What Is Facial Asymmetry

13 Jul What Is Facial Asymmetry

Treatment Options for an Uneven Face

Facial asymmetry occurs when the two sides of a person’s face are not mirror images of each other. While slight differences between the left and right sides are to be expected and are typically unnoticeable, significant asymmetry—such as pronounced variations in the size, shape, or position of facial features like the eyes, ears, nose, and mouth can be a concern for some individuals.

In this blog, Perth Specialist Plastic Surgeon Dr. Guy Watts takes a close look at facial asymmetry – its causes, identification methods and available treatment options. Dr. Watts will cover both surgical and non-surgical options to help increase facial symmetry.

What Causes an Uneven Face/Facial Asymmetry?

Facial asymmetry can stem from a variety of factors, ranging from physical development to lifestyle habits. Let’s explore some causes:

• Genetics Just like you inherit your eye colour and height from your parents, the shape of your facial bones and muscles is also determined by genetics. If you have family members with noticeable asymmetry, you’re more likely to have it too.
• In-Utero Pressure/Developmental Factors: The position you held in your mother’s womb can also contribute to facial asymmetry. Constant pressure on certain facial features during development can lead to slight differences in shape. Slight differences in the development of facial bones and tissue can also result in asymmetry.
• Childhood Habits: Habits you developed as a child, like sleeping on one side consistently or sucking your thumb, can influence the development of your facial muscles and bones, potentially contributing to asymmetry. Similarly, post-treatment sleeping positions can also impact facial symmetry, especially after certain aesthetic procedures. If you’ve recently undergone volumising treatments, you may find our guide on How to Sleep After Volumising Treatments helpful for optimising results.
• Ageing: As we age, our skin loses collagen and elasticity, which can result in excess skin and wrinkles. This process can happen unevenly on each side of the face, making existing asymmetry more pronounced.
• Sun Exposure: Excessive sun exposure without adequate protection can damage collagen and elastin fibres in the skin, resulting in premature ageing and potentially exacerbating asymmetry.
• Lifestyle Factors: Habits like smoking, excessive alcohol consumption, and poor diet can also contribute to uneven ageing and accentuate facial asymmetry.
• Trauma or Injury: Facial injuries, fractures, or surgeries can alter the shape of your face, which can result in more noticeable asymmetry.
• Medical Conditions: In rare cases, facial asymmetry can be a symptom of an underlying medical condition, such as Bell’s palsy, a condition that causes temporary facial paralysis, or a tumour.

Identifying Facial Asymmetry

Facial asymmetry exists on a spectrum – as mentioned above it’s rare for anyone to have a symmetrical face. But how can you tell if your asymmetry is more pronounced?

Here are some signs to look out for:

• Uneven eyebrows – One brow may sit higher or lower than the other. This is one of the most noticeable forms of facial asymmetry.
• Lopsided smile – When you smile, one corner of your mouth may turn up more than the other.
• Uneven eyes – The sizes or shapes of your eyes may appear slightly different.
• Crooked nose – Your nose may be slightly off-centre or angled to one side.
• Jawline irregularity – One side of your jawline or chin may be more pronounced.
• Lopsided facial features – Overall, the right and left sides of your face just don’t quite match up.

The degree of asymmetry can vary greatly from person to person. Some people have very subtle unevenness, while others have much more pronounced and obvious asymmetry. The good news is that there are treatments available to help balance out your features, no matter where you fall on the spectrum.

Assessing Your Facial Asymmetry

If you’re concerned about facial asymmetry, the first step is to assess the extent of the unevenness. Here are a few ways to do this:

• Take Photos: Use your phone or camera to take photos of your face from different angles. This can help you see the asymmetry more clearly and determine which areas are most affected.
• Use a Mirror: Stand in front of a mirror and observe your facial features. Pay attention to the position of your eyes, eyebrows, cheekbones, and jawline.
• Consult a Professional: If you’re unsure about the extent of your facial asymmetry or want a more detailed assessment, consider consulting a specialist plastic surgeon, like Dr. Watts.

