Unbearable tightness in chin

[phantast]

[quote=Sara123456789 post_id=497977 time=1508262516 user_id=30794]
Hi everyone, I had lower jaw surgery to move my jaw forward and also had a setback genioplasty to move my chin back. I am almost 6 months post-op. One of my biggest issues right now is I feel incredibly tight in my lower lip and chin. I can feel my lower lip/chin at all times, I am constantly conscious of it. I feel a pulling sensation downwards whenever I speak and this is amplified by when I pronounce certain words. Talking is very uncomfortable. Please let me know if anyone else is currently experiencing this and how they are going about resolving it? I can not redesign my life to live with this feeling every-time I speak. This whole surgery has been a disaster, I don't like how I look, it completely ruined the contour of my neck etc, but if I can fix this tightness, at least most of my issues will be cosmetic as oppose to functional.

Please help
[/quote]

Hello, i'm an older male (34y) and had double jaw surgery exactly 6 months ago. I don't have any hardware in my lower jaw or chin but I experience the exact same issue. My chin feels extremely tight and i'm constantly aware of it. When I touch my chin it feels like a small layer of skin sensation. My lower lip feels cold and when I move my finger over it it feels like electricity. I have the impression that this issue is getting bigger every day. It's really annoying and the quality of life is definitely reduced. The result of the surgery is also bad in my case. My teeth are straight on each other and not overlapping. I did have an underbite and big asymetrical jaw before the operation so the aesthetics have improved a bit but it's far from perfect.

But yea when I talk or eat and even when I don't do anything I can still feel the tightness of my chin. I'm convinced it's a nerve problem and I already start accepting the fact that it will probably not improve over time and I have to live with it. It's not exactly pain i'm experiencing it's just an extremly uncomfortable feeling.

Sorry for my English it's not my main language.

[phantast]

The biggest challenge for people like us will probably be to find a way to live with this issue. I will try to ignore the feeling and teach and train my brain not focus on the tightness and filter it out. I have experienced many painful and terrible events in my life (such as an eye disease, infections, and lung issues with extreme high fevers) so I will find a way to live with it, it won't be easy but I will manage. I know it's extremely unconfortable to live with this but there are many worse diseases or chronic pain that can happen in life.

Ofc I still hope that my nerves regenerate some day, I won't give up yet, I think it's safe to say that if there are no improvements after 2 years that you'll probably have to live with this for the rest of your life.

Keep me updated please in case anything change.

[Sara123456789]

Thanks for the replies. Please, please keep me posted if you try any treatments. I might get my chin hardware removed in a few months as I seem to be struggling right where the chin plate is. You are right about accepting this---that is the most difficult part. It is extremely difficult for me do let go of the frustration and disappointment I have towards my surgeon and my orthodontist for putting me in this situation. My overbite was SO small and NEVER bothered me at all, yet somehow they made me feel so insecure about it and kept saying I would look better after surgery etc, and downplayed all the risks, so of course, at 18 years old I agreed to the surgery. They also pushed my chin back even when it was receded to begin with, which made all the soft tissue bunch around my neck, so I even look worse than before. My surgeon, in particular, has been such an unethical bully about all of this. I am looking into getting them disciplined so they can't harm any more patients.

[phantast]

[quote=Sara123456789 post_id=505855 time=1543791807 user_id=30794]
Thanks for the replies. Please, please keep me posted if you try any treatments. I might get my chin hardware removed in a few months as I seem to be struggling right where the chin plate is. You are right about accepting this---that is the most difficult part. It is extremely difficult for me do let go of the frustration and disappointment I have towards my surgeon and my orthodontist for putting me in this situation. My overbite was SO small and NEVER bothered me at all, yet somehow they made me feel so insecure about it and kept saying I would look better after surgery etc, and downplayed all the risks, so of course, at 18 years old I agreed to the surgery. They also pushed my chin back even when it was receded to begin with, which made all the soft tissue bunch around my neck, so I even look worse than before. My surgeon, in particular, has been such an unethical bully about all of this. I am looking into getting them disciplined so they can't harm any more patients.
[/quote]

Yes I will let you know if I try any treatments. My surgeon seems to be sympathetic to my situation even though she made mistakes during my surgery. My aesthetic improvement would be huge if everything went according to plan but it didn't. My bite is far from perfect it's asymmetric and the teeth are not overlapping, it looks like a crossbite.

