Fillers for structural facial asymmetry?

Question

Hi! I’ve had a Ct scan done, the tissue or cartilage between one side of my jaw is nearly gone—leaving my face pulling to one side. Without an invasive surgery, I am curious if I can use filler in my face so that it appears more symmetrical. If so, where would this be? My jaw? And/or chin? Side note: I have tried Botox in my masseter and have had mixed results.

Jason Emer, MD · Answer

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.

Giuseppe Fiore, MD · Answer

Hello, thanks for your question. Unfortunately without photos I am not able to give you a bespoke and specific answer of your concern. 
Based on your description, it sounds like you may have a condition called temporomandibular joint (TMJ) disorder ? ? , which can cause the cartilage in the joint to deteriorate and lead to facial asymmetry. While dermal fillers (or fat graft)  may be able to help improve the appearance of your face, it is important to consult with a qualified and experienced doctor to determine the best approach for your individual needs.
The specific location and amount of filler ( fat graft) needed to address facial asymmetry will depend on the underlying cause and severity of the issue. In some cases, filler may be injected into the jawline or chin to improve symmetry and balance. However, it is important to note that filler cannot replace missing cartilage or tissue, and is not a permanent solution.
In addition to filler, other non-invasive treatment options  may include physical therapy, jaw exercises, and the use of oral appliances to help realign the jaw. It is important to discuss all of your options with a qualified healthcare provider to determine the best approach for your individual needs and goals.
Hope this helps,
Dr Giuseppe Fiore

Oakville Plastic Surgery &amp; Medspa · Answer

From what you are describing, I believe filler will help with your concern as I've used filler many times to balance asymmetries, and volumize areas that are depleted. Unfortunately, we do not have a picture to assess the variance. An in person consultation is always best!

Fillers for structural facial asymmetry?

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