Articles on cataract surgery

How Do I Behave When I Am Undergoing Cataract Surgery?

Dr. Manoj Rai Mehta, Ophthalmologist
Cataract Surgery nowadays is usually performed under 'topical anaesthesia' that involves instillation of drops of the anaesthetic agent on the eye surface.  The patient retains the power to close the lids and move the eyeball during surgery, feel no pain but touch and pressure sensations are unaffected.  A peribulbar block anaesthesia may be used at times on surgeon's discretion that involves an injection of anaesthetic agent around the eyeball with a short needle.  This takes away lid and eye movements to a large extent but some control may remain with the patient.     Operating Surgeon expects the patient to follow the instructions for a smooth surgery.  It is important to have a surgical counselling session with the doctor to understand the procedure and expected sounds/conversation during the operative procedure.  The sequence of events should be understood and played in your mind while you move through the surgical suite.You should be wearing loose, comfortable hospital pyjama suit.  Do not hesitate to change it if it is tight around your neck.  Some hospitals have the policy to allow you to wear your own loose clothes and give you a hospital gown over them.  Please ensure you are not wearing tight fitting clothes and your neck is free.  Ladies to tie their hair in a ponytail with a band or a soft bun with no clips or claspsSit quietly in the pre-operative area and use the washrooms before going to the OR.  You may take sips of water if your mouth feels dry but do not hydrate yourself too much.You may be given a cap and eye marked for surgery.  The antiseptic solution will be painted around the eye.  Let the solution dry and do not touch your eye. OR assistant will help you lie down on the OT table with a rubber ring under the head to prevent rolling from side to side. You should be comfortable and be able to breathe rhythmically while lying down.  Ask for a head raise if neck extension is hurting you and get the ring adjusted to your comfort and if it is hard for you to ask for a softer ring.When you are comfortable allow the staff to put monitoring devices which could be a pulse oxygen meter alone or additional cardiac electrodes.  Breath rhythmically and try to relax.Sterile Drapes will be placed around your head and an adhesive eye drape on the eye to be operated upon.  Please maintain your head in a position as required and adjusted by the surgeon.  Do not move your head or lower your chin.  The surgeon works under a microscope and any movement shifts the focus and obstructs in smooth surgery.There will be several sounds in the OR that you should ignore-beep of monitors, hum of air circulation unit, trolley wheels, the doctor would be giving instructions to staff and asking for instruments etc.  Try to keep your attention focused towards surgery only.Coughing and snorting during surgery can create complications, always ask the surgeon to stop the surgery if you feel like doing so.  Do not try to suppress a cough or sneeze by holding breath.  Do not bear down or move.Follow instructions of a surgeon and do not start a conversation. Answer only when a question is directed towards you.  The surgeon may ask you to look in a particular direction.  You have to follow the command by moving your eyes and not head unless the specific instruction is made. The first touch of the instrument will increase your confidence.  Do not wince, squeeze your lids or make a jerky movement if you feel some pain.  Inform the doctor, who will reinforce anaesthesia.Cataract Surgery machines also produce different types of sounds during different phases of surgery and also have synthesised verbal outputs.  Do not get distracted by the same.You will see movements in front of the eye during surgery and also perceive vibrations.  Light intensity will increase towards the end of surgery.  A calm patient who is having a regular rhythmic breathing and a regular normal pulse rate makes a surgeon's job easy.(In case of specific problems additional monitoring and specialised anaesthetic cover may be required which the operating surgeon will discuss before hand).               

Keep an Eye Out for Cataracts!

Dr. Smita Mukherjee, Ophthalmologist
If you read there as thea, see halos around your room lights, and see double then it’s time to visit an ophthalmologist! You could possibly have cataractsWhat is Cataract?Cataract is a progressive eye disorder that makes your eyesight deteriorate with time until it affects your vision completely.How exactly does Cataract affect my eyes?Have you ever tried blowing straight into your camera lens and then looking through it? What do you experience? Blurry and clouded vision? This is exactly what happens to your eyes when you are affected- the natural lens that lies behind the iris,turns opaque.Types of CataractsBased on the region they appear in, there are mainly three types of cataracts: subcapsular, nuclear and cortical.1. Subcapsular Cataract: Occurs at the back of the lens2. Nuclear Cataract: Appears deep in the central zone of the lens3. Cortical Cataract: Start from the edges of the lens and dig deeper to its centre.What can cause Cataract?Ageing,Diabetes ,injury or high doses of certain medications could be some common causes of cataracts ,but the treatments remain the sameWhat is the treatment for Cataracts?Using new glasses, strong bifocals, brighter lighting or other visual aids might help in the initial stages. If your vision has started affecting your daily routine to a great extent, you might want to consider surgerySurgery?!As scary as it might sound, Cataract surgeries are actually fairly simple and very commonly done procedures. They also have a high success rate. The surgeon simply replaces the clouded lens with a plastic Intraocular Lens (IOL). These IOL’s then block out ultraviolet and blue lights and helps you see at all distance.So YES, even if you have cataracts, you have nothing to fear. Just don’t turn a blind eye to vision problems, because your sight is PRECIOUS!!

