You're so vain, you think this class III malocclusion is about you
October 20, 2011 5:09 PM   Subscribe

I have a severe underbite. I'm leaning toward not treating it but I don't like what I see in the mirror.

I have a severe underbite. When I put my teeth together, my bottom teeth come over the top ones and there's a large enough space in between that I can easily put a fingernail in. The treatment seems to be the standard two years of braces with jaw surgery (to both upper and lower) in the middle.

I'm very hesitant about this for several reasons: the cost (I would have to shell out for the braces), the inconvenience (I'm planning some international travel), possible side effects being worse than the current problems, having braces in my thirties (dating, sex, career). I have some TMJ-ish problems: popping, clicking, ear aches, slight tinnitus, random pain, but I've learned to live with them. They don't seem bad enough to warrant the fix. My teeth themselves are white and straight. Dentists have warned about possible wear to my teeth, but I've yet to see any of that. Part of my motivation is also cosmetic. I've learned to hold my jaw slightly open to minimize the look and know how to angle my face in photographs, and if I do it right, I look quite good. But sometimes I can't hide it: a jutting lower jaw in side shots taken off guard, a sunken upper face if I'm smiling too wide. So this essentially feels like deciding about plastic surgery. I feel very guilty and vain even considering spending all this time and money on a cosmetic problem. I should concentrate on something other than how I look, right?

But I can't make peace with my face. A snaggletooth can be cute, a gap in the front teeth almost sophisticated, but nobody sighs over the woman with the Bill Cowher jaw.

I should clarify: I've never gotten teased about this, never gotten a comment, either malicious or curious. I get dates, I've had boyfriends. The person it bothers is ME.

I guess my questions are:
1. If you've had this specific procedure or braces as an adult, please share your experience and whether you thought it was worth it on the whole
2. If you've ever had plastic surgery in general, talk about how you made that decision
3a. How do you learn to accept a body part you can't change?
3b. How do I deal with the guilt from worrying about something so minor? I'm a pretty big believer in loving yourself as you are. Or at least I thought I was.
posted by unannihilated to Health & Fitness (16 answers total) 6 users marked this as a favorite
Ha, I went twenty-five years without knowing I had an underbite. (My upper teeth come down over my lower teeth, but that's just how they happen to fit together — my lower jaw is still thrust forward and I have the awkward side profile and all.) I saw a dentist who commented on my severe underbite — which again, until that moment, I did not know I had — and said I was right on the line between needing surgery for physical reasons, and just having the surgery for cosmetic reasons. And then he cheerily said, "Well, looks like it doesn't bother you too much! Let's move on!"

And that set off about two years of feeling real self-conscious about an underbite I didn't even know I was supposed to worry about until then.

I sort of shyly mentioned it to a couple of people, and they said, oh yeah! You have a total underbite, yes. It's so cute!

So I've just chosen to go with it. Sometimes I see a photograph from the side that I'm not too fond of, but eh. I have developed a reputation for being strong-willed and thoughtful at work in a way that has garnered respect, and I honestly think it's just because my jaw makes me look ever-so-slightly aggressive during meetings. Five years after my dentist's comments, there is no way I'd fix my underbite, I've made it so much a part of ME.

ON THE OTHER HAND. I just had a fibroma removed from my arm for no reason other than feeling self-conscious about it — no medical reason for it at all — and it has made a huge difference in how I feel about myself when I wear short sleeves, just to have that sucker gone. So I totally get it — this might be a seemingly minor thing, but if you'd be happier and more self-confident for the rest of your life if you have it fixed, then that's a worthwhile reason. And your dentists seem to think you need to do it for structural reasons, so you should take that into account. My gorgeous co-worker has the white porcelain braces at age 37, and I don't even notice them. I thought she'd gotten her braces off the other day, I hadn't noticed the braces in so long. Don't let the braces stop you.
posted by adiabat at 5:24 PM on October 20, 2011 [1 favorite]

If you've had this specific procedure or braces as an adult, please share your experience and whether you thought it was worth it on the whole

I had braces for 3 years in my 30s and double-jaw surgery (though I didn't do it for an underbite, I did it for a different jaw condition), almost bled to death during surgery (a problem you will NOT HAVE, I promise; it's only because I'm a medical freak and have a million conditions, including a previously undiagnosed bleeding condition), had a long, hard recovery, and consider it one of the two greatest decisions I have made in my entire life.

