Q and A Asymmetrical Face

Q: Unsure what makes my face asymmetrical and what procedure would help?

In photos where I center my chin, one eye is higher than the other. When my eyes are straight my lips and chin angle to the right. Though subtle I’m incredibly insecure about it and it’s something I focus on in photos. What sort of procedure would help with symmetry?

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A:Facial Asymmetry - One Side of Face Smaller Than Other

Hello,

Your situation is VERY common. No one has perfect symmetry, the question is not if you are asymmetric, but rather how asymmetric are you. There are lots of ways to be asymmetric, but I would say the most common asymmetry for which patients request evaluation is where one side of the face is smaller than the other. In your case, the right side of your face is smaller than the left. The smaller side of the face will have a lower eye and eyebrow position, a higher angle of jaw, the nose will appear to be curved toward the smaller side, the mouth will appear to be shifted toward the smaller side, and the corner of mouth may be higher on the smaller side. Most commonly, people with this condition perceive the crooked nose and it is for this that they seek my consultation. At its most fundamental level, faces that are smaller on one side can not be "fixed". There is no reasonable way to expand the skull on the smaller side (or shrink the bigger side). The eyes being out of level is unfortunately almost impossible to do anything about. Sometimes a brow lift can help give the illusion of correction, but needs to be carefully considered as it can make other things look more asymmetric. The crooked nose can't be fixed either, but there are rhinoplasty tricks to make it appear straighter. Cheek implants and jaw implants on the smaller side are often helpful. And finally, injections of filler like Restylane or Voluma on the smaller side will often help. Depending on the details of any one person, there are other treatments to improve the asymmetry.

Also, understand that it is not difficult to camouflage the asymmetry. Realize that even if you had a perfectly symmetric face, simply turning your head a microscopic amount to the left or right or tilting it the smallest amount will produce the look of asymmetry. Because of that, the human eye is used to seeing this and subconsciously, people looking at you don't see an asymmetric face, they see a face they believe to be slightly turned or tilted. It is often only during a conscious analysis of your face, that the symmetry becomes visible.

Hope this helps,

Dr. A