FAQ's

13/07/18

Since having my surgery 2 years ago, I have been asked a lot of questions about the operation. I thought it would be a good idea to put some of these questions and answers together on one post for those who are interested. Please leave a message if you have any more questions and I will try my best to answer them.


How long is the recovery?

• This isn't quite as straightforward to answer as you'd imagine, especially as everyone recovers differently and at different rates. But I'll try and break down MY recovery a bit:
• 1-4 weeks - This is the worst of the swelling/discomfort/nerve damage/lack of energy/not talking/ time off from work and college etc..
• 2 months - Most of the discomfort is now gone - Not quite speaking coherently - Since starting on solid food I have very quickly progressed with eating again - Back to college
• 3-4 months - Still a bit of swelling - Speech is back to normal - Still have some nerve damage in lips and chin - Back to work
• 6 months - All swelling is now gone - I have most of the feeling back in my face, but still experience some tingling in my chin where the nerves are still trying to repair themselves. 
• 12-18 months - No more change to the nerve damage, I am now fully recovered.

How long until you could go back to work/school after the surgery?

• I attempted to go back to college after 4 weeks, but due to lack of energy it wasn't until 6 weeks i could go back properly.
• I also attempted to go back to work after 2 months, but as i still could not speak properly and i worked in a customer service role, i couldn't properly go back until 3 months.

Is it painful?

• It is not painful. Since you get a lot of nerve damage during the operation, your face will be very numb and so you do not feel pain. However, you may experience some discomfort due to the swelling. A combination of ice packs and hot packs may help you with this.

Any advice on how to cope with not eating?

• If I am totally honest, I did not cope well with not being able to eat after my operation. It took me 10 months after my recovery before I could even think about having soup again! But seriously if you're having jaw surgery, you will definitely want to stock up on lots of different kinds of soup for a couple weeks after the operation. You will also want to stock up on lots of soft food such as bread and pasta. My advice would be take things slow when it comes to eating. Don't try and force yourself to eat solid food if it is too tiring, this is a big operation and you're not expected to be able to have fluid movement in your jaw straight away - it is a long process. Week 3 was the hardest week for me in terms of eating. I started to feel more human and less like I was in a drug induced trance and so I was starting to really feel the hunger, however I still couldn't eat solid food and I had absolutely no energy whatsoever. I think this is where it is most important to drink lots and lots of water. Also, yoghurts were soooo nice and easy to eat and such a nice break from the soup! There's not much more I can say about this as it's different for everyone - just take each day as it comes and prepare your family/friends for some hangry outbursts!

How much did this operation cost?

• I live in the UK where we have free healthcare and so this operation was done on the NHS. Unfortunately, I can not give an accurate figure of how much this would cost in other countries. I would recommend having a search online or asking a professional how much it would cost to have this surgery done in your country.

How old do you have to be to have this surgery?

• There is no set age limit to have this operation. However, most surgeons will advise you not to have this surgery until you are fully grown, due to the possibility of your bones continuing growing after the operation meaning you would have to go back after a few years to have the same operation redone - and I could not imagine many people would like to go through the recovery twice.

Did the surgery change the shape of your nose?

• My nose has changed shaped due to this surgery, it naturally widened and lifted a little bit when my upper jaw was moved forwards.

How long did it take for the swelling to go down?

• In total, it took about 4-5 months for all the swelling to completely go. 

How long did you have braces before and after the surgery?

• Before the surgery I had braces on my top and bottom teeth for a total of about 20 months. Afterwards, I only had braces on for about 3 and a half months.

Do you have any permanent nerve damage from this surgery?

• I was told about 1 in 10 people experience some permanent nerve damage after surgery. I do happen to have a tiny bit of permanent numbness in my chin. However, it is a very small area with what I'd say is about 70% feeling in that area. I rarely notice it and it is a very insignificant problem for me.

Were you bullied for your face before?

