Why Does My Face Look Different After All-on-4 Dental Implants?

Since having All-on-4 dental implant surgery at a large implant chain, I’ve noticed changes in my face. My cheeks are more sunken, my skin seems to sag, and my upper lip turns downward. The area below my eyes looks hollow, the distance between my nose and upper lip seems longer, and one nostril has partially collapsed. The changes were not gradual. I noticed them after the surgery. The doctors haven’t explained what may have happened. Could the implant surgery have caused these changes, and if so, how? – Thanks. Himari from NY

Himari,

While we can’t reach conclusions without an examination, the concerns you described with your All-on-4 implant-supported denture deserve careful attention.

Dental treatment affects far more than teeth alone. Restoring missing teeth also restores support for the lips, cheeks, and lower face. When that support is recreated properly, many patients notice a healthier, fuller, and even more youthful appearance.

Are You Experiencing Facial Collapse?

Implant-supported dentures are generally intended to prevent or correct the facial collapse that often develops after teeth have been missing for many years. They normally restore facial height and provide support that helps fill out the cheeks.

If the denture does not provide enough width or vertical support, facial tissues may appear less supported than expected. That can change facial contours even when the implants themselves are successful.

Could Surgery Have Changed the Nose or Upper Lip?

Preparing the jaw for implant-supported dentures often requires reshaping portions of the bone. In the upper jaw, that bone lies directly beneath the nose.

Although every patient’s anatomy is different, extensive bone reduction in this area could influence the appearance of your upper lip or nose.

How Should You Proceed?

Patients who notice major changes in their appearance should not feel they have to accept the result. An open discussion with the treating practice can help determine whether improvements are possible.

The conversation should include questions such as:

• Can the dentures be redesigned for better cheek support?
• Is the vertical height of the bite appropriate?
• Would a wider smile improve facial fullness?
• Are additional treatment options available to improve facial appearance?

While restoring bone after surgical reduction may not always be straightforward, modifying or remaking the prosthesis may improve your facial support. If you still have questions after a meeting with the treating dentist, get a second opinion from a dentist experienced in implant-supported dentures.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post. Read why many of his patients say he is one of the best dentists in town.

See a Dentist or Oral Surgeon for Dentures and Implants?

Should I see a dentist or oral surgeon for immediate dentures and implants? I lost most of my teeth to gum disease and agreed with my dentist that extractions are best for the few remaining teeth. My dentist showed me 10 to 12 pictures of her patients’ dentures, but I don’t like how they look. I will switch dentists, but I wonder if I should see a dentist or oral surgeon first. My mouth is in such bad shape that I want to get this done as soon as possible, so the thought of immediate dentures makes sense. I would like to have this behind me by early fall. Thanks. Curtis

Curtis,

Should You See a Dentist or Oral Surgeon for Implant Dentures?

If you want implant dentures, we recommend searching for a dentist with advanced implant training who can remove your remaining teeth, place dental implants, and restore the implants with a custom denture. Teeth-in-a-Day and All-on-4 dental implants are fixed implant overdentures. You can get all the treatment you need in one location from one provider, eliminating miscommunication between an oral surgeon and restoring dentist who provides the denture.

However, completing your smile and preserving your oral health will take time. Avoid looking for a dentist who promises to meet your timeline rather than doing what’s best for your oral health and quality of life.

What Is an Immediate Denture?

An immediate denture is a removable denture for an entire arch of missing teeth. A dentist places the denture on the same day as tooth extractions. Still, before agreeing to any treatment, we recommend consulting with a periodontist (gum disease specialist) or a dentist with periodontal training to ensure your gums are healthy. However, you mentioned that you also want dental implants. So, the process will be different.

How Long Does It Take to Get Implant Dentures?

Getting implant dentures takes six months to a year, even longer if you need gum disease treatment first. If you qualify for dental implants, you may be interested in Teeth-in-a-Day or All-on-4 dental implants. You can get dental implants and temporary dentures in one visit. Your dentist will provide a custom final denture after your implant heal.

However, before you get implant dentures, a dentist will examine your mouth and take X-rays and a 3D CT scan to determine the following:

• Your gum health and whether you need periodontal treatment
• Your jawbone quality and volume
• Whether you need bone grafting before dentures and implants

The treatment you get from an implant dentist depends on your medal and dental history and the status of your oral health.

Schedule a consultation with a dentist with advanced implant training to get high-quality implant overdentures, including All-on-4 dental implants. The dentist will explain your treatment options for dentures and dental implants.

 

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist and Diplomate of the International Congress of Oral Implantologist, sponsors this post. He serves Hartford, Connecticut, and surrounding communities.