I am a 37 year old female with microtia in the left ear. I have thought long and hard about pursuing the reconstructive surgery but I have decided not to proceed with it. I think I have become a little more comfortable with the situation just understanding more about the condition and I am also deterred by the uncertainity and expense. I am however interested in any suitable option to improve my facial assymmetry. Are there any options available to do so?
What is the Best Option to Improve Facial Asymmetry? (photo)
Doctor Answers 2
Facial Asymmetry Options
You likely have a form of what is called "hemifacial microsomia", which is a developmental facial growth discrepancy (and manifested in your case by also having the microtia). Focusing on the facial asymmetry concerns, there are a couple of paths you can consider. You could consider using filler materials to soften the asymmetries, but this would take alot of injection material and would likely require recurrent injections (which would add up to quite an expense). The surgical options include formal orthognathic surgery to lengthen the left side of your face and level the dentition/mouth (this would likely require orthodontics before surgery). This is a very involved process that many patients feel is just too much and you would likely still have some asymmetries requiring implants, etc.
My recommendation would be the following:
1. a size-specific left cheek ("malar") implant: this would hopefully improve the balance of the upper face
2. a left outer jaw ("mandibular angle") implant: this would hopefully improve the balance of the outer lower face.
3. chin bone surgery ("leveling genioplasty"): this is a clever procedured that moves the chin point to the midline.
Together all of these procedures may not completely balance your asymmetric face but would give the impression of significant improvement and take away from the significant facial asymmetry. I have numerous patient that I have treated with similar asymmetries who are quite satisfied with this "compromise" approach.
Finally, when choosing a physician, the key is that your physician is experienced and can show you their favorable results for your type of situation. While "Board" certification is important, skill and talent is equally desirable. Good luck to you!
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