How Can I Improve My Long Face With Asymmetry?

Q: Dr. Eppley, I’m dissatisfied with how asymmetrical and long my face appears. For asymmetry, I’m unsure if I’m supposed to reduce one side, enlarge one side, or a combination of both. For length, I was thinking that increasing volume of midface may help but I’m truly just guessing.

A:Thank you for your inquiry and sending your pictures. You have multiple facial issues which primarily are that of disproportions and asymmetry. You are correct in that your face is vertically long which is magnified by lack of midface projection. The lack of midface projection contributes more to your facial disproportion then the vertical length. But in improving the disproportion midface augmentation provides the best benefits. (see attached imaging) for some vertical chin reduction but this is primarily for the purposes of asymmetry correction. Suffice it to say dimensionally you can augment the midface much more then you can vertically shorten your face.

Your facial asymmetry is localized to that of the lower jaw and the reality is that the longer chin/jaw on the right side is the more ideal location by reduction for asymmetry in improvement. However during a limited reduction along the inferior border from in front of the jaw angles to the chin is very difficult to do with a great degree of precision. While V line surgery is commonly done this is a much more aggressive type of bone removal with the wrong shape to it to be successful in your case. It would also magnify your already vertically long face with elevation of the jaw angle. So while reduction of the longer right jaw seemsx appropriate it comes with its own set of aesthetic problems. Thus it is more predictable to look at augmenting the left jawline, leveling out the longer right chin and anterior jawline and trying to match the two jaw angles. (see attached imaging) Trying to determine exactly what needs to be done based on your pictures is an incomplete assessment and ultimately the 3-D CT facial scan is going to provide better information as to how improve jaw asymmetry as well as its overall shape.

Dr. Barry Eppley

World-Renowned Plastic Surgeon