Projected outcome.

I had my pre-op with my surgeon.  I didn't get as many details as I had hoped for because he has not yet done the surgery on my models.  He does that a bit closer to the surgery date.  But he did take photos and a new lateral ceph x-ray.  He uploaded the pictures and x-ray into his computer and used a program to make the tracings.  From that, he could "perform" surgery on the computer, and also give a picture of what things might look like in the end.

I have three pictures.  The first tracing (white lines) is where I am now.  You can see my open bite and how my teeth don't really touch.  I have a fair amount of lip incompetence as well (I am biting down all the way with lips relaxed).

This second picture (dark lines) is what I would look like with only jaw surgery.  He plans to posteriorly impact the maxilla about 5.5 mm and widen the palate.  This will close the open bite and remove the crossbite.  He will also bring the maxilla forward about 2 mm.  Finally, he will even out the cant and level the maxilla.  The posterior impaction will allow the mandible to auto-rotate forward.  He will also need to correct the asymmetry in the mandible.  He will likely do an IVRO, which requires wiring, because of the type of asymmetry I have.  But, he may do a BSSO instead, depending if forward movement is needed.

 



This third picture is what I would look like with the jaw surgery and genioplasty.  He said the genioplasty is not cosmetic, but necessary to increase the size of my airway which is constricted.  He first proposed 5 mm for the genio, but admitted that the chin looked big (I thought it looked huge).  So, the projected amount is 4 mm.  But, it's interesting, I don't have a choice on the genio.  He said that if he doesn't move the chin at least 3 mm, he may as well not do the surgery, because there is no point to leaving my airway constricted.  He asked rather bluntly if I cared more how I looked than I cared about breathing...  Point taken.

The chin still looks big to me, but I realize this is just a projection.  It may not turn out that way.  Besides, what I see as a "negative" change because it doesn't look like the "me" I'm used to, most people would think it was a positive change.  Most everyone looks better after this surgery; it just takes some getting used to.

The rest of the appointment was going through the consent form and then some details of what to expect in terms of swelling, bruising, numbness, etc.  He had one funny line, too.  He said a lot of people worry about nausea and vomiting.  He said, "You'll be on a liquid diet.  What's going in is liquid.  It's not like you're gonna throw up a pizza."  Ha ha (smirk).

Just 19 more days!!  eek!

Bite update (and one year blog anniversary!).

I started this blog one year ago.  Surgery seemed so far away then, and now it is just around the corner!  

Here are some pics showing the changes in my bite.  I am biting down as far as I can in all of these pictures (including the last one!).  Right now, I have only one point of contact.  As I've gone through the splint therapy, it's become clear that my problem is not so much overjet (though I do have some), but mostly an open bite and crossbite due to the asymmetry.

Bite, pre-treatment

Midlines, summer 2011

Midlines and open bite, today

Bite, summer 2011

Bite, this month.

Bite, about one year ago

Bite, this month

Can't wait to say goodbye to this!

Profile and my forward head.

When I saw my ortho last, he said he was very surprised at how fast my bite was moving since I got the splint.  He had to do a major overhaul of the splint and told me that I could go ahead and schedule my surgery so that I could have a date in place, but it will take longer than is typical for my joints to settle into their proper position with the splint.  This is because of the amount of the asymmetry and how my body has compensated for the asymmetry.

Over time I developed what's called a forward head posture.  It was probably to compensate for my bad bite and jaw alignment.  My body tried to put my jaw in a place where it would be more comfortable and functional.  Unfortunately, it has caused all sorts of neck and shoulder tension, plus poor posture.  I need to work on correcting my forward head position in order for my joints to sit in their sockets properly.

Here are some pictures to show what I mean.  (I took them myself, so they're not the best...)

Here are my right and left profiles (they're different because of the asymmetry).  In these pictures, I am holding my head in the correct position.  This is what my profile really looks like.

             

Here is what my profile usually looks like, because I always hold my head in this forward position.

Deprogrammer Update.

Well, my "bite" has shifted quite a bit since I've gotten the deprogrammer.  It doesn't allow me to posture my chin at all, but puts my jaw in its natural postion, so it's very easy to see the asymmetry and deformity. Thank goodness I can get this fixed!  I've taken some pictures of how my profile changes as well, but I'll post those later.  Here are pictures with the deprogrammer in:

* I apologize for how I look--I had a bad headache when I took these... *

Here is my bite with the splint--I can only bite with my anterior teeth, something I have never experienced!

