What Can Be Done About Facial Asymmetry That Results from Hematoma?

During a car accident in 2007, face hit dash board. Large hematoma developed on right cheek. End result: 1 cheek that is way larger than the other. It is very noticeable when I smile and in photos. Some scarring on the skin where it burst open from pressure and on the inside of mouth there is scar tissue that effects facial expressions. It’s really bad to hate your own face. I just want to know where I can get some help in this area from someone who knows what they are talking about. Thanks

Doctor Answers 3

Treatment of chronic organized hematoma

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Your posted photos corroborate your concerns. This is most likely an organized hematoma that will not go away on its own. If it was elsewhere on the body and superficial its removal would be straightforward. It is more complicated in the face because of the likely proximity to and difficult separation from muscles and nerves of facial expression. You will need an MRI to assess these spatial relationships and allow planning for surgery. From just the photo it is impossible to know if the approach should be from the outside, inside the mouth or both. Even if the residual hematoma is partially or completely removed you need to know the right side will most likely not look as it was before the injury.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon

Facial asymmetry from a hematoma.

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Presumably you were assessed at the time of the accident for fractures of the facial bones.  Generally the hematomas spontaneously resolve.  It is interesting how you do have a much larger right cheek.  It would be helpful to review photographs of you prior to your accident to see if this asymmetry existed prior to your accident. Either way, I would recommend being assessed by a board certified general plastic surgeon or a fellowship trained facial plastic surgeon who focuses their practice on facial issues to help assess you.  It should be possible to get the care you need in your community.  You might start by seeing what surgeons are on your insurance panel to minimize your out of pocket expenses for this assessment which may require facial imaging.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews


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This a very complex problem. I suggest you contact and consult several facial plastic and plastic surgeons for opinions. Your doctor needs to see feel and perhaps scan the area to see what can be done without risking fascial nerve damage

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.