Acromegaly_Chad
Offical Surgery Consultant
- Joined
- Apr 16, 2020
- Posts
- 2,050
- Reputation
- 5,194
This thread is about nerve damage after any type of jaw surgery. Many people here and on jawsurgeryforums are very afraid of jaw surgery due to possible nerve damage and therefore rather chose to rot with their stupidly recessed potato jaws instead of slaying their oneities.
Little do they know that severe nerve damage, meaning an extend that actually impacts you in everyday life, is extremely rare and can to almost 100% be avoided.
Some factors that influence the risk of nerve damage are:
- age
- surgeons skill
- the type of surgery. Generally the risk is as follows: Chin Wing > Genioplasty > low BSSO > high BSSO > Lefort1
- Vitamin B12 levels
- Immediacy of post surgical nerve trauma treatment
Since nerve complications after a lefort1 are much rarer than after a mandibular osteotomy, we will focus on the mandible.
The nerve that's critical is the Nervus alveolaris inferior as shown above, running in the Canalis mandibulae and forming the Nervus mentalis by passing the Foramen mentale. It's the Nervus mentalis providing sensation to your chin and lower lip.
Loss or alteration of sensation is always a result of trauma caused mostly by stretching the nerve too much. Even a stretching of a mere 12% of it's initial length is said to cause altered sensation. Altered sensation can be classified as follows:
The following image illustrates what nerve trauma looks like:
Hypoesthesia and Paresthesia make up the vast majority of sensory disturbances and are usually caused by Neurapraxia or Axonotmesis. I myself suffer from Hypoesthesia in my chin and lower lip but by the end of the month I'll get treatment.
This is the key part of this thread: When you suffer from nerve damage, maxfacs will tell you to just wait and wait even more until you don't go to them anymore. The truth is, after 6 months it's a more than 80% likelyhood that the type of sensory disturbance you experience is what will be permanent.
BUT you shouldn't listen to them. Unless you suffer from Neurotmesis (the whole nerve is completely cut through, major fuck up from the surgeon) it's possible to have good recovery. As always, the better your starting point the better the possible end result after treatment. If you still have sensation disturbance 2 months post surgery go see a neurologist. With different measurements he can determine where the nerve has been damaged and once that part is localized there are different types of treatment.
A common method, that even works in some cases for Neurotmesis is by bringing the ends of the nerve together where it has been divided:
If the gap is too long you can get a nerve transplant from you leg:
These procedures can be done up to 3 years post surgery for the Nervus alveolaris inferior (some other nerves not involved in jaw surgery require much quicker treatment). However, the sooner treatment starts the better the prognosis. Consult your Neurologist 1 year post surgery at the very latest. Don't listen to your maxfac as he will always tell you to just wait.
These procedures can't give you a 100% recovery if you had initial hypoesthesia or worse. But combined with good health, laser therapy, acupuncture and your (hopefully) very young age it's EXTREMELY unlikely to get permanent, noticeable nerve damage.
Btw. insurance has to cover the neurologist treatment in most countries.
There's simply no more excuses not to get jaw surgery.
Little do they know that severe nerve damage, meaning an extend that actually impacts you in everyday life, is extremely rare and can to almost 100% be avoided.
Some factors that influence the risk of nerve damage are:
- age
- surgeons skill
- the type of surgery. Generally the risk is as follows: Chin Wing > Genioplasty > low BSSO > high BSSO > Lefort1
- Vitamin B12 levels
- Immediacy of post surgical nerve trauma treatment
Since nerve complications after a lefort1 are much rarer than after a mandibular osteotomy, we will focus on the mandible.
The nerve that's critical is the Nervus alveolaris inferior as shown above, running in the Canalis mandibulae and forming the Nervus mentalis by passing the Foramen mentale. It's the Nervus mentalis providing sensation to your chin and lower lip.
Loss or alteration of sensation is always a result of trauma caused mostly by stretching the nerve too much. Even a stretching of a mere 12% of it's initial length is said to cause altered sensation. Altered sensation can be classified as follows:
The following image illustrates what nerve trauma looks like:
Hypoesthesia and Paresthesia make up the vast majority of sensory disturbances and are usually caused by Neurapraxia or Axonotmesis. I myself suffer from Hypoesthesia in my chin and lower lip but by the end of the month I'll get treatment.
This is the key part of this thread: When you suffer from nerve damage, maxfacs will tell you to just wait and wait even more until you don't go to them anymore. The truth is, after 6 months it's a more than 80% likelyhood that the type of sensory disturbance you experience is what will be permanent.
BUT you shouldn't listen to them. Unless you suffer from Neurotmesis (the whole nerve is completely cut through, major fuck up from the surgeon) it's possible to have good recovery. As always, the better your starting point the better the possible end result after treatment. If you still have sensation disturbance 2 months post surgery go see a neurologist. With different measurements he can determine where the nerve has been damaged and once that part is localized there are different types of treatment.
A common method, that even works in some cases for Neurotmesis is by bringing the ends of the nerve together where it has been divided:
If the gap is too long you can get a nerve transplant from you leg:
These procedures can be done up to 3 years post surgery for the Nervus alveolaris inferior (some other nerves not involved in jaw surgery require much quicker treatment). However, the sooner treatment starts the better the prognosis. Consult your Neurologist 1 year post surgery at the very latest. Don't listen to your maxfac as he will always tell you to just wait.
These procedures can't give you a 100% recovery if you had initial hypoesthesia or worse. But combined with good health, laser therapy, acupuncture and your (hopefully) very young age it's EXTREMELY unlikely to get permanent, noticeable nerve damage.
Btw. insurance has to cover the neurologist treatment in most countries.
There's simply no more excuses not to get jaw surgery.
