Can weight gain permanently alter your facial structure? i'm finally back down to my 2009 weight, but my face is rounder and wider.

Depends on factors: It depends on the AMOUNT of weight lost as a % of the total. So, if you lost 50% of your body weight I would certainly expect to see some of that weight loss in the face and next while only a 5% loss may not show much change depending on how the face looked before. It also depends on the speed one loses the weight. If you'd like to discuss this a bit more: www.healthtap.com/drsaghafi