We’ll cut right to the chase—facial asymmetry is completely normal. “100% of the population has an asymmetric face,” says Dr. Manish Shah, a board-certified plastic surgeon in Denver. Yes, this means that your features—eyes, nostrils, cheekbones—are, in fact, not exactly the same. Whether you’ve ever noticed the differences is another story, though facial asymmetry is what makes people feel like they have a “good side” and a “bad side,” points out Dr. Tanya Judge, a board-certified plastic surgeon in San Francisco.
So what causes facial asymmetry?
It’s simply a function of nature, stemming back to how the skull, face, and neck develop during the embryologic period, explains Dr. Shah. The head forms via two halves that come together, one of which is always slightly larger, creating asymmetry from the get-go, he explains. These differences can then become more prominent throughout childhood as the skull grows and changes over the first 14 to 17 years of life, he adds. After that point, your facial features stop changing, so it’s unlikely that you’ll notice any further asymmetries… until you start to age later in life.
“The face is made up of three different layers,” says Dr. Judge. “There’s the skin on top, then a soft tissue envelope made up of muscle and fat, and finally the bone underneath. As we age, all three of those layers start to change,” she explains. Bone structure shifts, fat and muscle start to sag, and collagen and elastin decrease in the skin, leading to a loss of firmness and elasticity. It’s why you may not notice any asymmetry until you start to get older—though sometimes it can be hard to pinpoint. “Many people come in and can’t figure out exactly what’s bothering them about their appearance. They simply feel like they suddenly don’t look like themselves. That’s when I can point out asymmetric differences and we can discuss options for correction,” says Dr. Judge.
Can facial asymmetry be corrected?
To that point, facial asymmetry can be corrected. The big caveat? Correction does not mean complete symmetry. “Features that are perfectly symmetric end up looking unnatural. We always want to leave some amount of subtle asymmetry,” says Dr. Judge. Dr. Shah agrees: “I tell my patients that their face is still going to be somewhat asymmetric after, just less so.”
How to correct facial asymmetry
There are various options for correction, all of which are geared toward adjusting and shifting that soft tissue envelope of fat and muscle as well as the overlying skin, explains Dr. Judge. (Changing the bone structure requires reconstructive surgery and is reserved for extreme facial asymmetry caused by congenital defects.) Correcting facial asymmetry with fillers is extremely popular, effective, and the most minimally invasive choice. “Hyaluronic acid fillers can be injected deep into the skin in the high points of the face, such as the cheekbone and jawline, to create an improved symmetry that’s very noticeable,” she says. They can also be injected more superficially, to make smaller corrections and fill in the hollows around the eyes (helping them appear to be more similar in size) or even around and on the nose to tweak its shape, she adds. (There is a wide array of HA fillers on the market, all with varying viscosities that make them better suited for use on different parts of the face.)
Dr. Shah points out that biostimulatory fillers, such as Radiesse, are also a good option for correcting facial asymmetry. “Unlike hyaluronic acid fillers, which add immediate volume but then get metabolized and disappear, these work long-term, stimulating the production of natural collagen and lasting anywhere from two to four years,” he explains. Either way, keep in mind that your provider will likely have to use a greater quantity of filler to correct asymmetry than they would for something such as filling in smile lines or plumping lips; this in turn increases your total cost. Dr. Shah says that sometimes up to four syringes are used, depending on the area being injected and the amount of asymmetry. Costs per syringe vary greatly, based on the actual filler being used and the provider. (As a point of reference, the doctors we spoke with charge anywhere between $375 and $900 per syringe.)
Facial fat transfer—in which your own fat is harvested from elsewhere on your body and then injected into the face—is another option. It can be used in the hollows around the upper eye, in the midface, at the jawline, or even at the temples to help create more symmetry, says Dr. Shah. The caveat here is that results are largely dependent on how your body metabolizes fat as well as the condition of the overlying skin. “We typically see great results in patients between the ages of 35 to 60 who still have nice skin firmness,” he adds. The procedure is costly, ranging anywhere from $1,500 to $7,000, depending on how much fat is injected, according to Dr. Shah.
Then there’s the option of plastic surgery for facial asymmetry. Implants are one route and are most commonly placed in the chin, cheek, or jawline, says Dr. Shah. Of these, chin implants are the least expensive ($3,000 to $4,000) and require the least amount of downtime, just a few days. Cheek and jaw implants require an intraoral incision and come with one to two weeks of recovery as well as a price tag of up to $7,000. Asymmetry can also be addressed during a facelift; a plastic surgeon can use slightly different techniques from side to 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 downtime is 12 to 14 days). Eyelid surgery is also an option for addressing asymmetry of the eyes, and it generally 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 realm of normal and what looks natural—and beautiful, says Dr. Judge. If it’s more significant than that or there’s a very noticeable difference that bothers you, take heart in knowing that there are plenty of ways to address the issue.
