Facial asymmetry can be detrimental to confidence and does not always have an easy fix. There are many causes of facial asymmetry. The solution for each person differs depending on the cause and diagnosis of their asymmetry.
Fortunately, there are now plenty of options to fix an asymmetrical face. Whether they are issues with the cheeks or the jaws, there are different methods to improve facial symmetry.
Facial asymmetry correction includes surgical interventions such as jaw surgeries or reduction, chin augmentation, facial fillers, or even liposuction. There are also non-invasive ways to improve facial symmetry, such as facial fillers and dental fixes. The jaw area is the most likely to have asymmetry.
What Is Facial Asymmetry, and Is It Normal?
To a degree, facial asymmetry is completely normal. Normal asymmetry is even preferable to a certain extent. Most of us do not have perfectly symmetrical faces and go about our lives with minor asymmetries on our faces. For instance, one of your eyes could be slightly smaller than the other or tilted the other way. No one would notice unless you are under serious scrutiny. This level of facial asymmetry does not need any fixes.
However, there are obviously degrees of asymmetry that are noticeable by others, and not just yourself. The question of where to draw the line between the two and whether fixing it is worth the risk isn’t always obvious.
There are a couple of ways that facial asymmetry can become a problem, such as the following.
1. Skeletal Asymmetry
Skeletal asymmetry is a type of asymmetry that stems from the facial bones. This asymmetry means that even though the soft tissues are symmetrical, the underlying bones are not. This skeletal imbalance leads to an overall asymmetrical appearance. The best fix for people with asymmetrical bones would fix the skeletal foundation itself via surgery instead of just fixing the soft tissues or adding implants.
2. Soft Tissue Asymmetry
There are also instances when problems with soft tissues cause facial asymmetry. When facial asymmetry is not bad enough to warrant the facial bones’ movement or augmentation, the soft tissues are the target.
Take note that many asymmetry cases are a combination of skeletal and soft tissue asymmetry. For example, a fix with skeletal asymmetry alone may not completely achieve the desired facial symmetry if the soft tissues are still imbalanced. It is only in the mildest cases of facial asymmetry that the soft tissues alone are to blame.
Or, a problem in the soft tissues, such as the muscles, can, over time, create problems in the bones by taking away the normal stimulus that the bones are used to. An example of this is stroke patients whose facial muscles no longer work, which thus changes the bones:
Reasons for Facial Asymmetry
Some people are just born with asymmetrical faces. This could be due to conditions that they were already born with. It could also be through genes passed on by their parents.
Facial asymmetry can also be due to physical trauma and accidents. Obviously, a broken nose will lead to facial asymmetry and require fixing to achieve symmetry.
Lifestyle choices could also make facial asymmetry worse. These lifestyle choices can either directly or indirectly affect facial asymmetry. Smoking causes certain physical changes in the face. These changes may exacerbate an asymmetrical appearance. Another lifestyle choice would be wearing sunscreen. It indirectly affects facial asymmetry by slowing down the signs of aging. It also slows down the asymmetries brought on by aging.
Another reason for facial asymmetry is dental problems. Dental problems such as overbites or underbites can undermine the face’s overall appearance. Some dental issues are possible to fix through braces or similar devices. However, some issues might require more serious interventions, such as surgery. For dental issues causing facial asymmetry, finding the issue early on is crucial. Most dental problems have relatively easy solutions when treatment begins at an early age.
As people age, their faces also start to sag in different directions. Some people will have it worse than others. Asymmetry is especially prevalent in the under-eye area and the cheeks or jawline.
Aging is the main factor contributing to the development of asymmetries, as underlying causes like dental issues or poor habits will compound in their effects over the years.
Considerations in Fixing an Asymmetrical Face
Final Facial Balance
Final facial balance is one of the first things to think about when correcting an asymmetrical face. The patient’s preference is atop priority.
The age of the person with facial asymmetry is also a consideration. A younger person will have treatment options such as dental devices available to them. Not all fixes for facial asymmetry are applicable at just any age, so it’s best to keep that in mind as well. Not all dental fixes are limited to children and teens. However, most of them work best in younger people. Take a look at a couple of these photos of facial asymmetries in children and teens resolved with dental devices.
The Diagnosis of the Asymmetry
The diagnosis or reason for the asymmetry is arguably the most important factor in determining how to approach facial asymmetry.
