Sunken face - what are my options? (Pohto)

Question

I had an overbite and crowded teeth and wore braces. I didn't have any extractions. When I put my lower braces my face slowly got sunken and now post treatment I have no idea what to do. I am 34 female

Goretti Ho Taghva, MD, FACS · Answer

Thank you for your question. It's not uncommon to observe changes in the lower face shape following orthodontic treatments like braces. The adjustment of teeth alignment can sometimes impact the overall facial aesthetics, potentially leading to what you've described as a 'sunken' appearance.

The good news is that there are effective cosmetic approaches to address this concern. A popular and minimally invasive option is the use of dermal fillers. Fillers can help restore lost volume and improve facial contours. In particular, Sculptra, which is a poly-L-lactic acid-based filler, or Hyaluronic Acid (HA) fillers, are excellent choices. They can provide a natural and rejuvenated look, subtly enhancing the facial structure affected by orthodontic treatment.

If you're seeking a more durable solution or if fillers do not achieve the desired outcome, fat transfer is another option. This procedure involves using your own body's fat, harvested from another area, to add volume to the face. It's a natural, longer-lasting alternative that can provide significant improvements in facial fullness and symmetry.

I recommend a personalized consultation to assess your specific needs and determine the most suitable treatment plan. It's important to consider all options and choose what aligns best with your aesthetic goals and lifestyle.

John Michael Thomassen, MD · Answer

Fat grafting to the submalar area can help improve this.  It may need a 2nd treatment 8-12 months later but it can look quite natural.  Sculptra is another option.

Ahmad N. Saad, MD, FACS · Answer

It is common to see facial changes after bite correction whether with braces or bone reconstruction. I recommend you see a plastic surgeon for an unperson evaluation in order to precisely evaluate these changes and your objectives.

Mats Hagstrom, MD (license on probation) · Answer

To make it quality assessment, we need quality pictures.
It would also be very important to understand if you’ve had any previous procedures other than the dental work you describe.
From the information included I’m guessing volume augmentation with the use of fillers is most appropriate.
Quality assessment requires quality information.
I suggest having multiple in person consultation with plastic surgeons in your community.
 Based on your description, you may want to consider consulting with oral surgeons as well. A lot of facial aesthetics are directly related to facial bone structure, and this impacts each individual persons facial appearance in a major way.
In fact, each individual persons, unique facial appearance is not so much based on soft coverage as it is facial bone structure. It is bone structure that gives each individual person, their unique facial appearance.
 And that says oral surgeons can sometimes shed great insight into getting quality assessment, and better understanding of why someone looks the way they do.
Best,
Mats Hagstrom, MD.

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