Saturday 12 July 2014

Form Follows Function: the reason for orthognathic (jaw) surgery

In architecture, there is a common saying which goes: form follows function. And I'd say that concisely sums up my reasons for jaw surgery.

When I was younger, I didn't have this crossbite and facial asymmetry which I saw in my teens. I guess it was a deformity which developed with time. 

Hmm, deformity... That's a nasty word.

Sure. It is as nasty as it is true. Deformity is an abnormally formed part of the body (quoted from Dictionary), or jaw, in this case. And for me, it caused some functional problems, such as being unable to chew my food properly as I'm supposed to, pain in the jaw joint when I'm chewing on some tough meat or vegetable, and also having chunks of meat and vege (yes, chunks) stuck at this particular spot in between my molars because of the way the molars have grown to be and are only half or less in contact with each other.

Psychologically, the asymmetrical external also affected me to a certain extent. Don't get me wrong, I am not dissatisfied in the way God had made me, but to say that I loved the way I looked, that's not true either. I merely accepted myself the way I was, and the way I am now. I was and I am happy! I'm not one who is so super conscious about looking pretty (I believe in beauty from the heart), but you know, I'd just like to look 'normal'.

So in view of the functional problems I was having, I decided to just do it, once and for all.

Of course, that came with a lot of worries, most of them about how others' opinions. And even up till now, I'm still trying to figure how I should approach the topic. How will I explain to others on the reason for surgery? Will they accept the reason of 'for function'? What if their impression of me changes to think of me as someone who is vain, and think that this is plastic surgery?

If any of you, dear readers, are in or have been in my shoes, I know you get what I mean. And for the majority of people with normal, well-functioning jaws, I also know that it's going to be difficult for you to grasp the reason that it's for function. But really, just listen with an open mind. And be thankful for your well developed jaws!

Jaw surgery is not a small surgery. And it doesn't come cheap too (thank God for insurance). The road to recovery is an arduous journey (and that now, nearing three weeks, just seems endless!). As with every kind of surgery, despite the medical advancements, there are still risks; and one can always expect the unexpected in life. Why would I want to go through so much pain and trouble and time, with money, for beauty sake?

Being brought up in a home with every decision based on christian principles and values, you can be sure that my parents would be the first to object to this surgery if it were just for aesthetics. It took my parents time to be convinced that the physical pain I will go through (if I were to undergo the surgery) is worth a risk to take, after considering both the procedure and surgical cost. When the orthodontist first presented my parents my dental situation and to consider this invasive surgery, they immediately rejected the idea. That was when I was 17. Three years later, after many back and forths from the clinic (to the orthodontist's exasperation, oops), and much prayer, we finally went ahead with the surgery. It was a big decision, but a good one at that.

I can't deny that this surgery gives cosmetic improvements. But, this is only because form follows the function of your jaws. The initial, and final factor, for deciding on surgery is still to correct function of the bite.

For those of you who are contemplating this surgery, I urge you to truthfully and seriously ask yourself what your primary reason is. Functional or aesthetics? For me, it was functional, but it doesn't mean that this surgery can't be done solely for aesthetics. During one of the pre-op consultations, the surgeon asked me if I had any dissatisfaction with my face. I truthfully replied: "Not really. Just my bite.", to which he responded: "Wah, so simple ah?" It's true :)

If you are more focused on the aesthetic results than the functional, I think you shouldn't do it. Reason being, in surgery, it is very difficult to obtain accuracy in alignment during the moving of your jaws (the surgeons can only do their best, minor tweakings are left to the orthodontist). And in cases of moderate to severe asymmetry, post-op residual asymmetry is not ideal, but neither is it uncommon to have. Imagine if you were to enter into the surgery with aesthetics on the top of your list, only to realise that you still have some asymmetry left, you'd feel so unhappy, dissatisfied, and that for all that suffering you experienced post-op was for naught.

However, if you are considering the surgery for the right reasons, I'd say GO FOR IT! It's definitely worthwhile, and better do it when you're young because recovery will be much faster and with less chances of complications. The road to recovery is tough and you may have bouts of temporary depression, but cling on to hope and when it's all over, I think the sufferings will be all but a distant memory. I think I might forget about it actually (that's why I keep this blog!).

As of now at three weeks post-op, if my face were still to have residual asymmetries but with my bite problem solved, I wouldn't really bother having another surgery to fine tune the external aesthetic imperfections. Reason being, it's just not worth all the trouble. Unless, the maxillofacial surgeon advises otherwise. (By the way, my surgeon did clarify that he was not a plastic surgeon, but an oral and maxillofacial surgeon.)

Hope that this has been helpful to at least someone who is considering the surgery and at crossroads. You need a lot of mental preparations and family support before and after surgery, and especially so during your recovery!

Feel free to leave any queries behind and I will be most glad to have them addressed!

Phew! That was a load off my mind. I've been wanting to post this for a long time but couldn't get a clear head to write, but now I have! Thank God.

See you next time!

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