We’ll get straight to the point – facial asymmetry is entirely normal. “One hundred percent of the population has an uneven face,” remarks Dr. Manish Shah, a board-certified plastic surgeon in Denver. Yes, this implies that your features – eyes, nostrils, cheekbones – are, in actuality, not precisely alike. Whether you have ever noticed these disparities is a different matter, although facial asymmetry is what makes people sense that they have a “preferred side” and a “less preferred side,” notes Dr. Tanya Judge, a board-certified plastic surgeon in San Francisco.
So what leads to facial asymmetry?
It’s merely a natural phenomenon, originating from how the skull, face, and neck develop during the embryological period, clarifies Dr. Shah. The head forms by two halves coming together, with one always being marginally larger, generating asymmetry from the beginning, he elaborates. These distinctions can then become more conspicuous throughout childhood as the skull grows and alters during the first 14 to 17 years of life, he adds. Beyond that point, your facial features cease changing, so it’s improbable that you’ll notice any additional asymmetries… until you start to age in later life.
“The face consists of three distinct layers,” states Dr. Judge. “There’s the skin on top, then a soft tissue covering composed of muscle and fat, and ultimately the bone beneath. As we age, all three of these layers commence to change,” she explains. The bone structure shifts, fat and muscle start to droop, and collagen and elastin decrease in the skin, resulting in a loss of firmness and elasticity. That’s why you might not notice any asymmetry until you begin to grow older – though sometimes it can be difficult to precisely identify. “Many individuals come in and can’t determine exactly what’s bothering them about their appearance. They simply have the feeling that they suddenly don’t resemble themselves. That’s when I can point out the asymmetric differences and we can discuss options for rectification,” says Dr. Judge.
Can facial asymmetry be remedied?
On this note, facial asymmetry can be addressed. The significant caveat? Rectification doesn’t imply complete symmetry. “Features that are perfectly symmetrical end up looking unnatural. We always aim to retain a certain degree of subtle asymmetry,” says Dr. Judge. Dr. Shah concurs: “I tell my patients that their face will still be somewhat asymmetric after, just to a lesser extent.”
How to correct facial asymmetry
There are numerous options for correction, all of which are directed towards adjusting and modifying that soft tissue covering of fat and muscle as well as the overlying skin, elaborates Dr. Judge. (Altering the bone structure requires reconstructive surgery and is reserved for extreme facial asymmetry caused by congenital flaws.) Correcting facial asymmetry with fillers is highly popular, effective, and the most minimally invasive option. “Hyaluronic acid fillers can be injected deep into the skin at the prominent points of the face, such as the cheekbone and jawline, to create an enhanced symmetry that’s very perceptible,” she says. They can also be injected more superficially to make minor corrections and fill in the hollows around the eyes (helping them appear more similar in size) or even around and on the nose to adjust its shape, she adds. (There is a wide range of HA fillers in the market, all with varying viscosities that make them more suitable for use on different areas of the face.)
Dr. Shah indicates that biostimulatory fillers, such as Radiesse, are also a favorable option for correcting facial asymmetry. “Unlike hyaluronic acid fillers, which add immediate volume but then get metabolized and vanish, these operate in the long term, stimulating the production of natural collagen and lasting anywhere from two to four years,” he explains. In any case, bear in mind that your provider is likely to need to use a larger quantity of filler to correct asymmetry than they would for something like filling in smile lines or plumping lips; this in turn boosts your total expense. Dr. Shah states that sometimes up to four syringes are utilized, depending on the area being injected and the degree of asymmetry. Costs per syringe vary significantly, based on the actual filler employed and the provider. (As a reference point, the doctors we conversed with charge anywhere between $375 and $900 per syringe.)
Facial fat transfer – where your own fat is harvested from elsewhere on your body and then injected into the face – is another alternative. It can be employed in the hollows around the upper eye, in the midface, at the jawline, or even at the temples to assist in creating more symmetry, says Dr. Shah. The caution here is that results largely depend on how your body metabolizes fat as well as the condition of the overlying skin. “We typically observe excellent outcomes in patients between the ages of 35 and 60 who still have good skin firmness,” he adds. The procedure is expensive, ranging from $1,500 to $7,000, depending on the amount of fat injected, according to Dr. Shah.
Then there’s the option of plastic surgery for facial asymmetry. Implants are one approach and are most commonly placed in the chin, cheek, or jawline, says Dr. Shah. Among these, chin implants are the least costly ($3,000 to $4,000) and require the least downtime, just a few days. Cheek and jaw implants require an intraoral incision and come with one to two weeks of recovery along with a price of up to $7,000. Asymmetry can also be dealt with during a facelift; a plastic surgeon can use slightly different techniques on each side to help create a more symmetrical appearance, says Dr. Judge. (According to RealSelf users, the average cost of a facelift is $12,175 and the downtime is 12 to 14 days). Eyelid surgery is also an option for addressing asymmetry of the eyes, and it typically costs around $5,000 to $8,000, according to Dr. Judge.
At the end of the day, a few millimeters of asymmetry between the different sides of your face is completely within the norm of what is natural and attractive, says Dr. Judge. If it’s more substantial than that or there’s a highly noticeable difference that troubles you, take comfort in knowing that there are numerous ways to handle the issue.