I didn't know this was a possible outcome, the tigthness in my chin drive me crazy sometimes it's always there, it's constant, always being aware of it. But Like I said I don't have any hardware in my chin so that's not an option for me to remove anything. My chin got cut and rotated to a more symmetrical position during surgery. I still hope to see improvements over time.

May I ask if you remember after the operation, was your chin completely numb or could you still feel some sensation? If your chin was completely numb then the possibilty to restore to normal is low, but if you had some feeling after the operation then the chances will be much bigger that the nerves eventually restore to pre surgery quality.

I have the impression that my nerves got severed. It feels like all my chin muscles are sewn together. What do you feel when you touch your chin and lower lip? I feel tingling and it feels cold when I touch my lower lip with a weird electricy sensation.

[phantast]

It basicly feels like a sleeping leg. It's super annoying. It feels like my chin and lower lip don't belong to my body, and yet I have full control over it.

Next visit at the end of this month I will discuss options with my surgeon... i'm hoping she has some steroid injections or something that magically make the stiffness dissapear.

And yes there are many cold hearthed people in the world, I did lose faith in humanity a bit. The jaw surgeons in my area are however very social and nice, thank God.

[Sara123456789]

phantast,

I had no feeling at all when I awoke from surgery, unfortunately I will say that even though it was numb, I was not tight or uncomfortable. This sensation started at around 3 months post-op and has stayed ever since. It bothers me most when I talk...I can tune it out well when I'm not talking (although I do have constant twitching ). I do have sensation, at least on the surface, and quite honestly, I can feel quite a bit. I know some of my nerves are off though, for example, when I scratch my lip, I feel it in my chin, or when I drink cold water, I feel it dripping.

My surgeon has been absolutely terrible to me since I brought up these complications. He has refused to give me referrals, yelled at me, and then abandoned me. I fear that he can cause real harm to patients due to his egotistical attitude. My orthodontist is a lot nicer, but hasn't been helpful at all, so it all just seems like a front. He also treats me in a private room with an assistant always present which sometimes makes it feel like I'm somehow viewed as untrustworthy, just because I have complications. If I could go back in time, I would wish I would have chosen a different team.

Fortunately, I met with a new surgeon and he seems nice enough, although, now Im skeptical about every doctor I meet. He said to give it a year, nerves can continue to heal for at least 2-3 years. If not, he can remove the hardware. You described it exactly right, like the chin muscles are all sewn together. For me, its mostly the right side of my face.

I'm not ecstatic about the cosmetic results either. They made such a big deal about how I had this facial deformity due to an overbite that I became so insecure over it, only to have looked better before or experience no difference in how I look. I think if they left the stupid chin alone I would be happier cosmetically, but since they pulled it back, the soft tissue accumulates around my neck which I hate. I also had absolutely no functional problems with my bite. It was a non-issue.

[phantast]

Yes I have the exact same experience. At start my chin was numb and it didn't bother me. But after around 2 or 3 months I regrained some feeling but the muscles remained stiff. And it seems to get worse day by day. I also have an itchy feeling in my chin area (so I have still hope that my nerves will repair). When I touch my lower lip it feels cold but I also have feeling in my chin when I touch my lip. I also have the same feeling about ny team, I wish I had chosen a different team, these people seem too young and inexperienced but they're nice enough to listen to my complains but I feel like a guinea pig.

Yes it's so sad that he yells at you, seems like he just want to get rid of you , he got his money so you're useless to him now. And yes the orthodontist and jaw surgeons usually back each other up.

Ok for me it's in the exact middle part of the face.

Sorry that you're happy about the cosmetic results seems like a real nightmare for you :/. I had a quite big deformity so the cosmetic results would be worth it if everything went well. But it didn't, the upperjaw has not been moved forward enough and I had a relapse. In addition my jaw surgeon played the role of God and she decided without discussing before the operation to not only move the upperjaw forward but also to move it downwards, so my long face even became longer!. She did this because she said when I smile you coudln't see my upper teeth.... I coudln't care less. My philtrum (the space between nose and upperlip) Is really long now!. It used to be short and nice.... I'm very insecure about this.
Yes I also have loose skin around my chin because they moved the lower jaw back.
Im 35 almost and single my entire life, never had a date or kiss and with the result I have now I don't think anything will change.

