What can I do about facial asymmetry? It seems that many people are aware that
having good facial symmetry is a characteristic seen in some famous
people and is considered to be a desirable quality to have facial
asymmetry particularly cheek asymmetry is a common concern I get asked about
fairly often I found that even some young people who contact us are very
concerned about their facial asymmetry facial asymmetry is of course natural
and everyone has it to an extent including the actors and models who
appear to have perfectly symmetric features I’ll discuss what contributes
to normal facial asymmetry and when I feel it should be left untreated and
when facial asymmetry can benefit from an aesthetic procedure
I’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon and
Fellowship-trained oculofacial plastic and reconstructive surgeon I’ve been in
practice in New York City and Long Island for over 25 years for facial
asymmetry I perform a range of facial filler treatments such as for the lips
the cheeks and chin as well as surgeries such as cosmetic eyelid surgery and
facelift surgery facial asymmetry is mainly the result of the facial bone
structure the face forms has two separate sides which come together to
meet in the middle this normal development of facial bone structure
will naturally have some degree of asymmetry for example one cheek bone can
appear to be projecting more than the other or the eyes are set slightly
differently in height or position relative to each other
generally speaking facial asymmetries unless very significant rarely draw
attention it’s interesting that when people often ask about improving facial
asymmetry they disregard other aspects of their appearance which can have a
potentially greater impact on how they look I find that a lot of my patients
who work in front of a camera are acutely aware of these subtle
differences between the two sides of their face
although bone structure cannot be changed with routinely performed
cosmetic procedures enhancements are possible for better overall appearance
facial asymmetry can be more noticeable when there are genetic volume
deficiencies such as one cheek having a noticeable difference in volume and
shape when compared to the other this genetic condition can occur in young
people and can be treated on a case-by-case basis
I would only consider these cases when volume differences are significant and
are easily noticed by others I normally don’t treat nor do I recommend treatment
for younger people with facial asymmetry that falls within the normal range the
differences in facial symmetry can actually become more significant with
aging as we get older we lose facial volume from diminishing bone muscle fat
soft tissue and skin the most significant volume loss from aging is
due to bone volume loss this volumetric loss is often overlooked with more
attention directed to the appearance of sagging skin
I see facial bone and soft tissue volume loss as a more significant part of
facial aging which actually precedes the excessive skin and soft tissue descent
age-related volume loss can actually accentuate facial asymmetry this is
because facial asymmetry can be less noticeable in
younger and fuller face so with aging and more noticeable loss of facial
volume facial asymmetry can appear to be more pronounced for facial volume
enhancement I would surgically place facial implants these implants made of
soft silicone are known as malar and sub malar implants with the cheeks and chin
implants for the chin in recent years with the introduction of more advanced
and longer-lasting hyaluronic acid fillers addressing
facial volume has become much more convenient safer and highly predictable
thicker longer-lasting hyaluronic acid fillers such as Juvederm Ultra Plus and
Juvederm voluma are appropriate for areas like the cheeks and chin softer
fillers are used under the eyes or in the lips a common objection raised is
how facial fillers can create a doughy look when the face looks pillowy and
bloated this look is most often due to facial fillers being placed at a more
superficial level or just below the skin the fat and soft tissue space that these
fillers get placed into lacks the strength and intrinsic structure to
support these fillers so naturally they migrate and create this stereotypical
soft and doughy look most injectors are using this approach what I do for my
patients is to apply my knowledge as a face lift and facial implant surgery to
place these same fillers deeper at the bone level which works has a much
stronger foundation for these thicker fillers when in comparison to this soft
tissue space by placing fillers at the bone level the fillers can add structure
to the face as it enhances and restores facial structure and definition
we call this Structural Volumizing I place these fillers using blunt cannulas
instead of needles so I’m able to glide through the facial anatomy rather than
pierce and tear the tissue with needles at the bone level the materials kept in
place by the muscle layer above it so you look more natural and more defined
there’s essentially minimal risk of migration so you can be confident that
you won’t have a soft or doughy look most doctors and mid-level injectors
don’t place fillers at the bone level even when they think they are
this meant that I’m describing is highly technique dependent after a Structural
Volumizing there’s typically little to no downtime patients can actually look
pretty good the next day and I see my facial filler patients about two weeks
after the procedure to see how the filler materials have settled and to see
if additional filler material is of benefit I feel that it’s always better
to be a little conservative initially with filler placement and then add a
little more later if needed another advantage of hyaluronic acid fillers is
that they can be easily dissolved with the enzyme hyaluronidase essentially
making them reversible patients can sometimes ask for semi-permanent or
permanent filler materials I advise them that these fillers are not reversible
and can require extensive surgery for removal if needed I’ve performed these
types of surgery for people who come to me from around the world so I know how
complex a problem these permanent fillers can become hyaluronic acid on
the other hand naturally occurs in the body and is safely metabolized with time
for most cases of facial asymmetry especially among younger people no
treatment is advised because facial asymmetry is not
and normal and usually it’s not detrimental to your general appearance I
feel that treatment for facials asymmetry is only recommended where
facial balance is affected and is noticeable and when volume deficiency is
affecting your natural facial harmony which is typically seen with facial
aging I hope you found this information helpful thank you for your question