It improved my bite, decreased jaw/facial/neck pain, and allowed me to like what I see in the mirror and in photogrpahs for the first time since I was about 7 years old. All of this led to a greater sense of confidence and self-esteem, and a shedding of what was (I realize now) a crippling sense of self-consciousness that contributed to me not doing a lot of what I really wanted to do in life (I did sometimes get teased in my teens and 20s).

As for dating and sex, well... my partner, who I met about six months after jaw surgery (while my face was still pretty swollen, actually), thought my braces were cute and said so about 15 minutes into our first date. That was 6 or 7 years ago. So, you know, it didn't stand in our way!
posted by scody at 5:26 PM on October 20, 2011 [2 favorites]

I have a severe overbite, which to be honest, I hate, but it's not too noticeable. A couple of years back I went though the consultation process with a oral surgeon who laid down what it would entail and how much it would cost. He also went over how it would improve my overall facial structure, so it was kind of a cost-benefits sort of deal. But I totally balked over the price and how serious the surgery would be, since they'd have to put me under full anesthesia (always a little risky) and the recovery time would have been considerable. Then I'd also have to have braces again, which I hated as a child and would cost me extra each most. I'm glad he was honest with me about that because I haven't seriously considered it since. I thought about all the cool things I could do with that money instead.

I think if I wanted to become a model or an actress I would consider it, but overall it does not impair my life and wasn't worth it. I suggest doing a consultation with an oral surgeon who is honest and won't do a hard sell.
posted by melissam at 5:31 PM on October 20, 2011

I had this surgery and the accompanying braces shortly after my eighteenth birthday. I am not exaggerating when I say that it was life-changing. It has increased my self-esteem a million-fold. I never felt attractive, and certainly not beautiful, before. This is not to say that I wasn't, or that you aren't -- I don't think it changed the way others perceive me all that much, but I changed the way I feel about myself tremendously.

That said, the braces were a bitch, the surgery (6 hours under, 3 nights in the hospital, two broken jaws, 4 metal plates, 16 screws, 1 new chin) was trying, and the recovery (4 weeks on a completely liquid diet with my jaws wired shut, 15lbs lost, 4 weeks of school missed) was absolutely brutal. Really really awful. I was lucky that my parents paid for what insurance didn't, so I can't even speak to that. Still, I would do it 1000x over.

If you have other questions, or want the link to my blog (with pics!) MeMail me.
posted by i_am_a_fiesta at 5:47 PM on October 20, 2011 [1 favorite]

I just got my braces off a month ago; I'm 33 years old. I hated braces - much more than I thought I would. Spent almost two years feeling awkward, hiding from photos, and generally cringing whenever I caught a glimpse of myself in the mirror. My self-esteem about my personal appearance was the lowest it has been since adolescence.

However, I'm glad I had them, for two reasons.

1. First, in my case, there were strong health reasons to do so. The dentist told me that my bite was bad enough that one set of teeth were eroding away the enamel on the other set, so that by my forties I'd be lucky to still have those teeth. That was why I wore the braces in the first place. If I were you, I'd want to check to see if there are long-term implications for your dental health if you do not have braces and/or surgery.

2. Second, I do look a lot better now. I like looking in the mirror! Flossing is so much easier (even though my teeth not being straight wasn't the reason for getting the braces, turns out they weren't very straight, so having them straightened was a great side benefit). I am at much less risk of cavities because I can now easily clean all parts of the teeth. All of these are benefits that I didn't really foresee ahead of time, but they are real. And if you currently don't like the way your mouth looks, the benefit to your self esteem -- once the damn braces come off, at least -- will probably be non-trivial.

