7 Reasons Why Your Face Is Shrinking

While attending one of our son’s high school sporting events recently, I was struck by how many of the teens had narrow facial features. From the side, it was clear that many had recessed jaws with pushed-back mandibles. I was also reminded of attending a football game last year, seeing something similar with many of the cheerleaders’ faces. Not all, but many more teens’ faces these days are more narrow than they used to be in the 1980s.
 
This prompted me to go back to my high school yearbook from the mid-80s. Scanning various profiles, it was clear that facial shapes were very different back then, being more rounder, with stronger facial features.
 
For those of you who are into classic Hollywood movies, notice that the most popular stars such as Clark Gable, William Holden, Bette Davis, or Marilyn Monroe had strong jaw lines. This is particularly noticeable for the actresses. 
 
An article in the New York Times a while back described a study suggesting that the modern American’s preference for facial beauty and attractiveness has changed over the years. Younger people now prefer softer, or more narrow faces. Notice Adam Driver’s face in the picture above. Very narrow jaws, and from the side, the jaws are sloping back.
 
Why is your face melting? Here are 7 possible reasons
 
1. Genes. You get your facial anatomy from your parents. More often than not, your mouth may mirror your parent with the smaller mouth. The good news is that your genes don’t determine exactly what you’re going to get. Epigenetics has shown that your environment, habits, and how you use your mouth can significantly alter facial growth patterns.
 
2. Soft diet. There are a number of studies showing that eating a softer diet increases your risk of malocclusion, or crooked teeth. Your jaws need constant stimulation with the right forces for optimal growth. Not using your jaws properly, or not using them enough can suppress optimal growth patterns. I had a fascinating interview with Dr. Robert Corrucini, an anthropologist who published on this subject. 
 
3. Bottle-feeding. The swallowing mechanism and forces used with a bottle nipple is very different from suckling from a mother’s breast. Dr. Brian Palmer has a great website describing this process and various negative consequences. (Click here for a recording of an interview I did with him on “The Evolution of Obstructive Sleep Apnea.”) There are also lots of studies showing significantly increased risks of malocclusion in bottle-fed infants. Here’s one such article on bottle feeding and OSA, and another study showing more crooked teeth in babies that were bottle fed. The smaller your mouth, the more crooked teeth you’ll have and the smaller your airway.
 
4. Pacifiers. This issue is very similar to sucking from a bottle nipple. Here’s one study showing more crooked teeth in children that use pacifiers.
 
5. Thumb sucking. Here’s a study showing higher rates of malocclusion for thumb suckers.
 
6. Prematurity. Not having enough time to grow your face fully before you’re born can also prevent optimal facial growth. Here’s a study showing that pre-term babies had 3-5 times higher risk of having sleep disordered breathing problems by the time they were 8-11 years of age.
 
7. Nasal congestion. This is a big one. Numerous studies have shown that chronic nasal congestion can prevent facial growth. The classic study that’s quoted is a monkey study showing that total occlusion at birth resulted in much smaller facial structures. In our society’s children we see “adenoid” faces, with head-forward, open-mouth posture, and recessed chins with underdeveloped cheekbones. As these children grow up, they can develop the “long-face” syndrome.
 
I often joke during my lectures that if our brains are getting bigger, and as our faces get smaller and smaller, what will our faces look like in 20,000 years? Click here to find out.
 
One observation that I see all the time in the operating room is that very obese patients almost always have very small mouths. Small mouths lead to small airways, and small airways predispose to weight gain. Weigh gain narrows the throat, leading to obstructed breathing, which leads to poor sleep, which results in weight gain. 
 
What can you do to avoid this? 
  • Introduce harder foods when younger
  • Avoid bottle feeding, pacifiers, and thumb-sucking
  • Treat nasal congestion aggressively
  • Avoid or treat allergies
  • Try to be as healthy as possible during pregnancy
  • Consider orthodontics for your child very early, even as young as 4 to 5  
  • Check for tongue tie and treat if significant
  • Consider taking out large tonsils or adenoids.
Do you or your child have “adenoid facies” or “long-face syndrome”?
How is it affecting your quality of life? Please write your responses in the box below.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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5 thoughts on “7 Reasons Why Your Face Is Shrinking

  1. What can adults do if they have recessed jaws with pushed-back mandibles and a long face? I’m a 50 yr old woman with severe OSA with huge tonsils, frequent sinus congestion, and a very small mouth. (partly genetics and partly from having 8 permanent teeth pulled for braces with a headgear). What are the hopes for someone at my age to improve health and sleep?

  2. What is your position on turbinate reductions in children who don’t respond to non-surgical therapy to reduce nasal congestion? My impression from research is that this would need to be done before the age of 4-5 to have a notable affect on facial growth.

  3. I’ve seen research backing up all the claims in this post but they’re all controversial still, even nasal congestion which has the strongest evidence in my opinion. What I have not seen is evidence that interventions such as those mentioned here are effective at mitigating problems with facial growth. Could you point us to some studies which back them up? I think you should add “pick a mate with strong facial features” to your list at the end.

  4. I have an additional comment to the previous one.

    I am reading on your blog the vicious cycle of acid reflux which causes enlarged tonsils and tongue swelling which causes sleep apnea which causes more acid reflux, etc. I frequently get sinus infections which seem to improve after starting on azithromycin. Now I am learning that the z-pak is mostly helping with stomach acid.

    To help break the vicious cycle do you recommend sleeping on a pillow wedge (lift up chest and head higher than stomach), not eating 3 hours before bedtime, and continue using cpap? I’m currently shopping for a pillow wedge hoping that might help a bit.

    If I do get hungry before going to bed is there any small snack that won’t contribute to acid reflux?

    Also, I have heard of a device called Winx which holds the tongue down and in place so that it doesn’t drop down to tonsils. Do you think this could be effective? I am having a hard time tolerating my Resmed Airsense cpap after 1 1/2 years.

    I’m also starting oralfacial myofunctional therapy to strengthen the tongue and soft palette. I’m hoping it can at least help train the tongue to stay in place.

    I want to break this vicious cycle and finally sleep well! I plan to buy your book tonight!

    Thank you for your time.

  5. So for the past ten years I have been striving to do five basic things. Obtain my nutrients, reduce the levels of toxins in my body, acclimate to sunlight, become active lifestyle, and live with good purpose.

    In those years changes have been afoot. Indeed, in the last ten years my actual shoe size went from eight and one half inches to now a bit over ten inches. At 62 I have become a growing boy.

    So I wonder if the changes we are seeing in the faces of our children might be more attached to epigenetic issues.

    Without the “raw materials” genes cannot express Our crops are now very much depleted of many critical nutrients. Living with our eyes glued to our phone or computer and so moving less than 2,000 steps a day with no heavy lifting yields a much different expression of growth and maintenance genes than does the 9794 steps I have averaged over the last three days along with the heavy lifting that I hope to do at the gym later today. While our coal fired power increases the levels of mercury in our crops, air, water, and fish we also use it in vaccines and some appliances so now it seems to be reaching critical levels in those of us whose bodies cannot remove it quickly. Our crops have become a source of insecticides, herbicides, and fungicides. There are also many other sources of toxins. This works all together too well with the lack of essential nutrients and lack of movement to leave the levels of toxins in our bodies high enough to “jumble our genes” and wreak havoc with many of our critical body systems including those which control growth. All of the media seems to scramble our purpose and compromise our peace.

    So I think we need to go back to the basics to cure the small narrow face and associated problems.