[Nochokin]

CloudyAngel
Sara12345678

Just want to give an update. I had chin plate screw removal in October. This did not help the tightness and pulling however in January, I saw Dr. Bagheri in Atlanta, to observe/ repair my IAN. All along I’ve been saying I cannot eat, I feel like something is hanging from my face etc etc. I awoke from anesthesia learning my alveolar nerve could not be found. Only fibrotic tissue so I will never have feeling on my left side and am still unsure about eating. I also had all of my hardware removed. 34 screws and 12 plates. I’m now left with numbness on right side that I’m hoping will go away.
What I’ve learned, in addition to the need to advocate for myself, having had all incisions cut open again to remove hardware, has helped the tightness or feeling horse bridled tremendously. In addition, the need to resuspend my mentalis muscle to close the new incisions, chin is a lot better. In my mind, this tells me that the awful pulling was the suture technique used and the mentalis muscle needed resuspencion. I wish these were my only issues bc they would have somewhat been resolved and have been absolute nightmare, but now not feeling my nose, my entire lip area, top and bottom, and the fact that I waited too long to see a nerve surgeon and will never be ok, I’ve traded awful issues for even worse. I regret my decision to do this. I flew 3000 miles away to go to supposedly the best doc in the US or the world and I could not have had a worse result. Be smart with your decisions and trust your gut. Time is very important with this process and don’t let the docs get you down. I’ve been treated horribly, ignored, and put in my place by almost every doc involved but at the end of the day this was my quality of life and my future AND most of them were paid out of pocket to listen and help problem solve! I wish you all well. Again, in regards to the tightness and mentalis muscle strain, I feel it’s definitely the way you’ve reacted to the suture technique and scars and the chin is Directly related to the muscle. Some of it can be attributed to straining to get your lips closed, if that is an issue, but also it’s the damage caused to the mentalus muscle from BSSO. I hope my experience can help others heal.

[Sara123456789]

I appreciate people like you so much Nochokin, who come back to give updates, so that others can benefit. So thank you.


I am so sorry to hear your problems. I had a terrible day today and broke down in the washroom crying at work. You are absolutely right about advocating for yourself. Some of these doctors are downright bullies. I pray that you get the miracle you deserve.

I just wanted to clarify, what exactly has helped the tightness and pulling/contraction sensation in your chin and lip? Does it feel much more comfortable to speak now? Do you mind writing out exactly what you had done? Was there a particular suturing technique that I can ask my new surgeon to look into? Im curious why the screw removal did not help the tightness, but the entire hardware removal did (I suspect it may be removing the entire plate required cutting the entire incision again)? Did the chin plate removal cause any more numbness on the chin? Are you taking any preventive measures to ensure the stitches don't get too tight again.

Im so sorry for the million questions, but any insight you can give, I will be eternally grateful.

[Nochokin]

Sara12345678

Sara123456789
Chin- from day one post surgery, my chin would contract in a ball at times and pull. Left side was and still is numb, but the numbness was nothing compared to pulling. After plate and screw removal, this actually got worse. What I have learned after this last surgery is that the mentalis muscle must have been affected by the original surgery and affected more so when I was cut below the gum to remove the plates and screws from the chin. With my plate and screw removal this time, incisions all had to be open around the gumline to get to all the plates and screws. This means that the last surgeon had to essentially re-suspend my mentalis muscle. It was not the purpose of this surgery, but was a bonus and that constant pulling has gotten better. I recommend mentalis resuspension to treat the chin issues. Once healed, a small amount of Botox May “calm” the muscle, but if no relief, the need to look at things more closely, is necessary.

Horse bridled- again since day one. I felt as if I was horse bridled. As if a thread had been tied completely around my mouth on the inside. After total plate and screw removal of which all the incision had to be opened up again, the symptoms have gotten better. They are not completely resolved, but, however this surgeon chose to close my incisions, relieved some of that horse bridled feeling. I don’t think there is a specific technique, it’s just how one surgeon closes incisions compared to another. My first surgeon kept telling me that because of my age and my hypermobility that my sensations were due to my being used to having hyper mobile gums and now the tightness was more apparent in my case. This may be true, but I can tell you that I am already feeling better with that tightness after the last surgery. I assume this was caused by scar tissue, but I’m confused because I felt it from day one. Once all incisions are healed, I would recommend seeing a PT to break up that scar tissue. Steroid injections can be used as well but can also cause damage if you use too much, so perhaps a one time treatment. I’ve also learned that fat injections between the gums may help relieve some of the tightness by filling in the space above the gum. Re-opening the incisions and closing them again was never offered to me. But in hindsight, if the other non invasive treatments do not help, I would request that the incisions be redone. Of course, there is always a risk of infection and I’m not sure this could be done in an office. I think with a very experienced surgeon, it could. This may not be heard of, but in my experience I think it would help using another surgeon.

