When someone talks about a long face, they usually mean a face that expresses sadness, stress, or exhaustion. But this is different from long face syndrome, a medical condition that deals with the actual structure of the skull.

Not everyone with a long, narrow face has this condition. Long face syndrome affects your everyday activities, like eating, talking, and breathing.

Treatments are available and can include braces, dental work, and surgery.

Long face syndrome is a condition that causes a long and narrow face that causes issues with everyday activities. The condition is also known by its medical name, facial hyper divergence.

When a person has long face syndrome, the lower third of their face, including their jaw and chin, are longer than is standard. Often, people with long face syndrome have very visible upper gums when they smile. Some people also have darkened or drooping skin under their eyes.

The physical signs of long face syndrome are generally minor and can go completely unnoticed. Many people with the condition may not be aware that they have it.

However, untreated long face syndrome can cause problems, because the lower third of the face is pulled away from the rest of the face. This affects how people breathe, eat, and talk. This can lead to complications, such as:

Because the physical signs are so mild, many people are already dealing with one or more of these problems before they’re diagnosed.

It can be difficult to tell whether a person has a naturally narrow face or long face syndrome. You’ll need to see a dental or medical professional if you think you or your child has long face syndrome.

In children, a medical professional might suggest long face syndrome if they notice a child breathes through their mouth and has a misaligned jaw or “gummy” smile.

In adults, long face syndrome is often discovered during a sleep apnea or dental condition diagnosis.

When long face syndrome is suspected, the doctor or dentist will start by examining the face. They might take an X-ray to get exact measurements of the facial proportions. In most cases, these measurements are enough to diagnose long face syndrome.

There are many possible causes of long face syndrome being studied. Researchers disagree about the exact cause of the condition. However, it’s commonly thought that long face syndrome is caused by chronic nasal obstruction.

Chronic nasal obstruction leads to breathing through the mouth. It may be caused by narrowed nasal passages or by the enlargement of your adenoids, the tissue behind your nose.

Over time, breathing only through your mouth can pull on your jaw and pull your face downwards. Breathing only through your mouth also causes your tongue to push against your front teeth and can change the shape of your jaw.

Other causes of long face syndrome still need more research but might include thumb-sucking and genetics. Some researchers think genetics might explain why some children who breathe through their mouth develop long face syndrome while others don’t.

It’s possible that long face syndrome develops due to a combination of factors.

Finding an oral surgeon

You’ll need to work with an oral surgeon closely to treat long face syndrome. Here are few tips for finding an oral surgeon:

  • Ask your dentist for recommendations.
  • Ask your orthodontist for recommendations.
  • Use this directory from the American Association of Oral and Maxillofacial Surgeons to find professionals in your area.
  • If you have dental insurance, see what oral surgeons in your area are in-network for your plan.

The treatment for long face syndrome depends on when it’s diagnosed. In children, there can be multiple options. Long face syndrome is the easiest to treat when it’s diagnosed in young children.

In some cases, the answer might be clearing up the nasal obstruction. For example, surgically removing the adenoids can allow the child to breathe through their nose.

Since a child’s face is still growing, starting to breathe through their nose can correct the condition completely. As the child grows, their face will develop normally.

Older children might benefit from a combination approach. They might have surgery to remove their adenoids and wear braces or other orthodontic help. This approach can prevent any further damage from happening and correct the damage that’s already occurred.

However, once the jaw has set, there are fewer options. Most people’s jaws are set in their midteens. At this point, surgery to correct a nasal obstruction might help you breathe easier, but it won’t have any impact on long face syndrome. That’s why teens and adults with long face syndrome often need jaw surgery to correct their condition.

You won’t have surgery right away. Before you can have jaw surgery, you’ll need to wear braces for 12 to 18 months. The braces will help realign your jaw and get your teeth into the right places.

In some cases, the braces might be enough to fully correct long face syndrome, but in many cases, surgery will be required.

Your orthodontist and surgeon will work together to come up with a care plan for your case. Depending on how severe your jaw misalignment is, you might also need dental work such as crowns or tooth reshaping.

Once the orthodontist and surgeon agree you’re ready, you’ll have jaw surgery.

Surgery to correct long face syndrome is a type of jaw, or orthognathic, surgery.

You’ll have this surgery in a hospital or surgery center. On the day of your surgery, you’ll have an IV placed in your arm to give you fluids and medications. You’ll be anesthetized during your jaw surgery, so an anesthetist will be there to monitor you during the procedure.

A surgeon will make cuts in your jaw to move it to the correct place. Most of these cuts will be inside your mouth, but some might need to be made around the outside of your mouth as well.

The surgeon will use tiny screws and wires to stabilize your jaw. They’ll move your jaw into place and may reshape your jaw bone so that it’s smaller and fits in your mouth better.

You might need to say in the hospital for a day or two after your surgery. Healing can take 6 to 12 weeks. During this time, your surgeon will let you know which activities and foods are safe. You’ll likely be given a prescription to help manage the pain.

Once you’re healed from surgery, you’ll need to wear braces again. These braces will help the changes from your surgery take hold. Your orthodontist will let you know how long you’ll need to wear the braces.

After the braces are removed, you’ll be given a retainer to wear at night. Your retainer will keep your teeth and jaw in place, and you’ll wear it for as long as instructed to make sure your long face syndrome is completely corrected.

In recent years, less invasive procedures are becoming more common. For example, the use of mini-screws and braces can replace jaw surgery.

The physical signs of long face syndrome can go unnoticed. However, there are some significant concerns for people with this condition. Long face syndrome can lead to sleep apnea, worn down teeth, and more.

The earlier long face syndrome is noticed, the easier it is to correct. Children might need a single surgery to correct their nasal obstruction, but adults might need years of braces and complex jaw surgery to correct the condition.