No, I am not speaking as a customer but, rather, as one who has over the years aided and abetted the performance of countless such surgeries.
Just as Lord Bismarck remarked, "A person should never see how his laws or his sausages are made," so with the performance of elective jaw surgery.
This is one of the more closely held secrets of modern medicine, one you will not read of anywhere else.
No matter.
I have been there and seen that, as it were, with my very own eyes, and winced and felt the pain–to–be of their hapless patient–victims.
Long story short: it's an inexact art governed more by time constraints and the surgeon's mood than dysfunctional anatomy.
The lower jaw's anatomy is extremely complex.
Much happens in a very confined space, culminating in the temporomandibular joint.
When something goes wrong in this confined space with little if any affordances, symptoms can be myriad.
Surgery to correct malocclusion (abnormal bite) is fraught with peril, namely that no one knows how the post–surgical jaw and related TMJ(s) will function — or even if they will function.
Elective jaw surgery to shorten the mandible (lower jawbone) for cosmetic rather than functional purposes is, in my opinion, tip–toeing right along the edge of malpractice.
I attended scores of such surgeries as the anesthesiologist.
Apart from the cost and postoperative misery — for starters, tremendous pain, and your jaw will be wired shut for weeks while the bone heals so you'll be dining through a straw — which are part–and–parcel of such work, the thing you will never know unless you are right there in the O.R. as part of the surgical team — or read bookofjoe — is that the surgeons proceed in an off–the–cuff and ad hoc manner.
For example, the O.R. cut–off time for elective dental surgery at UCLA was 4 p.m.
In practice, that meant the patient had to be out of the room and in the recovery room by that time.
That was so everyone could go home by 5 p.m.
Overtime is expensive.
The penalty for the surgeon who didn't comply was to have his O.R. time reduced.
Not a welcome outcome.
Now, it's not as if the surgeons didn't have plenty of time to do what they needed to do.
It's just that, having begun at 8 a.m. with all the time in the world, once they got going with their various bone saws and drills and other stainless–steel, high–priced carpenter's tools and toys and whatnot, time just flew.
At least it did for them.
Part of my job was to inform them at 3 p.m. that they needed to finish up so I could wake the patient up and get her/him to recovery by 4 p.m.
Frequently this would result in abandonment of some crucial part of the procedure or a shortcut to get done in time.
The patient would never know.
I remember when I moved to Virginia from LA and my new dentist looked at my severe crossbite and told me it was one of the worst he'd ever seen.
OK.
I mean, I'd heard that before and had never had any problems eating or whatever so it didn't seem to me that I had a problem worth thinking about.
Then he said I should have it corrected, which meant undergoing the kind of surgery I've just described above.
It was all I could do to keep a straight face while I listened patiently and then replied that I would give it serious thought.
For the next couple years he'd mention it each time I came in for my semi–annual cleaning but after a while I guess he came to realize that I probably wasn't gonna go for it.
I haven't heard a word — or had a problem — since.
Bottom line: if you're considering elective cosmetic jaw surgery, get not only a second but a third, fourth, and even fifth opinion.
Money very well spent.
And that's all I have to say about that.
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