The left side of my face feels deflated. Do I have progressive hemifacial atrophy?

Question

Hello doctor,

I am 30-years-old male, and I am suffering from left trapezius aches and discomfort for five years. About three years ago, I noticed a dark cycle under my left eye. This concerned me so much. I began to research this, and I came across a condition called progressive hemifacial atrophy, which I became obsessed with and convinced myself I had this. I have a history of anxiety and OCD (Obssesive Compulsive Disorder), along with hypochondria. It seems like the left side of my face continues to lose volume slowly; however, my family and friends do not see what I noticed. I get intermittent pain in my left jaw and discomfort in my left cheek. The left side of my face seems to look deflated to me compared to the right side. Do you see any evidence of progressive hemifacial atrophy? I am currently taking Paxil, Propecia, and Xanax.

Kindly help.

Answer 1

Hi, Welcome to icliniq.com.

I saw the pictures you sent (attachments removed to protect the patient’s identity). Both the sides of your face are symmetrical, and there is no noticeable difference. Your case is not facial atrophy as there is no change in the face's features, and you also have pain. Pain is never an indicator of facial atrophy without any other visible symptoms. If it is facial atrophy, it would have been seen in your CT (computed tomography) and MRI (magnetic resonance imaging) reports. So this means that you are interpreting the problem in the wrong way. For the symptomatic relief of facial pain, your doctor might have prescribed you tablet Paxil, which you can take whenever you get pain. According to me, your condition is called temporomandibular joint pain. And there is no surgical treatment for this pain disorder unless it is dislocated or dislodged. I suggest you take a painkiller and control the joint pain. You can keep hot and cold packs to the joint to expand the soft tissue over the joint to find relief from pain. Also, practice deep breathing techniques, meditation, yoga, pranayama, and even relaxation for a while after gymming or swimming to improve your positivity and keep you deviated from any fears that you get bothered about. Kindly share the MRI (Magnetic Resonace Imaging) and CT (Computed Tomography) scan reports with your healthcare provider and maintain proper oral hygiene like toothbrushing twice a day. Have regular dental visits, and in my opinion, you can consult an oral and maxillofacial surgeon who can examine your face and TMJ (temporomandibular joint) better.

Be positive, and do not worry.

Regards.

Answer 2

Hi, Welcome back to icliniq.com.

I appreciate your response. I suggest the following tips to ensure you have a stress-free mind and healthy oral cavity, and I hope this will help. Use an antiseptic mouthwash like Chlorhexidine mouthwash twice daily after brushing, and it will reduce any inflammatory symptoms associated with the oral cavity. Make sure you get rid of the habit of searching your symptoms or even about this condition on the internet. Keep yourself constantly deviated and try your best to avoid searching about atrophy or hypochondria. Positive reinforcement is not just thinking optimistic, but it is also keeping yourself relaxed. All the best.

Regards.