Just over 12 months ago I underwent bimaxillary osteotomy surgery (warning: don't google this if squeamish) to correct a severe underbite. My upper jaw was broken and moved forwards 6mm and impacted 1mm, and my lower jaw was moved backwards 4mm.


Comments: 1534 • Responses: 28  • Date: 

OnTheMidnightTrain2510 karma

Wow you almost look like a completely different person!

Did your speech adjust pretty well? Not to assume that you had a terrible speech impediment or anything, but years of speaking a certain way and then having it change had to be kind of different.

Branching off of that, what was the hardest adjustment?

minarima2685 karma

For the vast majority of my life (from the age of about 12 onwards) I've had a distinctly pronounced lower jaw and chin. For better or for worse this has assimilated itself into how I identify with myself and has heavily influenced my own self-image. Losing this trait was probably the most difficult change to adjust to, as I now have a pretty average lower jaw and chin (which is of course a good thing). However now some time has passed I've grown to appreciate the more balanced appearance to my facial features and don't feel so jarred when I look in the mirror.

In terms of speech I used to talk with a lisp which is now thankfully not the case, and aside from this I also speak much more clearly and with greater projection. The tone of my voice on the other hand has barely changed at all, which surprised me to be honest.

cohumi243 karma

How did your jaw deformity develop?

EDIT He says around 12, im curious about the science behind like if it was due to puberty and growth hormones or if a dental problem spiraled out of control but go ahead and downvote you pansies.

minarima198 karma

I expect (although can't be sure) that my jaw deformity was caused by faulty genetics and occurred during the onset of puberty.

cohumi84 karma

Could it have been prevented with retainers etc or is that unknown?

minarima121 karma

This is difficult to say, as one would need to be aware that the problem would occur before it presented itself. Perhaps it could have been reversed with quick orthodontic intervention while the jaw was still growing, but I can't say for sure.

tavernau142 karma

I lost a lot of weight (20kg) quickly (2 weeks) due to cancer treatment last year and I can relate to this. It's a strange thing to be looking at a different guy in the mirror.

How long did it take you to recover from old normal to new normal? I presume there was some wicked bruising etc.

minarima221 karma

I started to feel myself again roughly 5-6 months post op. Before this point I'd catch myself in some random reflection somewhere and jolt a little at the face staring back at me.

Familiarity slowly crept in and now the opposite is true- I look back at old pictures of myself and wonder how I managed to walk around in public looking the way I did.

Marubuyo110 karma

I'm post double jaw surgery for two years now and I can totally relate to this. I see old photos and cannot believe how insecure I was and how much my confidence level and overall mental health has improved. It seems superficial, but the way I looked was definitely a disability for me in many ways. Congrats on your new life guy!!! You look great!!!

minarima180 karma

Cheers. In a couple of weeks I'm booked in to attend a post surgical research survey seminar that's being held by my maxillofacial surgeon. I plan to attend to make sure they're aware how much it helped me both physically and psychologically and to ensure others get the same opportunity I did for treatment on the NHS.

koalakountry21 karma

I had it about 5 years ago. Best decision ever.

minarima12 karma


Captain_Farts_136 karma

a pretty average lower jaw and chin

you have a beautiful profile. your jaw-line is enviable to most men. And something has happened to your eyes that is indescribable, but they are very easy to get lost in your mirthful grin.

minarima249 karma

Thankyou Mr Captain Farts.

ross578164 karma

If you sing at all (or even casually) did this surgery have any effect? Do you notice a difference in breathing?

minarima478 karma

As soon as I woke up after the surgery I remember being able to breath through my nose (although it soon clogged up with blood) and thinking 'this is the easiest I've been able to breath my entire life'.

It seems my retruded upper jaw had constricted my airway to a small extent.

Also my singing sounds just as awful as it did before the surgery.

ross578155 karma

Thanks for answering!

