the other options. My parents are paying for the treatment since I’m still schooling (thanks mum and dad!), so I don’t really want to incur any additional expenses.

Pictures: 13 Months in Braces/3.5 Months Before The Op

I AM SO SAD. My stupid hard-disk crashed so I lost ALLLLL my progress photos. 😦 In fact, it crashed TWICE. In a month.

I’m probably going to back up my pre-op pictures on this blog. Will probably make a ‘Pictures’ page that can be accessed in the side bar.

I doubt my bite will change much in the months prior to the op since the pre-op orthodontic work seems to be more or less done, so they should be good for comparison later on.

Photo on 2013-09-20 at 22.25 #5

Photo on 2013-09-22 at 18.41

Front - upper row of teeth are not too visible

Front – upper row of teeth are not too visible

Profile - Left

Profile – Left

Profile - Right

Profile – Right

My profile takes after the shape of my jaw a lot, so I have a very steep mandible angle and a very long lower jaw. There’s also the typical sunken mid-face of a class III. I really hate any candid pictures that capture my profile.

Okay, off to catch up on Masterchef Season 4! Go Luca!!! (Yeah, I know the results are out and the season is over, but I like to pretend that I’m watching it in real-time)

Quick question for anyone who has already gone through the surgery: I was thinking of applying for a two-week internship that will be exactly 4 weeks after my surgery. Is that feasible or does that sound like a horrid idea?