Non-Surgical Options for Facial Asymmetry

If your facial asymmetry is relatively mild, there are several non-surgical treatment options that mayhelp reduce the appearance of unevenness:

• Volumising Treatments – Volumising treatments are injections made up of various different substances that occur in the body. As the name suggests they add volume to the areas of the face that appear sunken or uneven. Treatment areas include the cheeks, chin, and around the mouth.
• Wrinkle Treatments – Wrinkle treatments can be used to soften the appearance of dynamic wrinkles and uneven facial movements.
• Facial exercises – Performing specific exercises to target the facial muscles can help retrain them to work more evenly.

These non-surgical options are usually non-invasive and more affordable than surgical treatments. They can provide some changes, although the results are often temporary and may require regular maintenance.

Surgical Options for Facial Asymmetry

For more significant cases of facial asymmetry, surgical treatments may be recommended. These procedures aim to physically alter the underlying structure of the face to alter facial balance and symmetry. Some surgical options include:

Rhinoplasty (Nose Surgery)

Rhinoplasty, typically known as nose surgery, is a procedure that reshapes or resizes the nose. It can address a variety of concerns, including:

• Size Adjustment: Reducing or increasing the overall size of the nose to increase balance and proportion with other facial features.
• Nasal Tip Reshaping: Modifying the shape of the nasal tip to make it more symmetrical and aesthetically pleasing.
• Bridge Alteration: Adjusting the bridge of the nose, whether it’s too wide, too narrow, or has a bump that causes asymmetry.
• Nostril Reshaping: Changing the size or shape of the nostrils to make them more even.

The procedure typically involves making incisions either inside the nostrils (closed rhinoplasty) or across the columella, the tissue between the nostrils (open rhinoplasty). Dr. Watts then reshapes the bone and cartilage to achieve the desired outcome.

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Chin Augmentation or Reduction

Chin augmentation or reduction is a surgical procedure that modifies the size and shape of the chin. This can be done through:

• Chin Augmentation: Adding bone, cartilage, or a synthetic implant to increase the size of a receding chin. This can increase the profile and result in a more pronounced jawline.
• Chin Reduction: Removing bone or cartilage from an overly prominent chin to soften the facial features and increase symmetry.

Both procedures can be performed through intraoral incisions (inside the mouth) to avoid visible scarring.

Jaw Reshaping

Jaw reshaping involves surgical adjustments to the jawbone to increase asymmetry or alleviate functional or aesthetic concerns. There are several techniques used, including:

• Osteotomy: Cutting and repositioning the jawbone to increase alignment. This is often used for severe asymmetry or bite issues.
• Genioplasty: A type of osteotomy focused on the chin, where the bone is cut and moved to a new position. This can be used to alleviate the appearance of horizontal and vertical asymmetries.
• Jaw Contouring: Altering the appearance of the jawbone to remove excess bone, often resulting in a more symmetrical appearance.

These procedures often require the use of several surgical techniques and may involve collaboration with an orthodontist to address dental alignment issues.

Cheek Implants or Fat Grafting

Cheek implants or fat grafting are procedures aimed at adding volume to sunken or flat cheekbones, resulting in altered facial contours and increased symmetry. Here’s how they work:

• Cheek Implants: Synthetic implants made of materials like silicone are inserted through small incisions inside the mouth or lower eyelid. These implants provide a long-term option for increasing cheek volume and altering contour.
• Fat Grafting: Fat is harvested from another part of the body (usually the abdomen or thighs) and injected into the cheeks. This technique provides a more subtle look and feel than implants, as it uses your own tissue.

Both methods can increase lost volume and help lift the mid-face area.

