Just over 1 year ago, on December 4th of 2019, I had double jaw surgery (also known as orthognathic surgery) to correct an overbite that I had which was affecting my ability to eat and speak properly. I also had a chin augmentation (also known as a genioplasty) done at the same time, which was a cosmetic procedure that I chose to have done to change the aesthetics of my face.
In this post, I will be detailing my experience with these procedures, and how they have changed my life. I will be going into all the different sides of things, the good, the bad, and the ugly parts.
WARNING: I will be discussing or mentioning surgery, anesthesia/sedation, infections, painkillers, medications, antibiotics, needles/syringes, cosmetic surgery/plastic surgery, acne, food, weight loss, and disordered eating in this post. If any of these topics are triggering or disturbing to you, please do not read this post. Thank you.
Why did I get surgery?
In the autumn of 2018, I got braces, which is a very common thing to get in Canada and the United States if you have orthodontic issues (I had crowded teeth and an overbite). However, what’s not so common is the chronic jaw pain and locking that I had been experiencing along with my teeth being out of alignment.
Before I got my braces on I had some functional issues with my jaw. And unfortunately those only got worse with my braces, because as my teeth straightened my overbite became more noticeable to me when speaking and eating.
You see, the way my teeth had grown in was that my top front teeth were kind of tilted backwards, so even though I had an overbite, my front teeth could still touch each other enough that I could take a bite out of a sandwich if I needed to. When my teeth began to straighten and my front teeth were pulled forward, I could no longer do that, and the front of my mouth became virtually unusable for eating. This also made my speech a bit slurred, because pronouncing certain consonants (such as ‘s’, ‘d’, and ‘t’) became more difficult for me.
While it wasn’t a guarantee that getting jaw surgery would help with the chronic jaw pain I was having, it did mean that I could have proper use of the front of my mouth for eating and speaking, which was enough to seal the deal for me.
If you’re not interested in the process of the surgery and recovery, you can skip this section and go straight to ‘The Good, The Bad, and The Ugly’. This next section is more aimed and people who are considering getting jaw surgery themselves.
What did the process of surgery (and recovery) entail?
Warning: In this section I’ll be explaining what the surgery involves and what it was like to experience it (and I’ll be describing anesthesia/sedation, and mentioning post-op weight difference, food, needles, antibiotics, and opiate painkillers), so if this could be disturbing or triggering to you, please skip to the next session of the post.
When you decide to get jaw surgery after getting braces, you have to wait at least a 12 month period between getting the braces on and doing the jaw surgery, so about 13 months after I got my braces on, I was able to get the surgery. My surgeon (who did a fantastic job) took scans of my jaw that allowed her to see both the shape of the bone as well as where the nerves were, to avoid causing permanent nerve damage, and it allowed her to plan how much to adjust my jaw. I also had some X-rays done before and after surgery.
Since I had a very flat chin because of my overbite, she also offered to do a chin augmentation during the surgery, to improve the aesthetics of my face, which I agreed to.
Before I could get the surgery I had to get a blood test and a nasal swab at the hospital to make sure that I was in good health for the surgery. I also got the first slot of the day in the operating room (OR), so on the day of the surgery my mom and I had to get up at around 5 am to go to be at the hospital in time for my surgery.
At the hospital they gave me a gown to wear during surgery, and then after some waiting, I was wheeled into the OR on a stretcher (standard procedure, and honestly kinda fun). Unfortunately my mom couldn’t come with me in that wing of the hospital, so it was a bit scary for me.
Once I was in the OR I was prepped for surgery. The anesthesiologist first attempted to sedate me using the anesthetic in a syringe, however that wasn’t working (my nervousness was making my veins much less apparent than they normally are) so I was then sedated using a gas. The experience of being sedated was, quite honestly, like the nausea effect in the game Minecraft. As in, it exactly looked like that. Everything got wavy, and then I fell asleep. (Jaw surgery has to be done under general anesthesia, which means that I was unconscious throughout the entire procedure.)
During the surgery, my surgeon made incisions in the bone of my upper and lower jaw, moved them into more functional and symmetric positions and attached titanium plates so that they would be held in place as the bone heals. She also did basically the same thing to my chin, but rather than being held by plates, my chin was held using wires.
During the surgery all 4 of my wisdom teeth were removed, since it would be easier to remove them while I was under general anesthesia than to have to have them removed with just some numbing at an earlier time.
Later, after the surgery was over, I woke up with a plastic plate in my mouth (which kept my bite in alignment when my mouth was closed) as well as several elastics holding my jaw shut. Because of the weakness in my jaw post-operation, I could only open my mouth enough to get a feeding syringe in (basically a large plastic syringe used to push liquid foods into the back of my mouth, so that I could swallow it).
