The Straight Facts on Facial Asymmetry: Is Surgery an Option?
In many cases there is no reason to correct facial asymmetry. However, for those that do require treatment, there are basically two options: minimally invasive treatments and surgery.
Facial symmetry is regarded by many as a primary factor in beauty. However, everyone’s face is a least slightly asymmetrical — even your favorite actor or supermodel — and symmetrical faces are not necessarily the most beautiful.
However, those with noticeable or extreme facial asymmetry may feel self-conscious and wish to achieve a more balanced facial appearance. This can be achieved through injectable facial fillers, surgery or other means.
Causes of Facial Asymmetry
There are several potential causes of facial asymmetry:
- Trauma that breaks the nose or alters other facial features
- Stressors during physical development
But as Ken Dembny, MD, a board certified plastic surgeon in Milwaukee explains, facial asymmetry is usually multifactorial. “It is usually related to some combination of differences in facial length, underlying skeletal shape, muscular size and activity, and underlying subcutaneous volume,” he says.
Does It Matter If Your Face Is Asymmetrical?
Researchers have been able to show through surveys that respondents associate symmetry with facial attractiveness, and many plastic and cosmetic surgeons take into account certain proportions and geometry when assessing a patient’s face. Some even assess how close a patient’s facial measurements are to a ratio of 1:1.62, also known as Phi or the “Golden Ratio.”
But perfect facial symmetry does not exist in nature; every person’s face is at least slightly asymmetrical. This is easily demonstrated through a simple photography exercise.
As William H. Truswell, MD, President-elect of American Academy of Facial Plastic & Reconstructive Surgery (AAFPRS), explains, “Even the most beautiful and seemingly symmetrical of faces can be photographed, the image divided in half on a computer and two faces assembled from the two right halves joined together and two left halves likewise. The result will be two very different faces than the original face.”
Moreover, few plastic surgeons believe that perfect symmetry is the goal. “The combination of proportion, shape, and volume are probably more important than facial symmetry in terms of true beauty” says Demby. “Linda Evangelista comes immediately to mind. During her super model days in the 1980s photographs frequently documented her upper facial asymmetry. Yet, she was stunningly beautiful. So for some, asymmetry can actually create a uniqueness to their beauty.”
This sentiment is echoed by Dr. Maria Lombardo, a cosmetic surgeon in Rancho Mirage, California. “We do interpret ‘different’ as interesting in some cases,” says Dr. Lombardo. “A man with a particularly strong jawline (that doesn’t fit the Golden Rule exactly) is perceived as more masculine, which is considered attractive as well. For a woman, an example might be a particularly high cheek bone that makes her stand out despite being outside of the classic Golden Rule.”
Dr. Gregory A. Buford, MD, FACS, of Englewood, Colorado, also agrees, stating that the presence of asymmetry can actually create beauty. But he also points out the flipside: “A little goes a long way… too much asymmetry and beauty decreases. And this holds true for both men and women.”
In fact, significant facial asymmetry can be the source of both functional problems and aesthetic issues. Consequently, when a patient complains of facial asymmetry to a surgeon, the surgeon will investigate the underlying cause.
A thorough assessment of facial asymmetry usually means looking at patient history, a physical exam, and possibly medical imaging tests, the last of which can make it easier for a surgeon to make an objective diagnosis and take a more accurate measurement of the patient’s facial symmetry. It can also help the surgeon decide on a treatment plan. Soft tissue, skeletal and dental disparities between the right side and left side of the face, are part of any comprehensive evaluation of facial symmetry.
Face Symmetry Calculators
For a true analysis of your facial symmetry you should turn to a pro — in other words, a board certified plastic surgeon or facial plastic surgeon. But it’s also possible to get a rough idea of whether you have an asymmetrical face. In fact, there’s an app for that — several, actually — not to mention websites, to help you in this endeavor.
For example, the facial symmetry test SymFace allows you to upload a photo of yourself and then provides you with a symmetry score. Another DIY option is to try dividing a photo of yourself in two and then reversing one side, using PhotoShop or another program.
But since perfect symmetry isn’t the goal anyway, you don’t really need this facial symmetry tool or any of the other newfangled digital tools to analyze your facial symmetry.
“While there are probably apps that will point out asymmetry and compare one side of the face to the other, detecting asymmetry is as simple as taking a photograph (of a straight-on headshot) and carefully analyzing that photo for differences in volume, lines and wrinkles, and other suggestions of asymmetry,” says Buford.
How Can Facial Asymmetry be Corrected?
In many cases there is no reason to correct facial asymmetry. However, for those that do require treatment, facial asymmetry correction basically comes in two forms: minimally invasive treatments and surgery.
Slight asymmetries can easily be addressed with certain minimally invasive treatments.
For example, fillers such as Radiesse, Voluma or Sculptra can be administered to add volume to one side of the cheek or jaw. Botox is used by some surgeons to help reduce the prominence of the jaw or raise an eyebrow that sits too low. Even nasal asymmetries can be addressed in some cases. “Tiny amounts of filler, in the right places, can create the illusion of straightening a nose or diminishing a hump,” says Lombardo.
Indeed, the fact that so many people are talking about facial symmetry these days is due in part to today’s use of soft fillers, according to Dembny. “From a current plastic surgeon’s standpoint, the attention given to facial asymmetry is probably more prevalent than it ever has been. Today’s use of soft tissue fillers always includes an assessment of facial shape, volume, and symmetry,” he explains.
“Soft tissue fillers are no longer just ‘line fillers,’” he continues. “These products are now more appropriately used for facial volume restoration and/or enhancement. In order to properly restore and enhance facial volume, particular attention is also paid to shape and symmetry. The key to a successful soft tissue filler treatment is to improve and/or restore facial volume while at the same time maintaining and/or enhancing facial contours and improving facial asymmetries.”
Asymmetrical Face Surgery
If the asymmetry is severe, with noticeable skeletal differences between the right and left sides of the face, administering facial fillers may result in a “doughy” appearance. In these cases some surgeons recommend the use of facial implants to balance out the face.
Truswell says that while surgery cannot create perfect symmetry it can improve it in some cases. Examples he cites include using two different sized cheek implants in the case of mid-face imbalance; a unilateral brow or forehead lift to elevate a lower eyebrow and bring it more in line with the higher side; and surgery for one protruding ear to reduce the projection and match the unaffected side.
But Truswell also points out that in some cases neither a surgical procedure nor minimally invasive treatments are necessary because proper use of cosmetics can camouflage certain imbalances. And it should also be noted that aging of the soft tissues of the face can eventually make facial implants look out of place, in some cases.
In the end, the only way you will know for sure if you would benefit from cosmetic treatment for your facial asymmetries is to visit a board certified plastic surgeon or facial plastic surgeon.
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