My Experience of undergoing Bi Jaw Surgery

Hello Everyone, I am Sumit Ghewade (SuperSumoz), from India-> Maharashtra->Pune. I m writing this blog hoping to help some of the few people who have similar condition like me or those who might soon be going under a Bi Jaw surgery. So to begin with, Bi jaw surgery or in the medical terms Orthognathic surgery is required when there's a discrepancy between the alignment of  the upper and lower jaw. Upper and Lower Jaw discrepancy is also know as Maxillary prognathism and Mandibular prognathism respectively. The following picture will give you a better perspective of it.

As you can see clearly that in Maxillary prognathism the upper jaw alignment is a bit front of the lower jaw and whereas in the case of Mandibular prognathism the lower jaw is shifted in the front of upper jaw. In both the cases subject might face problem such as not able to chew properly, pronunciation may differ, and aesthetic looks may also be disturbed. Jaw surgery is performed to overcome all such issues and give the subject a proper aligned jaw where in the subject can chew properly, talk properly and also look great. As you can see in the above image Maxillofacial surgeon try and achieve the Jaw without prognathism State.

 In my case of Bi jaw surgery my lower jaw was forward that my upper jaw. When i was around 18-19 i noticed that something is wrong with my jaw but never really cared about it and sadly my family also didn't notice it very well. Anyways, as i went by my mandibular jaw kept waxing and soon it was looking peculiar. In 2014, my upper jaw was looking very small compared to my lower jaw. In order to treat this peculiarity i visited Dentist Dr. Nikit Lokhande. After examining my jaw structure he said this is a Type 3 or Class 3 Jaw and there is a very little hope that this can be treated via orthodontic treatment (braces). I was in shock and scared too. He suggested me to be calm and meet Dr. Kiran Gadre for further guidance, he is one of the renowned Maxillofacial surgeon in India.

Furthermore, i visited Dr. Kiran i m sure you are not at all interested in knowing his description, how did he look like but anyways i would like to maintain few points about him. He might be 6 foot tall, in his 50's probably, hair were properly dyed with black color, a proper mustache and a stern doctor like look on his face.Well, he saw my case examined my jaw structure and told us the what he had concluded after examination. My finger were crossed and i hoped he would say something nice, so that we can some how escape this surgery process. And then he said that surgery will be required because my Jaw has reached Class 3 and to treat such case surgery is necessity. 

He explained as follows the process would go like.

First Option :- Surgery will be directly performed before performing any orthodontic treatment and after surgery is done then orthodontic treatment will start.

Second Option:- Or else undergo orthodontic treatment first and then the surgery would be performed and again the orthodontic treatment for a while.

Here he also specified some conditions and time line required for both the cases. For the first option:

• He specified that the first option will take approximately 1.5 years to complete.
• This process is a bit fast then the mundane process (Second Option).
• Results would be satisfactory and would be same as second option.

For the Second Option:

• He specified that almost 2 years it will take for the whole process to get complete.
• This process is slow and safe compared to First Option.
• Again results would be satisfactory. 

He again asserted that first option is now feasible because technology has advanced and the desired results can be obtained now in small period of time. Although, he stated that if go by the second option, as the orthodontic treatment goes on the surgeon also get a surfeit amount of time to analyze and have an idea that how the Subject will look like after the surgery.The total expense which he stated in 2014 was approximately 2-2.5 lakhs INR which means 3000-4000 USD. 

After the discussion we decided to go with the second option as it was safe. But due to my studies and further job opportunity which i perceived, i was not able to undergo any orthodontic treatment. Mean while 3 years of my life was gone and suddenly i felt the urge to change my jaw structure once and for all , then i started my orthodontic treatment with Dr. Salil Nene in April 2017. About Dr. Salil Nene, he is a very nice person and dedicated to his work and the staff over there is also friendly. Dr. Salil quoted me 40000 to 50000 Rs for the overall orthodontic treatment. Unlike other orthodontics he took the treatment fees in small installments of 2000 - 4000 INR each month.

Before the treatment started i use to look like this.