EDIT: Would you recommend the surgery?

minarima210 karma

I would recommend the surgery 1 googleplex %

DausenWillis779 karma

Wow, what a difference with just mm.

How are people treating you.

Severe underbites seem to be depicted with a low iq in movies and on Tv, did you experience that as well?

minarima1516 karma

I felt as though strangers tended to judge me very quickly on appearance, and wouldn't necessarily take what I had to say very seriously, which made my day job as a technician difficult at times. Also an annoying side effect of my severe underbite was a strong lisp, which also contributed to the overall appearance of being 'stupid' or 'unconfident'.

My lisp has now thankfully gone, and I feel as though strangers are much more warm to my appearance now than they were before the surgery, which although being a positive change, does make you realise how superficial we as humans can be to those with facial deformities.

toaurdethtdes405 karma

How was the recovery?

minarima1376 karma

Probably one of the most difficult experiences I've ever had to go through physically. I was one of the unlucky ones and had severe swelling post-op, which when combined with having your jaws wired shut and your nose blocked with dried blood makes breathing almost impossible. In the first 3 days of recovery I had two panic attacks because I was so worried that I would vomit from swallowing so much blood and it wouldn't have anywhere to go...

I was on a purely liquid diet for 6 weeks (even lumpy soup had to be blended until it was completely liquid), and then I had my jaw unwired and could eat mushy food that could be eaten without chewing. At 8 weeks I started to chew soft food very very slowly.

Recovery from this type of surgery is long and rather tortuous. Strangely one of the hardest parts wasn't the not eating bit but actually the sleeping upright every night bit.

alicebirdy77 karma

I had a similar surgery (both upper and lower) and on the third day had a reaction where I could not stop throwing up liquid. I seriously considered just giving up on life that night.. what an experience. But here we are today :) you look great.

minarima99 karma

I also had a bad time roughly 4 days post op- something happened at the lefort 1 incision site at the base of my nose and I began to bleed severely. Annoyingly a lot of the blood was draining to the back of my throat and I wasn't in a position to spit it out..

This was probably one of the only times in my life where I truly entered 'survival mode'.

DausenWillis41 karma

Yikes! Did you end up skeletal thin?

minarima105 karma

I lost roughly a stone in weight during recovery, but have since made it back thankfully and then some.

defacto3335 karma

How did people who knew you react to your new face? (Friends, family, acquaintances etc.). Did anyone not recognise you? Any memorable reactions?

minarima723 karma

Most friends and family hid their initial reactions from me for the sake of politeness, however after a few months most confided with me that it was a big shock when they first saw me but that they were pleased it all went smoothly.

My most memorable post-op experience actually happened roughly 6 months after the fact, while I was walking down a railway platform to catch a train. I'd happened to bump into an old university friend who I hadn't seen in a couple of years and who wasn't aware of the surgery. I called out his name as he passed by but he just looked at me as though I'd killed his cat.

After messaging him over Facebook to confirm it was me he admitted that he didn't even recognise me due to my sudden change in appearance.

Fortune_Cat30 karma

Well at least you're off the grid from the NSA

minarima216 karma

I used my old passport during a flight to Germany late last year and the airport face recognition scanners didn't detect any facial discrepancies.

I've yet to decide if this means they're super intelligent or super stupid.

modern_drift254 karma

how did sneezing go, while your jaws were heading/wired shut?

minarima661 karma

This is actually something my surgeon had a serious conversation with me about before the surgery. Sneezing directly post-op is a huge no no, and you must try to avoid any sneeze triggers such as staring at bright lights and breathing in pollen/dust etc (who likes to stare at bright lights anyway?). If you do accidentally sneeze it's possible to rip all of the internal stitches out and bleed profusely, so should be avoided for obvious reasons.

Luckily I managed to avoid sneezing throughout the first 4 weeks of recovery, but it was harder than you'd think!

pHlevel9187 karma

I also have an underbite, so I'm very curious about the procedure.