Facial Liposuction

Facial liposuction is a procedure designed to remove excess fat deposits from areas like the cheeks, chin, and neck resulting in more even contours. It is particularly effective for:

• Reducing Double Chin
• Shaping the Jawline
• Reducing Cheek Fullness

The procedure involves making small incisions through which a cannula (a thin tube) is inserted to suction out the fat. It’s usually performed under local anaesthesia with sedation or general anaesthesia, depending on the extent of the surgery.

These surgical treatments are more complex and involve longer recovery times compared to non-surgical options. But for severe cases of asymmetry, they can provide more visible and long-lasting results.

Lifestyle Changes

Certain lifestyle habits can contribute to or exacerbate facial asymmetry. To help prevent further facial unevenness, consider adopting the following lifestyle habits:

• Sun Protection: Wearing sunscreen daily, even on cloudy days, can protect your skin from harmful UV rays and prevent premature ageing that can exacerbate asymmetry.
• Nutritious Diet: A balanced diet rich in fruits, vegetables, and antioxidants can help support skin and overall well-being.
• Hydration: Drinking plenty of water keeps your skin hydrated.
• Quit Smoking: Smoking accelerates the ageing process and damages collagen and elastin, making existing asymmetry more noticeable.
• Limit Alcohol Consumption: Excessive alcohol consumption can dehydrate the skin and contribute to premature ageing.

FAQs about Facial Asymmetry

Can facial asymmetry develop over time?

• Yes, facial asymmetry can develop or become more noticeable over time due to factors like ageing, injury, or changes in your dental structure.
• As you age, the skin loses elasticity, and underlying tissues may shift, making asymmetry more apparent.
• Injuries can also lead to changes in facial structure as they heal, and dental issues like tooth loss or shifting teeth can affect the alignment of your jaw and face.

Are there non-surgical treatments for facial asymmetry?

• Yes, there are several non-surgical treatments for facial asymmetry. These include volumising treatments, Wrinkle treatments and facial exercises.
• Volumising Treatments can help add volume to areas that appear sunken or uneven, while Wrinkle Treatments can relax overactive muscles that contribute to asymmetry.
• Facial exercises can help strengthen and balance facial muscles, potentially reducing mild asymmetry over time.

How can I determine if my facial asymmetry requires medical attention?

• If you notice sudden changes in your facial symmetry, such as one side dropping on one side or difficulty with facial movements, it is important to seek medical attention. These symptoms could be indicative of underlying medical conditions such as Bell’s palsy, stroke, or other neurological issues. Consulting with your GP or Dr. Watts can help determine if there is a medical cause for your asymmetry and what treatment may be needed.

Can orthodontic treatment alleviate facial asymmetry?

• Orthodontic treatment can help alleviate facial asymmetry, particularly when it is related to dental issues like misaligned teeth or an uneven bite. Braces or clear aligners can gradually shift your teeth into a more suitable alignment, which can increase the overall symmetry of your face. In some cases, orthodontic treatment may need to be done in conjunction with other procedures, such as jaw surgery, to achieve optimal results.

Does facial asymmetry affect one side more than the other?

• Yes, facial asymmetry may be more pronounced on one side of the face. This can be due to a variety of factors, including genetics, habitual behaviours (such as chewing predominantly on one side), or previous injuries that have affected one side more than the other. Each person’s facial structure is unique, and some degree of asymmetry is to be expected.

Further Reading about Face Surgery with Perth Specialist Plastic Surgeon Dr. Guy Watts

• Read more about Turkish Rhinoplasty
• Read more about Swelling and Bruising after Blepharoplasty
• Read more about What Is the Difference between a Forehead Lift and Blepharoplasty
• Read more about What Is Chin Ptosis? – Options for Treatment of a Double Chin
• Read more about What Is Jaw Augmentation?

Medical References about Facial Asymmetry

• Facial asymmetry: a current review – PubMed
• Asymmetrical face: Causes, treatment and more – Medical News Today
• What to Know About Facial Asymmetry: Causes and More -WebMD
• Original Article Facial asymmetry, the right-side dominance – Science Direct