Sunday, 1 May 2011

What's cracking? Day -9 (April 30)

My name's Gordon, and I'm going to be undergoing double jaw surgery on May 9 to fix my class 3 occlusion (underbite). So what does that mean to all of you with perfect jaws? The bottom jaw grows out farther than the top jaw, so what's to be said about the myriad of problems is: "That ain't right."

There's a good picture of what looks like a 10 year old with it.  Apparently it's mostly genetic(Yet I only know distant Aunt who is questionably related to me with it)

Why would I go through such a thing?
  • Fix my bite primarily, so I can chew properly.
  • My teeth have now shifted to the side as I grind sideways to chew. My teeth have been shaving down from vampire like incisors to dull boring ones.
  • Talk without a lisp.
  • Talk without spitting.
  • Breathe through my nose instead of my mouth.(will be interesting with my year-long allergies how that will work)
  • Jaw hanging down constantly as if you're a panting dog. 
  • Jaw profile changes for the better, and symmetry issues are resolved. (symmetry is more attractive right?)
Personally, chewing is the biggest one for me, and I tend to grind my teeth a lot which can get annoying. When most of your teeth do not touch, it makes anything mouth involved complicated(try sticking your jaw out and doing anything properly.)

I am blogging my small adventure here for friends and family to follow, as well as give those prospective jaw surgery people a candid take on the whole process, hopefully providing all of the necessary details.

Here's a quick picture of me smiling right now.

Gathering information...

My Surgeon is Dr. Tocchio. He came highly recommended and is a really good guy at explaining the processes. I couldn't have picked a better surgeon. The operation was done at North York General Hospital in Toronto, Canada.

I had my Pre-Op a few days back on April 19 at the hospital and a following visit with the surgeon

The actual surgery would go down like this:
  • show up to the hospital 3 hours early
  • have surgery for 2 and a half hours
  • stay and be monitored in the 'recovery room' for 2 hours
  • Overnight for 2 nights, all inclusive, full service

They took simple baseline measurements like height, weight, blood pressure, and a sample of blood.  I was first briefed by a nurse about the stay and what sort of accommodations I should be expecting at the hospital and how to prepare and was basically told everything I couldn't do forehand, and all of the great foods I couldn't eat afterwards.

Following that somewhat depressing encounter I had the chance to talk to the anesthesiologist who told me that his drug of choice would be codeine in elixir form so I put them back like a shot. Also, a tube would be running through my nose during my surgery for air which would be put in and taken out during the time that I am knocked out(thank god) and following that tube, I get another following that during my 2 night hospital stay, but the point is to equalize pressure in my stomach. I didn't understand that process but didn't interrupt Dr. Brown as he was on a roll. Something about sticking a tube down another tube is not that cool.

Following this appointment, I had an hour to kill at Ikea in which I had 2 hotdogs, pop, frozen yoghurt cone, and grabbed a 6 pack of cinammon rolls to go and was off to see mr. bossman, Dr. Tocchio, the Oral Surgeon.

Firstly, my doctor is a great guy. It always helps your own confidence when the guy doing your surgery talks about the procedure like it's no obstacle. During this official pre op session I took a few quick x rays, a mould of my mouth, and had a sensible chat bout what was going down in the jackdaw.

In summary, it turns out that my jaw was going to get the works. To ease this informative process I decided to add pictures(I apologize if they are too graphic, but I was real excited)

1. Bottom jaw - was getting cut medial, lateral, sagittal at the back of my mouth on the inside. These 3 cuts allow for the jaw to slide back and forth. It was undoubtedly going to slide back to fix the underbite.

2. Top Jaw - it was getting popped out. Apparently the top jaw can literally come out of the skull since I suppose it is floating and 'pops out' like a cutout from just under your nose. Freaking sweet. I wish that I would be awake during my surgery to see my jaw. Anyhow, it would be moved forward. This type of movement to the top jaw is called a Lefort 1.

 I apologize this was the only picture I could find illustrating the cutout. Not the prettiest sight.

