What can cause SUDDEN sunken eye, teeth drop, loss of cheeks, facial asymmetry? (photos)

Question

8 months ago suddenly my left eye become sunken in. Teeth on my left side dropped down. Since then I lost my chubby cheeks. Looks like my whole face is atrophying, with left side more visible. Eyes and cheeks sunken in, face got longer, especially in jaw area. Also nose looks bigger. Doctors thought on pituitary tumor (cos of jaw) but MRI was ok. Thyroid hormons (on ophthalmologist advice) were normal. Photos are showing two months changes. Please help me as no one seems to have an answer

Sirius K. Yoo, MD · Answer

Thank you for your question.  There are many causes of facial asymmetry and you probably need to consult with someone who sees a lot of craniofacial deformities.  It is impossible to guide you in the right direction from the these photos and history alone.  Certainly, you would want to look into "sick sinus syndrome",  "hemifacial microsomia", "Parry-Rhomberg Syndrome", among others.  MRI is often not the best study to look at the bony structure of the face (its great for the soft tissues though).  You need a CT scan for that.  See someone who specializes in this area.  All the best!

Adam J. Oppenheimer, MD, FACS · Answer

Some degree of facial asymmetry is common in everyone. Progressive facial asymmetry can be from a number of medical causes. If the changes are on one side only, two common causes can be Perry-Romberg syndrome or fibrous dysplasia.In Perry-Romberg syndrome, there is atrophy (loss) of the facial fat only on one side. The cause is unknown. The treatment is with fat grafting (where fat is taken with liposuction from parts of the body and injected into the depressed areas of the face). Often several treatments are required for full effect.For fibrous dysplasia, the treatment can be more complicated. CT scans are often required to determine the degree of bone involvement. Fibrous dysplasia involves the growth of abnormal bone masses that can be localized to the jaw and facial skeleton.It is best to be seen at a university hospital craniofacial center if you have not had good success with private practice providers. NYU has a world renown craniofacial team that would be able to be of service.

Naveen Somia, MBBS, PhD, FRACS · Answer

Thanks for your post.Sick sinus, Parry Romberg, Fibrous Dysplasia, Endocrine problems involving growth hormone or thyroid hormone are possible. You should consult with a CranioFacial Surgeon who can initiate a series of tests and scans to help you with the diagnosis. Other medical disciplines may be consulted as required.All the best

Dan Landmann, MD · Answer

There is certainly a difference between your eyes from one photo to the next. The best suggestion I can give you is to find an Oculo-Plastic Surgeon in your area. You may likely need a CT Scan, which shows different information than an MRI. Another common issue that causes eye asymmetry is Thyroid Eye Disease. You can have normal thyroid blood tests and have orbit findings years before the blood tests become abnormal. Good Luck!

What can cause SUDDEN sunken eye, teeth drop, loss of cheeks, facial asymmetry? (photos)

Answers (4)

Answer: Sunken Eye - Eye Asymmetry

Answer: Sunken Eye - Eye Asymmetry

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What can cause SUDDEN sunken eye, teeth drop, loss of cheeks, facial asymmetry? (photos)

Answers (4)

Answer: Sunken Eye - Eye Asymmetry

Answer: Sunken Eye - Eye Asymmetry

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