After the surgery they keep you in the hospital for at least 24 hours before you can be released to go back home. During this time I was on morphine, as well as IV fluids. They keep you at the hospital to make sure that you’re able to eat enough, before they send you home. I wasn’t eating enough during the first 24 hours, so I had to stay an extra day, but after that I had regained enough strength to be able to eat liquid foods and to walk more than a few feet at a time.
After I was sent home I was on a strict schedule of antibiotics. I spent most of my time in the first week after surgery sleeping, watching TV, eating liquid foods (such as meal replacement drinks, milk, apple juice, and soup broth), and taking antibiotics in a liquid solution. I have to say, having to wake up in the middle of the night to take antibiotics wasn’t very fun. And despite that, I still wound up getting an infection (which I’ll discuss later in the post).
However, the good thing is that because of (temporary) nerve numbness after surgery, I didn’t have to take painkillers for very long. I was on morphine for the two days I was in the hospital, and then codeine for two days when I was at home (so a grand total of 4 days on painkillers). While it’s more common to be on painkillers for a week after surgery, I stopped a bit early because I dislike taking medication for pain (I don’t know why). After all, there was a lot of numbness from surgery, so the pain was tolerable for me, especially after having to deal with the chronic jaw pain for years (but everyone deals with pain differently).
As I got my strength back I was able to open my jaw enough to fit in a spoon, and then after a week post-op I was able to eat some soft and mushy foods such as rice and scrambled eggs. I had dropped about 10 pounds in a week after jaw surgery (and was already quite a small person to start), so I was eager to gain back the weight, though it was difficult for me (for reasons I’ll discuss later in this post).
Despite my recovery seeming to be quite speedy from what I’ve written, it really wasn’t. Even though I was able to stop the painkillers and begin to eat soft foods rather quickly, my overall strength and energy levels were quite slow to return, I think in part due to the infection that I had, as well as the Canadian winter weather making it difficult for me to spend time outside getting sunlight and fresh air.
I also think I may have been experiencing some post-op depression, as it was very difficult for me to get motivated about things. All I really remember from my recovery period was rewatching one of my favorite shows from childhood (H2O Just Add Water) and playing Fallout New Vegas, as well as eating a lot of scrambled eggs, spaghetti, and meal replacement drinks.
Now that I’ve described what it was like to have and recover from jaw surgery, let’s get into the good, the bad, and the ugly.
First, I’ll start off with the good part of my surgery and how it has changed my life for the better.
My confidence in my appearance has improved so much since getting my surgery. The jaw surgery fixed my malocclusion, so my teeth are aligned properly in my mouth, and it also improved the angle of my jawline. The chin augmentation, which was only 10.9 millimetres, helped reduce the flat look of my face, and gave me a more conventionally pretty profile.
It also became easier for me to speak, which continued to improve once I got my braces removed. I’ll go into more detail about how I can actually speak more clearly later, but for now it’s enough to say that being able to speak more easily has helped improve my confidence when it comes to speaking.
After the main part of my swelling went down, it became such a relief to look in the mirror and be able to say that’s my face! That’s my face and it is a wonderful face with a wonderful jaw. A jaw that is functional.
No more pain
As I explained before, one of the deciding factors in getting surgery for me was the chronic jaw pain that I was getting. When I went in to get a consultation with my orthodontist on the topic of getting braces, she told me that the braces wouldn’t make the pain in my jaw go away, but surgery might.
And then when I went to get a consultation with my surgeon to decide whether or not to do the surgery, she also said that the surgery might not correct the jaw pain I was having. But there was a chance that it could, so I took it into account when considering if I should get surgery or not.
I am happy to say that the jaw pain that I had been experiencing has not returned post-operation! While my jaw does still click a bit when I open it, I no longer need to crack my jaw multiple times a day to relieve pain.
I hope that the pain never comes back.
I can eat! And speak!
The ability to eat properly is one that is easily taken for granted, until it gets taken away.
Before I got my braces on, I could bite down on things using the front of my mouth. It wasn’t the most functional bite, but because of the way my teeth grew in it did roughly work. But then when I got my braces on and my teeth began to correct, I could no longer bite down on things using the front of my mouth, because of my overbite.
But now I can! I can take bites out of things! I can actually eat a sandwich now!
I can also speak! Because of my overbite it was difficult for me to enunciate certain sounds, such as the ‘s’ sound and the ‘d’ sound, without slurring them or sounding like I had a lisp. It was also strangely difficult for me to say “you’re welcome” without slurring the words together, so I switched to saying “no problem”.
But now that my teeth and jaw are in correct alignment, I can speak more clearly! But although I can say “you’re welcome” the habit of saying “no problem” has stuck, so I still usually say “no problem”.
Now we’re going to get into the psychologically and physiologically difficult parts of my jaw surgery.
Again, a warning: in this section I will be discussing infections, antibiotics, food, and disordered eating. I will also be mentioning anesthesia, and needles/syringes. If these are difficult topics for you, please skip this section of the blog post. Thank you.