3. Top jaw expanded - when the top jaw is popped out, it will be cut down the middle as my top jaw is too narrow. It is then expanded to be as big/bigger than my bottom jaw.

4. Top jaw moved up - I have a bit of a 'gummy smile' so when I smile, the top of my gums are showing. Basically he's removing some gum/bone above my top teeth and less gum should show the next time I smile.

5. Bottom jaw symmetry - to line things up, he's going to slide one side farther back on my bottom jaw to line up with my top jaw.

6. Bone graft - when you move your front jaw forward, apparently there's a bit of a dip in the appearance of the indent of your nose/top jaw. The excess bone on the bottom jaw that is going to be shaved off when it slides backwards is going up top! Incredible. This man is a magician.


7. Septoplasty - since the surgery involves the top jaw, the surgeon was able to straighten my deviated septum. It has improved my breathing a lot and opened up my nostrils.

8. Genioplasty - the chin would be cut and moved back to make the face less long and therefore appear shorter. It would also be straightened.

I think I tried to crack a funny like, "Oh, that's a mouthful" when he finished but I had to laugh at my own joke. The way I see it is that the worse it is now, the better it will be when I see the final product - so I hope it's pretty terrible.

I'll give more details as things move along and I get closer to surgery.


Incognita said...

Hey your blog is great! Glad I came across it. I'm having double jaw surgery and genioplasty in the next year so I'm gathering all the info I can. I can totally relate to your reasons for having jaw surgery. It looks like your surgery turned out great! You look great! Sorry I'm commenting on an old post.

Gordon said...

Hey Terra,

It tells me everytime there is a comment so it doesn't matter which post it is. We all have our reasons being aesthetic, functional, etc. but in the end the surgery benefits all of them(except financial.)

Thanks for the kind words! Keep me updated when you go for surgery!

Amanda Ryan said...

Wow, so pleased I found this blog. I have a very similar combo of underbite / crossbite / deviated septum!!! Still at braces stage (am bored of them now) so reading with great interest.....!

Gordon said...

Hey Amanda,

Great braces progress. Your teeth look well, I have never heard of orthodontists bringing a bite forward to create an underbite for surgery, but if it is necessary then I suppose. Can't wait for surgery, you already look really beautiful and I wonder how it's going to look after.

All the best. Please keep updating your blog. I clicked the follow button :)

Anonymous said...

Thank you! Very informative!

Anonymous said...

Hey Gordon!

I'm still on dr. Tocchio's august waiting list. I was wondering how long before your surgical date did they give you an actual date? Seeing that July starts next week, I'm starting to worry that either my surgery will be in late august or no surgery at all...


Gordon said...


Don't stress out over a date, I'm sure you'll get in one way or another. I got my surgery date around the same time that I had my PRE OP. I'm pretty sure that they put them close together on purpose, so when there is a surgery date, you'll have a pre op a week or 2 before that day. So even if you do get in on august, your pre op would still be in late july/early august.

Hang tight! If it comforts you, keep talking to your orthodontist and call Dr.Tocchio's office to check every so often. You have plenty of time since July just started, you're still a month away anyhow.


Alyssa said...

Hey Gordon,
I just came across your blog and was happy to read it. I'm doing double jaw surgery next summer for my underbite with Dr. Tocchio as well. I was wondering how large your underbite was before hand?

Erin said...

Hi Gordon, thank you for your blog, it's such a great resource as I am considering orthognatic surgery as well. After you were recommended to see Dr. Tocchio, did you bother to check out other oral surgeons as well? If you were to do it all over again, would you stick with the same oral surgeon? Thanks :)

Gordon said...

Hey Erin,

I actually just answered this question via email around the same time (same person?) either way my answer was the following:

I was given the decision of Tocchio or Caminetti (sp?) from my orthodontist. Both were reputable from web searches, and I visited Tocchio first. From his appointment I was comfortable enough as it was, and just went ahead and booked surgery. He's a good guy. It worked out well, because Tocchio has been doing his job for a long time. Just found out my physiotherapist had surgery from him as well over 10+ years ago.

So no regrets.