How expensive was the surgery? Also, were your teeth still aligned after the procedure?

My jaw is also shifted to the left, but I also have an underbite.. so my teeth would be misaligned . :(

minarima331 karma

I had the dental splint removed 6 weeks post-op, and I distinctly remember the uneasy sensation of my teeth not meshing together as they should. I was told that this is completely normal, and that the orthodontist will make fine adjustments in the coming months to bring my teeth together harmoniously. This is exactly what happened, and they now fit together perfectly.

My surgery was performed in the UK under the supervision of an NHS maxillofacial and cosmetic surgeon. I luckily didn't have to contribute to the overall cost of the surgery.

wildeflowers96 karma

Op seems to be gone now. I can answer a few questions since its been almost 2 years since my orthognathic surgery.

Braces were about 7k I think. Surgery was approx 30k. I did have about 2k of coverage for braces and about 20k was covered by health insurance. I went to a surgeon that was out of network or more would have been covered, but he was a top surgeon, highly experienced and recommended by my Ortho. I live in an expensive part of the country so keep in mind everything is more $$$ here.

My teeth are perfect now and breathing is incredible. I can't believe the difference. I wear an Invisalign type retainer at night. If you wear your retainer, your teeth will never shift back. They can fix the cross and underbite all at once. There are complex mathematical models and surgical plans they go over with you during the process.

Feel free to message me if you want to know more. Recovery is tough but I can honestly say now I'm glad I had it done.

foxdale7 karma

Any tips post op? Especially easy liquid food to eat?

minarima9 karma

I very quickly tired of readymade protein drinks/smoothies and found strong tasting soups to be the more satisfying and likely more nutritious option. I blended mine with copious amounts of double cream for both its calorie and calcium content.

I'd also recommend a dissolvable vitamin C and zinc tablet just after you wake up every morning.

CalligraphyFantasy157 karma

I had the same operation last summer, how did you feel when you had your first solid meal?

minarima407 karma

I was so happy I almost cried.

I've now come to realise that human beings need to eat solid food not only for physical wellbeing but also for psychological happiness.

TeddybearTyrant139 karma

I also got this surgery about 10 yeas ago (I was 16, I think). I was swollen for years after. The not being able to eat real food bit was torture, especially when you are eating with your family and they are over there munching on pizza rolls eyes I found the not-throwing-up part hard, as the anesthesia and pain killers made me woozy. Did you have any trouble with that?

Also, what was your first "meal" after you got your mouth un-wired? What did you wish it could have been if you were magically all healed and able to eat anything?

minarima206 karma

My first 'meal' in inverted commas after being un-wired at 6 weeks was scrambled eggs with brown sauce, but let's face it that's not really a meal, despite tasting like the greatest food of all time while I was eating it.

My first proper meal came about 9 weeks post-op and it consisted of my favourite 'New Yorker' style beef burger from a local gourmet burger restaurant.

Of course I had to deconstruct it and eat it in sections - I could only open my mouth about 2 finger widths and tired easily- but it tasted like pure heaven nonetheless!

s00perguy24 karma

have you ever seen GradeAUnderA?

minarima22 karma

I have now.

dEDg3AFQar15 karma

I had the same operation in 1990. Do they still require your jaw to be wired shut for 3 weeks afterwards? Did you get constant post-nasal bleeding into your stomach (I was often vomiting up black congealed blood).

minarima18 karma

In my case I was tightly 'banded' shut. This meant that they wrapped tight elastics between the top and bottom brackets of my braces to keep my teeth closed. I was also required to wear a dental splint for the first 6 weeks post op in order to keep my teeth in the correct alignment.

I don't think wires are used anymore to wire the jaw shut after this type of surgery, unless you severely broke your jaw during an accident and weren't wearing braces at the time.

