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Pre-surgery myofunctional therapy! Don’t skip it. Seriously.

Dr. Hockel had recommended myofunctional therapy to help get the tongue and lips ready for surgery. Dr. Movahed had noted its importance but also acknowledge low availability (uncommon specialty). Luckily, working with them in Oakland was Virginia Downing.

Meeting Virginia Downing was fun. She is no nonsense and straightforward. She is a hard working often 7-day-a-week queen of myofunctional therapy. I was a bit lazy and decided not to start myofunctional work until three months before surgery. But she did the initial consult and said, “Well, let’s see what we can fix before the surgery.” If you want to work with her plan on working hard. She dislikes wasting time on people who don’t do their exercises to make progress, and rightly so. Hard to find anyone to do this specialty so every slot is a person who has to really want and work for the improvement.

In our initial consult it was clear that mouth breathing so long caused a bunch of funky issues:

  • I had a huge tongue thrust during swallowing. This came from the fact that when mouth breathing, my tongue was always low on my mouth floor. A proper swallow required the tongue to be in the right spot (behind the top teeth). It meant that I couldn’t swallow with the right muscles.
  • I had no strength and no idea where my tongue was. We did ‘typical’ movement tests with a mirror and I couldn’t do most of them. I was horrible at it.
  • I had a lot of tension in my lips and cheeks. Getting that out before surgery would help with tearing and stretching as they expand your face.
  • I had a posterior tongue tie. TBD whether I want to fix that or not.

So we set off, meeting every 2-4 weeks with new exercises each time. It was always super tiring, but I found the only way to get the work in on my time was to do the exercises in the car, while sitting in a meeting, while sitting in any idle slot. It’s a lot. The running joke was I would have to quit my job to focus on doing therapy.

I can definitely say it reminded me a lot of playing piano. For example, when you have a difficult passage and you need to work slowly and carefully to learn the motion then do it more and more and at greater performance.

In the end though, as I will mention later in my post surgery results, this step made a huge difference. Do not skip it. Do not! If you are a mouth breather like me you need this before surgery.


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