Pre-surgery Meeting with Dr A

So today I had my pre-surgical meeting with Dr A. He took a couple more bite molds just to make sure that the models he has of my teeth are lined up true to my bite. Then we got to discuss some of my questions and concerns. Let me tell you, I feel so much better having had this discussion. So here's the summary.

Q. How are we going to do this as I don't have braces?
A. He showed me using the cool skull model. During surgery they will place an appliance on my upper and lower jaws. It will be held on by individually wrapping wires around my back teeth. This is also what they use on trauma patients who don't have braces that the surgeon can use to wire/band the jaw shut during and after surgery.

Q. Will my jaw be wired/banded shut when I wake up?
A. (this one surprised me) Probably not! He said he usually only wires jaws shut when the lower jaw has been brought back. In cases such as mine where the lower jaw is advanced, he says it will not be necessary. The only reason he would wire my jaw shut is if, when they make the cut in my lower jaw, the jaw does not break properly. However, the people most at risk of this happening to are skinny Caucasian girls. Guess what I am? That being said, just because I'm at a higher risk does not equal probability.

Q. Since my jaws won't be wired shut and immobilized, how can I be sure that that my jaws will heal properly and not get knocked out of place?
A. The plates and screws (made of surgical grade titanium) are more than capable of holding my bones in their new positions. I will have three screws on each side of my bottom jaw - six in total, two plates holding my chin in place after a sliding genioplasty, and two plates on each side of my upper - four in total. Wow, that's a lot of metal!

Q. Will I have a splint?
A. Nope. I'll only need it in the rare case that my jaw needs to be wired shut.

Q. I actually like my rather "large" nose. After they cut into my top jaw, will my nose look different?
A. Yes and no. The shape of my nose would not change, but it will be a little more prominent. If, however, I truly would like it to remain exactly the same, Dr A will just shave down a bit of the nasal spine after he moves my upper jaw. I have to think about this one, but I'll likely opt to have him keep it the same.

Q. Another orthognathic surgery patient recently passed away due to some rather unfortunate complications. I'm a little worried now. Will I be ok?
A. While it is very unfortunate that another patient passed away, what happened to him is not the norm. Dr A is confident that I will be quite safe. His only concern is that I may lose a lot of blood if the arteries in my top jaw are accidentally nicked when they chisel away at some things (sorry I know it's kinda gross). The good news is that even this is not something to panic about. They would be able to easily stop the bleeding with pressure and they'll have two units on hand in the event that they are needed. If more is needed, they can of course easily get a hold of it in time. So all in all, I'm pretty safe as far as the procedure is concerned.

Also, I was given a choice between sliding genioplasty and a chin implant. I have opted for the sliding genioplasty. This surgery is for functionality more than cosmetics, and I would like to maintain as much of my natural face as possible. I love myself for who I am, and if I don't have to change it I won't. An implant would leave me with a rounder chin and get rid of my slightly cleft chin. So in the name of keeping my natural features, and leaving some of those little details that make me me, I have opted for the genioplasty.

After some discussion and the molds, Dr A sent me on my way with a pre-op blood work order. I went to the lab right in the hospital to have it done. I'm glad that this means I won't need to blood work done tomorrow at my pre-surgical physical and health history appointment, but I can't pretend I wasn't less than thrilled about it. I hate blood-tests and IV's, and I hadn't planned on needles today. The good news is I didn't pass out this time and the phlebotomist was funny.

And a bit of disappointment: due to a scheduling error my surgery has been pushed forward to July 21 rather than the 20th. Not a huge change, but I'm still a little bummed. Dr A is in a different office on the third Wednesday of every month, and we hadn't realized that the 20th was the third Wednesday. Other than that everything is set and ready to go. I have a physical tomorrow and then the next time I see any medical personnel it will be on surgery day!

If I missed something you'd like to know, feel free to ask :)