Long-Face Syndrome (Vertical Excess) Non-Surgical Option?

[val89]

Hello, I am a 20 year old female trying to find someone else who has/had long-face syndrome and what they did to treat it.
I have the common signs of vertical maxillary excess: mouth breathing as a child, crowding, a very high arched palate, lip-incompetence, and I am a tongue thruster. I have had to train myself to keep my mouth closed in public. The part that bothers me the most is my mentalis strain, the narrowness of my smile, and also the tension from having to keep my mouth closed all the time. Fortunately I have really nice teeth and they aren't crooked due to prior braces, but I really want to at least lessen the mentalis strain so my face looks "normal" when my mouth is closed, and I'd like to achieve a "wider" smile... all without resorting to surgery.

Over the past year and a half I have seen about 5 different orthodontists, 3 TMJ specialists, and 2 facial surgeons. Some told me there is no solution to my problem, others suggested a LeFort I surgery to shorten the 3rd of my mouth and attain facial balance. I finally met a TMJ specialist who offered my a 12-16 month plan of starting with a palate expander and using top & bottom braces. His idea was to lessen the angle of my bite by widening my palate, and then bringing the rest of my upper teeth up to the same level as my last molars and wisdom teeth which are slightly higher than the rest (this would involve anchoring and probably nightly head-gear). He would then adjust the bottom teeth accordingly, and VOILA, normal (or close to normal) facial proportions, all without surgery! I would, however, need night retainers for the rest of my life.

I am kind of skeptical about this since I'm almost 21 and afraid that the rapid palate expanders won't work... but it does make sense that by widening the palate there will be a shortening of facial length. I am afraid of receiving a LeFort surgery since there can be serious post-operational problems, including nerve damage, infections, and even developed twitches, etc...

My case isn't as severe as others, but I still would like to finally fix this!!!
Here are some pictures:

[Steph in Sac]

I can't add anything too helpful. I just wanted to say you have great teeth and a great smile! Think twice about everything!!

[fosterp]

if everyone suggests you need surgery to get the outcome you desire I would be skeptical going with any ortho that thinks he can do it without

I guess the widening of the arch would make sense since long face syndrome refers to the vertical length compared to the horizontal width, and widening the lower face with arch expansion would bring the proportions more in balance

as an adult the amount of expansion i believe is pretty limited to a few mm or so since we are done growing, to get any real significant expansion I think you need to have surgically assisted rapid maxillary expansion (sarme) where they cut your jaw in half and then expand with the appliance, this is different from the lefort surgery the orthos talked about though

im not sure how arch widening would fix the lip strain though since the vertical length would remain the same

[Chicagogal]

I went with the area expert on non-surgical expansion and to be honest, i'm still a little nervous since most others said that I'd likely be a surgery candidate (if there's only 1 saying they can do it without, research them heavily!!). I'm doing expander and braces w/ bone plates to realign my jaw. I have similar issues to you except I don't have you absolutely gorgeous smile that i'm paying thousands to achieve!! honestly! surgery is pretty significant, costly (especially if insurance sees it as cosmetic) and sometimes with equal good and long-lasting bad effects. my dentist has patients that still have numb spots in their face or are losing teeth because of hasty surgery. your teeth look amazing to me, be so careful!!

ps. my ortho was clear that TMJ is a joint issue that's too similar to arthritis to actually be "cured" by any orthodontic treatment.

[Kitagirl]

I see what you are talking about (having to keep your mouth closed) but your teeth are gorgeous!!!!

I'm older than you, 35, and my ortho didn't give me the option of palate expander although he told me I really should have had it done as a child. Now I just should have surgery to break my jaw and expand it. But I chose not to do that, and to just straighten the teeth with the room I have, with braces.

Anyway my point is what someone else said...not sure if you can expand your palate now that you are pretty much done growing? That sounds odd. Just make sure you check alot of references and reviews and get lots of opinions before you go with that because it sounds like any decision you make is going to be very drastic.

Good luck with it!

[braceface418]

My understanding is that your jaw doesn't stop growing until around age 23. At very least, you could give the palate expander a shot now and see what happens. The only risk I can think of is your teeth tipping, which doesn't happen overnight and something that you can see happening.

[loftry]

Hi,

I am a 17 year old male who is a similar case to you: mouth breathing all my life, now has lip incompetence and mentallis strain when close mouth, long narrow face (more specifically thin and long jaw), thin and short upper lip, etc and also had crowding which had to be corrected with braces aged 15-16. I am depressed about my face as i feel i have an other wise fairly good looking face, but my lower face ruins this.

