How Can I Fix My Facial Asymmetry From Congenital Plagiocephaly?
Q: Dr. Eppley, I just recently found out through your blog that as a child I had positional plagiocephaly. I have a flat spot on the right side of the back of my head. I have always thought there was something wrong with my eyes and was in the process of finding a surgeon for my facial asymmetry. I now know where the asymmetry came from and I really want some of the asymmetry to be improved as much as it came be. I personally like my right eye better because it appears bigger and more of the eyelid can be seen. I also believe I have a small deviated septum which causes my nose to curve over to the right which I would prefer be fixed If I do a consultation will it need to be done in person due to the cause? I’m not sure what needs to be done to make my face feel more symmetrical so I am hoping your practice can help me. Thank you so much!
A: Thank you for your inquiry and sending your pictures. Your facial asymmetry is undoubtably due to congenital plagiocephaly. The left eye is more posteriorly positioned as is the brow bone, cheekbone, and infraorbital rim. The challenge in preferring the right eye is how to make the left eye appear more similar. One thing you can not do with an eye is to bring it further forward since it is attached/tethered by the optic nerve. Thus the left eye can not be brought further forward which is the ideal manuever to improve the eye symmetry. But besides being more posteriorly positioned it also sits a bit higher. The orbital floor can be lowered which will being the eye down a bit. That combined with cheekbone reduction should help the eye/facial asymmetry.
A 3D CT scan of the face is the first place to start in making an accurate assessment of the bony asymmetries and in making a more informed treatment plan for them.
Dr. Barry Eppley