Post-Surgery Facial Recovery: Addressing Concerns After Jaw Surgery

Q: Post-Surgery Facial Recovery: Addressing Concerns After Jaw Surgery

Hello： Your description does not rule out issues related to peripheral facial nerve problems. <br>Aside from corticosteroids, there is insufficient evidence to support the effectiveness of other treatment methods. <br>After the acute phase, there are almost no medications that ar

Poor recovery status after orthognathic surgery?

Hello, doctor...
It has been over two years since my orthognathic surgery to advance my mandible, but the left side of my face is still experiencing muscle stiffness.
When I smile, my face is uneven, and the left side of my mouth feels tight and cannot close on its own.
During my follow-up appointment with the oral surgeon, they only advised me to do more exercises, apply heat, and supplement with B12.
I feel a pulling sensation in the muscles of my left cheek and mouth corner when I close my eyes.
Although my condition has gradually improved over time, I am really anxious that I haven't recovered during the critical period.
My mouth corner is indeed drooping, and the left side of my nose even lacks normal folds.
Is this due to my nerves being too short when the mandible was repositioned? I am very afraid that my face and mouth will be crooked for the rest of my life.
However, I clearly had a mandibular surgery, so why do I feel like the issues are occurring in the upper part of my face? Which specialty should I consult for this? Thank you, doctor!

Huang, 20~29 year old female. Ask Date: 2018/10/19

Dr. Jiang Junyi reply Neurology

Hello: Your description does not rule out issues related to peripheral facial nerve problems.
Aside from corticosteroids, there is insufficient evidence to support the effectiveness of other treatment methods.
After the acute phase, there are almost no medications that are definitively helpful, and patients are advised to take vitamin B complex as an adjunct.
Approximately 10 to 20% of cases of facial nerve paralysis do not fully recover, with Bell's palsy being the most common clinical cause.
This condition is often due to unknown reasons or viral infections, which can impair the blood circulation that nourishes the facial nerve, leading to dysfunction and resulting in facial muscle paralysis.
It is recommended that you consult a neurologist to discuss and arrange for facial nerve conduction studies to rule out these issues.
Wishing you good health and peace.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2018/10/19

More Info

Post-surgery facial recovery, especially after jaw surgery, can be a complex and sometimes frustrating process. Your concerns about muscle stiffness, asymmetry, and difficulties with facial expressions are not uncommon among patients who have undergone such procedures. It’s important to understand that recovery can vary significantly from person to person, and while some may see improvements in a relatively short time, others may experience prolonged challenges.

Firstly, the symptoms you describe, such as muscle stiffness on one side of your face, difficulty in closing your mouth, and asymmetrical facial expressions, could indeed be related to nerve involvement during surgery. The lower jaw surgery, particularly procedures like orthognathic surgery, can sometimes affect the surrounding nerves, including those responsible for facial movement. If the facial nerve or its branches were impacted, it could lead to the symptoms you are experiencing.

The fact that you are noticing some improvement over time is a positive sign, but it’s understandable to feel anxious about the potential for long-term effects. The "golden period" for nerve recovery is typically within the first six months post-surgery, but some patients may continue to see gradual improvements beyond that timeframe. Physical therapy, including facial exercises, can be beneficial in promoting muscle function and reducing stiffness. Heat therapy, as suggested by your oral surgeon, can also help relax tight muscles.

Regarding your concerns about the asymmetry and the inability to form normal facial expressions, it may be worthwhile to consult with a specialist in facial rehabilitation or a neurologist who has experience with post-surgical nerve recovery. They can provide a more comprehensive evaluation of your condition and may recommend additional therapies, such as electrical stimulation or specific exercises tailored to your needs.

In terms of the B12 supplementation, while it is essential for nerve health, it may not directly address the muscle stiffness or facial asymmetry. However, maintaining adequate levels of B12 is crucial for overall nerve function, so continuing with this supplementation as advised by your doctor is wise.

If you feel that your current treatment plan is not adequately addressing your concerns, seeking a second opinion from a craniofacial surgeon or a specialist in facial aesthetics may provide you with additional options. They can assess whether there are any underlying issues that need to be addressed, such as scar tissue formation or other complications from the surgery.

In summary, while your recovery may be taking longer than expected, it’s important to remain proactive in seeking the right care. Engaging with specialists who understand the complexities of facial nerve recovery and rehabilitation can help you navigate this challenging period. Remember, you are not alone in this journey, and there are resources and professionals available to support you in achieving the best possible outcome for your facial recovery.

Similar Q&A

Understanding Recovery After Jaw Surgery: What to Expect

My colleague underwent a mandibular angle resection and chin augmentation surgery. It has been four days post-operation. The facial swelling has decreased somewhat, but it seems that talking too much may have caused some issues. Yesterday, the lower lip suddenly swelled to the po...

Dr. Lu Daokuan reply Plastic Surgery
Swelling and numbness can occur for 3 to 4 weeks post-surgery. Ice packs should be applied to the facial wounds for a longer duration, approximately one week, before switching to heat therapy.

Managing Numbness and Misalignment After Jaw Surgery: A Recovery Guide

At the end of 2018, I was involved in a car accident and was treated for an open comminuted fracture with displacement of the left mandible, accompanied by malocclusion. I underwent facial internal fixation surgery. After the surgery, I experienced tingling and numbness in the le...

Dr. Zhou Hongzhang reply Plastic Surgery
1. The recovery period after nerve damage can range from 2 months to 1-2 years. 2. It is possible that complete recovery may not be achieved. 3. The more severe the injury, the higher the likelihood of nerve discontinuity. 4. You can consult your original plastic surgeon or...

Understanding Facial Bone Plates: Is My Recovery Normal After Surgery?

Hello! A few days ago, I sustained multiple fractures in a car accident. My current concern is regarding the fractures in my face, where I have metal plates and screws in my right cheek. After having the stitches removed from my face the day before yesterday, I noticed that whene...

Dr. Chen Yongxue reply Orthopedics
Hello, the likelihood of healing after facial bone fractures is very high following surgery, so there is no need to worry. Any discomfort in the short term after the surgery will also improve quickly. Please be patient, thank you.

Post-Surgery Pain: Understanding Long-Term Effects After Facial Surgery

Four years ago, I underwent surgery on my face due to a car accident. Recently, I've noticed that the surgical area sometimes becomes red, swollen, and painful. In more severe instances, the pain is intense enough to cause dizziness, and I also experience pain in the teeth o...

Dr. Lu Daokuan reply Plastic Surgery
Is it normal to have redness, swelling, and pain four days after surgery? Is there a possibility of scarring? Additionally, if there is tooth pain, could it be due to a fracture causing malocclusion? It may be necessary to consult a craniofacial specialist or an oral and maxillof...