Bottom line, I still wouldn't have done it if it weren't for #1, because braces suck. But I'm glad I did do it.
posted by forza at 5:48 PM on October 20, 2011

I had a more severe underbite than you. Don't necessarily assume you need to have both upper and lower jaw surgery, it depends entirely on why you have the underbite. I ended up only needing upper surgery because my top jaw was too small, but my bottom jaw was appropriately size. And actually the upper jaw surgery is the one you want if possible, because you don't have to have your jaw wired shut afterwards (which you do with lower). Also, how much you need braces is a different issue, I initially had braces where they tried to just flair my upper teeth out to cover the underbite without needing surgery, but then that didn't work, so I had braces to straighten them back out for surgery, but then I didn't need braces afterwards. So if your teeth are already straight, or straight enough for you, you may not need to have braces before or after surgery. You really need to see an orthodontist to see what you'd need to have done and what you might have done, before making decisions one way or another.

But I found the underbite to be very unattractive (for me) and so there was no doubting whether I'd get it done.
posted by katers890 at 5:50 PM on October 20, 2011

Thanks for all the replies so far. I've had a couple consultations over the years with both oral surgeons and orthodontists. The last consult with an orthodontist said braces before and after. The last oral surgeon I saw said upper jaw was underdeveloped and lower jaw needed to be moved as well. But I'll certainly get a few new opinions, especially since it's been several years since the last consults.
posted by unannihilated at 6:00 PM on October 20, 2011

2. If you've ever had plastic surgery in general, talk about how you made that decision

I had a breast reduction just under a year ago and went through a lot of the same stuff you are going through with regards to necessity vs. vanity.

I agonized about it for years. Years and years. Well, six years. I had biggish breasts for my size in my twenties and early thirties and then when I got pregnant I suddenly (like, really suddenly) had very, very big breasts (36C to 42DD). When they didn't get smaller after I weaned my daughter, I was pretty devastated.

I would mention it to people from time to time, and invariably everyone knew someone who had done it and absolutely loved loved loved it. I knew several women who had done it and were thrilled.

But, I did a degree in Women's Studies! How could I bow before the patriarchy and get a boob job!?

Like you, it was a borderline medical vs. cosmetic thing. I had backaches, but I'd had backaches before I got pregnant, too. And it was hard for me to admit that even if it did nothing for the backaches, I just wanted smaller boobs. (FWIW I still have neck and shoulder pain, which is probably work related, but the lower back and pelvic pain is completely resolved. It has improved my quality of life more than I ever would have expected.)

Two things kind of pushed me over the line. First, I had an appointment with a new gynecologist and one of the first things she asked was whether I had ever considered a breast reduction. Part of me was insulted, part of me was relieved. Second, I went to an osteopath to deal with chronic pain in my lower back and pelvis that 7 years of yoga, massage therapy, and physio hadn't fixed. He did his assessment and then said, Yeah, basically all that is because of your breast size. If you had a reduction, it would take care of most of it.

So then I just read everything I could find, talked again to women I know who'd had it done, and prowled the web looking for forums. Talking with other women on line, hearing people's stories--including some really terrible ordeals--and seeing how pretty much every single one was thrilled clinched it.

(Also, I'm in Ontario, Canada, and breast reduction is covered under the provincial medical plan, so the only thing I had to pay for was the prescription for painkillers after the surgery. I don't know if I would actually have been willing to save up $5K to have it done if it hadn't been free.)

3a. How do you learn to accept a body part you can't change?
3b. How do I deal with the guilt from worrying about something so minor? I'm a pretty big believer in loving yourself as you are. Or at least I thought I was.

I come from a family that is very much about playing the hand that you are dealt. Having surgery that was at all cosmetic felt like cheating.

And it was really hard for me to frame it in a way that wasn't about hating on myself. You wouldn't change your body if you loved yourself, right? I thought I was a pretty big believer in loving myself as I am, too, but it turns out I loved myself as I was. Getting to a place in my late 20s where I genuinely felt great about my body was a long hard slog. I just didn't think I was going to be able to do it again, especially since I could never find any clothes that fit properly.

I've been in therapy for the past couple years and so I talked about this a lot with my therapist and she had a whole other take on it. Which was: there's something about yourself you don't like and you can fix it. Why wouldn't you fix it? Learn to love the things you really cannot change, but change the things you cannot love. I don't back that idea 100%, but I believed in it enough to go ahead with the surgery.