Steps After Cataract Surgery for Optimum Outcome

Dr. Vaibhev Mittal, Ophthalmologist
Cataract is the most commonly performed eye surgery. With modern advanced phacoemulsification techniques and better anesthetic drugs, there is a shift in paradigm from large incision suture based surgeries (Extra capsular cataract extraction) to minimal incision sutureless surgeries. Now cataract can be operated even under topical anesthesia (No injection required to anesthetize the eye) which speedens the recovery and minimizes the need for post operative bandage.What to expect on first Post operative day?With new techniques involving minimal intervention, sometimes, it becomes difficult to differentiate operated eye from normal eye. In most patients eye is usually white with clear vision. But it is not unusual to see red eye on first day which could be damage to small blood vessels present in conjunctiva. This redness usually resolves over 2-3 weeks without any visual disturbance.Sometimes, the vision may be blurred on first day which could be due to mild corneal swelling which resolves over 1 week. It takes nearly 4 weeks for eye to heal completely after cataract surgeryPrecautions to be taken in first post operative week for best results after surgeryThough cataract surgery is a quick and painless day care procedure but still few precautions need to be taken for optimal resultsMost devastating complication after cataract surgery is infection. Usually doctors take preventive measures both pre and  intra operatively but still antibiotic eyedrops should be used as prescribed by doctor during post operative period to reduce the risk of infection. Cataract surgery is also associated with minimal inflammation in eye. For that doctors prescribe steroids along with NSAID eyedrops.Other precautions that need to be exercised are:Avoid rubbing eyes as it may cause wound leak and increases risk of infectionCover your eyes by dark glasses to prevent exposure to dust and irritantsAvoid swimming and exposure to water for atleast 10 days after surgeryAvoid lifting heavy weight or strenuous exerciseAvoid bending  or gym for initial 2 weeksKeep using medicines as advised by doctorClean eyes with cotton dipped in hot waterThese are simple precautions that should be exercised for optimal visual outcome


