Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 7/18/2007

Question
QUESTION: I had upper jaw surgery in early May to correct my bite. I knew going in my nose ways going to go up slightly. It has been 2 1/2 months and I am mortified with my face.  My nose went up considerably, the base has widen and it is completely different. My upper lip is very droopy too. I regret this soooo much because the "slight" changes were much more dramatic than I was lead to believe. What are my options now? Can I reverse the surgery and can the composition of my nose be restored?

ANSWER: Debbie-  You are right to be upset by these changes.  With excessive movement of the upper jaw, the soft tissue of the upper face can easily shift. 2 1/2 months down the line, the tissues have not fully healed.  With time there should be some tissue correction, but most likely not fully.

You should not consider redoing the surgery, but if you see a knowledgeable plastic surgeon, near where you live, I believe the soft tissue changes you are uncomfortable with can be restored.  Wait another month and then make that appointment.

If you have any further questions, please feel free to contact me again.

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

QUESTION: Thank you for your prompt advice.

I really hope it does heal a little better. At this point the changes to my nose does not validate the correction to my bite. I just hate my nose now. I wish he would have said your nose will change completely after the operation and not slightly, I would have definitely not gone through the operation.

I have another question. I have the screws on the left side of my face much higher than on my right. Actually I hardly feel the ones on the right. The left side of my face is raised higher and my OS said he can take them out.My questions related to this are the following:

1) Will this cuase more nerve damage (my upper lip and nose are still numb)?
2) Will I swell up again?
3) How much is this and does the insurance usually cover it?
4) Will this cause more damage to my nose? (My nose got wider on the base and sides)

Thank you again for your advice! I wish  I had been on this site before my operation!

Distraught,
Debbie

Answer
Debbie -  Depending on the location of the screws, the removal may initiate more damage to the nerves.  Just by stretching the tissues to uncover the screws, nerves that were already injured and attached to the soft tissue of the face can become more inflamed.  I am not telling you not to remove the screws if they are annoying, but you should know that because of their proximity to where nerve tissue is, just pulling on the soft tissue to expose the screws may irritate the nerves more.

The cost should be rather negligible and should be done under local anesthesia.  Because the surgery was done in early May, it is too soon to remove the screws.  They should remain in place for a couple of months more.

The nose itself should not have any further effect by screw removal (dependent on their position and if the nose has to pulled aside to gain access to the screws).

I understand your feelings, but I think I would wait a little while so as to not affect the healing bone.