I mentioned in my last post on facial asymmetry a study that found that facial asymmetry increased over time in patients who had broken jaws treated by maxillomandibular fixation (MMF, colloquially known as wiring the jaw). As such, I thought it would make sense to post updates on my own asymmetry here. It’s now almost 9 months after my accident. Nine months isn’t one of the times for which the aforementioned study reported data, but it’s when I’m getting around to doing this.
Here’s my closed mouth.
It looks roughly the same as last time. Now, here’s my mouth with my lips opened but my teeth still closed.
This time, it appears that my lips are opening slightly further on the left side than on the right side.
Here’s my mouth opened slightly.
Here, it seems that the asymmetry in my teeth (largely a product of my repaired tooth on the upper right side being smaller than its neighbor to the left) is more noticeable than any asymmetry in the way my mouth is opening.
Now, here’s me moving my lower jaw as far as I can to the left.
That’s even further than I was able to move it last time. However, I still can’t really move it visibly to the right.
Finally, it looks like I can open my mouth a little bit further than last time, but the asymmetry is now perhaps even more pronounced than last time.
Opening my mouth like that, by the way, is actually fairly painful. It’s certainly nothing unbearable, but I do feel a sharp pain in the left side of my face near the site of the fracture.
As I mentioned last weekend, my jaw has healed in such a way as to compromise my facial symmetry. As promised, here are some more details. Note that all of the photos here, like most photographs, are mirror images.
The asymmetry is least obvious when my mouth and lips are closed. My chin looks a little bit slanted, but my lips look fairly normal.
When I open my lips but leave my teeth together, the asymmetry becomes a little bit more visible. My lips open a little bit further on the right side than the left side.
It becomes more obvious as soon as I open my teeth. My lips open significantly further on the right side than on the left side, and my repaired teeth are smaller than my natural teeth.
One of the more striking asymmetries is seen when I move my lower jaw as far as I can to the left…
…and then to the right.
No, I didn’t upload the wrong photo for that last one, I just can’t move my mandible visibly to the right.
Finally, here’s my wide open mouth. The picture’s a little bit deceiving because my head isn’t quite straight, but there is some serious asymmetry. My mouth opens considerably wider on the right side, and this is visible not only in my slanted chin, but the different amounts of tooth visible on the left and right side.
Unlike some of the other little remaining signs of the accident, this isn’t something I expect to go away. I’ve read much of a study (subscription required) by Edward Ellis and Gaylord Throckmorton in the Journal of Oral and Maxillofacial Surgery found that patients who had condylar mandibular fractures treated by closed methods developed shortening of the face (measured from x-rays of the facial bones). Ellis and Throckmorton found that asymmetry in patients with closed treatment tended to increase somewhat over time rather than decrease. One caveat is that their study didn’t include any patients treated by maxillomandibular fixation (MMF) as I was, but they speculate that patients whose jaws were wired might develop even more asymmetry than the ones in their study. Thus, I don’t think this asymmetry will be going away unless I should fracture the right condyle.