Will My Neck Posture Improve After Skull and Jaw Reshaping?

Q: Dr. Eppley, I am interested in surgery to help fix my facial / cranial appearance and to help me feel like i can easily have a good neck posture. I have a weak chin, jaw, and cheek bones. My orthodontist agreed with me and has x-rays but said she couldn’t do anything to help. In addition i feel like my head is misbalanced in that most of my weight is the back. I did not have the benefit of positive horizontal facial cranial growth forward. For years i’ve felt awkward trying to have a natural neck position. When I try to have a natural neck position most of my face looks squished and most of my head is balanced in the back making it difficult to keep this position. In addition to trying to keep my natural neck position it is hard to talk. Maybe i’m over correcting my posture at that point but it’s hard to know without a medical profession correcting me with what is actually natural. Over the years my neck posture has gotten worse and have neck pain because i’m trying to look “normal” without my face looking squished and my natural propensity to keep my head slightly forward so i can talk correctly. Keeping my head forward from a natural neck position isn’t very comfortable on the neck. 

The follow pictures will show my side profile and front profile. I would like the doctor’s opinion on my comments and my pictures. Is there anything that could be done? At the very least I would like to improve my neck posture and have a “normal” side profile. 

A: Thank you for your inquiry and sending your pictures. While there are procedures to help with your jaw deficiency (custom jawline implant) and protrusion of the back of your head (occipital skull reduction) which will have aesthetic benefits (see attached imaging) I would not expect that to change how you hold your head. (neck posture) Neck posture is a learned behavior. It is possible that you hold your head that way because of your short chin/jawline and these aesthetic improvement may help, but any improvement in your neck posture should be perceived as an unexpected bonus and not an expected outcome from these surgeries.

Dr. Barry Eppley

Indianapolis, Indiana