6. The Team

My Team Finally Comes Together

Despite my worry that I wouldn’t approve of Dr. G. as my surgeon for this endeavor, he immediately put me at ease during my first appointment with him. His laid-back manner and confidence actually made me look forward to tackling my treatment, which was a welcome change from my usual bitterness and cynicism concerning the next two years of my life. After taking some pictures of my profile and me straight on, he explained the treatment in more detail. The surgery would take about 3 hours, and I should be able to leave the hospital that same night. I would either have my jaw wired shut or would have it rigidly fixated for six weeks, the main difference being that I would be on a liquid diet if my jaw were wired, and a soft foods, etc, diet if it were fixated. He mentioned the same risk about permanent numbness that I had heard from the other oral surgeons. Dr. S. had told me that numbness is common for most people directly after surgery, but while most people regain all their feeling in their lower face, some people experience permanent numbness. He had also told me that my chances of having the lingering numbness was less since I was younger and would therefore heal faster. Some other risks that Dr. G. mentioned were excessive bleeding and infection, both of which he said he had never had happen in his experience.

Dr. G. then showed me a model of where the break in the bone would be, and the proximity of the nerve to it. During the surgery, he will be cutting into my jaw from the inside, back by the tempomandibular joint. The bone will be cut diagonally, more like a sliver being cut vertically from the jaw than a horizontal break. This break exposes the spaghetti-sized nerve, which is about in the middle of this slab of bone. The nerve’s safety didn’t seem as tenuous to me once I had seen how my jaw would be broken, since, in my interpretation, I had imagined that the jaw would be broken across, the nerve would be exposed from above it, and a wedge would be placed under the nerve. Finally, we discussed the financial matters of the treatment, and Dr. G. completely surprised me by saying that he didn’t anticipate any problems with my insurance company. Although the orthodontics weren’t covered by insurance, Dr. G. did give me hope that we could get the oral surgery approved. Apparently, he works very closely with CareFirst, and even does their final reviews for them, so he claimed that he knew exactly what they were looking for in order for us to get approval. His next step was to put a packet together for them that included my models, pictures, and anything else needed to prove that this was not simply a cosmetic procedure I wanted to have done. He expected to hear back from insurance after about a month, so we were waiting to see if a rebuttal were needed then, which thankfully proved not to be necessary.

I had one final appointment with Dr. G. before my braces went on. We confirmed the treatment so he could send the packet off to insurance. He also showed me some pictures and drawings of my jaw pre-surgery, post-surgery, and post-surgery with a chin implant. Luckily for my wallet, I was dumbfounded - and also slightly horrified - by the chin implant pictures, and realized that I would be perfectly content with the more subtle repositioning of my jaw with just the surgery. While the implant definitely gave me a stronger chin, it also made it so I no longer looked like myself. The surgery was expected to not only level out my jaw, but also bring it slightly forward, closing up my overbite and helping my chin be more defined without changing my appearance too drastically.