Wednesday, October 22, 2008

Ask Bella: Changes in appearance

Q: I had upper and lower jaw surgery (turbinates removal & genioplasty as well) about 2 1/2 weeks ago. Like most people, I did this surgery for purposes of function and not appearance. I loved my appearance - I loved how dainty I thought I looked.

While I don't think my reaction a week post-op is much indication of how I will feel forever...after most of the swelling had gone down and I could tell what I would look like, I was devastated. I didn't recognize myself. I had this dysmorphic type of reaction to the results of my surgery and I couldn't stop staring at what I saw as the destruction of my appearance. Even 2 1/2 weeks out, the steroids have worn off, I'm not on meds, I'm getting normal sleep, I'm not in much pain at all....yet my reaction to the alteration of my appearance still stays.

Have you received emails from other people that have had this reaction? Do you know how they overcame it?

A: I'm so sorry you're going through such a hard time. Your email made me want to reach out and hug you.

My surgery wasn't nearly as extensive as yours, so I can't speak to the dysmorphic reaction to your reflection from personal experience; however, I have read on message boards about other people who have had similar reactions to yours.

And, really, who can blame you? We all identify with our outer appearance - you've lived within this skull and skin your entire life and then one day, suddenly, you look in the mirror and don't recognize the person staring back at you? That is a huge shock to the senses, psyche, and identity. How are you supposed to just accept that you look completely different in just 2 1/2 weeks?

Let yourself mourn your old appearance. It's okay to feel sad because you have lost something that was a big part of who you are. But at the same time, try to find things that you like about your new appearance. Take a good look. Check out your profile. (I know I always hated mine because my weak chin made my nose look bigger. Now, it's more in proportion, which I like a lot.) Make a list of what you like and focus on that as much as you can. Because the reality is that this is what you look like now, so you need to find ways to look at yourself in the mirror and like what you see, after the surgery.

I think time will help, focusing on the positive will help, and then if you still feel that things aren't where you would like them to be, talking to a therapist would be the next step.

When I'm frustrated and upset about the fact that I still don't feel like myself these days (I'm struggling with a lot of fatigue, even after my post-surgery anemia has gotten better), my boyfriend always says to me, "You're pretty hard on yourself, you know." It makes me realize that I do put a lot of pressure on myself to be perfect, to be healthy, to be this super achiever and that sometimes, I just need to be good to myself and say, "It's okay if it's not happening as fast as I want. I'll get there" and just give myself a break for once.

Two and a half weeks is not that long. Even if everything seems to be going swimmingly, you've had major, major surgery where they took a bone saw to your face and rearranged your bones. That affects your body and your mind and your spirit in a big way. So, don't pressure yourself to be totally healed and accepting of everything just yet.

Just be good to yourself. I hope everything goes well for you.

*To ask Bella a question about her jaw surgery, email her at smilingbella at gmail dot com or leave a comment on this post. Go ahead: ask away!!

6 comments:

dearsweetbriar said...

I also wanted to add that after two weeks your face isn't going to be nearly where it will be when all of the swelling and settling is done - I know that it won't help with the immediate depression, but it will probably be six months or more before everything is where it's *really* going to be.

I know that for months certain swelling in my cheeks made me very unhappy, but it's completely gone now (seven months post-op). And I only had a lefort-1, so your face would have had much more trauma! Bella's advice is so good - because right now you're so focused on the surgery and the immediate alterations to your face - I mean it was so hard for me not to look into the mirror every 25 seconds! But after a few weeks, you'll get back into your routine and think about it a little less (like, every 45 seconds), and eventually you'll grow into your face, so definitely listen to Bella and find things you think you'll love about it *now*, because I'm fairly certain that even if it's not the perfect face you had before, it will look much better in a few months.

Hope you have a good recovery - and I'm sure the surgery was worth it! I know mine was.

Schmutzie said...

My heart jumps out to this person. Due to a completely different kind of experience, I get what they are talking about, and I want to let them know that it really is a matter of time. When your face or body changes, it brings up matters of identity far deeper than than the skin. It is so important to be gentle with yourself during this time, allow yourself to mourn, and try to see the opportunity in getting to know yourself more, maybe even a better you!

Dr. J said...

Wow! As surgeon who has done many many facial operations, no one I ever did had this reaction. One patient was worried about how her young daughter would feel about the change, but it was not a problem. I would be hopeful that in time, you will accept your new look and be OK with it.

Mollieb said...

Bella's advice is pretty dead on. I had turbinate surgery last year, and my jaw surgery this year. I am three weeks out and still have some decent swelling. Your not going to see your true appearance for months. As Bella said, it's ok to mourn what you used to look like. For me, the daintiness of my appearance was what I hated. I looked so underdeveloped. Now I feel like I look like a grown woman; like an adult and I really like that. Focus on the positive. You will have so much less pain now, and given that you had a genioplasty, I am sure you are sporting a stellar profile. It can be a bit of a shock, but you'll get used to it!

Kerry Rose said...

I just wanted to email an update about this particular post. I am the gal that sent in the question in the first place. Its now 12-14-08 which means I am almost 3 months post-op.

I have adjusted to my altered appearance and my initial terrified reaction at my transformation.

In fact, my post-surgery experience unfolded in ways I never expected.

After I sent this message, I started to experience great amounts of pain as a result of muscles spasms. For about a week, I couldn't sleep because the muscle spasms would wake me up every few minutes. Using a combo of prescribed sleeping pills and the pain medications, I was able to overcome it.

Then about 6-weeks post-op, I experienced an unanticipated break-up with a person with whom I had been dating for 5 1/2 years.

Ironically, I have met a lot of fellow ortho patients whose surgeries were the catalyst for numerous major changes in their life (including break-ups like mine).

I can honestly say that I am better than great!

I still think that my doctor should have been more clear about the physical transformation I would go through. I would even suggest that going to a therapist that deals with body issues (specifically one that relates to people undergoing surgeries) should be done ahead of surgery.

Thanks for all of the comments. It turned out to be so important for me to express what I was going through - especially because I had become somewhat of a prisoner of my home and my body. I needed reaffirmation that there was some action I could take to change my situation.

dearsweetbriar said...

"As surgeon who has done many many facial operations, no one I ever did had this reaction."

As a surgeon? How about as a patient who has had this surgery like EVERYONE ELSE commenting on this blog.

I didn't talk to my surgeon about any of this shit, because it wasn't relevant to him. I did talk to my therapist, my family, and other people who had been through this surgery. Trust me. ALL of your patients have had some reaction or another, and very few of those reactions were "OH EM GEE, Dr. J is a GOD."

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