Why do I look weird right after double jaw surgery?

 

Why do I look weird right after double jaw surgery?

Immediately after double jaw surgery, potential awkwardness and unnaturalness can happen. Today we’re talking with Dr. Shin about what are they and why it happens.

Basically, the Double jaw surgery that we perform is on the bones, which is on the endoskeleton. We do the surgery on the endoskeleton and aim to have external change that is visible through the skin through surgery. In reality, when we move the bone, the skin needs to follow suit. But, after the surgery, the area will be swollen. When it’s swollen, no matter what you do with the bones, you won’t be able to tell from the outside. After the swelling goes down, the skin goes to where it should be. The skin goes like “Where’s the bone?”, and don’t know what to do. It will sag and look like it has lost elasticity. When you make a facial expression, it will look awkward. Immediately after surgery, it’s only normal that this happens. We call tissue that is hard, such as the bones and teeth, hard tissue, and everything else such as your skin, muscles, and fat called soft tissue. Your soft tissue will have difficulty following the movement of the hard tissue at first. It will take time to follow. So, the awkwardness that stems from this disparity is the biggest issue. 

Another thing is for double jaw surgery, patients will wear something called a wafer. This is when we move the jaw to a specific position through surgery, the wafer will play the role of guiding the bite. When you continuously bite the wafer, the muscles are activated in a way that they have not been used before. The strength of the bite itself because it’s a foreign, new position, you might bite excessively strongly, causing your facial expression muscles to become awkward. So the wafer may also play a role in this.

The main reason you would look strange after surgery is from swelling. Immediately after surgery, you will be wearing a compression band. When you wear the band, we can make the area that the band covers to make sure it doesn’t swell as much. The band is used to prevent swelling but we can’t do that for the mid-face area. So the area around your nose will swell a lot. When your nose swells but your chin doesn’t, you can look like you have a recessed chin. When your chin moves back, it has the same effect as if the rest of your face moves forward. So your eyes and nose will appear larger, and your cheekbones will appear larger, that’s how you might feel due to the relative position of everything. If the chin used to be at the very front, your nose will swell the most because when we operate on the upper jaw, we do it behind the nose, so it’s impossible for that area to not swell. So it can temporarily look wider. This can also happen when you push the check bones inwards, there is a muscle here called the temporalis. But when we push this area inwards, that looks like an arrow. When we push it inwards, the muscle there will be pressed, so it can look like it’s protruding. This area can look like it’s jutting out. But with time, it will become more smooth. So for the most issue, they will resolve themselves with time. 

It will take at least three months for most of the swelling to go down. But even at 3 months, we can’t say that the swelling has fully dissipated. The checkpoint at which we can safely say that the soft tissue has taken its final place somewhat is at about 6 months post-surgery. After 6 months there will no longer be any major changes. Prior to the 6-month mark, your face will change continuously.

Doctors who perform double jaw surgery do something called the cinch suture. Under the nose in order to maintain we tie the base of the nose together from the inside. All the doctors do this, but even if they do, it will still look swollen and wide immediately after the surgery. Because it swells. So this will be recovered eventually too, all you need to do is wait and trust your surgeon.

To summarize, most issues will take time to resolve, all you need to do is wait. It will take 3 months at the very least before we can say anything for sure. In the shoes of the patient, they’ve gone through a lot recovering from the surgery, it’s understandable that they would be concerned. But please trust your surgeon and observe your recovery over at least three months. If there is still an issue, then at that time the patients may want to explore their options. Even if you are a little anxious, it’s necessary to wait.