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Sudden facial volume / fat loss

Hi,

Im a 27 year old male. Over a period of one month I lost a LARGE amount of volume/fat from my face. Most people I think that I have lost a substantial amount of weight, or I am sick. One person even guessed I had lost 30lbs. My weight never changed. The only place where the fat loss is occured is in my face.

My temples, cheeks, eyes have all sunken in, and you can see the musculature structure and veins under my  forehead.

Ive gone to doctors and all tests come back normal. Im HIV Negative and otherwise healthy. The loss is bilateral and symmetrical.

This has caused me to become severely depressed for the year and a half. In an attempt to fix things I gained 25lb of pure fat, and it did little to change my face.

Im so lost I do not know what to do, Im considering plastic surgery because I feel as though I have no other option, I dont recognize myself in the mirror and whenever I spend time with people I know they just look at me like what happened to you.

One test that did come back irregular was a hormone test. My blood levels of Testosterone and Estrogen were in normal limits, but then I decided to do a full hormonal 24hr urine panel. The Urine results showed my Testosterone levels were very low for someone my age. And one doctor recommended going on Testosterone Replacement Thereapy.

Im not sure how reliable Urine testing is for hormone levels, since opinions on it differ and dont want to start hormonal therapy if i dont need it, since my blood levels were fine. Can someone help elaborate on this?
One other thing i did notice when my face deflated was my oily skin became dry. Not dry, like flaking, but just dry. Prior to that I had the oiliest skin Ive seen on anyone, it was quite a change. I know testosterone plays a role in skin oil levels so I am intrigued there.
But what I dont understand is that, wouldnt higher testosterone levels cause my face to become thinner? Why would why face thin out if my testosterone levels had suddenly became low?

I dont know where to turn, any help would be much appreciated. This depression is getting to much to handle, I have been seeing a psychiatrist, and on medication for over a year.


25 Responses
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Avatar universal
I took 15mg mirtazapine for sleep two months ago, things are worsen in just a week, my lower cheeks sunken in even more and skins also become saggy, still haven’t recovered
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It might sounds ridiculous, but I find that masturbate can worse the condition and make it occurs more frequently
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I also been experiencing the sudden fat loss in face since teen. But it happens on and off, some days my face is full some days sunken,  I have recently went to check my sex hormones, it turns out that I have high level of estradiol and prolactin(i am a male).  And I read about the estrogen dominance being possible cause posted here. Could that really be the case, what’s could be the solutions?
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Avatar universal
I've just recently had sudden fat loss in my right cheek. I've been to 4 types of specialists and still no answers. I'm thinking that I'll try an endocrinologist to have hormone levels checked. I would like to get fillers, but for insurance to pay I would need a diagnosis.  Anyone with answers?
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Avatar universal
Hi I had braces for 2 yrs at at the age of 26 n now I turned twenty eight .i lost my facial baby fat n cheeks look hollow now n really regrets braces n extraction of my 4 teeth . Does nyone recovered their facial fat then pls do share coz this is causing depression in me
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1 Comments
Deep3, I went through the same thing as you. I had braces for 1 1/2 years. I noticed during and after my face started to sunk in. I pray that we find in explanation
Avatar universal
did you take accutane? that could cause it
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Avatar universal
I had bite turbos, with the traditional braces, and the Invisalign gives the bite turbo effect, because you can't completely close your bite.  I felt extreme tension in my face in both cases.  Especially, my temples.  I wish I could post pictures of before and after.  People would be shocked.
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Avatar universal
I agree!  I am going to try Physical Therapy for TMJ to see how that helps return facial volume.  I will try to post back on the results.
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Avatar universal
I'm certain it was the braces.  How did you make out?  Did you have bite turbos with your braces?  Did you have traditional braces, or invisalign?
I am sure the sunken look is attributable to TMJ reaction to braces.  Google sunken look and TMJ.  Loads of other's experiences pop up, same with braces and sunken look.
Key search words: sunken, hollow, wasting, fat loss, etc.

