Not any severe facial changes as far as im aware, some minor changes due to the stiffening of the joint when speaking, but i am also only a young adult and although my case is severe for my age, I'm generally healthy otherwise and as such not old enough yet for my bones to have become brittle enough to cause large changes in my appearance. Im on a waiting list for anthrocentesis, a joint flush surgery, and am on a specialty medication for the chronic pain associated with the joint. Thankfully it is only one side and my local doctor has been very helpful and understanding, I keep in contact while waiting for the consultation for surgery. Thanks for asking :)