Dr. Rajesh Babubhai Shah, Ophthalmologist
 Practice ManaCATARACTSWhat Are Cataracts?Cataract SymptomsWho Is at Risk for Cataracts?Cataract CausesCataract DiagnosisCataract TreatmentCataract SurgeryIOL Implants: Lens Replacement and Cataract SurgeryCataract Vision SimulatorCataract Pictures and Videos: What Do Cataracts Look Like?IOL Implants: Lens Replacement and Cataract SurgeryWritten by: Kierstan BoydReviewed by: Elizabeth Yeu MDMar. 01, 2016Before intraocular lenses (IOLs) were developed, people had to wear very thick eyeglasses or special contact lenses to be able to see after cataract surgery. Now, with cataract lens replacement, several types of IOL implants are available to help people enjoy improved vision. Discuss these options with your Eye M.D. to determine the IOL that best suits your vision needs and lifestyle.Cataract lens replacement: How IOLs workLike your eye's natural lens, an IOL focuses light that comes into your eye through the cornea and pupil onto the retina, the sensitive tissue at the back of the eye that relays images through the optic nerve to the brain. Most IOLs are made of a flexible, foldable material and are about one-third of the size of a dime. Like the lenses of prescription eyeglasses, your IOL will contain the appropriate prescription to give you the best vision possible. Read below to learn about how IOL types correct specific vision problems.Which lens option is right for you?Before surgery your eyes are measured to determine your IOL prescription, and you and your Eye M.D. will compare options to decide which IOL type is best for you, depending in part on how you feel about wearing glasses for reading and near vision.The type of IOL implanted will affect how you see when not wearing eyeglasses. Glasses may still be needed by some people for some activities.If you have astigmatism, your Eye M.D. will discuss toric IOLs and related treatment options with you.In certain cases, cost may be a deciding factor for you if you have the option of selecting special premium lOLs that may reduce your need for glasses.Intraocular lens (IOL) typesMonofocal lensThis common IOL type has been used for several decades.Monofocals are set to provide best corrected vision at near, intermediate or far distances.Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly.Some who choose monofocals decide to have the IOL for one eye set for distance vision, and the other set for near vision, a strategy called "monovision." The brain adapts and synthesizes the information from both eyes to provide vision at intermediate distances. Often this reduces the need for reading glasses. People who regularly use computers, PDAs or other digital devices may find this especially useful. Individuals considering monovision may be able to try this technique with contact lenses first to see how well they can adapt to monovision. Those who require crisp, detailed vision may decide monovision is not for them. People with appropriate vision prescriptions may find that monovision allows them see well at most distances with little or no need for eyeglasses.Presbyopia is a condition that affects everyone at some point after age 40, when the eye's lens becomes less flexible and makes near vision more difficult, especially in low light. Since presbyopia makes it difficult to see near objects clearly, even people without cataracts need reading glasses or an equivalent form of vision correction.Multifocal or accommodative lensesThese newer IOL types reduce or eliminate the need for glasses or contact lenses.In the multifocal type, a series of focal zones or rings is designed into the IOL. Depending on where incoming light focuses through the zones, the person may be able to see both near and distant objects clearly.The design of the accommodative lens allows certain eye muscles to move the IOL forward and backward, changing the focus much as it would with a natural lens, allowing near and distance vision.The ability to read and perform other tasks without glasses varies from person to person but is generally best when multifocal or accommodative IOLs are placed in both eyes.It usually takes 6 to 12 weeks after surgery on the second eye for the brain to adapt and vision improvement to be complete with either of these IOL types.Considerations with multifocal or accommodative IOLsFor many people, these IOL types reduce but do not eliminate the need for glasses or contact lenses. For example, a person can read without glasses, but the words appear less clear than with glasses.Each person's success with these IOLs may depend on the size of his/her pupils and other eye health factors. People with astigmatism can ask their Eye M.D. about toric IOLs and related treatments.Side effects such as glare or halos around lights, or decreased sharpness of vision (contrast sensitivity) may occur, especially at night or in dim light. Most people adapt to and are not bothered by these effects, but those who frequently drive at night or need to focus on close-up work may be more satisfied with monofocal IOLs.Toric IOL for astigmatismThis is a monofocal IOL with astigmatism correction built into the lens.Astigmatism: This eye condition distorts or blurs the ability to see both near and distant objects. With astigmatism the cornea (the clear front window of the eye) is not round and smooth (like a basketball), but instead is curved like a football. People with significant degrees of astigmatism are usually most satisfied with toric IOLs.People who want to reduce (or possibly eliminate) the need for eyeglasses may opt for an additional treatment called limbal relaxing incisions, which may be done at the same time as cataract surgery or separately. These small incisions allow the cornea's shape to be rounder or more symmetrical.Protective IOL filtersIOLs include filters to protect the eye's retina from exposure to UV and other potentially damaging light radiation. The Eye M.D. selects the filters that will provide appropriate protection for the patient's specific needs.Other important cataract lens replacement considerationsIn some cases, after healing completely from the cataract lens surgery, some people may need further correction to achieve the best vision possible. Their ophthalmologist may recommend additional surgery to exchange an IOL for another type, implant an additional IOL, or make limbal relaxing incisions in the cornea. Other laser refractive surgery may be recommended in some cases.People who have had refractive surgery such as LASIK need to be carefully evaluated before getting IOLs because the ability to calculate the correct IOL prescription (PDF 650K) may be affected by the previous refractive surgery.Additional cataract information resourcesIf you're interested in learning more about cataract from the ophthalmologist's perspective, follow the link below to read American Academy of Ophthalmology practice guidelines for clinicians.American Academy of Ophthalmology Preferred Practice Pattern: Cataract in the Adult EyePreviousCataract SurgeryNextCataract Vision SimulatorRelated Ask an Ophthalmologist AnswersDid my six-month glutathione deficiency cause my cataracts?MAY 01, 2016Why has my near vision gotten worse since my cataract surgery two weeks ago?APR 26, 2016Are penicillin and clindamycin used in the antibiotic eye drops prescribed after cataract surgery?APR 21, 2016Which precautions should a diabetic patient take after cataract surgery?OCT 05, 2015Posterior Capsulotomy and TASSAUG 31, 2015Leer en Español:Reemplazo de Lente y La Cirugía de las CataratasSelect LanguageAfrikaansAlbanianAmharicArabicArmenianAzerbaijaniBasqueBelarusianBengaliBosnianBulgarianCatalanCebuanoChichewaChinese (Simplified)Chinese (Traditional)CorsicanCroatianCzechDanishDutchEsperantoEstonianFilipinoFinnishFrenchFrisianGalicianGeorgianGermanGreekGujaratiHaitian CreoleHausaHawaiianHebrewHindiHmongHungarianIcelandicIgboIndonesianIrishItalianJapaneseJavaneseKannadaKazakhKhmerKoreanKurdish (Kurmanji)KyrgyzLaoLatinLatvianLithuanianLuxembourgishMacedonianMalagasyMalayMalayalamMalteseMaoriMarathiMongolianMyanmar (Burmese)NepaliNorwegianPashtoPersianPolishPortuguesePunjabiRomanianRussianSamoanScots GaelicSerbianSesothoShonaSindhiSinhalaSlovakSlovenianSomaliSpanishSundaneseSwahiliSwedishTajikTamilTeluguThaiTurkishUkrainianUrduUzbekVietnameseWelshXhosaYiddishYorubaZuluPowered by TranslateFind an OphthalmologistAdvanced SearchAsk an OphthalmologistBrowse AnswersFREE NEWSLETTERGet ophthalmologist-reviewed tips and information about eye health and preserving your vision.Privacy PolicyRELATEDPet Fish Fitted with Fake Eye in Rare ProcedureJUN 30, 2016Firework Blinds Teenager, Severs HandJUN 29, 2016Ethnicity and Eye Disease: A Risk Reminder for Asian-, African- and Latino-AmericansAPR 26, 2016Vitamin See: Foods Rich in Vitamin C Help Curb CataractsMAR 28, 2016Los Alimentos Ricos en Vitamina C Ayudan a Controlar el Desarrollo de CataratasMAR 28, 2016Follow The Academy Professionals:        Public & Patients:   Contact UsAbout the AcademyJobs at the AcademyFinancial Relationships with IndustryMedical DisclaimerPrivacy PolicyTerms of ServiceFor AdvertisersFor MediaOphthalmology Job Center© American Academy of Ophthalmology 2016OUR SITESEyeWikiInternational Society of Refractive SurgeryMuseum of Vision