I had Invisalign two years after the traditional braces were removed and the protruding cheekbones returned, immediately.
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Avatar universal
I will have had braces for 4 years, this March. Just three days ago I noticed that my temples had started to sink.  I am 43. I had noticed my face looking thinner, but I thought it was no big deal. I haven't been to a doctor but just had a blood tests done in October and there was nothing. I also had Bells Palsy in October.. I was wondering if the both could be related. Through my internet research I have noticed the dental connection and inflammation being possible culprits.  I just want to get to normal.  
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Avatar universal
I am facing same problem since year 2000. I went to Dental hospital to fill my teeth. from that time the problem is started. is it because of teeth xray?
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Avatar universal
Im experiencing the exact same thing (but not braces related) and its extremely distressing. As everyone has said above, people keep asking am i sick and ive now become super conscious of it. I can understand how the original poster was feeling depressed. I am avoiding all socializing at the moment. Ive been referred to a plastic surgeon 4 weeks from now. Has anyone had any successful treatment?
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1 Comments
Have you found what caused it yet. I found that masturbate and antidepressant can trigger or worsen the symptoms
Avatar universal
I have had a similar experience but the cause while dental related was not from braces.  A few years ago I had to have my front teeth replaced with crowns because they were tipping inward and wearing.  The dentist said in order to tip them outward he could't just replace the two fronts he would have to replace my front 6 teeth.  
I was in the process of moving out of State so as soon as he was finished I would be leaving on a plane.  The first set he gave me were awful looking. so he redid them.  The second set weren't much better but I was out of time.  They were much longer, narrower and donkeyish looking.  I was extremely disappointed.  
I began to notice a change in my face and movement in my other teeth over the next two yrs.  My arch narrowed and my palatal vault is higher and especially on one side.  I also notice one eye protruding.   Dentists tell me these are impossible changes but people that haven't seen me in a few years don't recognize me.  
I had the crowns removed and now I'm in even worse looking temps from another dentist.  What is going on in Dental School???  Why are dentists insisting on giving everyone such big teeth?  That is not going to fill out my face.  I feel I lost fat and muscle and bone because of bad fitting teeth.
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Avatar universal
Exactly the same here. Got braces at 30 and within months my face had noticeably aged. I had sudden volume loss under my cheekbones, my eyes sunk in and crow's feet and saggy jowls developed. I got the braces off last month after 16 months and nothing has changed for the better. I went from looking 25 to 45 in about 6 months. Such a quick change has been devastating to my self confidence and mental health. Orthodontists need to start acknowledging this - there should be research into why some people have this. I regret the braces more than anything, they haven't even made my teeth look any better, if anything I preferred my old teeth. So frustrating.
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Avatar universal
Hi, to others that posted in this thread, did you ever manage to find out what was causing your facial weight loss or did it resolve itself?

I am experiencing the same thing. Over the past few months I have had dramatic weight loss from my face, my face looks gaunt and I look ill while the rest of my body has maintained a similar weight. I have had basic blood tests at the doctors etc but they all came back normal.

Anyone work out what was causing this?
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Avatar universal
Hi this happened to me too but it seemed to be a result of a rhinoplasty I had just before this occurred.  Several experts in the field say it's not possible.  I am wondering if something else has happened just around the same time as the rhinoplasty..I have lost facial volume but it doesn't seem to be symmetrical, one side of my face appears fuller but both sides have lost fat it seems and sagged.  Any ideas woul be helpful, I thought it could be hormonal.  I am female by the way.
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1 Comments
Have you found what caused it?
Avatar universal
I've noticed this with me as well recently. My face doesn't look as full as it once did. It might be hormone related maybe. I' was taking flaxseed oil daily. Like 3 a day for months.  Suddenly I started to notice my face get smaller. I remember hearing something about men shouldn't be taking flaxseed oil due to estrogen properties etc. But I learned of this way after the fact. So I stoped taking it but still no change whatsoever. idk if I wrecked my hormone levels which caused this or what.
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Avatar universal
Hi,
Your post is very recent and I'm going through the same thing for 2 months now! Has your face return back to normal? I'm so scared this is permanent. Thank you in advance.
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1 Comments
did it come back???
Avatar universal

Hello,
I went throught the same thing. It´s such a horrible experience. Please did you find the cause? Did you recovery?
Thanks in advance