These were the overall changes which happened during the course of 1 year.

Fortunately when my orthodontic treatment started my teeth were very responsive. They were aligning as it was desired and unexpectedly it was happening quickly. Dr. Salil was also happy and surprised with the progress we were making. Soon ,Dr. Salil said you are almost ready for the surgery and now you must visit Dr. Kiran Gadre and there i was left with no other option other than meeting Dr. Gadre. I met him he said the subject is absolutely ready for the surgery. But there were few things which have been changed since 2014 and it was the cost of the surgery. The cost of the surgery inclined to 3 - 3.5 lakhs INR and the cost was also dependent upon the type of implant we selected. There were foreign implants and local implants, if we opt for the foreign implants the cost would go upto 4 lakh INR and if local the cost will remain till 3.5 lakhs. This total amount included everything from surgery to hospital expenses.

Finally, the date of my surgery was decided 13th April 2018, i was admitted to the MJM hospital which is situated in Pune on 12th April 2018. One day before the surgery i was filled with anxiety and fear was looming over my head. And in that all scenario one of the hospital brother comes and tells me that he will trim body parts which doctor has specified and that is the strict protocol of the hospital. I was like What the !*@# ??  but i somehow made myself understand that this is so called PROTOCOL and i have to follow it. But wait don't overthink and feel awful about it , i somehow convinced him that the process of shaving can be done by me and later he can check. Trust me guys this was the worst feeling i have ever got and had no option but to do it. Everything happened smoothly THANKFULLY and i thought worse part was over but i was dead wrong. In some time i was about to experience what was urinary catheterization. It was the most painful thing happened to me on that day but again it was protocol. Finally, it was time the surgery was going to take place, i was taken to the operation theater and was given anesthesia and boom after 15-16 hrs i got up and yeah, i was feeling really weak.

Surgery was performed successfully on the given date and now i'm recuperating. Generally the surgery takes up to 4-5 hrs, as in my case both maxillary and mandibular operations were required plus my chin has also been shifted 10mm ahead. Doctors have mentioned that it will take approximately 1 month to recover completely and for swelling to go. I have been prescribed to take Steam 3 times a day, protein drinks 3 times a day, fruit juice or soft food every 2 hrs and some vitamin medicines. 

First 10 days of the surgery was very though as they have kept me under nasogastric intubation, where in a food pipe is inserted through the nose, past the throat and down into the stomach. During the first 10 days after surgery, i was not able to swallow properly or drink anything. I was warned not to eat or drink anything, only a few spoon of water or coconut water allowed. After the 10th day the pipe was removed and finally i was able to drink and swallow properly. Trust me you will have the beatific feeling when you will be able to drink and taste something after a very long time.

Some suggestions and tips who are gonna go under Surgery:-

1) Don't be afraid, you have to just sleep there and in no time you will be out there won't be any pain       trust me on that.

2) Your Orthodontist and surgeon, both should be well acquainted with each other. As they have to           further coordinate, how your teeth alignment should go and have to make important decisions             about the surgery.

3) Stay very healthy, get in habit of exercising, yoga or workout at least a month before.

4) Eat and drink highly nutritious food & fruits. Believe me it will help you recover faster but start this process well in advance like a month or 2 months before surgery.

5) There would be lots of swelling in your chin, lips, cheeks and maybe nose.

6) Your tongue might be slightly cut to make it fit in your new aligned jaw. (Don't worry tongue will heal well with 2-3 days). And it's not necessary that your Tongue might be under surgery.

7) Be prepared for Nasogastric_intubation and Urinary catheterization.

8) Don't talk more often.

9) Follow the prescriptions properly.

10) There can be numbness in your lips, chin, cheeks and you might not be able to drink properly. Right after the operation you will create lots of saliva, carry a small vessel  to spit the excess of it or carry a napkin.

I think this was it, my experience about the surgery. I think might be missing out some other few details regarding the same. But please feel free to ask your questions regarding the surgery, if i know the answer i would surely would like to help you out.

Thank you for taking out your valuable time to read my post.