Cant, asymmetry resulting from surgery

[stravinsky]

I realize I can't get the answers I need without pictures, but it's so hard to post them for everyone to see. Would love to just hear some thoughts.

I had double jaw surgery with genioplasty in August to fix a severe overbite/recessed chin. My profile is a lot better, and I have a proper bite for the first time in my life, but so many things went wrong. I have a large bone bump on the angle of the right side of my lower jaw, which my surgeon plans to smooth down. My nose became noticeably crooked to the left such that my midline of my teeth appears way off, even though it's roughly centred on my face. The crooked nose causes my whole lower face to appear to pull to the right. My bottom lip is off by a couple millimetres to one side. (The midline of my lower teeth is some mm away from the centre of my lower lip, but the midlines of my teeth match when I bite down, so my bottom lip looks crooked when my mouth is closed and also when I speak. This is probably hard to picture without seeing it.)

I've also developed a cant of 1mm on both the upper and lower jaw. That sounds like a small amount, but it's noticeable both when I smile (more gum shows on one side) and when my mouth is closed (the right side of my jaw/chin appears lower than the left).

I saw my surgeon for the first time since August the other week, and he confirmed the cant (had been emailing him about the bump etc. and he didn't have much more to say). I didn't ask him the right questions - it's hard to process all this information so quickly, and I'm kind of an emotional/mental mess because of this. He says it's a great result, and when I'm listening to him and so emotionally vulnerable, I believe him. Then I come home and see all of these problems again and I feel so helpless. He said he could redo the surgery on both jaws to fix the cant, but he wouldn't recommend it. No idea about whether it would be covered or what the risks would be or how this cant might be affecting the lower lip. These are all of the questions I need to ask him when I see him again this week.

I don't know what advice I need in the meantime, but I need advice. Would you settle for canted jaws after surgery? Is this cant the reason I have joint discomfort nearly five months in? Am I severely, severely depressed because of body dysmorphia or is this to be expected when things go wrong after surgery? Everyone tells me I look great - my surgeon calls it a great result both functionally and aesthetically - but I am far more asymmetrical than before the surgery, and I think it all looks so strange. I don't know what to do.

[Gregor Samsa]

My surgeon tells me my nose is not in the center of my face but it actually looks like the entire mouth is shifted to one side. It's a bit strange how asymmetry like this can arise. I wonder how hard it is to move a nose horizontally in the face?

[anglii]

Stravinsky,

I know how you feel. I had double jaw surgery as a teenager 30 years ago and I haven't been able to look at myself since. I hideout when it's time for pictures. I am so psychologically messed up because of what was done to me. I'm disfigured and feel like a freak. I too have a cant since the surgery of 3 to 4 mm (both upper and lower jaws). I have no smile only a reverse smile (the muscles pull the corners of my mouth downwards). I have no lips when before the surgery I had beautiful full lips (my best feature).
 
I do now have a prominent masculine looking chin, a crooked nose as yours, my midline of my upper teeth doesn't line up with my nose nor the center of my mouth. When I try to smile the muscles pull my mouth way up on the left side so it looks like I've had a stroke. My profile is very flat from my nose down which makes my nose look more prominent too.

You at least have people telling you that you look great. Not one person said that they liked the results of my surgery. To the contrary they say they liked me better before the surgery.

My daughter is getting married in a few months and I'm terrified of having to look at pictures of myself. Instead of helping me, the surgeons I've consulted with over the years tell me to get counseling to accept the new me.

I would never want to go through a second surgery but have recently found a neuromuscular dentist who believes he can help me with orthotics.  Neuromuscular testing showed my face needs 6-8 mm of vertical height (the surgery removed 4 mm from my upper jaw -- absolutely the wrong thing for my already short/wide face), it also showed my muscles are very tight, out of balance and over worked from the surgery. He's never seen anyone clench so hard. I feel the tension in the tip my nose and my jaw feels tired all the time. This all has a negative impact on facial symmetry and esthetics. And my TMJ. My face is collapsed. The orthotics will straighten the cant and relax the muscles so they don't pull every which way, and give my face support. All without surgery.

He also thought I was a good candidate for NUCCA chiropractic. NUCCA chiropractors focus solely on the C1 vertebrae. When it's out of alignment the rest of the body tries to compensate thereby becoming asymmetric. I had a moderate misalignment confirmed by x-rays. After my first adjustment, the tension in my jaw improved markedly and the left side of my face relaxed so when smiling I don't look like a stroke victim anymore.

I'm expecting good results from the orthotics which will align my jaw on 6 levels (forward-backward, left-right and up-down) I get them placed in March just in time for the wedding and will keep you posted. In the mean time I highly recommend being assessed by a NUCCA chiropractor.

Blessings