Methods to Fix an Asymmetrical Face
Facial implants are small materials surgically planted into the patient’s problem areas. Implants usually have a composition made out of silicone or another solid material compatible with human tissue. Facial implants are customized depending on the final look that the patient wants. The goal of implants is to optimize facial appearance and contour.
Facial implants are a very versatile procedure. They are usually applicable to most areas of the face. However, the chin, cheek, and jaw are the most common areas for implants. This is also presumably due to the concentration of most facial asymmetry in those areas. The goal of facial implants in each area is to augment the feature to match the other side and/or improve the feature in general.
A jaw implant primarily improves the size and definition of the jaw. A weak jawline or uneven jawline is an unattractive characteristic that is bad for facial harmony. Thus, a jaw implant’s goal is to adjust the jaw’s size to improve facial balance.
A chin implant’s goal is also to improve chin definition. With a chin implant, the patient’s chin will become much more prominent and improve the facial features.
Cheek implants lift the cheeks and make them look more defined. Some cheek implants make cheeks fuller. Some might focus more on the definition. It depends on the needs of the patient and what the end goal of the procedure is.
Take note that facial implants are a surgical procedure. Thus, it is necessary to make the necessary preparations and ensure that you are consulting with a board-certified surgeon. Facial implants are relatively safe. But there are still risks associated with minor cosmetic surgeries like implants.
Dental occlusions affect the face just as much as any other feature. Teeth that are in the back can determine how balanced a person’s face is. That said, orthopedic processes can help correct asymmetries. It especially helps in patients who are still growing (Thiesen et al., 2015). In young people, utilizing orthodontic devices is a good option for correcting asymmetries. Taking advantage of how there is still room for growth is a gamechanger. Take a look back at the photos above and see how drastic the difference braces made in correcting malocclusions. Not only did the dental device make their teeth look better, but it also improved facial harmony.
Tooth extractions can also be a way to improve facial balance. There are instances when the space for a row of teeth becomes too crowded. This is shown in the photos below. The treatment for this patient included braces and three extractions. The extractions helped create some space for the teeth to move properly. It also allowed the teeth to settle into their ideal spaces.
For people who are no longer growing, dental interventions like braces become less useful (though these devices can still create significant changes). At that point, other methods become more valuable.
Facial fillers are an easy fix for mild asymmetries that are not due to bones. Dermal fillers are non-invasive and are readily accessible in many areas. The fact that fillers are not permanent can be a double-edged sword. For one, the lack of permanence makes reversing them quick and easy. The patient can also wait it out until the fillers fade with time. But, this also means that the patient has to keep going back for the procedure. Going back over and over again can be expensive.
One of the major cons of facial fillers is that they can migrate to other facial areas. You will need to assess the risks of the process with your surgeon or medical practitioner to ensure that you understand facial fillers’ consequences.
There are dermal fillers for the cheeks, jaws, lips, and virtually all the other areas of the face. They are useful in many situations, especially in common problem areas like the cheek or the jaw. There are also facial fillers to soften the nasolabial folds when asymmetry is in that area.
The results of facial fillers usually settle in at around the two-week mark, and the results stay for around six months to a year, depending on the type of facial filler. Synthetic fillers usually last longer because the body does not absorb the material, unlike fillers like hyaluronic acid. The general idea is that the denser the product is and the deeper the application, the longer the filler will last.
Unfortunately, sometimes this filler can last for years. Not every part of the filler always dissolves. This is especially problematic when it migrates to other parts of your face. Over time, you lose your natural look.
Jaw surgery or orthognathic surgery is another way to correct facial imbalances. Orthodontic and orthognathic solutions often go together to achieve optimum results. Jaw surgery could not only improve a patient’s appearance, but it could also help reduce their discomfort and pain as well. Jaw surgery is a functional procedure in most situations. Though it has cosmetic applications, jaw surgery is a serious procedure that no one should take lightly.
There are several types of jaw surgery: upper jaw surgery (maxilla), lower jaw surgery (mandible), or surgery on both the maxilla and the mandible (double jaw surgery). The riskiest procedure out of the three is the one that involves both the upper and lower jaw since it takes much more time and is usually more complex.
Since jaw surgery is one of the riskiest ways to fix asymmetry, the process is best for major facial asymmetries and those who have obvious skeletal asymmetries. Some conditions cause facial imbalance over time, like temporomandibular joint disorder, which is not bone or soft tissue but still affects facial asymmetry.
