maxillofacial surgery

Four Years: Conclusion

I had my last orthodontic appointment two days ago which was just to make sure the retainer was doing what it’s supposed to do. I also got my last set of photographs from my orthodontic office, so you can compare before and after. The braces are still on in those photos but they were taken the day the braces came off. My gums were also inflamed, they have since recovered.

Also general photos, before and after.

The change to my jaw is prominent, even to me, when you look at those two side by side.

It’s been a long four years but my jaw doesn’t pop out of place anymore, nor do my teeth cut into my gums and they align properly without any gaps. Despite everything in the end it was 100% worth it.

Four Years: Part 6

Part 5

There are a few topics I have not covered during the telling of my story. Plus there are a lot of pictures I still haven’t posted. My last orthodontic appointment is in three days and I should have comparison pictures then. Until then, I will do my best to wrap up everything else with this post.

Metal In My FaceThis is the X-ray of my jaw post surgery. I still have the braces on my teeth but you can also see the titanium screws in my jaw bones, the screws and plates in my chin as well as those in my upper jaw.

During talking  about my recovery the one topic I did not cover is one of the most obvious: how I managed to feed myself. Since my jaw was held shut for six weeks, and for half of that I was unable to move it despite the elastics, I was forced into eating on a liquid diet. It was eating through a tube.

To be exact it’s a rubber tube, about the size of a straw, attached to an over sized syringe. Anything I ate had to be liquid and fine enough to be forced out through the straw. I couldn’t produce suction strong enough to eat things like soup through a straw (for the first few weeks I couldn’t even produce enough suction to drink anything, let alone soup) so the syringe was the only option I had.


The big risk here is that being restricted to a liquid diet is not the most versatile diet, which means it’s easy to begin losing weight. When you’re recovering from major surgery losing weight is not ideal. My doctors didn’t want me to lose more than 10% of my body weight during my recovery and given that I didn’t weigh much to begin with I didn’t have much leeway. In the end I didn’t lose any weight during the whole ordeal, so that was a pleasant surprise, to both me and my doctors.


I ate a lot of soups and blended shakes, plus some of those soups were blended as well. For a while I had only tomato soup, since it is all liquid but after a while that became boring. Soups had to be blended very fine to make it through the straw without clogging. My mom started looking for powder based soup mixed so that it would be easier for me to have a variety. The shakes were more to fill in the gaps in my diet, with a lot of protein and Ensure to round out the vitamins.

Blender GoodnessAll of my medication was liquid and taken through the syringe as well. There was a lot of them, and I had a schedule. Every few hours I was taking something. Most of them were diluted a bit with water just so there was enough liquid for the syringe to draw it into the reservoir. The red one is Oxycodone, the purple one is Tylenol and I don’t remember what the pinkish colored one is.

ReadyGiven how messy eating through the syringe was, and how often I had to take medication as well as use mouth wash to try to clean my mouth I spent a lot of time over my kitchen sink. It became the most common place for me if I was awake since I was usually doing something there. Because it was a liquid diet I ate a lot in small doses instead of trying to eat a lot at once, a lot of that had to do with the syringes had to be cleaned after usage and I only had two of them and I believe one of them broke early on. All of the bottles of medication and mouthwash can be seen all over the bar counter.

Usual SpotI owe every easy part of my recovery to my mom, since she held it all together. She managed all the food and medication, making sure it was all ready to go and taken when it needed to be.

I cannot thank her enough for that.

Four Years: Part 5

Part 4

May 23rd, 2011My initial follow up appointment was two weeks post surgery. They undid the rubber bands for the first time since most of the healing inside my mouth had run its course. That is still one of the most euphoric moments of my life. Being unable to clean my mouth during the rotting and the disgusting healing process and then at last having the freedom to do so.

It was bliss.

After that I was permitted to change the rubber bands myself, which meant I could brush my teeth at least once a day. I didn’t take them off for any other reason, since it was an absolute pain to get the rubber bands back on. I think it took me half an hour to get them back on the first time I took them off at home and I didn’t even try to do it the correct way.

The proper way to put the bands on is to hook the band on one of the bottom brackets on my braces, then loop it over the top bracket before bringing it back down to the tooth next to the starting point. This creates an inverted V shape. Since it was meant to hold my jaw closed you then place them all the way around, alternating inverted V and regular V, instead of just near the molars as is standard for V orthodontic elastics. All of that using elastic bands no wider in diameter than the head of a Q-tip.

Disgusting SplintOn the right we have the splint and some of the elastics after they were taken off. It’s disgusting. Six weeks of being affixed to my upper jaw, without moving, without proper cleaning.

Yes, the red is blood.

The rest of the swelling had for the most part receded from my face, as had most of the numbness. I have, to this day, partial numbness in my lower jaw. My estimate is somewhere around a 30% loss of sensation in my lower lip and chin. I still feel things just fine but not to the full extent someone with full sensation would.

The numbness feels most bizarre when I eat or drink something cold. Some days the numbness is more noticeable, today for example I can feel it when most of the time I can’t unless I provide some sort of stimuli. I also noticed since the surgery if I drink from something with a wide brim, say a soup or cereal bowl, without paying extra attention, I now dribble a bit down my chin when I didn’t before. Nor do I notice because I can’t really feel it.

I lost the ability to whistle after my surgery. Two years of practice and I can at last whistle again.