UFOsRus13 karma

Congratulations on your transformation. You look now similar to Gary Oldman (as others also pointed out), which I think is a good thing. My question is a bit of a sensitive nature: Do you worry about carrying these traits into your offspring and would you show your gfriend/wife your old pictures at some point or take it by chance and worry about it later if the features surface?

minarima19 karma

I have thought about the potential of passing on this trait, and to be honest it does worry me slightly.

Although hopefully by the time this is an issue with any of my future progeny I'm hoping advances in orthodontic technology would allow such a problem to be fixed non surgically during infancy >crosses fingers< .

demetriustherooster4 karma

I apologize if this is intrusive, but do you have any before and after X-rays you'd be willing to share? The outer change is really dramatic and it would be interesting to see more of the underlying process.

minarima15 karma

I'm afraid I didn't request a hard copy of my pre and post op x-rays. However I did see them on a computer screen and can confirm I'm now a cyborg.

IndustrialTreeHugger3 karma

When I was younger I had braces to correct a minor misalignment of my teeth because they were giving me so much pain in my jaw. The TMJ pain was giving me severe migraines. Did you have pain in your jaw because of your extreme condition?

minarima4 karma

I can thankfully say no, although weirdly I now experience severe cramping under my chin and upper neck at times whereas this never happened before the surgery.

boske7773 karma

I have a friend with similar surgery going on in like 10 days. Honestly I'm pretty much afraid of hows she's gonna look after or if something happens bad, and I think she is thinking the same way. She is also afraid of staying too long at hospital and not being able to eat.

How much does recovery lasts? Did you have problems with speaking and eating normally? Did they show you before surgery somehow how will you look after surgery?

minarima9 karma

I was never shown beforehand a prediction of how I would look post-op. This is quite rare from what I hear. To be honest I'm quite glad that they didn't, as the final result would inevitably stray from their prediction no matter their level of surgical expertise.

In addition I purposefully aimed to go into the surgery with very little aesthetic expectations, as this way I was less likely to be disappointed and upset with the overall outcome. In any case the surgery was largely corrective as opposed to purely cosmetic.

Ceanatis3 karma

First of all, I know you heard this a lot of times now, but Jesus Christ you look different! Congrats on surviving the terrible recovery (and I thought that my week of swelling and liquid foods after getting my wisdom teeth removed was bad, hah!), and I'm also glad it changed your appearance for the better.

So, I'm having a similar surgery in some time to correct an overbite, and I have some questions:

Firstly, how long did it take for the swelling to go away? I looked around a bit and couldn't see an answer to that. Some people said a full year, but that sounds awfully long! Are you fully recovered now?

And also, does your jaw feel more fragile now? I mean, obviously it does after the surgery, but it goes away, right? Or does it kind of stay there, like a sprained ankle that then isn't as flexible as before or more fragile?

minarima3 karma

Expect the swelling to linger for a really long time after the initial 'holy crap' swelling has subsided, and this is especially true around my upper lip/lower nose and cheeks near the lefort 1 incision site. I began to look 'normal' (whatever that means seeing as I looked different anyway) at around the 6 month mark, although puffiness lingered in my cheeks until 8-9 months post op. I'd say I'm now completely free of swelling, although the experts do say that the process of 'bone remodelling' can take up to 2 years to complete.

Also it doesn't feel any more or less fragile than before surgery, although i guess i don't bump it into things as often ;)

notabigmelvillecrowd2 karma

Have you noticed improvements beyond just your face? It looks like you have a bit more forward head posture in the previous picture, though it may just be coincidence, I wonder if you were getting neck/shoulder/postural problems before and if they've improved as well.

I had the kind of old school orthodontics where they just ripped out my molars instead of enlarging my lower jaw with surgery like they probably should have and now I have so much neck and upper back pain just from my crappy bite. It's amazing how much of a difference it can make in your whole body.

minarima3 karma

I imagine there's more truth to this than I'm able to comprehend without a medical degree. Still have a forward head posture though despite the correction. Seems I just like looking down a lot.