What Procedures Do I Need To Treat My Facial Asymmetry?
Q: Dr. Eppley, I want a consultation about my profile. I am confused as to what I may need. My bite is not bad and I have never had braces. My dentist told me my upper teeth forms a c-shape. I think my jaw line is asymmetric, my chin points to the left and my right side profile looks concave or flat. This had been bothering me for a while but I don’t know what will be the best to make my face look more symmetric and balanced. I have attached some pictures so you can see what I mean.
A: When looking at a face there are two views to consider. The patient themselves sees the frontal view and, understandably, often considers it to be the most important. The profile and oblique views are what other people see and how the patient will usually see themselves in photographs. In your description of concerns, you mention both the profile and frontal view concerns.
As you have described in your frontal view, the chin and jaw angles are asymmetric (right chin deviation and left angle deficiency), and the right cheek is flatter or less pronounced than the left. If you look at other features of your face, you will see that there is an overall right facial deviation compared to the cranial base. This rotation is also why the right facial profile seems flatter in the cheek area.
I can not speak for your bite (occlusion) as it is not contained in any of the pictures you have sent. However, I doubt if your bite is severely off or misaligned and I don’t think it has any contribution to your facial asymmetry.
To improve your facial asymmetry, you have to think of ‘camouflage’ procedures for improvement. I would recommend left jaw angle and right cheek implants and either an asymmetrically-placed chin implant (with minimal horizontal increase) or a chin osteotomy with rotation and shifting to bring the chin point in the midline.
Dr. Barry Eppley
A detailed description and pictures of your concerns allows for the most informed response.