Part 6

Four Years: Quiet Work Days

Part 4

May 16th, 2011My mom flew back to New Hampshire on May 3rd, 2011.  This photo was taken on May 16th, which is a month and a few days post surgery. My convalescence from work had ended the day before which explains why my hair is no longer quite so out of control. The splint and rubber bands were still in my mouth though, but those were due to come off soon.

While I could speak it was too quiet for easy communication at work since I could only open my mouth so far. That led to quiet days at work, which was fine with me since I had plenty to catch up on since I had been gone for the past month.

Since I had a lot more practice opening my mouth I could keep it open for longer. It grew more difficult the longer I kept it open, since I was fighting the force of the rubber bands. Now I could drink with a straw without having to tuck it back by my molars. Another simple thing that was normal again.

Four Years: Outdoors

Part 4

May 1st, 2011This was taken May 1st, 2011. The status of everything is still steady with the last photo except for some reason my bottom lip is uneven in this one. I would guess it’s due to swelling from sleeping on my side. The hair is also getting a bit crazy.

Around this time is when I felt confident enough to leave the apartment without drooling everywhere. Or trying to answer awkward questions about my looking like I had been run over.

My mom and I first visited the Foster Botanical Gardens in downtown Honolulu. Established in 1853 the site boasts one of the most well known orchid collections in the world.

We also went to the National Memorial Cemetery of the Pacific, in what is known in Hawaii as the Punchbowl. Dedicated in 1949 it serves as the resting place for 34,000 United States military veterans and their dependents.

Four Years: Speech!

Part 4

April 28th, 2011This photo was taken on April 28th, 2011, which brings us up to sixteen days post surgery. By now I could speak and be understood, though no where near the speed and ease I could before. I had to take my time with it. Plus I would still swell up if I slept on my side but not as bad as it was before. Over all my recovery was looking good across the board.

The numbness in my face was beginning to decrease in gradual increments, no longer reaching from my chin to my zygomatic bones. Instead it began to almost work its way down toward where the more intensive surgery took place. It felt almost as though the numbness was “draining” in slow motion down my face. Both my lips were still numb however, which was about as awkward as you can imagine.

The drooling was starting to cease as well. That alone would have been enough to keep me happy. The rest was a bonus.

Four Years: Vocalization

Four Years

April 21st, 2011Taken April 21st, 2011 (nine days post-surgery) when I decided to take the bandage off. It was getting disgusting and I don’t know why they expected me to keep it on longer.

The swelling in my lips was still at a ridiculous level, with special emphasis given to the middle of my upper lip. I still also drooled non stop, but at least now it wasn’t running down into the bandage. That’s part of what made it so disgusting.

I also began to recover muscle strength in my jaw. I still couldn’t talk in a manner that anyone could hear me, but I could part my teeth, if only just millimeters. Being unable to open my jaw I think was less about the rubber bands holding it shut, though that was without a doubt part of it, but more on that my jaw muscles were weakened a considerable amount from all the bruising and damage from the surgery.

That being said it was still a lot more than I had been able to do even a few days before. At this point I was relying on my second computer monitor with notepad blown up in huge letters to talk to my mom. It worked out pretty well but speaking is just simpler so being able to speak again, and be heard and understood, was something I was looking forward to.

Four Years: Progress

Part 4

April 20th, 2011

By the time this photo was taken on April 20th, 2011 my lips had almost healed. The only reminder of the damage to my lips is a small scab on the left side of my bottom lip. Most of the disgusting rotting in my mouth had abated as well, much to my relief. The swelling in my face and lips hadn’t receded much but at least there was still visible improvement.

There was also progress that you can’t see from just the picture. The sutures inside my mouth had begun to dissolve and break apart. When the photo was taken at least two of the multiple sutures had already come undone and fallen out.

Drool was still a constant in my life but Portal 2 had come out the day before so I spent most of my time playing it. Portal 2 was a blessing since it provided a great distraction from the persistent stream of saliva, which I was beyond done with.

Four Years: South Fork Dam

Part 4

April 19th, 2011This one was taken April 19th, 2011, one week post surgery. There’s a reason most of these pictures show me with a towel. I was not expecting this torrential downpour of drool.

Your lips act as a dam holding back a reservoir of saliva and jaw surgery is akin to the South Fork Dam failure. The South Fork Dam collapsed in 1889 and sent 20 million gallons of water surging into Johnstown, PA killing 2,209 people.

I’m certain 20 million gallons of drool poured out of my mouth as well. Don’t take this as fact but I think our subconscious mind helps us retain the saliva in our mouth. When your lips are numb that doesn’t seem to work anymore. Cue the drool.

Now that wouldn’t be so bad if it wasn’t a constant, never ending stream of drool. To the point of outrage at the inability to stop it. And it’s as gross as it sounds. Hence the towel.

Four Years: Balloons

4 Years

April 17th, 2011I took this picture minutes after I woke up. My doctors told me not to sleep on my side during my recovery and this picture is why. If you look at my right side the swelling is unreal.

Sight from that eye was almost gone, obscured by my cheek. I guess the pressure from sleeping on that slide caused the swelling. I had done a my best to follow the doctor’s orders but I have a hard time sleeping on my back.

It wasn’t until a year later that I figured out how to sleep on my back. I still prefer sleeping on my side, but if I ever need to again, I know how. For anyone else, do this: place a pillow under the hip of the side you sleep on, or sleep on a couch with the back of it next to that side. This will feel more natural to you, as though you were on your side.

I hope that helps someone, it would have been a life saver.