My Face

On January 10th, I went to see my dentist for a very small cavity filling. I was in and out of his office in under 30 minutes, including waiting time; the actual procedure, from injection of the anesthetic to Dr. White ushering me out of his chair, was probably 15 or 20 minutes.

Two hours later, I was sitting in front of the TV, watching Dragon Prince on Netflix and waiting for the local anesthesia to wear off. I was a little sniffly from the cold weather, so I tried to blow my nose. With the left side of my face was numb, my nose-blowing was not terribly successful. No matter; that was to be expected after a dental procedure. So I blew my nose harder and hoped for the best.

Between the numbness and my distractedness, it took me a moment to realize something was wrong. I reached up to touch my numb cheek and realized that the left half of my face had inflated like a balloon. My cheek was bulging and my eye was swollen half shut. To my horror, gently prodding the skin around my eye and nose produced a clearly audible crackling sound.

I panicked. I’d had a couple cavity fillings in the past, and I’d gotten my wisdom teeth removed six months prior, but my face had never swollen like this before. Was I having a sudden allergic reaction to the anesthetic?
Google told me I probably had subcutaneous emphysema, which is when air gets trapped under your skin. It’s a rare condition that can sometimes happen after dental procedures. That made sense to me.

My dentist was kind enough to see me the next day, though it was his day off. He came into the office wearing flannel and hiking pants. It was a five minute meeting.

“Sorry,” he said, “I just came off the mountain. Sorry about your face.”

He prodded my face and confirmed that it was subcutaneous emphysema. “I agree that it’s probably from blowing your nose too hard,” he said. “Nothing we did yesterday could have caused this; it was just a tiny cavity. I’ve never seen anything like this.” But he did offer a more substantial hypothesis: “Your upper wisdom tooth on this side grew very close to your sinuses. Maybe you blew a sinus. Just don’t sneeze or blow your nose again. You should see your oral surgeon. Can I take a picture? If you wear these sunglasses it’ll hide your identity.”

The soonest I could see Dr. Savage was a week later; we scheduled a check-up in between his other surgeries.
Over the course of that week, the swelling went down drastically. After only a couple days, I looked fairly normal, albeit slightly lopsided. A couple days after that, my face had completely returned to its typical shape and size. My jaw muscles on that side were incredibly sore for a little while, but beyond that, I had no pain.

When I finally saw Dr. Savage, the first thing he did was check my wisdom tooth extraction sites.

“They’ve healed perfectly,” he said. “They look great. You think your face is swollen?” I showed him pictures I’d taken on the 10th. He seemed surprised. “I only see injuries like this when people break bones,” he said, and asked to take an x-ray of my face.

He checked my sinuses on the x-ray scans.

“Wow,” he said. “Look, there’s air!” And then he laughed in my face. “You have the thinnest, most delicate sinus bones I’ve ever seen. They’re always supposed to be thin and delicate, but yours, yours are super extra thin. You’re no brute – you’re a delicate flower!” Ouch.

Dr. Savage proceeded to tell me what he thought happened – I’d blown my nose so hard that I broke a bone in my face.
“So, what do I do now?” I asked.

He shrugged. “It fixed itself. Just be careful for a couple weeks. And, well, if it happens again… don’t worry about it. Or you can give me a call – I’d love to get an x-ray of that!”

My face has since returned to full functionality (I have successfully sneezed with no ill effects). It aches sometimes, though I can’t tell if that’s psychological or not. My only lasting injury is my bruised ego from being diagnosed “a delicate flower” by Dr. Savage.

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