(This section is a little bit gross.)
After my jaw surgery, I got a recurring infection. It originated at the lower left side of my mouth, where one of my wisdom teeth was removed, and then spread forward to the plate that had been installed on that side of my lower jaw.
I first noticed this infection a few days after I got home from the hospital, and it lasted until I got a second procedure done in February. During the second procedure my surgeon put me under general anesthesia (though it can be done under twilight anesthesia, I requested general anesthesia), and then removed the infected plate and cleaned the area.
Because of the recurring infection, I had to go on several courses of antibiotics, over the course of about three months (first two and half were for the recurring infection, and the last two weeks were standard for after the second procedure). I also had to regularly and gently squeeze out pus and blood from the site of the infection, to reduce pain and swelling, and to be able to clean the area (I used a waterpick on a gentle setting to help clean my mouth, as well as regular toothbrush and toothpaste to clean my teeth).
Fear of needles
After my surgery I developed a fear of needles. I won’t go into how this fear developed, but for awhile after surgery if I saw a needle or a syringe I would get phantom pains in my arms, wrists, or hands. These phantom pains have gone away, but the general fear of needles still remains.
Psychological difficulties with food
In ‘The Good’ section of this post, I wrote about how I could eat more easily and bite down using the front of my mouth, which is true. But I want this post to be a transparent look at my experience with jaw surgery, so I must also bring up my experience with the psychology of eating food.
After surgery I had to be on an all-liquid diet for a week, and then I could begin eating mushy or soft foods. However the feeling of having any kind of food in my mouth after surgery was one that I found gross and uncomfortable, so for quite a long time after surgery, I experienced some issues with not wanting to eat certain foods because of the texture. This texture sensitivity worsened at points in my life when I was stressed, and it made it difficult for me to even feel hungry.
This issue lessened a lot after I got my braces off though! While I still have some texture sensitivities if I eat while I’m stressed, overall it’s a lot easier for me to eat now then before I got my braces removed. It’s also possible for me to eat healthy snack foods such as nuts and seeds now, which helps to make sure that I’m getting protein and fiber in my diet, as well as enough calories.
Disclaimer: I put these experiences under ‘The Ugly’ section, because that’s how I felt when I was dealing with them.
Fungal acne, also known as Pityrosporum folliculitis or Malassezia folliculitis, is a type of skin infection, which is similar to acne vulgaris, but rather than being caused by too much bacteria, fungal acne is caused by too much yeast. Under normal conditions, our bodies are able to balance the amount of yeast and bacteria is present on the skin, but certain things can offset this balance, such as antibiotics.
I have to admit, that when I was on the antibiotics for the three months, my skin was very clear, despite my lack of a skincare routine at the time. I was pleasantly surprised at this side effect of the antibiotics, but it definitely didn’t last. A couple weeks after I stopped taking antibiotics I began to develop fungal acne on my face, especially on my forehead.
I have to admit, I didn’t really do all that much to clear it up. I’ve only recently gotten into maintaining a skincare routine, but my fungal acne began clearing up during the summer. Throughout late summer and the fall I took probiotic supplements daily, which seemed to help finish clearing it up, and it hasn’t come back since.
Swelling and bruising
After surgery I had a lot of bruising on my face, and extending down my neck, only stopping at my collarbone. This is common after surgery, but I wasn’t aware of just how bad it would be, so it was a bit disturbing to see the all the bruising on my face each time I passed by a mirror. Fortunately it cleared up after a couple of weeks.
The swelling on the other hand, took a lot of time to clear up. For the first few days after surgery my whole cheeks and part of my neck were swollen to the point that the skin was shiny. This also led to my skin drying out and flaking, so I had to regularly apply Vaseline to my face just to try to keep the dryness to a minimum.
And the swelling is something that takes a long time to go away. After around the first month after the surgery, the swelling had gone down enough that the average person wouldn’t be able to tell that I was swollen, but to me, my parents, and my surgeon, it was still apparent that there was some residual puffiness, puffiness which didn’t completely go away until a few months post-operation.
I do have to note that now, a year after my surgery, despite being at around the same weight as I was before I had my surgery, my cheeks are less soft and full then they were before my surgery. I don’t have super gaunt cheeks or anything, but my cheekbones look more defined and my jawline is also more defined than in the soft tissue simulations that were made before my surgery. I’m not entirely sure what this was caused by, but I have a feeling that it’s a combination of the results of my surgery, and my increased exercise levels this year.
So was it worth it?
In the end, I’d say the answer to that question is: yes! I’m more than happy with the results of my surgery, and I’m glad that my recovery ended up going well, minus the infection.
If you have any questions about jaw surgery, feel free to leave them in the comments! I’d love to help clarify any questions or concerns you may have, especially if this is something that you’re considering for yourself.