Eva
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2 Comments
did u recvr?
For me, The sunken cheeks/ eyes symptoms happen on and off,  is it the same for you?
Avatar universal
I'm having the same experience.  Thought it was Scarlet laser treatment I've just had, still think this was a contributor, however I too am in my 4th month of braces and my cheeks and eyes are sunken.  Now I'm thinking it might be this also.  Has anyone else experienced this?  Are fillers now my only option or will the volume come back to my face?  My dermatoligist who performed the laser said that it should come back in a couple of months.  I'm having trouble believing her.
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Avatar universal
I had the same exact experience when I was 37, after having braces put on.  Initially, I lost some mild facial volume and then at the 3rd month wire change my entire head wasted.  Cheeks, temples, eyes, scalp, ears stuck out further and seemed stiff.  It even seemed like  my head had shrunk.  Everyone told me I looked sick.  The ortho. tried to attribute it to weight loss but I had also not lost any weight.  I panicked!!  The orthodontist swore it wasn't the braces, but I KNOW it was.  It literally happened overnight, at the first wire change. I had the braces removed.  Nine months later, I recovered some....my glasses which I had to adjust smaller, are now tighter.  But my cheekbone is still protruding and my cheeks and jaw are still much thinner.  I have made connection with some other people who had the same reaction with braces.  I wonder if this was your experience, or might you have had metal fillings, or some exposure to metal?
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Avatar universal
Hi Racoon86,

I hope your issue has been resolved by now, if not I hope to be of some help to you.  

I think if you look at what happened immediately before the large volume loss this may substantially narrow down the possibilities for lines of investigation.  Without a narrowing down it really is much larger a challenge to figure it out.  Did you take unusual supplements or start any new medication?  Were you under a lot of stress?  I just feel that there may be a direct cause for it happening so suddenly.  

I know that for instance in the aging process hormonal changes are said  by some to be partially responsible for volume loss in the face  [http://www.ncbi.nlm.nih.gov/pubmed/19338976].  I think it is important to say that it is important to take medical research opinion more seriously than hearsay but also remember that medical research is sometimes wrong.  I have worked in Medical research and seen this first hand.

I know for instance that estrogen dominance (more estrogen than progesterone) can cause fat distribution changes in the body.  This process occurs naturally as we age but is accelerated by stress.  I am unsure how advanced our knowledge about the effects of hormone changes on fat distribution is.  I wonder if fat can change so substantially in other parts of the body due to hormone changes then why can't it change in the face as well in a significant way?  The point is, I think medical research is unsure as to how significant a role hormonal changes play in volume change for the face.  In fact, many in the medical community have a direct financial interest in volume changes not being resolved by cheap hormone replacement.  I think Botox alone is valued at $50 billion.

So what hormonal changes could you try?  Well the first one that springs to mind is Progesterone.  You would have to restore the normal ratio of progesterone to estrogen to correct the estrogen dominance. (There are many creams for men in the market).   If estrogen dominance can affect fat around the tummy and upper thighs so much then it may affect the face in some way (sometimes it is not reported in the medical literature as it is not noticed).

It is also important to note that it is not always the levels of hormones (although this is important) but the ratios as well and it may not be a linear relationship between hormone levels and facial volume.  E.g. higher testosterone levels may thin the face but who knows what really low testosterone levels would do.  The body is an incredibly complex thing.

I also think its important to not conclude that testosterone was the cause as I assume you did not do a test before the event occurred. I think it is tempting to latch on to that but in reality the problem will require a lot of thinking and effort even to figure out what was the cause.  I definitely think hormones are a great place to start.

It would be great to hear how you are doing and also I hope you are coping well.  I think if you try Mindfulness meditation once a day as a regular practice, this can really help with coping with the distress.


Helpful - 0
1 Comments
Hi, I think you may be right about hormones being the cause.  I have recently went to check my sex hormones, it turns out that I have high level of estradiol and prolactin(i am a male). Can you recommend me with some supplements?
Avatar universal
As a rule, localized lipodystrophies are not associated with metabolic or systemic disorders, they tend to resolve spontaneously, and they have an excellent prognosis.
http://emedicine.medscape.com/article/1082390-overview

Take heart, you should recover with good diet and moderate exercise.
Cheers!
Helpful - 0
1 Comments
What is the causes of it?
563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,
Low testosterone can cause  sexual dysfunction (unable to maintain erections), reduced sex drive (reduced sexual activity) , decreased energy, loss of body hair, reduced shaving, depressed mood , decrease in bone strength and reduced muscle mass.

For the same, you can consult a urologist and get your serum testosterone levels checked. For the sinked in cheeks, you may need collagen fillers or plastic surgery.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.





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