Q: Dr. Eppley, . I have a multitude of facial asymmetry issues stemming from a mild Kaban/Pruzansky birth defect. I have a confirmed hemifacial microsomia that has primarily affected the eye, orbit, and cheek regions and ramus of my jaw. They really bother me and I want to fix some of them. I am not sure whether to go for orthognathic surgery and a custom cheek implant. Or to do all implants on the affected side. If you place an implant in the cheek (malar-ygomatic arch), will this also make the affected eye and brow look more bizarre as it will look even further back with the projection of the cheek? How do I improve my facial asymmetry without looking even more bizarre in other words. I also have a skinny face with the cheekbones projected like you see in fashion models (though I am no model!). Will custom implants look bizarre as I do not have a tremendous amount of overlying fat? I have dealt with this for almost 30 years as I am almost 29 and I want to move on with my life.
A: Thank you for your inquiry about facial asymmetry correctiobn. There is little I can tell you by your description alone. To be most helpful and to properly treatment plan, I would need pictures of your face and bite and a 3D CT scan.
With this information meaningful recommendations can be made. In short, if your bite is fine and your occlusal plane is reasonably level, custom implant augmentation of the smaller side would be appropriate.
Dr. Barry Eppley