• I was lucky enough to not experience much 'direct' bullying, by this I mean there were only a handful times where people would be rude about my appearance to my face. However, I did have to put up with a lot of people staring, whispering, and occasionally pointing at me and laughing throughout my teenage years. My advice to anyone experiencing being bullied would be to remember it is only temporary. You are not going to be bullied your entire life and you should not let it get to you - as difficult and sometimes impossible as that seems to be. Often those who bully others are hiding their own insecurities by lashing out at other people. Just remember that EVERYONE is different and EVERYONE is beautiful. 

Did you lose any weight after the operation?

• I did lose quite a bit of weight after the operation. Within the first 3 weeks I lost 1st 7lbs, most of this I put back on once i could eat solid foods again.

Was the surgery worth it?

•  100% - no doubt about it.

Post-Operation: In Hospital

20/04/16


As some of you may already know, on 18th March 2016 I underwent corrective double jaw surgery to fix my class 3 malocclusion. Firstly, I will start this post by explaining the surgery itself.

To put it in simpler terms, my lower jaw was broken, re-structured and screwed back into place. My upper jaw was also broken and the excess bone taken from my lower jaw was inserted into my upper jaw and screwed together - I was lucky enough that there was enough bone from my lower jaw to put in my upper jaw so the surgeon did not need to take any extra bone from hip. 


On the morning of the 18th, I arrived at Chichester hospital ready for my operation. I was told I was not allowed to eat anything for 12 hours before my operation as you have to have the operation on an empty stomach to try and prevent throwing up while on the anaesthetic. I was also told i could drink water up until I left the house that morning but then I must not have anything else to drink afterwards. I went through all the last minute checks to make sure I was healthy enough to have this operation. I also met my surgeon one last time before the surgery, where he once again checked to make sure I still wanted to have the surgery. After all of this was done, I spent about an hour in the waiting room before my name was finally read out around 11am. I remember feeling very very nervous as I walked down the corridor to the operating room. When I entered the room, there was a team of nurses and the anaesthetist waiting preparing everything. I was asked to lie down on the table where they hooked me up the various machinery needed to check my health throughout the operation. The last thing I remember was the anaesthetist asking me to put on the anaesthetic face mask and count down from 10. I only got to 7 before I went under.

When I woke up, at about 5:30pm,  all I could remember asking the nurse for was my glasses because I could not see a thing without them which made me feel very disorientated. The next thing I heard was one of the surgical team members telling me the operation was successful and that they were just ringing my parents to tell them they could now come and see me. I think I went in and out of consciousness for a little while or I was just on such strong medication that I don't remember, but next thing I knew I was in a different ward where I would stay for the rest of my time in hospital. Luckily there was a private room available for me and the ward I was on was very quiet so it was about as perfect as I could hope for to recover in.

Throughout the rest of the evening I was given a lot of care and treatment from the nurses to ensure I was stable after the operation. I didn't feel any pain in my face or mouth as everything was numb, however I did have a bit of a sore throat from tubes being in there for just over 6 hours - the amount of time the operation took. I remember starting to feel very very thirsty as i had not had anything to drink since about 6am that morning, however I was not allowed to have anything to drink for 24 hours. Around midnight I told the nurse I really needed some water (I have no idea how she managed to understand me as I could not feel any part of my face including my tongue, and my jaw was wired shut - but somehow she knew what I was saying!). Since I could not feel anything and therefore couldn't drink or even swallow water, the nurse had to get a piece of sponge soaked in water and just push it gently against my lips in hope that some water would get through. Even that seemed to be very difficult for me to do but I eventually managed to get enough water in so that my throat didn't feel like sandpaper anymore. I don't remember much more from that evening I was was on such strong medication, but i do remember a nurse checking on me about every 15-30 minutes throughout the night, including one nurse who came in early hours of the morning to inject my tummy with something which I later found out was to help prevent DVT from lying down in a hospital bed for so long. Usually most patients on adult wards like me, are only allowed visitors during visiting hours, however as I was on the adults ward but I am still only 17 the nurses allowed my parents to come and go as often and whenever they liked.

