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Contour Surgery for Torticollis Induced Facial Asymmetry

Homepage Star of April 2015
[ Author:Fushun Ma | Time:2015-11-02 21:33:28 |  Font Size: [Large Medium Small]
Tags: torticollis, facial asymmetry, middle twist, face countour

The cause of wry face or asymmetric face may vary. Some due to the congenital factors but most of them is caused by the asymmetric facial growth during a person's development stage. Among them congenital muscular torticollis counts for the most common single causative factor for all wry faces. In torticollis the sternocleidomastoid muscle is injured during delivery and the muscle heals with contracture. The shortened muscle keeps dragging the neck of the patient to tilt to the affected side involuntarily. This fixed abnormal posture will eventually brake the balance of the growth rate at both sides of the face. The affected side grows slower then the other side and this in turn causes facial midline twist. As this process lasts for the entire development stage and the wry face, which forms gradually and insidiously, may only be noticed in adulthood after the finish of the development stage. Thus the window of facial deformity adjustment using simple technique of bone growth rate rebalance can be easily missed and at the end surgery becomes the only choice of selection.

The asymmetric face of the lady in this page was cause by muscular torticollis. She had already noticed her facial asymmetric problem for many years. However she didn't know why her face was twisted till she met Dr. Fushun Ma. Even after Dr. Ma explained to her that her facial problem was caused by her tilted neck she still couldn't quite be able to relate her facial problem to the muscle problem of her neck. At her age though she can still do surgery to release the sternocleidomastoid muscle but this surgery can do nothing to the facial asymmetry. So instead she selected facial contour surgeries that could restore the symmetry of her face directly. After surgery her sternocleidomastoid muscle on the right side is still tight. However her face looks more symmetric and defined.

facial asymmetry caused by torticollis
Facial contour surgery improves the facial asymmetry caused by torticollis.

 

correction surgery for torticollis facial asymmetry
Before surgery the lower face looks wide, after surgery this part of the face appears slimmer.

torticollic facial deformity correction
After surgery this girl's face looks much symmetric though the length and the elasticity of her sternocleidomastoid muscle in deferent side are still not the same.

This lady's facial asymmetry is characterized by a flipped "C" shape facial middle line curvature. Other problems including right deviated chin and bigger left face are all based on this middle line deformity. So a perfect correction should start with upper and lower jaw surgeries to make the middle line straight and then make both sides of the face balance in volume. However she didn't want to the major surgeries than some modification surgeries. She ended up reduced her mandible bone and softer tissue in the middle and lower face in different volume at different sides. After surgery as depicted in the above pictures the symmetry of her face is restored and the soft tissue reduction also made her face more defined.

The contour surgeries made the lower face slimmer. Because the middle line distortion was not dealt with the narrowing of the face in fact visually enhanced the curvature of middle line. This phenomenon shown at he chin down position most vividly. In the front view photos the middle line deviation was not exaggerated by the facial reduction, on the contrary as the outline of the face is more symmetric her facial figure looks more beautiful and the patient is satisfied with the finial result.

Dr. Ma frequently encounters patients of facial asymmetry cause by torticollis in his practice. Their main complain typically is distorted face or asymmetric face at present. The torticollis is frequently ignored or can't be associate to their facial problems. The mechanism of how torticollis cause facial deformity is obviously due to the imbalanced growth stimulation by the gravity. In another word if one's head is constantly tilts to one side the gravity force will stretch the side of the face that facing the sky longer than the other side, rendering a curved facial midline.

It is easy to find out if someone suffers from torticollis. Tilting one's neck as the last photo depict and comparing the tension of both sides of the sternocleidomastoid muscle, in torticollis patient the tension defers from each other dramatically. As this lady's picture shows the right side of the sternocleidomastoid is shorter and tighter compared to the left side.

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