What to do about extreme face asymmetry? (Photos)

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Everyone has some asymmetries. Both implants and fillers in the cheeks can create good results for patients.  Both can build up the cheeks and create symmetry.  You must balance the pros and cons of each procedure and do what you feel is the best decision for you.
Fillers:
Pros: No downtime Reversible Quick
Cons: Temporary More expensive in long run
Implants Pros: Permanent Great for patients with poor bone structure Less expensive overtime
Negative: Risks associated with surgery Possible infection Downtime
I hope this helps.

As you have already heard many times, every face is asymmetric and mild asymmetry is considered normal. Based on these photos and short of clinical evaluation you belong within normal group. Many elements of asymmetry may improve with volume addition to same areas and reduction in others. However, good in person evaluation, discussion about your goals and expectations should come first. Good luck.

In facial asymmetry most affected patients will have one larger and one smaller side so to speak. I think the right side of your face is smaller and everything is more tilted towards that side The important diagnostic information is to get a 3D CT scan to determine the location and extent of the bony asuymmetries. From there a treatment plan is developed creating a list of the most important asymmetries to the least important and the procedures needed for them.

 I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  From the photo, your cheeks are concave in the front with the right the weaker side.  This gives the illusion of the center of the face tilting toward the right which has less mid face volume.  A lack of mid face volume also makes the face appear elongated.  In addition, as you mentioned, the left ear sits lower (also sticks out further from the face) and your lips are very thin. Following my beauty principles, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  The following procedures would create a more ruggedly handsome face.
Cheek augmentation using a dermal filler (temporary augmentation) or silastic cheek implants (permanent enhancement) to add angularity to the cheeks and mid face.  Liposuction can be combined to reduce any excess fat to further shape the cheeks and face.
Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line.An otoplasty can bring your left ear closer to the face thereby making it less noticeable.The lips can be augmented using a dermal filler or silastic lip implants.
  As a side note regarding using fat for facial shaping.  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or silastic facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.