The next day is also very fuzzy in my memory. I remember seeing my surgeon for the first time post operation who told me some of the details of the operation. As my swelling was starting to come out, he told me to expect the left side of my face to be slightly more swollen as at the beginning of the operation he spent 45 minutes trying to remove a nerve which had fused to the bone. Due to this I was also told the nerve was more damaged and the feeling in that part of my face may take longer to come back. I was also allowed to eat on the Saturday, however when the nurse brought out my lunchtime meal it soon became evident that there was no way I would ever be able to eat any of it. Instead, the nurse brought me a yoghurt which after what felt like hours of trying various ways to eat it, I learnt that by putting a little bit of yoghurt in between my bottom lip and bottom teeth, the yoghurt would slowly get pushed to the back so I could swallow and at least consume something other than water. Later that day, I started to get a bit of a fever and so my surgeon was called back. Shortly after they found out the fever was due to a UTI which I had got from the catheter - a very common issue. I was prescribed antibiotics to help the infection. The rest of the day was made up of me trying to eat more yoghurt and receiving treatment. 

I remember Sunday was the worst day of the recovery. I felt absolutely awful and I was fed up of being in a hospital room and just wanted to be in the comfort of my own home and sleep in my own bed. I stopped trying to eat as often as it was starting to become very tiring and uncomfortable for me and I just wanted to sleep for the rest of the day. I was hoping to be discharged from hospital as I had spent the 2 nights in hospital that is expected from double jaw surgery patients - they estimate 1 night in hospital for each jaw and as I had both jaws moved the estimated time spent in hospital was 2 nights. However, my fever was still high and my surgeon would not let me leave until the infection had cleared up. One thing that did lift my spirits was that my family were allowed to visit me. This was the first time I had managed to walk all the way down the corridor of the ward, as before Sunday I was too weak to walk farther than the bathroom. 

By Monday afternoon, when I found out I still couldn't be discharged from hospital, I was still very fed up of being stuck in hospital and the swelling was really starting to come out resulting in more discomfort. Some of the stronger elastic bands holding my jaws together were taken off so that I could open my mouth just a little bit more to get the edge of a teaspoon in so i could try and eat a bit more yoghurt.

I was finally allowed to be discharged from the hospital on the Tuesday afternoon. I saw my surgeon one last time who again explained some of the things to expect over the next few days, and more importantly the things that shouldn't happen and I should go back to hospital if they did. We picked up the medication I would need from the pharmacy and then we were finally on our way home.

In the next post, I will explain some of the details of my recovery at home.

Thanks for reading,
- Sophie

Pre Operative Assessment

16/03/16

On Thursday 10th March 2016, I had my pre operative assessment at Chichester hospital. I was very excited about this appointment as it marked the last appointment before my operation.

After arriving, the nurse made a note of my height, weight, blood pressure etc. I then had to do a urine test and a blood test too. These checks ensured I am physically fit enough to have the operation - as some factors such as being too underweight would cause a lot of issues due to the amount of weight most people lose after the operation.

After this, I had a one-to-one with another nurse who mainly talked me through what would happen when I woke up. She explained to me that I will be moved to the High Dependency Unit for the first 24 hours, as I will need to be checked on quite often as the possibility of throwing up after a 5 hour operation under general anaesthetic could be quite high - which of course with a jaw wired shut could potentially be fatal if I'm not in the right care.

She then continued to explain who would be in the room with me during the op, and she gave me a variety of leaflets for me to read over the course of the week. She then checked I was still okay with the surgeon taking bone from my hip if necessary and that a catheter would be put in place (but most likely removed before I even wake up.)

Since my operation is on Friday, the nurse told me I would be in hospital over the weekend, and I would probably get to go home on the Sunday or Monday. I also have my first post op appointment on Wednesday 23rd March (only 5 days after the op!) and then another one booked for April 1st.

I now only have 2 days until the op and it's safe to say I'm very very nervous! Up until now I've been focusing on everything pre op, and it's just dawned on me that I will be in hospital over this weekend. Before, I never actually thought about being in hospital as weird as it sounds, but in my head I've always skipped over the first couple of weeks of recovery!) But this is something I have to do, and I'm lucky enough to have the support of my family who have done everything they can the last couple of weeks to make this process as easy as it can possibly be!