Nerve- I was told that during my surgery my left inferior Alveolar nerve “ruptured” and that an attempt of repair at the time was made. However I was also told that the ends could not be connected and were within 3 mm apart. My surgeon chose to wait and see how I did in hopes that that nerve was repaired. My symptoms never ever improve. My nerve was never mentioned on his behalf let alone doing a baseline nerve assessment. Month after month I was ignored. It wasn’t until month eight that I asked why are we not seeing a nerve surgeon? Is it because you think what you did was sufficient? To my surprise, his response was no not necessarily. I immediately made an appointment to see Dr. a microneurosurgeon in Atlanta Georgia for nerve repair. I had been reading articles for months, all which said that time is of the essence. Given my age, gender, and the fact that I was over three months out would only decrease the chances of a nerve cadaver graft being successful. My surgeon gambled and it was not until after a year that we attempted repair and found my nerve could not be found. The surgeon in Atlanta tunneled for several inches until it made no sense to continue looking. A nerve graft of that length would not have been successful given the time out and the other factors. I am devastated. My life is changed forever. And in my mind, could’ve been avoided. I’m not even sure if this happening to the nerve from orthognathic surgery has ever been documented before.
I’m sure by trauma or a tumor but this is beyond.

Orthodontics- again, from day one I felt as if my orthodontist was not acting on my behalf. He wasn’t listening, and no attempts were being made to close my open bite. Despite him assuring me that in the end they would put restorations on my teeth and build up the bite, the fact that I could not eat or get my teeth together orthodontically was essentially ignored. The surgeon kept saying we all needed to wait until the ortho fixed the bite, but communication between the two offices, 3000 miles apart, was subpar. I now have a new orthodontist, had to pay him additional $3000, and he has been able to close my bite almost completely, in two months. These doctors are going to give their opinions, this surgery is evolving very quickly, please don’t hesitate to seek consult. I should have trusted my gut. I knew better and I never had functional bite issues and had no tmj pain going into this despite changes in my tmj.

I supposedly used one of the best surgeons in the US and the world, over $67,000 out of pocket for just surgeons fees initially not including travel, hospital, anesthesia etc. A college education gone. I trusted in him and his team. I understand that things happen in the OR, but the lack of initiative to resolve problems postoperatively is incomprehensible to me.

I am not posting to create more anxiety by any means. But if I can help anyone in anyway or motivate someone to take charge of their own health, I am here.

[Sara123456789]

Thank you once again for your thoughtful reply. I will call my new surgeon Monday. I would love to keep in contact with you, I have private messaged you.

[phantast]

I'm pleased to announce that most of my tightness is actually fading, it's only a small area on my chin that is left with this tightness. I do get some tingeling sensation in my lower lip every day.
So hang in there, it might actually resolve on it's own. So the tightness is gone for like 50% since my last post, and if it goes on like this it will be gone within a month.

[Sara123456789]

thank you for returning with an update!

how far post-op are you? have you done anything specific to help it

[Sara123456789]

Got an appointment to see my new surgeon in a few weeks! I'm going to tell him to schedule the plate removal ASAP.....I hope and pray this surgeon is able to fix this mess, I would be sooooooooooooo eternally grateful to him.

[phantast]

[quote=Sara123456789 post_id=506808 time=1549913645 user_id=30794]
Got an appointment to see my new surgeon in a few weeks! I'm going to tell him to schedule the plate removal ASAP.....I hope and pray this surgeon is able to fix this mess, I would be sooooooooooooo eternally grateful to him.
[/quote]

So I felt improvements however since a week I have horrible burning sensation in my lower lip and chin area even when not moving my lips or chin.
So first it felt completely numb, then for 7 months it felt like my muscles were all sewn togetherer with lots of electricity feeling when touching my lips.
After 8 months I had improvements, the electricity sensation in my lip faded
Now after 9 months I have a horrible burning sensation in my lower lip and chin, like fireants or tobasco. So I hope my nerves come awake or something i'm quite scared that it will get worse though.