So what was actually done?
Bilateral Sagittal Split Osteotomy or BSSO
This is the lower jaw surgery. My lower jaw was broken on both sides and it was tilted up towards the back to correct the occlusal plane (angle at which the teeth meet, I talk about it here).
Le Fort I Osteotomy with downgrafting
This is the upper jaw surgery. The upper jaw, or maxilla, is broken/separated from the skull, and three things were done.
1. It was moved down using a bone graft taken from my chin.
2. It was moved forward to bring my bite forward and correct the size of my midface
3. It was tilted down at the front and up at the back molars to again correct the occlusal plane
Sliding Genioplasty Reduction or Osseous Genioplasty Reduction
This is the "cosmetic" side of things whereas the other two were mostly functional. Of course, such is natural selection that when you have a functioning body part it tends to be considered more aesthetic than a non-functioning body part, so I won't say the other two procedures didn't have a cosmetic effect, because they certainly did! The point of the genioplasty is to balance the face aesthetically.
Check out my post here to see my surgical planning with all measurements.
Does your new face feel foreign?
No, not at all. I love it. Feeling like your face isn't yours isn't an uncommon experience, from what I've read. But in my case, it finally feels like I've got the face I was always meant to have.
I'll try explain. I never had an attachment to my old face, and deep down, I always new I would have to do something about it one day. How could I ever get married, when I would be self-conscious every step down the aisle, and loathe the wedding photos? I couldn't. I only took photos on certain angles, and spent a lot of time Photoshopping what my face "should" look like or else avoiding the profile view altogether. Whenever I saw a candid photo of me from a bad angle, I would get a jolt in my stomach. "Is that really what I look like?" It never felt like me.
So now, as exciting as it is to have my new face, it just feels right. I wasn't looking to be beautiful, or perfect. My nose is a little off-centre at the bridge and I wish my eyes weren't quite so prominent and my forehead wasn't so big, but I know that is 100% me and I am totally okay with that.
How much did it cost?
Orthodontics: $3, 200
Surgery: $5, 100
Hospital: $9, 700 (one night in intensive care, theatre costs, and four nights general recovery). I will say I have great hospital cover and only had to pay $500 out-of-pocket on hospital.
X-Ray while in intensive care: $90
Anesthetist (I paid full amount minus Medicare/Private Health): $3, 160
Blood tests that weren't covered by Medicare (I had blood clotting tests done which are only covered if you have a family history of blood disorders): $300
Cost of medication on discharge: $120
Total before Medicare and Private Health Rebate: $21, 670.00
With private health cover and Medicare (for Americans, Australian Medicare is not the same as yours), I did not pay anywhere near that amount. However, I also have to consider the cost of time off work (so far two weeks), the cost of taxis to get to appointments (I estimate at around $200), and the cost of extra essentials which you can see listed at my "Must-Haves for Surgery" page.
Did it hurt?
Not as much as I expected! Everyone's experience is different, and thanks to my excellent surgeon Dr Julian Hirst and my fabulous anaesthetist Dr Danielle Moses, pain was minimal considering the extent of the surgery. Pain for the first five days was limited to an achy feeling in the bones, and high pressure from the swelling and inflammation. The pressure was the worst, and ice helped the most. I needed ice all the time for the first five days or the pain from the pressure was enough to make me cry. However, your nerves have taken a serious hit and you're already on the mend by the time you regain sensation.
The stitches can be painful if pulled from too much talking or laughing, and my jaw ached a lot after too much movement, including eating.
Around day 7, I had very irritating pins and needles for around 48 hours as my nerves started coming back to life. Days 8-10 there was pressure around the cheekbones and eye sockets that brought on headaches.
At around week four post-op, the main pain was at the end of the day from smiling and talking during work. This wasn't too bad - it was similar to when your cheeks hurt from laughing a lot. Yawning can also hurt quite a bit and there is still nerve tingles at week five.
Week six pretty much all pain is gone. There is some tooth sensitivity, and I still couldn't open my mouth quite as wide. Most of my sensation was back apart from one vertical section of my chin and lip.
How long were you on a liquid diet?
Six weeks. All pureed, no chewing allowed at all. You can view tried and tested recipes here.
How long did you have braces before and after surgery?
I had braces on for about 9 months before surgery, and I am expecting to have them on for about 6 months post-op. I will update this when I know for sure. Don't forget, I had braces for 18 months previously when I was 13, and a lot of the general straightening was done then.
How long did the surgery take?
Four hours. I was told between 4-5 hours.
What should I do to prepare?
Read my blog and others, join the Facebook group We Need/Got Jaw Surgery (link at bottom of page), and check out my Must Haves page here.
How long was recovery?
Still going, baby! I'm back on normal foods, although the idea of biting into an apple is still a ridiculous concept to me. There's still a bit of swelling, but most swelling expected to be gone at 6 months. And I still have my braces on.