Jaw surgery is usually not treated as a primary option as other non-invasive options can be tried first. If you are seriously considering jaw surgery, make sure you have a board-certified surgeon to guide you and do the surgery. The risks for jaw surgery include infection, numbness, and bleeding. All that said, jaw surgeries are the best solutions we have for extreme asymmetries that require making bone-deep changes.
Jaw reduction is technically a surgery on the jaws. However, it is different from the previously mentioned jaw surgery. Unlike orthognathic surgery, jaw reduction focuses on removing some parts of the jaw instead of alignment. The goal of jaw reduction is to shave off certain parts of the jaw bone. A jaw reduction is great for those who want more feminine faces. The goal is to reduce the jawline’s angle to create a rounder and more feminine silhouette. It can also be used to fix asymmetries by reducing the larger side.
With jaw reduction, it is essential to determine whether or not the problem is the bone itself. Otherwise, the surgery will not be helpful. For example, correcting asymmetry by shaving off some bone would be useless if the real problem lies in the masseter muscles. Obviously, your doctor should do a careful workout on you to determine whether this is the case or not.
Jaw reduction is not as complicated and invasive as orthognathic surgery. Thus, many people like to explore this option first. Jaw reduction can have a downtime of 2 weeks in many cases. By that point, the patient can go back to their daily routine. However, fully healing from the procedure may take a couple of months.
The most common way of doing a chin augmentation is to use an implant. This topic is already covered in the ‘facial implants’ section. However, there are other ways to correct chin asymmetry. Sliding genioplasty is one way to fix chin projection without an additional implant. Instead, the procedure involves making an incision inside the mouth or underneath the chin to change the chin’s position. The surgeon will cut part of the chin off and move it forward. The surgeon then screws the chin into place in its new position. Over time, new bone will start to fill in that area.
There will be some swelling after the procedure. The recovery time is around 2-3 weeks. The effects of swelling and bruising will gradually wear off during the recovery period.
Liposuction consists of removing fat from a particular area of the body through a cannula and suction. Liposuction is useful for asymmetries due to stubborn fat in places like the jaw and below the chin. Uneven fat loss in the face is unusual, but it can still happen to some people. In those cases, getting rid of the extra submental fat through liposuction is a valid treatment option. However, this is only optimal when other options have already been exhausted.
Liposuction is possible in several areas of the face, such as the cheeks, chin, and jaw, but requires a very skilled surgeon. Liposuction in the space below the chin is most common. The whole process is an outpatient procedure that takes anywhere from 30 minutes to an hour, depending on the size of the problem area. Recovery time takes a few weeks. During this time, the patient should wear a compression garment.
Like with all other procedures, there is a risk that liposuction could go wrong and not yield perfect results. It is essential to choose a board-certified surgeon that already has plenty of experience in the field. Risks for liposuction include infection and lack of sensitivity or decreased sensitivity in some areas. After the procedure, it is normal to feel slightly sore and have a bit of swelling. Those after-effects should go down during recovery.
Botox is also a pretty reliable and versatile fix for facial asymmetry. Botox is a material that restricts the movement of muscles and, in effect, will help contour and shape certain areas. Though the most common use for Botox is to get rid of wrinkles and signs of aging, the drug has a lot more uses than just that.
For example, facial asymmetry due to the eyebrows is possible to fix with Botox. An eyebrow higher than the other can be lowered with Botox. The drug will inhibit the force that the muscles above the eyebrow exert to bring the brow up. Botox is also helpful for asymmetries with the lips.
Botox could also help with masseter muscles that are too large on one side and do not look proportional to the other. However, the applications of Botox are, of course, limited to the diagnosis of the asymmetry. Botox focuses on inhibiting muscles. If the problem is not with the muscles, Botox may not be a good fit.
Botox results start to appear a few days after the procedure. These results usually last between 4-6 months or longer for some people. However, Botox’s effect generally does not last very long.
Do Facial Exercises or Face Yoga Work for Correcting Facial Asymmetry?
There is no conclusive evidence on whether or not face yoga works for correcting facial asymmetry. Sure, some blogs and people dedicate their time to practicing these exercises. Most of the evidence backing facial yoga and exercise is anecdotal.
Still, if it makes you feel more confident with yourself, then there’s nothing to lose by trying. This study by D’souza et al. (2015) even says that some muscle restraining exercises help create facial balance. While not entirely a conclusive piece of evidence for facial exercises, it’s a good starting point.