I Am Undergoing Cataract Surgery, Which Is the Suitable IOL for Me?

Dr. Manoj Rai Mehta, Ophthalmologist
Cataract surgery is the one of most commonly performed eye surgery.  It has got high levels of safety and predictability of outcomes.  IOLs are manufactured mostly from Hydrophilic or Hydrophobic clinical quality plastic polymers. Hydrophilic polymers create highly pliable lenses that are relatively easier to introduce in the eye.  However ,the incidence of lens capsule becoming opaque is higher, though eminently treatable with YAG laser capsulotomy.  This kind of material may also be avoided in diabetic patients as it binds to silicone oil, in case patient undergoes VR surgery in future (the chances are low though for this kind of surgery). Hydrophobic Polymers are increasingly the choice of material for eye surgeons across the world.  The polymer research is continuing in various directions to make the IOLs behave as close to the natural lens as possible.IOLs are available in different refractive options as well; mainly mono focal and multi-focal. Mono- focal lenses have a fixed focus and necessitate use of reading glasses after surgery.  Multi-focal lenses are designed to work at all distances and obviate reliance on corrective lenses post surgery for most of the daily activities.  There are advantages as well as limitation of multi-focal lenses which you must discuss with your doctor.  Current knowledge discourages use of multi focal lenses in diabetics.  Toric lenses are also available to take care of of cylindrical power as well as Toric Multifocal lenses which also help in assisting in near vision.There is a fiscal impact for each lens that a patient should know and discuss probable outcomes as well as challenges that may arise in the post operative period peculiar to a lens design such as glares, halos, floaters etc.It is important to discuss with your surgeon about the material, design, probable visual outcomes and limitations of an IOL that is selected for insertion in your eye.  Please obtain the bar code of the IOL inserted in the eye from the hospital and keep it safe for future reference.   An informed decision is always important to match expectations in outcome of a surgery. 

"Oh God! I Have Been Diagnosed with Cataract!"

