Recovery Challenges After Orthognathic Surgery - Neurology

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After undergoing orthognathic surgery, particularly a procedure that involves repositioning the mandible (lower jaw), it is not uncommon for patients to experience a range of recovery challenges. Your concerns about muscle stiffness, asymmetry in facial expressions, and difficulties with mouth closure are valid and warrant careful consideration.

Firstly, it is important to understand that the healing process after such surgery can take time, often extending beyond the initial recovery period. While many patients notice significant improvements within the first few months, others may experience lingering symptoms, such as muscle tightness or asymmetry, for a year or more. The fact that you are noticing gradual improvement is a positive sign, but it is understandable that you feel anxious about the remaining issues.

The symptoms you describe, including the tightness on the left side of your face and the inability to close your mouth fully, could be related to several factors. One possibility is that the surgery may have affected the surrounding muscles and nerves, leading to temporary or, in some cases, longer-lasting changes in muscle function. The facial nerve, which controls the muscles of facial expression, can be impacted during surgery, leading to asymmetry or difficulty in movement.
Your mention of feeling a pull in your left cheek and mouth corner, as well as the inability to form normal facial folds, suggests that there may be some degree of muscle imbalance or nerve involvement. It is crucial to follow up with your oral and maxillofacial surgeon or a specialist in facial rehabilitation. They can assess your condition more thoroughly and determine if there are any underlying issues that need to be addressed.

Physical therapy can be an effective treatment for muscle stiffness and asymmetry. A physical therapist specializing in facial rehabilitation can provide targeted exercises to help improve muscle function and coordination. These exercises may include facial stretching, strengthening, and coordination activities designed to enhance your ability to control facial movements and improve symmetry.

Additionally, your surgeon's recommendation to apply heat and supplement with Vitamin B12 is a common approach to promote healing and nerve health. Heat can help relax tight muscles, while Vitamin B12 is essential for nerve regeneration and overall neurological health. However, if you feel that your symptoms are not improving with these measures, it is important to communicate this to your healthcare provider.

In terms of the specific concerns about your facial appearance and the potential for long-term effects, it is essential to have an open dialogue with your surgeon. They can provide insights into what is typical during recovery and what you might expect moving forward. If you are feeling particularly anxious about the possibility of permanent changes, discussing these fears with a mental health professional may also be beneficial.

In summary, while it is normal to experience some challenges after orthognathic surgery, persistent symptoms should be evaluated further. Consider scheduling an appointment with your oral and maxillofacial surgeon or a specialist in facial rehabilitation. They can provide a comprehensive assessment and recommend appropriate interventions to help you achieve the best possible outcome. Remember, recovery is a process, and with the right support and treatment, many patients see significant improvements over time.