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Botox, Cocaine and Plastic Surgery: Post-Jaw Surgery & Septorhinoplasty

cleft lip and palate patient after septorhinoplasty (nose surgery)

After my second jaw surgery, I had more intensive post-op care to make sure the jaw was healing properly. I went back to my hospital weekly for the first month and then fortnightly to check everything was going to plan. At first I was concerned that my teeth were moving back since I could feel them grinding together, and eventually the bottom teeth were in front of the top again. To sort this I wore elastics to gradually ease in the new bite and correct it, with the main concern being that I had a stable jaw function rather than a perfect bite. In the end, we managed to get both.

After surgery, I also had a big issue with clenching. I clench my teeth/jaws when I’m stressed anyway and after going through so many issues with my jaw (and with the added pressures of second year university coursework), I was clenching like I’d never clenched before! To resolve this, my surgeon came up with what seemed like a bizarre solution: botox. The botox would work by breaking down some of the muscles in my jaw, meaning that I wouldn’t be able to clench my jaw so strongly (which would relieve pressure on the healing bone). I’d never thought I’d have botox, and I certainly won’t be repeating the experience: I had ten injections in my already very swollen and sore face. I’ve never sworn in front of a health care professional, but the injections were so painful it seemed the only way to get through it. I consider myself to have a very high pain threshold – after having so much surgery, this isn’t surprising – but the pain of having botox has put me off for life! Luckily, they did the job well and my jaw healed fully.

7 months later, it was time for my reconstructive nose surgery (septorhinoplasty). For a septorhinoplasty, there are many options when it comes to how the nose will be reconstructed. For me, on my left side, my nasal passage was collapsed (although whether this was due to deformed cartilage or deformed bone growth was still uncertain). In the operation, the surgeons made a small cut at the bottom of my nose and effectively broke the nasal bone and pulled out the material from inside. The amount of material (quantities of bone and cartilage) would alter how they would proceed to make a stable ‘L’-shaped strut, which would hold the foundations of my new nose. If they needed more cartilage, they would graft a small amount from inside my ear; if they needed more bone, they would graft some from my hip and if they needed a stronger form of cartilage without it being bone, they would graft some from my rib to create the strut. (I hadn’t realised that your ribs don’t firm up into actual bone until you are in your forties – until then, they are cartilage.)

On the day of surgery, I was very lucky: although I had been told in detail about the potential need to graft material from ‘elsewhere’, the surgeons did not need to undertake any such procedure. The fact that I didn’t have to have a graft from my ear, hip or rib meant my recovery was (probably) a lot more comfortable and a lot quicker: I stayed in hospital overnight and was discharged the next day.

When I got home, I felt very swollen, but fairly clear headed. I had big cotton pads taped around my nose and cotton buds up it to help with the bleeding, some pain killers (to add to the tiny amount of cocaine used in the surgery which acted as an anaesthetic) and antibiotics to take. I also had the external splint, which came off just under a week later.

On the day the external splint came off, I was overjoyed with the sight of my new nose. My surgeon said just before the external splint was taken off that they hadn’t been able to do as much as they wanted because I liked to give them a ‘challenge’. However, after my new nose was revealed, he admitted that they are often ‘too harsh on themselves’, and said how delighted he was that I was so thrilled. Due to the unpredictable nature of cleft operations, I wasn’t given any idea on how my nose would change, a part from that they would try and make it straighter and less flat to resolve my collapsed nasal passage. In the end, I was delighted with the result – all those long years of waiting were definitely worth it and my confidence sky-rocked.


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