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Dentistry/Orthognatic surgery went wrong?

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QUESTION: I used to have an underbite and my jaw was not centered;it was a bit towards the right side. I went to a oral surgeon and in the first visits he said I needed a double surgery (upper and lower jaw). The last visit before the surgery he said that I didn't need a double surgery because my orthodontist had done such a great job aligning my teeth. For the last 2 months I could see that my face just didn't look right. My jaw was still towards the right. My teeth were aligned  (upper and lower), but they still don't look right. I also noticed that one side of my jaw is higher than the other side (one side is shaped like a square while the other side oval).
When I smile one corner of my mouth is upper than the other. It looks weird to me. I also have a limited range of motion. 31 milimeters.
2 weeks ago I tried to point my concerns to the surgeon that did the procedure and he pretty much shut me down saying that everything was right.
Yesterday I saw another surgeon to get a second opinion and he could see the same things I do. In order to fix everything I will need a double surgery. So, what do I do? I don't think it's fair that I paid the amount I was asked for to fix a problem and that I didn't get what I was supposed to. I mean, the doctor got what he wanted (what he charged me), but I didnt. Instead I'm just unhappy and frustrated. I live about an hour from Minneapolis and I just hope this can be fixed soon. What is your opinion in this matter. Is this a matter of involving a lawyer as well?
Please let me know...
Thanks in advance!

ANSWER: MH - if the surgeon did not produce a proper result and says he did and does not want to address the obvious problems that you notice, a different surgeon also acknowledged and you are not happy with, getting an evaluation from a lawyer is appropriate. So find a lawyer skilled in malpractice cases to assist you.

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

3D Tomography
3D Tomography  

X-ray
X-ray  
QUESTION: Thank you so much for getting back to me. I just wanted to send a tomography file done before I started wearing braces and before the surgery AND an x-ray done after the surgery. I'm just wondering if you could tell me what should have been done so I could have a symmetric face. Please let me know. Thanks a lot!

Answer
MH - Both Tomographic picture definitely shows a facial imbalance with one side of the lower jaw longer than the other.  The xray shows that the doctor did surgery only on the lower jaw, but like the presurgical tomogram, there is an imbalance of the upper jaw that was continued on the lower jaw.  Not directly examining you, it is a little difficult for me to be completely sure, but from the films, both upper and lower jaws should have had surgery to balance your bite and face.  The orthodontist did make a mistake if he did not align the teeth for a surgery of both the upper and lower jaws, but the surgeon should have been on top the orthodontic treatment while it was being done.  The surgeon should have also sat down with the orthodontist before, during and after the orthodontics to make sure that the bite created would allow an appropriate alignment of the upper and lower jaws, to eliminate the obvious angle of your face and bite.

The surgeon should have told you and showed, in advance, the results that would occur from the surgery.  You can see an attorney, but before, you need to have a full examination by a knowledgeable surgeon, showing pictures, xrays and possible models made by the surgeon and then have him evaluate where you are now.  An attorney alone is not usually skilled, unless they do malpractice cases.  I looked up online and saw that there are a number of attorneys in Minnesota who handle malpractice cases and a few with experience in oral surgery cases.

So be careful to choose a skilled attorney.  I wish you well.  It is so difficult for me to see the type of treatment that was done on you.  

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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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