COSMETIC SURGERY COMMUNITY
sutures left behind under mandible concern me

sutures left behind under mandible concern me

Hi,
Ten years ago a surgeon attempted to lengthen my face with a chin implant. It was placed on the inferior edge of the mandible by intraoral approach and sutured in place with permanent sutures (6 or 7) spaced along the length of the 10cm extended antomical silicon chin implant and passing from the periosteum, through the implant and possibly also into the overlying fascia/soft tissues. I had the implant removed altogether two weeks later as it looked dreadful, caused ongoing pain & prevented me opening my jaw.
The surgeon said he did not remove the sutures as they 'did not require to be removed', and apparently only cut them to release the implant. I now have hardened lumps along the underside of my mandible corresponding with  the sutures and there is much scar tissue formation around the suture remnants, tissue adhesion and contraction beneath the mandible and over the chin, causing pain and distortion. Worst of all it causes constant extreme tightness through my anterior neck mostly on the left, restricts oromandibular function, neck movement and head/upper body posture. Over the years, I have developed: idiopathic cervical torticollis/dystonia (left turn, tilt & tremor); hyoid syndrome (hyoid & larynx elevated, pulled leftward & twisted with left tip of greater cornua of hyoid pressing into cervical spine); C5,C6,C7 canal stenosis; right rotation & left lateral tilt of Atlas (C2); omohyoid syndrome causing brachial plexus compression/carpal tunnel, narrowed airway and sleep apnea (during sleep my jaw opens & retrudes, & the muscles at the hyoid spasm almost closing the airway; the left hyoid greater cornu also impinges on the airway); the floor of my mouth is higher on one side and tongue movement is restricted and painful at the tongue base. I have painful aching lumps in the retro hard palate at the pterygoid hamulus. My jaw is retruded, mostly on the left and involuntarily opens all the time (I can feel pulling coming from the hyoid bone & down thru left omohyoid & sternohyoid), whilst at the same time pulling along the base of my skull (presumably posterior digastrics or styohyoid). I cannot stand up, back straight, head high without enormous effort. My thyroid cartilage is hardup against the hyoid, larynx elevated & I feel tracheal tug when I breathe deeply. My voice is strained & altered. The hyoid/larynx will not be depressed even manually. I have no rest position for my jaw or head. I get sharp pains through the tissues on the left side, worse during function. Breathing, talking, chewing & swallowing take great muscular effort due to tightness & restriction. Many muscles and even ligaments (stylomandibular, temporomandibular, sphenomandibular) are extremely tight growing shorter and harder probably due to calcification. Its getting worse as the years go by, not better. I am involved in an ongoing battle against pain, exhaustion & disability.
What can be done to fix this? Would going back in by intraoral incision & debriding/releasing the whole chin/mandible tissue complex and excising the suture capsules & scar tissue help? I also need mentalis resuspension as this was not done (I had a very deep labiomental sulcus & lower incisor show after the surgery). Also the tissues need to be re-draped symmetrically (my chin pad was placed left of centre).
If the contracture along the left underside of the mandible was released, wouldn't the hyomandibular distance be increased and allow my hyoid bone to assume a more symmetric and relaxed position again? When I manually pull the hyoid out and to the right so the cornu is not pressing in between the transverse processes or into the groove, then I can flex and extend my head and turn to the right normally (as long as I hold it there).
I appeal for help, and ask that surgeons be mindful but not overwhelmed by the number of symptoms. As many may develop with cervicomental post-burn scar contracture & the soft tissue result of my surgery is not dissimilar. A full thickness shortness of tissue, particularly somewhat unilateral, in the submental region could be expected to produce such plethoria of symptoms, especially left untreated over a period of ten years.
If the tissue shortfall cannot be addressed with release, could a submental fascial flap return normal function?
Any thoughts, ideas appreciated.
Post a Comment
To
Comment
Post A Comment
Go
Blank
Weight Tracker
Reach your weight goal faster
Start Tracking Now
MedHelp Health Answers
Submit
RSS Expert Activity
1741471_tn?1336957856
Blank
LIVE WEBINAR TOMORROW!-SUPER BODY, ... Blank
May 22 by Michael Gonzalez-WallaceBlank
2126606_tn?1335910182
Blank
Fibromyalgia Awareness
May 11 by Clare Waismann Kavin, RASBlank
2126606_tn?1335910182
Blank
Opioid-induced hyperalgesia reduces...
May 03 by Clare Waismann Kavin, RASBlank