If you do decide to go through with it, prepare yourself for a really hard time recovering. My surgery was relatively minor--it's just skin and fat, really--and the recovery was still really difficult. Not just physically, but emotionally. It was surprisingly difficult, even after they healed, to look down and see breasts that were not mine. I knew they were going to be smaller, but I was unprepared for how different they were going to look (nipple placement, shape, etc.; in my head I was just imagining I'd get my 25 year old breasts back). I had an uncomfortable few of months of weird body dysmorphia where I felt very alienated from myself. And what I thought about during that time was how I could not imagine how much more shocking it would be to change your face.

Do I regret it? I don't. Am I as thrilled as all the breast reduction cheerleaders I met are? No. But I do like them more every day and do feel more at home in my body than I did when they were three sizes bigger.

(Sorry for the novel; brevity is not my strong suit.)
posted by looli at 7:06 PM on October 20, 2011

A good friend of mine in college had a noticeable underbite and had the surgery one summer. She did have her jaw wired shut, which was no fun. She lost some weight. That was more than 20 years ago. She's looked great ever since. Her bite/jaw no longer overshadow her fine features and intelligent eyes.

I have a bit of an overbite and my teeth are growing ever more crooked as I age. I would get braces in a New York minute if I could afford them. How I long for straight teeth. I think about it all the freaking time. I cover my mouth with my hand when I smile. It sucks.
posted by Occula at 7:14 PM on October 20, 2011

This might seem unrelated, but i don't think it is: I had a breast reduction. I had it for primarily cosmetic reasons, although there were physical health benefits as well (but weren't my primary motivator.) The mental health benefits (increased self esteem, less uncertainty and distrust about other people's motivators for interacting with me or their perceptions of me) have been indescribably beneficial. I consider it the best thing (or, rather, best non-education/career thing) that i've ever done for myself. (I had the surgery 13 years ago - enough time to have some perspective.)

Our bodies inform how people perceive us. While "the inside" counts in the long run with people who care about, its our physical selves that make the first impression. Feeling confident isn't selfish. Feeling attractive isn't selfish. Or silly.

Sure, you might feel awkward about how you look with braces for a few years, but that's better than feeling awkward about how you look for the rest of your life. Travel can either be accommodated or postponed - the world isn't going anywhere, and it definitely doesn't mind when people with braces visit.

Its sounds like its something you want to do. And reasons not to just sound like self consciousness about the decision.
posted by Kololo at 11:24 PM on October 20, 2011

I had jaw surgery when I was 15. My jaw was wired shut for a couple of months, and I wore braces for several years. I survived. My parents were able to pay for it. Apparently the surgery was necessary because I would gradually destroy my upper palate if I didn't do it.

The only remaining issue from the surgery is that my teeth are crammed together (thanks to braces), so I get cavities more often.
posted by KokuRyu at 11:35 PM on October 20, 2011

I had the double jaw surgery you are talking about 10 years ago when I was a teen. The braces before and after made it unnecessary to wire my jaws shut.

The bad:
--painful. SO painful. But with the pain management medication not unbareable.
--your face will be swollen for a long time. You are NOT going to recognize yourself in the mirror the first couple of weeks after surgery, but honestly, all you're going to want to do is lie down so you're not going to be looking at yourself in great detail.
--you cannot eat solid food.
--recovery is a long process
--you will need to carry around a drool rag with you for a few weeks. Your face is so swollen there is no way you CAN'T drool.

The good:
--the results are AWESOME.
--much less pain in the jaws.
--if you're looking for a diet, man does the all liquid diet for those 6 weeks work.
--my confidence was way up after I had the surgery done.
--cool x-rays to freak people out with, haha.