This is the last update pre-op, but I will be making a short video on YouTube which will include a daily photo of my recovery over the first few weeks.

I'm hoping this operation will go smoothly, and the recovery won't be too long!

Thanks for reading,
- Sophie

The Date

27/02/2016

I came home from college a few weeks ago to find a letter addressed to me. It was the date for my double jaw correction surgery - Friday 18th March 2016! Anyone who has had or will be having jaw surgery will understand the importance of this letter. Just as I do every time I visit or hear anything from my orthodontist team, I then continued to read blogs about people who have experienced this surgery. This lead me to deciding to start my own blog, to help anyone else who is going through the same thing.

My name is Sophie and I am 17. I have a class 3 malocclusion - basically this means a severe underbite. I have had it all my life, and although it has grown progressively worse throughout my teenage years, I can not remember a time in my life where I have had a correct jaw position. I started treatment at 11 years old when I was referred to Worthing hospital under the maxillofacial ward. Originally, I was given the choice of whether to have just braces to try and correct my bite, or the surgery. However, as I got older, and my underbite got more and more severe, the option became obvious to me.

In 2012, I had braces put on my upper set of teeth, to correct my awful teeth alignment. This, at the time, was mostly for cosmetic reasons - My two front teeth stuck out and the rest of them were very misaligned. I refused to laugh, smile or eat without my hand covering my mouth. I only had these first set of braces on for 6 months as my teeth moved pretty quickly. 

In July of 2014, I had braces put on my bottom teeth in readiness for my operation. About a month later, I had my bottom wisdom teeth removed, as they would have been in the way during the surgery. Because my wisdom teeth hadn't fully developed yet, I had quite deep holes at the back of my jaw, which didn't take as long to heal as I expected. This was the first time I was old enough to remember being put under general anaesthetic, and I can recall waking up feeling completely disorientated. Having my wisdom teeth out is the only experience I can relate to being similar to the operation I am soon to have. I remember hating the feeling of a swollen face, which I think will be something that I will struggle with most during my recovery (and the fact I won't be able to eat anything for several weeks!!)

A few months later I had braces put on my top teeth once again, to allow both sets of teeth to straighten into the correct position so that my surgeon could use my teeth as a guide during the operation. Since then, I had the usual orthodontics appointments; check ups, braces tightened etc.

Like most people who have had this operation, the estimated date kept getting pushed back later and later. I was originally told I could have the operation in the summer of 2014, however it soon became evident this would not be possible. I was then told summer 2015, and then October 2015, then December 2015 etc. However I now have the official date in writing! For the last few weeks, I have been very worried that the date of the op would be changed. However my orthodontist told me that the likelihood of the date changing is very small, which was very reassuring to me.

My braces were tightened for the last time pre op on January 29th 2016. Since then I have had 4 appointments. On February 5th, my appointment was short and sweet. I went in to have one set of moulds done (which is an absolutely horrible experience by the way!) On February 12th I ended up spending 2 hours in hospital having various X-rays, photographs, moulds, a frame fitted, jaw measurements etc. I then went in again on the 16th as I had a phone call to say they needed one more set of moulds. At this appointment, I also saw a computer generated image of what I will most likely look like post op, which was very strange for me to look at! I was looking at a photo of myself, but half of my face looked completely different, obviously I already knew and have been expecting this, but seeing a picture was just very odd!

On Tuesday 1st March, I had my last orthodontic appointment pre op. This was to check the moulds of my jaw fit together nicely. The head of the MFU came along to check everything was ready and was very happy with the moulds. I also had my surgical hooks fitted on to my brace which feels really weird against my gums! Then I got to see the before and after photos of my jaw again from the side profile, and I could really see a difference!

I now have no more orthodontic appointments left! The next update will be on Thursday 10th March, after my pre operative assessment!

Thanks for reading!
- Sophie