Sternocleidomastoid Release and Facial Asymmetry
Q: Dr. Eppley, I am a 26 year old male and realized in early high school something was wrong with my face when I first took a picture of myself. I always thought I was good looking when I looked in the mirror but when I saw what I truly looked like to everyone else I was very concerned.
From early trauma / sleeping on one side / torticollis, I realize I have plagiocephaly, with my head leaning to the left. This means my right side is elongated in comparison to my left, with my jaw hanging lower and being skewed off center, my right eye is higher, and I also have a flatter right side of the head as well as a forehead protrusion on the right forehead also. Basically my right side is my bad side, and in comparison my left side looks fully developed and frankly very good looking.
My head naturally tilts into this position I believe to support this deformity, when I force tilt my head to the right I am able to line up my eyes and ears but obviously my jaw stays very asymmetrical (can’t move that so easily.) So I had some questions, I believe I have torticollis, which in my case means the left muscle in my neck is shortened, hence the head tilt.
1. Is the sternocleidomastoid release something you can operate and perform?
2.If you cannot, should I get that operation first before moving on to fixing my face cosmestically?
3. I know skull implants are possible, but is shaving down the protruding bone in the right forehead possible as well, to match the left sides sloped back appearance, which I think looks very good.
4.If I were to get jaw surgery, going off the things I have seen online, what side of the face would you try to match up, my right jaw is very elongated and skewed off center, so I would like to match the left sides more up tight and angular position, not trying to make the left side like the right side, if that makes sense?
You seem to be the only surgeon that specializes in these niche catogories, so I hope to hear back from you, I have heard great things about you!
A: In answer to your questions:
1) Sternocleidomastoid (SCM) release is a procedure typically done in young growing children to avoid many of the symptoms to which you have described. I have done many of them in young children. However the procedure is not known to be effective in adults meaning that the releasing the muscle will not make the head become straight nor improve any of the craniofacial asymmetry appearance issues.
2) Thus, correcting its symptoms of craniofacial asymmetry is all you can do.
3) Reducing one side of the forehead, within the limits of the thickness of the bone, with augmentation of the opposite side would be the appropriate aesthetic approach to frontal forehead asymmetry.
4) A 3D CT scan and pictures is ultimately needed to first make a diagnostic assessment and establish the proper treatment and its sequencing. While what you are describing for your jaw asymmetry may be the correct aesthetic approach, I can not comment on your exact situation with such information.
Dr. Barry Eppley