u/Cheersyalllll

Some background: male, 40+ years old, double jaw surgery (advancement + CCW) with chin correction.

Before (left) + after (right) X-rays.

Goal: fix sleep apnea (increase airway obstruction) and misaligned jaws. Still super early days, but I'm very happy with the result so far.

This is my second surgery (the big one) after the previous one more than a year ago that expanded my upper jaw (I had crossbite as well, so quite a complex case?).

Post-op was super rough as expected (almost impossible to sleep, hard to breathe, pain, hunger, side effects from meds, etc).

I'm at day 10 post surgery and feeling relatively great: my chin and bottom lip are still numb, but I have been walking and driving around since like day 6 or so post-op. My face is still a bit swollen, but almost back to normal. I'm actually surprised how fast the recovery is given my "old age" compared to the teens on here.

scared. pre-op

Day 3 post-op (peak swelling, zombie mode)

Day 9 post-op

What I did different this time based on my previous surgery:

1. Get fit as hell before the surgery. VO2max at 50, weight lifting, resting heart rate 48, etc.
2. Use tons of salt-spray to the nose and gently try to pry any snot snakes out with kitchen paper.
3. Probably the most important: ask an LLM what a proper diet is for my weight and height. In my case: 6 bottles of a certain meal-drink (DM me for the name as I don't think I'm allowed to post it here) a day to hit all proteins, vitamins, minerals (has zinc, copper, magnesium, calcium, super important for nerve and bone repair), etc. On top of the meal drink I took extra Vitamin C + 4000 UI Vitamin D3 (temporarily for a few weeks only!! only do this if you know your levels prior!! in my case vitamin D was on the low side pre-op) + COLLAGEN PROTEIN. I think this is probably the biggest difference for me compared to last time. I arrived from the hospital feeling dead after 2/3 days of basically eating hospital crap (fake juice, fake yogurt drink and soup almost 0 nutrition). A few days later I felt almost normal.
4. I rented a Hilotherm device for good cooling of the face instead of messing around with ice packs. This was a huge difference with the first surgery where I messed around with ice packs and could barely sleep because of it.

cooling mask @ hospital post-op

1. I started having diarrhea and stomach pains due to the antibiotics they gave me, so I added some yeast to the diet (the stuff from the pharmacy against diarrhea, forgot the name). Works well.
2. Use tons of pillows and get one of those book reading/breastfeeding triangle pillows from Amazon if you can to be more comfy in bed.
3. I noticed my nose would clog up almost immediately and my face would start swelling and being painful as soon as I laid too flat. Sitting/getting up for like 10 minutes is essential to make that go away, including the clogged nose. I still have to sleep half sitting on day 10 to avoid this even though I feel fine otherwise.

Hope this helps people. I feel all of the above made a huge difference in recovery speed. I wish I knew all this the first time they opened me up.

Post-op 8mm bimax advance + counter clockwise rotation of bite plane (upper and lower) with hinge point at front teeth + chin advancement 4mm

I have about 2 weeks to go until surgery and just received the treatment plan. Upper and lower jaw will be advanced (as well as some chin work for looks), but the treatment plan showed something about opting for 8mm advancement of both jaws, even though 12mm would be possible.

My personal main goal is to fix obstructive sleep apnea as well as possible (and fix my bite, but that's unrelated to this choice).

The before photo:

Pre-op photo now/before

After. Simulated.

I asked the clinic about it and they said that the only reason they'd recommend 8mm over 12mm is for looks (facial harmony whatever). They can't really show me the difference, so I tried to simulate it myself (see above) and can barely spot the difference in looks. This might be due to the fact that my simulation is simplified/limited/not super realistic.

Any opinions? Will 4mm difference really be that different in terms of looks? If the looks aren't impacted that much, I'd rather go for the highest probability of fixing apnea.

Another thing that made me wonder: since the surgeon will have custom guides made to use during the surgery, would this choice impact the guide manufacturing? Or can they be somewhat flexible? In other words: did they secretly already make the choice for me and will the guides be fixed to that?

I'm about to undergo bimax advancement with some chin correction in a few weeks. One of the first questions I asked the clinic when discussing the procedure was whether they can show me a simulation of what my face will look like. How it will change.

But to my surprise they didn't really seem to have or know of software for that. So I wrote my own software to try and figure out what I'll look like. I'm curious whether people on here feel that this is a realistic simulation or not?

I'm curious if people would find this valuable for themselves to figure out what they'll look like.

I haven't shown this to my surgeon yet, so this is just me trying to figure it out by myself (I have no medical background at all).

https://i.redd.it/a4jwmae5v9dh1.gif

https://preview.redd.it/05b1kt66v9dh1.png?width=2767&format=png&auto=webp&s=4c31e747028bdb7a27a4934a5f5f1ffa6e44e009

https://preview.redd.it/0jkm7w66v9dh1.png?width=2756&format=png&auto=webp&s=798b417f920c91dc258a2a80af9583f86931eeac

https://preview.redd.it/lb8c6t7l831h1.png?width=1097&format=png&auto=webp&s=e9a9f28968c8985c99dbfb2a86fe84440ba70c0a

Does anybody know how to get an appointment for the conversion of an expired CRUE for EU-nationals to a permanent resident card after the CRUE expired?

All forms on AIMA website broken as usual. Calling doesn't work (can't get through), emails still get ignored, just queuing at AIMA office impossible (I have a job also).