Sharing a Face and a Life Journey

Stand by me: Identical twin sisters are supporting each other through surgery

25 June 2017

“My sister, Hnin Wut, was my in-home nurse,” shares Hnin Pwint Hlaing, an identical twin from the United States, who recently underwent surgery to correct malocclusion of her jaw.

Hnin Wut’s help in caring for Hnin Pwint on a daily basis, from medications, to feedings, to helping Hnin Pwint take care of her daily hygienic routine, was invaluable. “Every day, she fed me antibiotics on time,” Hnin Pwint explains. On the days when Hnin Pwint was not in the mood to consume her liquid diet, her sister made sure that she would drink enough to stay hydrated and prevent any major weight loss.

“Throughout this whole process, our bond became stronger, because I could feel her sincerity in helping me to recover faster,” Hnin Pwint reveals. Shortly, the siblings’ roles will reverse, when Hnin Wut undergoes the same procedure, and the twins will again work together to put their best face forward.


Correcting malocclusion in identical twins

Both Hnin Print and Hnin Wut have prognathism of the lower jaw, from Greek, meaning: pro (forward) and gnathos (jaw). “It is not a congenital condition in the sense that people are not born with it, but there is certainly a genetic component to it, as you can see with the twins,” explains Dr Sabine Girod from Stanford.

“The Habsburg royalty was famous for their big lower jaws, and one can immediately recognize a Habsburg prince on old paintings because of this. Sometimes it is already evident in children, when the primary dentition comes in, but usually it becomes evident when the person matures, and the jaws grow out of alignment later during puberty,” she reveals. In many cases, the orthodontist can correct the bite with dental movements, but sometimes, it is so severe that the jaws need to be surgically repositioned to improve functionality.

“Throughout this whole process, our bond became stronger, because I could feel her sincerity in helping me to recover faster”
Hnin Pwint

Planning surgery to improve functionality and aesthetics

“For 18 years, I hated the fact that I looked different, and I could never give myself compliments as I grew up,” Hnin Pwint openly reveals. “I used to receive questions from strangers about my under bite, or why I look different from my family members,” she adds.

“When preparing for surgery, my office spends a lot of time talking to patients about what they would like,” shares Girod. “I love planning maxillofacial surgeries with my patients, because in many cases, I can help to fulfill their dreams,” she adds.

Because the twins’ front teeth did not meet, the primary goal of the surgery is to correct functionality. “As a first step, we look at the position of the upper and lower and what the airway is like. If there is a problem with something like sleep apnea already, we need to plan the surgery differently, to correct the sleep apnea, and not make it worse,” she shares.

Secondarily, but very important for the patient, are the aesthetics. “Every patient, and especially every culture, has different ideas of beauty and that is why it is so important to find out what a patient wants,” Girod explains. “To achieve a nice cosmetic result, we do measurements before the surgery to find out what the best way is to correct the bite. We actually still use a variation of the aesthetic guidelines and measurements that Leonardo da Vinci used when he painted the Mona Lisa. We do the planning on the computer in 3D, so that we can also share with the patient some outcome predictions, even though this only provides a good approximation,” she explains.


A reshaped self-image—a fresh start in life 

“Since the surgery, I am extremely happy with my new appearance,” explains Hnin Pwint. “While I suffered for a few weeks, due to the pain in the jaw, swollenness, diet, and infection, the pain was nothing compared to my overall appreciation for my new face. Now, I can confidently walk anywhere I want, and eat anything I’d like to eat. Every day, I am ecstatic seeing my new look in the mirror, and I am thankful to my surgeon for performing a successful surgery. My smile is beautiful, and I am no longer insecure about my face,” she adds. “Now, when I look at my baby pictures, my facial structures look exactly the same. This surgery has given me a fresh start in life,” she confides.


“It was extremely hard for me to watch my sister go through this whole process,” Hnin Wut expresses. “I was often worried that her health would be severely affected. I was also hesitant to go ahead with the surgery, not because I was afraid of the pain, but because of the result,” she adds. “At the end of the day, I could not be more proud of Hnin Pwint for handling everything with ease. Now, in watching my sister smile confidently and love herself, I have found the answer I was searching for when I was still indecisive about my surgery. My sister does not regret her decision to have the surgery, and I am confident that I will not regret it, either,” she conveys.


Helping to contribute to others’ success

“Maxillofacial surgery can make big differences in peoples’ lives,” offers Girod. “I have had patients who felt very uncomfortable with their face, which affected them on multiple levels. One patient even refused to be in pictures with his family. Today, he is a changed man. The best compliment you can ever receive as a surgeon comes from patients who return, confident and content, to thank you for helping them,” she beams.

Dr Girod looks forward to conducting Hnin Wut’s surgery. “These are extraordinarily remarkable young women in the way they are supporting each other through this surgery. It makes me very proud to be able to contribute to their happiness and their success,” she concludes.

AO CMF is very grateful to Hnin Wut and Hnin Pwint for sharing their story.

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