### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
i have a question. i am an adult. i have had orthognathic surgery ..and then a revision of it along with total joint replacement of both tmjs this past july. i am still in braces. when i was a child the orthodontist extracted 4 bicuspids. the orthodontist i have been seeing prior to the most recent surgery..has helped me tremendously by reopening the spaces on the maxilla . i will hav implants when stable. the problem is..that i still feel that i do not have enough space for my tongue . i was okay prior to the 2nd surgery bc the orthodontist pushed the teeth way out..to where they should have been all along. i was told i never needed the extractions..just the surgery. now that the occlusion is back to the proper place..i now feel very crammed with the tongue..especially on the lower palate . my dr is trying to help me keep lips together..et..and tongue to roof of mouth..i am doing this the best i am able..but at times..the tongue literally seems too long. it is uncomfortable..and i am concerned that when the braces come off..i will have problems. i had a long face syndrome..from allergies i guess as child. i have kept in shape..however..my neck posture ..and the entire posture all around is off...and always will be. i dont know if this could be making the tongue posture forward. i just am to the point i am about wanting to have a tongue reduction. is it possible that my palate, upper and lower..are so underdeveloped that the tongue is too large..despite the sugeries. i was concerned of this prior to the 2nd surg..because this was a major problem after the 1st surg...and there was relapse. my oral surgeon is excellent..but he and the orthodontist are so focused on what they specialize in..im not sure they understand..there may indeed be a problem. the only other thing..is that maybe it is swelling...even so...it still extends past the lower arch..when at rest.. they do not want me tongue thrusting..et..or mouth breathing ..so if i keep lips together..et..tongue is crammed. i have had so much surgery..and other things..i just dont know if something rt the surgery is causing this.. i am concerned if i dont do something..i will continue to have problems...my palate is very narrow..despite that they split it..on the last surgery..

### output:

Hello, Firstly, quite a strong person you are. You have had so much in past & still you are standing strong. You might be suffering from macroglossia or pseudomacroglossia due to narrow palate. Please provide some radiographic records so that we can understand the situation in a better way. Consult some other maxillofacial surgeon to have a second opinion. You might need a tongue reduction surgery. I hope this might help you. Please do follow up with the proceedings of your case. Get well soon. With 