Dr. Manoj Rai Mehta, Ophthalmologist
When a patient is diagnosed to have cataract the following questions pop up immediately:Is it unusual at this age?Can it be cured with medication of any sort?Is the surgery a must?  What if I do not get operated?How long can the surgery be avoided?  Cataract is the commonest cause of gradual, painless, progressive diminution of vision in middle-aged and old people.  The reaction of a patient varies from utter shock, disbelief to acceptance and discussion of further treatment.Why Me?     While cataract is known to occur at all ages and even congenitally, it is the senile, age-related, a cataract that is the commonest in prevalence.  People get cataract at different ages depending upon familial trends and associated systemic illnesses and exposure to certain light frequencies.  Diabetes (and other metabolic afflictions), steroid intake and exposure to Ultra Violet light cause early cataract formation.  Trauma to the eye also causes cataract formation. Why does vision decrease?The normally transparent crystalline lens of the eye becomes translucent and some areas turn opaque, thus causing scattering of light as well as a blockage.  Location of opaque areas also matters as central changes affect vision much earlier than those in the periphery.  Opaque areas close to the nodal point of the lens will affect vision profoundly even if small in size.Is there a medical cure available?In spite of tall claims no medical treatment has been established scientifically beyond doubt till now. Anecdotal claims do not satisfy scientific hypothesis.  Use of antioxidants may retard the progression of cataract as a general anti ageing effect.  Avoid using eye drops of unknown composition and dubious sources in the name of magical cures!  They may cause more harm than benefit.What is the "Right Time" for surgery?It depends on upon the lifestyle, profession and visual needs of a patient.  It is ordinarily an elective surgery and a patient should discuss all the elements of procedure and care with the surgeon and decide on the timing of surgery.  Surgery is aimed at improving "quality of life".  Glare, difficulty in driving and reading are some of the things that can affect the quality of life of a person and surgery is expected to alleviate them.  A driver, an IT professional, an avid golfer may choose to undergo surgery at an earlier stage than a person who does not drive and read much.Gone are the days when patients used to wait for the cataract to mature! Surgery time is decided after a mutual discussion on outcomes and QOL targets.  Surgery should not be postponed for long in case of advanced cataracts as they turn harder with time and surgery becomes more challenging. There are situations when surgery can not be postponed such as a swollen lens causing a rise in pressure or a leaky lens causing inflammation.Cataract surgery is one of the most gratifying surgical procedures and safest as well.  Do not get scared, discuss the goals of surgery and take a cool decision.   

Myth vs Reality: Cataract Surgery

Dr. Vishal Arora, Ophthalmologist
Cataract surgery is one of the most common surgery being done on the planet. Yet there are numerous misconceptions associated with it this articles deals with three most common myths about cataract surgery.Myth 1: I cannot develop cataract, my father didn’t have it and so shall I …Reality: Cataract is due to natural AGE RELATED clouding of crystalline lens present inside the human eye. As you can’t stop ageing, hence, you can’t stop cataract formation. But on the other hand degree of cataract formation and progression is variable and cannot be predicted.Myth 2: I don’t want surgery, can't it be dissolved naturally ?Reality: Unfortunately all the research that has been done or being done is unable to Stop/ reverse/dissolve cataract formation. The various drops available claiming to dissolve /reverse/stop cataract formation have no scientific basis.Myth 3: I heard that the surgery is painful and it takes lot of time for the vision to come back..Reality: Earlier cataract surgery used Injections around the eye, large cuts, sutures and rigid intra-ocular lenses and took a long time for vision to come back. Modern day cataract surgery involves NO INFECTIONS, LESS THAN 2 MM CUTS, NO SUTURES and FOLDABLE INTRA-OCULAR LENSES, where the patient gets his vision back on DAY 1 post surgery and can resume his/her normal activities.modern day cataract surgery is one of the safest surgeries today. We don’t wait for the cataract to reach maturity i.e. the patient to loose his vision, but operate as soon as the patient feels his vision is decreasing gradually and is affecting routine activities.The future has also arrived which  involves using Femtosecond Lasers to make incision (cuts) in patient’s eye rather than relying on the surgeon to do so. Almost 95% of modern day cataract surgeon use phaco-emulsification (laser technique as it’s popularly known) as primary modality for cataract removal.