So I was wondering if you have had this problem fixed for you, and if yes what exactly you did about it and whether or not you are happy with the results?

I would really appreciate any help!

Thanks

[hypocrite opportunist]

Hi there,

I'd like to add my perspective on this topic, even if it may not be a popular one. I am a 30 year old female who has this identical problem- lip incompetence, recessed chin, mouth breather as a child, etc. However, I had no idea this was a "problem" or "deformity" until I joined this board. I always thought my profile looked a little funny, but it was never something that concerned me. I have spent my entire adult life oblivious to what is apparently considered by many on this board to be some horrible disfigurement that warrants expensive, painful surgery to correct. The point I am trying to make, is that it's only an issue if you decide to make it one. I have never had a problem getting boyfriends, making friends, or anything of the sort. I have been confident in my looks for many years and I actually think my face is pretty. ( gasp, awful deformity included)! So, as trite as this statement is, no one is perfect. If I had surgery to "correct my face," I wouldn't look like me anymore, and unless this issue was causing me serious problems, I would never consider undergoing surgery. I wish you the best luck, and if it is any consultation, my own narrow smile has widened quite a bit with braces. Take care.

[catgyrl]

Hypocrite Opportunist-
Beautiful post!! We could all learn a lesson from you to be more tolerant of our looks. I used to complain all the time about my round "moon" face; however, at the ripe old age of 43, I'm discovering that that is the one thing that makes me appear about 10 years younger than I am, and now I wouldn't change it for anything. Hell, I'll take "cute" at my age! For the past 3 years, my brother has asked, "Are you 40 yet?"

Val89-
I think you have beautiful teeth!! But I completely understand that you want it fixed so that it doesn't look like you're straining to close your mouth. I'm sorry I can't offer any constructive advice; I just wanted to let you know you have a beautiful smile.

-Cathy

[ladybits011]

All my life I complained about two things: my gummy smile and headaches. My headaches began when I was 10 years old, and I think that those headaches what onset my depression. I honestly only began noticing my gummy smile when I started puberty. I noticed that when I smiled I showed a lot of gum and I thought that was because I was smiling to big. I didn't think much of it because my orthodontist never said anything, so I just thought my gummy smile is just a quirky trait of mine that I deeply despised.

My orthodontist corrected my overbite and gave me a beautiful smile much like the original poster. My headaches began getting worse around the age of 15, around the time I took my braces off.I never thought it was because of my bite. So I went to a lot of doctors to find out why my headaches were getting worse and none of them understood. Until I went to another dentist and he said I had TMJ. So I got the mouth-guard, but it still didn't help because I don't grind my teeth at night. However, I thought I'd give the mouth-guard a chance cuz maybe it was all about geting used to it. I went on to my next cause.. my gummy smile. I thought I could get a gingivectomy, but I went to the same dentist and he told me I couldnt because its not that I had excess gum tissue it was my bone structure.

I looked up online, and I self-diagnosed myself. I realized I had long-face syndrome, so I went to the same dentist to talk about it and he said it was nothing. My face was the way it is and it was beautiful, and that the procedure was too dangerous. However, I searched this a year prior before talking to him and I read many testimonials saying its not that dangerous. It's not his fault he didn't know, he was just a dentist and that was not his specialty. I had to beg him to give me a name of a doctor that was specialized in orthognactic surgery, and he did.

The doctor told me everything I already knew... my upper jaw is long and my lower jaw is small, thus, the reason for my long time headaches. Then he later just asked me a series of question.. like if my tongue feels like its to big for my mouth, and if i have pain around the upper inner corner of my eye and the corners of my nose which I agreed to all of them. I was like.. finally somebody who's describing the pain i felt throughout my whole life. My parents were a lil worried, because they thought the surgery was too extreme so my doctor talked to my parents and explained: Your daughter has long face syndrome. It looks adorable now, because it gives her that bunny-esk look and that youthful appearance. However, in the long run it's only getting worse. You're daughter is only 19 years old, and she's complaining about headaches. Imagine when she's 30, or 50? Her headaches will only get worse. Not only that, but other consequences are premature aging, loss of teeth and many more. I know when you hear about this surgery you believe the only people that need it are the ones who suffer from a huge underbite, however, an underbite does no harm while an overbite does.

