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Dentistry/upper and lower osteotomy over bite

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QUESTION: Hello and thank you ahead of time. I had long face syndrome all my life and was teased unmercillesly, nice body, ugly face. I had severe tmj also with the splints, ear surgery etc. Then they said at Mass General, Dr. Donoff, head surgeon he could make it better, and one of the assists said, you'll bury her upper teeth, I didn't realize he still was going ahead with his plan. It's a hard surgery but I didn't care.
A year later the swelling was going down, my upper teeth cannot be seen, I had a very open wide smile with a full upper lip. That was gone, my face too short and wide. My upper lip gone and looks like I have been a smoker, the skin wrinkled and slack, I was asking about an orthotic, no answerw. This has destroyed my life. My friends don't recognize me and others ask if I was in a really bad accident. I'm devastated,, any ideas????? thank you very much.

ANSWER: Lesley -  What I question is if Dr. Donoff showed you, in advance of the surgery, what your facial appearance would be after the surgery.  The doctor should have gone over an approximation of what your facial appearance would be before the surgery.  

It sounds like the surgery involved elevating the upper jaw and that produced the effect of of a short wide face.  Burying the upper jaw is basically what was performed during the surgery.  It gives the appearance that your teeth and face were shortened.  This effect causes the upper lip, which sounds like it was stretched before the surgery to now appear to be in excess and hide the upper teeth and produce wrinkling.  

Well, what can be done.  You have only a couple of choices, but the initial one I would suggest would be physical therapy to attempt to strengthen the upper lip.  I'm not sure if that will produce the desired effects, but the second choice would be a revision of the surgery.

Without examining you I'm not sure if the physical therapy would work nor if a partial correction of the surgery would be possible, but if Dr. Donoff is not willing to help, you should seek treatment from a different oral and maxillofacial surgeon in the Boston area.  The problem is if there is a surgeon there willing to correct Dr. Donoff's surgery.  I'm  not sure, but if you want a second surgeon I should be able to find one in the northeast to evaluate you.

So speak with Dr. Donoff first and tell him you are not satisfied with the surgical results and see if he can help correct what you are unhappy with the results.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your very proffesional answer, that is exactly what happened when I was 25. I am now 55, and I don't know if at my age now how much I would have to go through. If I could afford it and Dr. Donoff is not there anymore. I have no feeling whatsoever inside my mouth, the palate. I am very athletic and young looking except for the lip and mouth area. I would like the name of someone if you could suggest one for me. I thank you with all my heart. No, Dr. Donoff did not show me what I may look like. It was all angles and planes, no idea this would happen. Marshmallow face.. I think I have a long life, I would like to enjoy seeing myself in the mirror again. Thankyou, Lesley Stewart...

Answer
Lesley - first of all, let me tell you that no surgery will allow you to regain your senses in your mouth and palate.  I am going to recommend you see a group of surgeons in New York City associated with New York Center for Orthognathic and Maxillofacial Surgery.  They have three offices, two on Long Island and one in NYC.  I am going to give you their number-  (212) 308-9200 -and suggest you make an appointment with
Dr. Gregg Jacob.

I hope the doctors there can answer your questions and come up with a solution, if possible.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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