Getting Clear About Cataracts: Causes, Symptoms and Prevention

Dr. Somdutt Prasad, Ophthalmologist
Growing old is a wonderful thing, if you embrace it. You can celebrate several things about it- strikingly steely hair, mature and classy look and elegant persona. Sure, there are challenges like aches and pains, but these can be managed with a few lifestyle changes and necessary medical assistance. Bigger things in life can always be dealt with, but sometimes the smallest of things can cause big problems in your advanced years. And, cataracts are one of those things! Causes of Cataract Cataracts are clouding of the eye’s lens, which impairs vision leading to blindness in old age. There are various causes for developing cataract, and the most common cause is build up of protein in the eye, which prevents light from passing through the lens, leading to blurred vision in old age. Genetic history, eye injury and inflammation, diabetes, hypertension and exposure to direct sunlight for long hours are some of the other causes for this condition. Cataracts usually form very slowly through the years, and you might not notice it until it starts blocking your vision considerably.People with cataract will experience some of these symptoms:Unclear vision, something like looking through an old cloudy glass or frosted glassCloudy vision with spots, dots or patchesBad eyesight when the light is dim or during the nightImpaired vision on bright daysDifficulty in readingUnclear vision even with glasses onSeeing a halo around bright objects, such as vehicle headlights or road lightsSome people also experience double vision in one of the eyesCataracts cannot completely be prevented; however, you can reduce the risk of developing it in later stages by adopting the following steps-Say no to smoking: Some studies suggest that people who smoke develop cataract more that those do not smoke. Smoking not only increases your chances of developing cataract, but also increases the risk of other eye related diseases.Nutritious food: Include lots of green vegetables, fruits, whole grains, plant/lean meat proteins and carbohydrates to your diet. This reduces your chances of getting cataract early in life.Stay away from direct sunlight: The UV radiations from the sun can harm your eyes, leading to cataracts. Protect your eyes by wearing sunglasses when out in the sun.Diabetes: If you have diabetes, take your medication and keep blood sugar level in control. People with diabetes are at a higher risk of getting cataract.Don’t let cataracts creep up on you and steal your colours. Get yearly eye checkups done, take necessary precautions and live life to the fullest!

Jaw Surgeries for a Proportional Face

Dr. N Srinivas, Dentist
It may take more than a new smile to help you look your very best.Having a great smile is undoubtedly an asset, regardless of other aspects of your appearance. However, your smile is only one part of the whole composition of your face. Once you have improved your smile, you may be inspired to make a few other changes to look your very best, and it may be necessary to look beyond your dentist to help.If you are unhappy with your facial profile,the condition of your skin, or specific facial features such as your lips, nose or chin. An oral and maxillofacial surgeon reveals how repositioning the jaws can improve not only your bite but also your entire facial appearance, especially in profile.What is orthognathic surgery?Orthognathic surgery involves dividing and repositioning the jawbones to bring them into better alignment. It is typically used to correct bite problems that cannot be fixed by orthodontics alone.Often bone or soft tissues may be removed or augmented to further enhance facial esthetics. Orthognathic surgery can bring about significant changes in your appearance.Is orthognathic surgery right for me?Orthognathic surgery is typically performed by an oral and maxillofacial surgeon and can achieve dramatic improvement in facial esthetics. Orthognathic surgery may be the best option if you:1. Have jaw problems that can be treated only by surgery.2. Can pay for the procedure, as its a bit expensive.3. Feel strongly that your condition is inhibiting your success and happiness.4. Are willing to experience some discomfort and inconvenience.5. Understand and accept all associated risks.Communication is critical to success!1.It's important that you tell your doctor exactly what you want to correct.He or she may zero in on a particular problem,and you need to be sure that problem is also your primary concern.2. Your surgeon will design a highly specialized treatment plan for you based on information gathered by obtaining casts of your teeth, photographs,video images,and special x-rays.3. It's highly important that you know what results to expect from treatment.Some surgeons will use digital imaging to give you a good idea of what you'll look like after surgery;others may show you tracings of your new profile based on your x-rays.4.It's also essential that you understand each step of the surgical procedure that you're to undergo.The main risks and possible outcomes should be explained thoroughly, and it's then up to decide which procedures you wish to have performed.What can orthognatic surgery do?Problems that can be addressed using orthognathic surgery include. Recessive or protruding lower jaw and/or chin.. Chin that is too short,too long,or otherwise unattractive.. Open bite(teeth do not meet). Lower and/or upper jaw positioned to one side or a narrow arch. Discrepancies in upper and lower facial height (gummy smile or lack of enough tooth or gums showing)What does an oral and maxillofacial surgeon do?Oral and maxillofacial surgeons do more than just tooth extractions and jaw surgeries.If  you're interested in cosmetic procedures to enhance the appearance of your face and neck,talk to your surgeon about including them your overall treatment plan.