I'm sorry this was such a long story. I just think people should realize its not JUST a cosmetic surgery. Yeah, if you don't like how your bite aligns then this surgery will definitely fix that. I'm 21, I have a boyfriend and I'm planning on putting braces again so I could do the surgery. A lot of people think I'm ridiculous, because ( i don't want to sound conceited) a lot of people think I'm very good looking. My grandmother has a small lower jaw and she suffered headaches throughout her life. She use to tell me that when she was young she would excuse herself from the games because her head was hurting. I rather have braces for a year ( to fix what my previous orthodontist did) and have the surgery and be swollen for a year, because it sucks having a headache everyday. It drains your whole spirit away.. i sound I'm being a lil dramatic but I'm trying to make a point here lol.

SO conclusion.. Do the surgery or dont. If you feel uncomfortable with your appearance, that's still a legit reason to do it. You're not adding implants, you're just fixing your face to what it should of been. IF you never had any pain in your life, and you love your appearance then don't do it. The only reason we think this surgery makes people beautiful, because societies standard of beauty is based on the greeks standard of beauty (proportion). I hope this help.

[ladybits011]

I tried to cut myself short on my last post, cuz I felt like I was rambling on and on lol. I forgot to mention, like any surgery there are of course risks. However, because of how extreme the surgery is most people think (including myself at one time) a lot bad sh**t can happen. I suggest looking at youtube video of people that had the surgery, and see their testimonial about it. It really made me feel better knowing all these people had surgery without any complication.

[ladybits011]

Urgh! i feel silly. I should've read val's post instead of just skimming through it. I don't think there's any other way but Le for I surgery to fix what we have. I know many doctors warns us about the consequences if the surgery goes bad, but they're very slim chances. There's a higher chance of the anesthesia going wrong, then your doctors skills. Like I said, check out youtube. There are tones of people who record there recovery and post it on youtube. There's also a few blogs out there that talks about it, and there are tones of pictures of before or after. I personally would stay away from the plate thing you were talking about. Just having to remember to wear that every night before you go to bed. It just kind of ruins the spontaneity of life. In the long run, its just very unlikely anyone would keep treating it However, that's just me.. I don't have the best discipline.

[ohshegoes]

I agree with ladybits. I have had migraines since i was a child to the point of being rushed to the e.r serveral times. I have had braces already but never jaw surgery. It wasnt until just recent (I'm now 27) that i talked with an orthognathic surgeon and i finally had someone tell me i wasn't crazy or imagining my issues. i have an answer to a problem thats been lurking my whole life. I have decided to take 2.5 years of my life to correct this issue so i never have to deal with it again and will be much happier not having to fake smile or cover my mouth when i laugh or just be insecure about my lower part of my face in general. the peace of mind alone is worth going through this surgery in my eyes. the important thing is to find someone that is a support system for you. luckily both my mom (who was nothing but supportive when i told her what i was doing) and my husband support my decision and will be there with me every step of this journey. By the way the surgeon diagnosed me with maxillary hyperplasia with vertical dimension and mandibular hypoplasia. I will be treated with lefort 1 to move my upper jaw up and bsso to move my lower forward and possible genio.

[val89]

Hello again everyone! I know it's been quite a while since I posted this, but I wanted to say thank you a million times to you who made me feel so much better about my smile. I realized that I have good teeth and a nice smile now (took long enough, huh) and that I should make due with what I have.
I decided to get braces to widen my smile just a tiny bit, and to correct some bite problems I have. I have also been seeing an Orofacial Myologist to help strengthen the muscles of my face and reduce the mentalis strain. My myologist doctor aslo identified my tongue-thrusting problem (common in people with long-face syndrome), so I have to do all kinds of exercises to retrain how my tongue and facial muscles work! This has also helped the left side of my face which is a bit less "toned" than the right side.

Since I still have a bit of a mentalis strain, I have booked an appointment with with a maxillofacial surgeon to discuss the possibility of a sliding genioplasty. This is a "camouflage" technique that makes the face look more "natural", and an alternative to having a Lefort surgery. It is much less expensive, generally $1,500-3,000, with a 7-day recovery time. What they do is shorten the chin bone length to help the muscles relax. Since my chin is recessive, they will also push the bone forward to attain a more aesthetically appealing chin that lines up with my lips. This surgery also advances the tongue muscles to further help retrain my tongue and stop it from thrusting.
It's a bit hard to explain, but I recommend looking up that procedure and deciding whether or not it's something you're interested in having done.

Again, thank you for all the support and the kind words. I will post pictures up again soon!

[Alexteeth]

Hello, I want to say that a have the same problem with the way I looking, And My teeth are proeminent compared with the rest of the face, I'm desperate cause It's a problem were nobody know exactly how to deal with, and the doctors tell me to enjoy the life , but how? They no have idea how I feel
Also my jaw is verry small and I'm a boy... :(