Metal Mouth Message Board

Hello everyone,

I’m new here and quite desperate right now. I’ve tried RealSelf with no success.

Ok, so a brief summary of my situation.

I had a chin implant ( 6mm ) placed from incision under my chin and neck liposuction. This looked great but from the surgery I had burning pains and over the months the implant feel tight and stiff. Had this for 18 months then decide to remove and have a sliding genioplasty inside, then the real problems started....

I had an 8mm genioplasty advancement, at first, all seemed ok but things felt tight and stiff which I expected for a couple of months. Nothing felt too bad, I was pretty numb so couldn’t feel much. My surgeon said everything would heal and go back to normal. Around 3 months after the feeling started to return, then from 5/6 months things started to feel really bad, I’m now 9 months post op and I’m struggling.

I have constant tightness in my chin, lower teeth and lower gums. Every time I speak there is a pulling and tugging feeling. Not when I eat, only at rest and when speaking which is weird! It feels like everything has been sewn together and all my gums and chin muscles are all stuck together. The middle of the chin and lip feel frozen and I feel they have no movement. It’s very hard to talk. Feels stiff and heavy, it feels like I have weights hanging from my chin, it feels like I can feel the weight of the muscles hanging from where the incision was made. It then feels sore. I constantly have to stretch my mouth as I feel like everything is stuck together and needs releasing. It’s really unbearable!

My surgeon said he’s NEVER heard of this and he’s been doing jaw surgery for 20 plus years!

My lower lip feels like it is constantly straining and pulling.

Hi There- has anyone mentioned starting with Physical Therapy? I know my surgeon had mentioned it to me as a possibility if I had serious issues with the popsicle stick stretching exercise. This was to manually force open my jaw as I had the MMA procedure.

Another thought is Botox. I know I've read on several strings patients receiving this but I have no personal experience with it.

There are quite a few posts about tightness. I think they've been full MMA procedure folks but similar issue of tightness.
Karla

Hi Karla,

Thank you, I will look in to that.

I’ve tried Botox and has some affect but very minor, which suggests to me that it may not be the muscle as such as relaxing the muscle should have relaxed the chin. I’m wondering if it’s scar tissue or some kind of nerve damage.

Maybe it’s just nerve regeneration? Ha, that’s the positive side of me coming out!

I was thinking, maybe it could be cause the bone has been advanced too much 8mm, and my chin just can’t take it and this is causing too much strain on the tissues but I’ve read issues of tightness with set back genioplasty too and a lot of people have 8mm plus genioplasty advancements and are fine.

My surgeon is at a loss. I may go and consult with another surgeon for another opinion. M

Thanks,

Gary

Hi Gary,
If you do decide to go with a second opinion; consider obtaining it from a doctor in another city who will likely not know the surgeon (hopefully). My MMA surgeon was located in NYC; I live in MD. I had several complications ; of which, one of them required me to have a second surgery at six months. The surgery was for a major deviated nasal septum and the ENT/Plastics had me go to an oral surgeon affiliated with the hospital for clearance.

The surgery clearance went very smoothly and during the meeting; I asked if I could continue to follow-up with him. The surgeon very cordially agreed and said come back in six months. During the six months; I started having issues with opening my jaw where even eating was an issue. When I went for follow-up it was like Dr. Jekyll had become Dr. Hyde. This time there was a resident present (I don't know if that was a factor) and he asked me what I was doing there, that I should be following up with my own surgeon, and "I don't do complications from other surgeons". I responded by reminding him of what he had told me and that it was his recommendation that I follow-up with him in six months. 'Dr. Hyde' responded that according to his documentation, he had told me to follow-up with my surgeon in NYC. I responded with thank you very much and promptly left.

Long story short; be very careful with what you say to the new surgeon. The world has become a very litigious society and you will find it to be very challenging to get someone else to take you on to fix someone else's complication. I would look specifically for someone who does revisions as they are most likely use to dealing with someone else's complications.

Interestingly; a lot of patients on this site describe feeling as though they are wearing a horses bridle. When I had my braces on, I don't think it felt that way myself. Perhaps because I had a mouth full of metal?? Now that I have them off; I have a permanent retainer on my lower front teeth. I'm not sure if it is that or what but it kind of feels like I have a mini bridle on my lower teeth. I'm wondering though if it's something that I just need to get use to because I remember feeling like I had a foreign object in my mouth with my crown years ago and feeling as though I wanted to rip it out of my mouth.

I did find an article on chin augmentation complications that might be of benefit at https://academic.oup.com/asj/article/31/6/634/209878 . Another good one that I looked at for myself and may be applicable to you is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5342970/. The second one is for complications associated with an MMA procedure. It's quite in-depth though and may resonate with you too.

Keep us posted on how you're doing.
Karla

Thank you Karla for that. I am based in the UK. I’ve found that it’s best not to mention the surgeon until the end of the second opinion consultation as it turns out they all know each other and at some point have worked together and they all have each other’s backs. I don’t mention my surgeon now to anyone, I just tell them the symptoms and show the x Rays. Im. Not slagging my surgeon off, would just be nice to have some answers, which, he himself cannot give me.

I understand what you mean, doctors are the first to somehow blame the patient and ‘turn’ on them should they have ‘complications’ My surgeon is actually a very nice man but I do get the impression that he thinks I’m just nuts maybe and it’s all in my head as he did say ‘Maybe you could just try and move on with your life?’ I thought that was strange and if only it was that easy!

There was a young lady on here called ‘Sara’ with almost identical symptoms to me. I read some of the thread but I wonder if she got her issues resolved... and how.... I can’t seem to be able to find the end of the thread or message her to see how she is doing...

Regards,

Gary

Hi Gary,

Sara here. I have identical problems. Its been over two years and its no easier to deal with today then when this sensation started. It truly is unbearable when you have to talk at work or to socialize and the only thing you can think about is ripping your lip off or the discomfort in your mouth. It has brought me to tears on countless occasions. Physiotherapy, stretching etc has not helped. I had botox injected on Monday, which decreased the twitching, but the tightening and pulling sensation is still there so I probably won't be getting it again.

I'm really at a loss for what to do. This has really negatively impacted my quality of life and I don't think I can adapt to this being my new normal. I guess the next step is removing the chin plate and restitching the area? My chin was actually moved back a couple mm, so I don't think it has to do with the bone physically stretching the chin muscle. I could vent on and on about how stupid this surgery was for me (I had no functional or cosmetic issues) but was put on the surgery path at 18 by a money hungry surgeon and ortho.

Please PM me if you would like to work through this together. There has to be an answer.

Sara

How are you now?

I wanted to chime in with my experience, I had MMA surgery and a sliding Geno 11 months ago. My chin is still really tight although it still feels like it is improved my but so little. My surgeon said if would take a year but it feels like I have way more healing still. Or I hope I do, as I don't want to be like this. Besides numbness my lower lip usually feels cold. When the weather gets colder my lip is unbearably cold.

I'm writing now though about my speech, I talk with a bit of a slur/lisp now and it feels like it is due to my chin. Are there any exercises I should be doing? Currently I'm only doing popcicle sticks to stretch my mouth.