Here is my real bite, right after I took the splint out:

Here is my smile without the splint.  Seems I can't smile without sticking my tongue through the gap...

One Year.

Today marks my one year anniversary of getting lower braces (well, now it's one year + 10 days since I had trouble uploading the pictures on the actual day).  It's hard to believe it's already been a year.  It's gone by fast and slow at the same time.  While I'm eager to have the surgery sooner rather than later, I have to say that this year wasn't as bad as I thought it would be even though it seems I need to wait longer than most to be surgery ready.

Here are some flash back pics and the current state of affairs:

Before anything began... until now...

Bite update.

Nothing too exciting.  Here's what things look like now.  I have my next ortho appointment next week.  I should be getting new wires!

Asymmetry.

Here are some pictures of the asymmetry of my mandible.  I also have a cant in the maxilla, but it's the difference in length on the two sides of the mandible that give me the most trouble.  It's somewhat noticeable from the front, but most people can't tell (or at least, no one says anything).  You can't see it so much in my profile either, unless you put the right and left profile side by side.  Where you can see it is from an angle that, fortunately, no one ever sees unless I take a picture of it...

You can tell that my chin veers to the left (my head is actually perfectly straight in both of these pictures), but it is nothing so terrible looking at it face on.

But here you can see how much shorter the left side is (again, my head is straight in these pictures).  My left TMJ did not develop properly, and this is what is causing all the problems.

Strain.

My jaw is asymmetrical, and you can really see the strain it puts on my facial muscles.  I think it's gotten worse since I've had braces and my bite has shifted, because I haven't noticed it this much before.  These pictures are in a "relaxed" position, but you can see that when I let my jaw fall where it wills, there is a definite pull and tension in my face.  Even when I posture my chin forward, you can still see it because my jaw is noticeably shorter on the left side.

Narcissism, why not?

I was fooling around with Photo Booth last night.  I realized it's pretty self-absorbed to sit there taking pictures of yourself...whatever.  I've been hesitant to post any full on shots of how I look presently.  But, with Photo Booth effects, I feel somewhat disguised, and I actually felt pretty last night!  So here goes!

I know it's hard to see in these pics, but my chin tilts off to the left, and actually the whole left side of my face is a bit higher.  It looks a bit like I'm raising my eyebrow, but really it's just higher up on my face!  I do sort of wonder if that asymmetry will look worse once the bottom half of my face is fixed.

Bite update.

I am mid-way between adjustments.  I've had top braces since the beginning of December 2010 (about 7 months now) and bottom braces since mid-May (about 2 months).  Here is how my bite is looking now.  It's not too much different from the last time.  In each of these pictures I am biting down as far as I can.  I still have only one point of contact--a back, right molar.  The top picture shows the cross-bite; the middle, the overjet; and the bottom, the difference in midlines.

Oh, ugh.

So I had thought my profile wasn't all that bad, that my chin was okay.  Then I saw this...  Oh, boy.  Glad this will be fixed!

This is my chin and partial profile from the right.  This is supposed to be the "good" side.  This is completely relaxed, at rest, no posturing.

My shifting bite.

My 2nd molars seem to be way ahead of everyone else in the moving game.  So, my bite is shifting to even a more wonky position as my jaw tries to adjust to my pseudo-bite.

Note how far off the midlines are off now.

Cross bite is also getting worse.  Overjet is more too.

Bite is becoming even more open.

Profile shots.

To be honest, I have never really noticed or have been bothered by my profile before. I only started examining it after I learned it was affected by my jaw, and since I am obsessed over my jaw, I am looking at my profile... I still don't think it is all that horrible. I do have a chin. I think my profile looks funny from the side mostly when I smile big or laugh, but that is mostly because of how my teeth stick out funny, not because of my profile. Anyway, here are some shots.  My left side is the more wonky side because that's where the joint damage is.  It also looks a little swollen to me, and I do have more pain in my face on that side.  I do have to "posture" my chin to make my lips close normally, so that is the third photo.

       
Right profile, lips relaxed.          Right profile, lips closed.

Right profile, "postured."

                      

Left profile, lips relaxed.   Left profile, trying to close lips.   Left profile, "postured."