Wednesday, March 01, 2006

A Sigh of Relief!

Ok, so yesterday I got the RPE in. Dr W also gave me the prediction photos, he emailed them to me and I didn't actually see them until I got home. As I was in the chair he described to me that after doing the photos he thought we might get away with doing just upper advancement. Cool, only breaking one jaw is a-okay with me! But, he said Dr T would have to make that call once I'm actually ready for it, which isn't for another year and half.

I forget what was said exactly but I ended up asking him, "so is that the difference between a LeFort I and II?" ..."No, a I and III", he replied. So off home I went to research a LeFort III. What I found was utterly terrifying. A LeFort III involves moving the entire mid-face forward in three sections completely away from the rest of the skull. They have to peel your scalp forward in order to access the sutures around the eye sockets. You know how some people have very bulging eyes? A LeFort III will correct that for them, but it is VERY invasive. I was horrified that I might be doing this and was rather dumbfounded at why this possibility wasn't presented way back in July when I had my initial consultation. I searched and searched and couldn't find ANYTHING or ANYONE who had this done as part of getting their teeth straightened, you know, like normal ortho. All I saw were pictures of children with major facial deformities (Granted the surgery worked wonders for them).

So I lost a lot of sleep last night and was wondering what the hell I was gonna do. So today I decided to call Cathy Tocchio. She works in the reception at Dr T's office and is very knowledgeable about all the surgeries and is also Dr T's wife. I described my concerns to her and it turns out that my research on a LeFort III greatly mislead me....

A "segmental LeFort I" can have up to 3 segments, usually. Depending on the situation the maxilla may be segmented in up to 3 pieces and placed accordingly. Everything they touch is below the zygote and the procedure is completely intraoral. ...This is WAY different than a LeFort III!! Got that kids? Get your terminology straight. Thank god I got this explained to me or I was totally going to throw up the red flag.

By the way, the reason why the LeFort III scared me in the first place was because Dr W's simulation of it looks awful (my nose jets out a lot) and I sure as hell wasn't going to let them morph me into that. I am now convinced that Dr W just isn't a very good artist (or rather maybe it's hard to do photo manipulation). He doesn't have the software which actually calculates the differences based on digital x-rays and "real" simulation. I've seen this done elsewhere and the photos I have are nowhere near as good. No reason to be discouraged though as I've looked at tons of real before and after photos of other people and they all look like improvements, and in many cases stunning improvements. So I'll hold off on posting my photos for now. I'm hoping that after the big surgery I'll be able to make a before-prediction-actual photo and laugh at the prediction because the actual will be so much better.

Also, as I was talking with Cathy we also found that Dr T had made some notes regarding my chin as well. So I might end up with some genioplasty in the mix as well, which is fine. The bottom line is that it is impossible to tell precisely what will be needed until after I've had braces. With a 3-segment LeFort I the nose may be moved forward slightly, which causes some concern as to whether rhinoplasty would be needed. Cathy said she didn't know of anyone who actually needed it but it is something to discuss beforehand. She also offered to have me come in and look at some before and after photos when the time comes.


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