Thank you Pete for allowing us to share your forum post.
It’s now almost 2 years to the day that I had my left arthroplasty with discectomy, debridement of joint surfaces and dermis-fat graft. Before I go on, I wonder what your procedure actually is? You have used the term ‘temporalis fat graft’ which piques my interest. Perhaps I’m a bit of a stickler for accuracy, but generally a temporalis graft is a muscle graft in which a flap of temporalis muscle is cut – if you can imagine cutting three sides of a rectangle and the fourth being the bottom left intact to form a hinge, it is folded downwards and tucked into the TMJ to form a new disc. Some surgeons suture the temporalis flap to the back of the condyle and to the lateral pterygoid muscle to emulate the original structure according to its original design. Fat grafting by contrast typically involves a slug of dermis fat being excised – usually from the lower belly region – and it is then packed into the TMJ space after the discectomy and cleaning up is performed. Normally the fat graft is not attached at all. So, two different approaches, two different procedures, both to treat the same problem. I have not had a temporalis muscle graft so I cannot speak from experience about it. I have had a dermis fat graft. The dermis fat graft involves two surgery sites – one being the TMJ and the other being the fat harvest site. Some surgeons shy away from this a bit as it does increase the risk factors for infection and so forth. Personally, I had no issues whatsoever and a very small amount of discomfort post op. With the temporalis graft, there is one surgery site, but it is invariably larger than the fat graft requires due to requiring access to the temporalis muscle. That is also not without risk. It would pay to discuss these things with your surgeon. For me, two years out I eat normally without discomfort, I can yawn, sneeze and cough occasionally without too much drama. Functionally, I am about 80%. Pain-wise, I still get some and it is variable which is a blessing. My right side is more painful than the left. It took fully 12 months post-op for the joint to really settle down and in that time I experienced the full gamut of symptoms. My doctor told me to expect this. It happened and it went away eventually. The surgery is not an instant fix. It does not restore a damaged joint to 100%. If you have a realistic expectation, chances are you won’t be disappointed. I have my life back to a large extent and am thankful. Please let me know if you have any questions. I will do my best to answer and help where I can.