Would I do it again? In a heartbeat, even with all the negatives. If you have specific questions, feel free to memail me. :)

Good luck with the decision!
posted by whitetigereyes at 7:07 AM on October 21, 2011

I had a nose job several years ago. I had been thinking about it for awhile, but then I broke my nose (purely coincidentally) and needed surgery to fix it, so I decided to have some cosmetic work done at the same time. I don’t regret it at all. I love my new nose! It didn’t radically change my face (I don’t have a perfect nose still) but enough that it gave me a big confidence boost. Why feel bad about changing something about your body? You’re not obligated to love every single thing you were born with, and if you have the means to change what you don’t like, what is the harm? We change how we look all the time – with our clothes, our hair, by shaving/not shaving, wearing contact lenses, getting tattoos and piercings, gaining/losing weight/muscle…the list is endless. I don’t see this as any different. If you’re unhappy with your look, don’t feel guilty about wanting to change it!
posted by yawper at 9:22 AM on October 21, 2011

Okay, so this is a little different from your situation, because it happened when I was rather young (before the end of primary school, not sure my exact age), but may be helpful anyway.

I had a severe underbite. Like, so severe I could get, not just a fingernail, but an index finger between my upper and lower teeth. My parents took me to a good orthodontist office nearby, and while both doctors thought I might need surgery (and I actually had a consult at the Mayo clinic on getting my lower jaw shortened), they ended up doing some sort of therapy with magnets. A cast was made of my upper and lower molars, from which an appliance was created that had one magnet inside for each four sets of molars. I guess they were offset enough that the intent was, after sleeping with this thing in every night for a couple of years, it brought my jaws much closer in alignment. I then still needed braces for several years, though that may have been for more reasons than just jaw issues.

I realise that vague memories from 15+ years ago might not be the most helpful, but the work was incredibly successful (totally normal, non-surgery jaw now), and I would think that similar techniques can only have advanced in the interim. I don't remember much about the procedures, but I do still remember the doctors' names, so if you would like to find that out and see if they can give any advice or suggestions, feel free to memail.
posted by the luke parker fiasco at 2:00 PM on October 21, 2011

I had an overbite, wore braces for 2+ years and had the surgery (at 21).
Make sure you go to the best doctor you can afford. My biggest problem was wear and 7 years after the surgery, it's back. The should have raised my teeth, too, but for some reason that was never done.
The surgery is painful and the recovery takes a long time. Your teeth will be wired shut, you will lose weight (cool, right? not really unless you like seeing your ribcage), your face will be swollen for a long time and you will lose feeling in your jaw. My friends had to remind me to wipe drool/food off my jaw for a year. I still haven't gotten all the feeling back and I doubt I will. BUT I like what I look like now. Would I do it again i needed? Quite possibly. If you think it will make you happier, get the surgery.
posted by marais at 3:02 PM on October 21, 2011

I had my double jaw surgery shortly after turning 17. This was after about 4 years of braces because I had the excellent fortune of an underbite that made my face seem very long and my chin pointy, as well as a couple of snaggletooth (why isn't snaggleteeth a word yet?). As you can imagine, I was very self conscious throughout my life, and I was always THAT friend who didn't want to be in group photos.

So for me, the surgery was absolutely worth it for my self-esteem and because the recovery wasn't as rough as I was expecting. I had a friend who got the same procedure two months before me, and I ended up recovering a lot quicker--very surprising. I went in for surgery at 6am, stayed the night, and left the next morning. I was also on a morphine drip and given pain medication, but I didn't actually use them once I got home. My surgery was during the last week of summer before school so I was only willing to take 1 week off but in those first 2 weeks of recovery, the swelling went down significantly. I must add that I did very little during my time off--hung around the house and would feel like sleeping on and off throughout the day, but I felt like it was a good decision to rest up. Coming back, I looked a little puffy, but it wasn't anything to be embarrassed by. The liquid diet and having my jaw wired shut for 3 weeks were not fun, but you learn to love or at least tolerate v8 juices and muscle milk. Moral of the story: Don't let the surgery scare you because the experience truly isn't the worst thing, especially if you're making a decision that can potentially make you feel good about yourself every day for the rest of your life.

Something to note: I had really good relationship with my orthodontist who knew the best maxillofacial surgeon for my case. He also walked me (or rather, my parents) through the process of changing our insurance so that the surgeon could operate on me and part of the surgery would be covered. So while you're at the consultation stage, figure out an orthodontist you trust and then work with an oral surgeon that THEY trust. It makes you feel like you're getting a tighter network that is more willing to coordinate your care and understand your case.

Best of luck!
posted by bodyofproof at 1:59 AM on October 22, 2011

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