Friday, December 11, 2009

A perfect revision and the strength of muscle over titanium

The word "revision" is something you don't really want to hear a week after an orthognathic surgery. It means something went "wrong" and the doctor needs to go "back in" an make an adjustment. My doctor looked closely at my face last Tuesday and said, "That's not the way I put you together on the table last week. There is no way I can sugar coat this, we are going to need to do a revision surgery". Not once did I think of using another surgeon. I put my complete faith in this man in a decision process over the last four months. I just thought of when. "How about tomorrow afternoon?", he said.

Holy shit! I just got done with mentally preparing for this and going though it. Now we are going back though it again tomorrow? The hospital, the anesthesia, the painkillers, steroids, and antibiotics all start over again. Most of all, the recovery clock when I could eat regular food again ,would be set back to zero. Instead of 5 weeks and counting to tacos, it would be six weeks plus another day!

I've been looking at that open bite all week and wondering if rubber bands and braces would really correct it over the next 18 months. Then I started wondering what went wrong because I am an engineer. My orthognathic surgeon is one of the best and I hand picked him. My ENT stated he was the best he had seen and heard nothing wrong about him. My orthodontist works closely with all the local orthognathic surgeons in the Austin area, and recommends him over the others. An OD assistant and an OD assistant's wife are having upcoming surgeries with him. You go where the mechanic takes their cars to get worked on, right? I could of gone up north and had some world renown orthognathic surgery stars work on me, but these people are also known for doing marathon surgeries that also replace jaw joints when they may not be needed to be replaced.

So what went wrong? After an orthognathic surgery, they xray you on the table to make sure everything is straight. They open your jaws, close your jaws, look at centerlines. They even have some piece of equipment that sticks a needle in the bridge of your nose and leaves a mark they line up stuff with. I know because I had that needle mark on the bridge of my nose twice. These people aren't just surgeons, they are also craftsmen making sure everything is true. Because I had a severely recessed jaw and severe sleep apnea, my lower jaw moved forward, alot. A whole 10 mm. People were surprised at this measurement on the Yahoo orthognathic group. In addition, my chin was coming out too.

In my first surgery, everything lined up under anesthesia. Sometime in recovery, my jaw muscles must of woke up and began pulling things out of place. By the time the doctor saw me in my hospital room loopy after the surgery, he didn't like what he saw. Luckily, my TMJ joints had not shifted or slipped. It appeared we needed stronger titanium plates to hold my upper palette in place. In addition, they were now thinking of wiring me shut for four to six weeks to keep those pesky jaw muscles quiet. I should of just bought stock in Ensure.

I stopped thinking of what went wrong and didn't lay blame on anyone. I started blaming those inanimate plates in my skull as they weren't strong enough to keep my palette straight. Yes I could of gone down the road of saying, why weren't stronger plates put in first, but that would get me no where.

I woke up surprised as I had very little pain, and wasn't nearly as groggy or confused as last time. I was only under a few hours instead of five, but it was almost like I took a nap. The pain started to hit soon enough, but the recovery nurse took care of that quickly and mercilessly. My jaw felt locked in place and I was worried wired me. I lifted my hand and felt the front of my braces. There was a huge mound of tight rubber bands on my braces. No wires! No having to walk around with emergency wire cutters to save me in the event I was choking! Praise God!

The last words my surgeon said to me before he left for the OR on the second surgery was "Thank you for your confidence in me". I never lost confidence in him, his staff, his anesthesiologist, or the nurses. They all are the best. You'll notice I took my orthognathic surgeons name off my blog. I am still his biggest fan and would send anyone his way. Email me if you need it. I didn't know if he wanted his name openly associated with a revision surgery listed on the internet. He has done so few compared to other surgeons that I looked at, he still has a better record in the long run. I guess statistics finally caught up with me and my freakishly strong jaw muscles. From looking at how straight my teeth line up under that mound of rubber bands, I think it was one of the best revision surgeries ever.


  1. glad you took the unforeseen revision in stride man. now get started growing back those bones!

  2. Hi, I will need a revision myself, but I am a few months out. Who is your OS?

    You can reach me at mikejung2 (at) gmail (dot) com

  3. Thank you very much for this blog. I am facing a revision surgery in 3 days. My story is nearly identical to yours and your blog has given me less anxiety on my pending revision.

  4. Did your doctor says that the revision puts you at increased risk for permanent nerve damage?

  5. Did your doctor says that the revision puts you at increased risk for permanent nerve damage?