Face droopage after jaw surgery
July 12, 2015 12:21 AM   Subscribe

My face (skin? muscles?) did not tighten up the way I'd hoped after jaw surgery. What's next? Are there exercises I can do? Would losing weight help? Do I need a facelift or face lipo? Has anyone had that done and not looked cartoonish? Any way I would I could get insurance to cover it? Can you recommend me doctors to see?

In November 2013 I had surgery to correct a severe underbite. This involved breaking both of my jaws and repositioning them. I wasn't wired shut, but no chewing for two months, only light chewing for the third. Most of the change came from moving my upper jaw forward. My lower jaw was also moved backward by a tiny amount. The surgery on the whole was very successful, and one of the best decisions I've ever made.

However, I did have a severe issue with something this Cracked article on having a broken jaw described like this: "And while not technically dangerous, there's one last thing you don't expect. A complex set of muscles in your upper jaw do not get used at all when your mouth is wired. These muscles will take this opportunity to become lazy and useless. The atrophy will cause your face to slide down your bones till you begin to resemble some kind of jowly Dick Tracy villain." It did sort of look like the accompanying picture. Basically the area from my nose to my lips puffed out and culminated in a jowliness around the corners of my mouth.

Time improved this greatly, as my surgeon said it would, but not completely. At 18 months, times has done its thing. But I don't like the way it looks. I'm only 33, and it really ages me. So what now?
- Are there any face exercises I can do to further tone those muscles? (I didn't do any type of facial exercises during or after recovery.) Do those work?
- Will losing weight help? I weighed 20 pounds more before surgery and didn't have this problem, but my face had a very different, longer shape. I'm currently working on losing another 20, and sometimes I think this is helping, but other days the weight seems to be coming from my cheeks, only accentuating the problem.
- Do I need more surgery? Jaw surgery didn't scare me because I knew I had a great surgeon and this was a medical procedure. A facelift or face lipo realcares me because it seems like there's more potential for things to go wrong, namely looking horrible like so many celebrities do.
- How do you find a plastic surgeon? Any recommendations in the NYC area?

posted by unannihilated to Health & Fitness (8 answers total) 1 user marked this as a favorite
Just want to clarify that the area is from my nose to my mouth but BESIDE my nose and mouth, not the little piece that connects them.
posted by unannihilated at 12:25 AM on July 12, 2015

My understanding is that facial exercises don't do much, for most people. (There is some controversy, but I've done some looking into it and the more reliable sources don't seem to think much of it.) But your situation is unusual, in that it's a post-surgical change and (presumably) not normal aging. I'd suggest contacting the office that did your surgery and seeing if they can suggest anybody for you to talk to about this. If there are legit facial exercises you should be doing post-surgery, there is somebody out there to guide you through that stuff so you don't do yourself any harm.

There are some injectable treatments that supposedly can tighten the chin and jawline a bit. Look around on Realself.com, but bear in mind that the responses there are from plastic surgeons and their bias will be to address things surgically.

There are plenty of people who will try to sell you major surgeries, expensive woo-woo facial exercise programs and weird, useless gizmos. Stay skeptical and frugal.

Before you do anything drastic, I'd suggest you reach your goal weight and see what that does. Even a little extra weight can really change the shape of your face, especially the cheeks and chin. If you lose the weight and it doesn't help or it makes things worse, gaining the weight back won't be difficult!

Have you experimented with facial contouring makeup? Even if that doesn't really change the problem, it can give your face some definition.

And finally, remember that attractiveness comes in many forms and other people may not see your looks the way you do. A soft jaw is not universally seen as a bad thing. You say you're jowly, but perhaps others would say you're baby faced!
posted by Ursula Hitler at 1:37 AM on July 12, 2015 [1 favorite]

I'm having a little trouble understanding what you're describing. But, I had the same procedure done, was wired shut for 4 weeks, and it took far longer than I expected for all of the swelling to go down (1 year+). I'm wondering if some of what you're seeing is swelling related? My next guess is nerve damage. It doesn't make sense to me that the muscle would be permanently weakened from under-use.
posted by i_am_a_fiesta at 6:37 AM on July 12, 2015

Are you saying your nasolabial folds are more apparent? That can happen just with weight loss (and it settles for some people, once they've been at their target weight for a while, and others do get fillers for that). A quick google suggests the kind of jaw surgery it sounds like you had can lead to some changes in soft tissue. It seems that the nature of the changes depends on a number of factors, though.

2nd everything Ursula Hitler said.
posted by cotton dress sock at 8:59 AM on July 12, 2015

You got it, cds. This culminates in this little pouch of fat near the corner of my mouth, kind of like what Hillary Clinton has. As I'm not in my 60s, this is not acceptable to me. The weight loss has been more recent (early this year) and the most severe of this was in early 2014, right after my surgery, which leads me to blame the surgery. Though perhaps further weight loss will hurt, not help, which just further makes me want to get the ball rolling on muscle exercises or surgical consultations. (I need to lose the weight. Gaining it back is not an option.)
posted by unannihilated at 9:14 AM on July 12, 2015

I don't see how doing exercises could actually hurt you. Furthermore, if the cause of the droopiness was atrophy, it stands to reason that exercise COULD possibly be the remedy.

Google Jack Lalanne, he used to promote facial exercise on his TV show. I think a lot of the videos have been pulled from YouTube but I am also pretty sure his collected works are for sale on DVD somewhere.
posted by tel3path at 10:08 AM on July 12, 2015

Here is a question on RealSelf.com from someone who reported similar effects after jaw surgery - suggestions range from having fillers in the cheeks and/or folds to create a different underlying structure for the skin, trying temporary fillers first to see how you like it, to a "modified cheek lift" for very deep folds.

I think it makes sense to go back to your original surgeon for recommendations - because this may have come up in the past for other patients - and yeah, go for a bunch of consultations. (I can't help with navigating that; personally, for any surgery, I would probably want a whole lot of consultations and recommendations.)
posted by cotton dress sock at 10:59 AM on July 12, 2015 [1 favorite]

Yeah, this sounds like a nasolabial thing and not a jowl thing. Jowls are the flabbity things people get along their jawlines, and correcting those is a bitch. Nasolabial lines aren't as challenging. You can start with weight loss, and if that's not helping look into dermal fillers for a quick and relatively inexpensive potential fix. A lot depends on if you're talking about superficial lines (pic 2) or deeper grooves (pic 2-4). Lines are simpler to correct than grooves, but in either case you can probably get something done that doesn't involve a full facelift at 33.
posted by Ursula Hitler at 5:23 PM on July 12, 2015

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