Can My Facial Asymmetry (Vertical Orbital Dystopia) Be Fixed?

Q: Dr. Eppley, My face has a lot of asymmetry to it. One eyebrow is significantly higher than the other. My chin points more in one direction. It almost appears as though one part of my face stopped growing with the other half. I had braces a while back, and I remember having a pretty dramatic shift in my teeth (bracket came out of holder). My TMJ worsened, and I believe it all goes hand in hand. I was told this couldn’t be fixed because it was a vertical bony orbit asymmetry. 

A: Thank you for your inquiry and sending your pictures. You have a right-sided facial hypoplasia which is most manifest at the north (eye) and south (chin) ends. The most significant component of your facial asymmetry is your vertical orbital dystopia (VOD) and the surrounding changes that come with it from a lower orbital box. (lower brow bone and eyebrows, lower upper eyelid, lower globe position, lower orbital rim and smaller cheek) 

It is not an accurate statement that it ‘can’t be fixed’. While perfect eye symmetry may not be achievable, significant improvements can usually be obtained. The first step in the diagnosis and treatment planning process is a 3D CT scan which will clearly show the bony differences and what can be done to improve them.

Dr. Barry Eppley

Indianapolis, Indiana