Nerva damage thirty years ago caused asymmetry - Can my asymmetry be corrected during a facelift? (Photos)

Question

I have facial asymmetry from nerve damage during a dental procedure 30 years ago. Multiple nerve surgeons have told me I’m not a good candidate for nerve surgery because my asymmetry is too mild and too longstanding. What cosmetic techniques might help me? Most prominent is that my lip is not centered under my nose (as seen in photos). Less noticeable but bothersome are differences in my nasolabial folds and differences in the two sides of my face when I smile. I am planning a lower bleph and facelift later this year and hope there may be some way to help minimize the asymmetries during the surgery.

Guray Yesiladali, MD, FEBOPRAS · Answer

Facial asymmetry is one of the most challenging issues to address surgically, and it’s important to set realistic expectations from the start.
A facelift primarily repositions sagging tissues and improves overall contour and balance. It can soften the appearance of asymmetry caused by tissue descent, but it is not designed to fully correct asymmetry, especially when the differences are subtle or long standing.
When asymmetry is dynamic, meaning it becomes more noticeable with movement such as smiling or speaking, a facelift alone is usually not sufficient. These patterns are often related to underlying muscle activity, skeletal differences, or nerve related factors. In such cases, correction may only be possible with additional or alternative procedures, depending on the exact cause.
A careful in person evaluation is essential to determine whether the asymmetry is structural, dynamic, or a combination of both, and to decide which approach would be most appropriate.
I hope this helps clarify what a facelift can and cannot achieve. My wish is that you move forward with a plan that is thoughtful, realistic, and tailored to what will truly make a meaningful difference for you.

Arthur Dean Jabs, MD, PhD, FACS · Answer

Photos of your complete face resting and when smiling would help in this evaluation.

From what I see from the photos provided it is your lower lip that you see that is different at rest. The upper lip not being "centered" with the nose may be due to a nasal tip distortion more than the lip. I can't evaluate the situation when smiling.

A deep plane facelift along with judicious use of fillers for the lower lip would help.

Thank you for the question

Dr. Jabs

Albert Yang, MD · Answer

Hey, I can see the minor asymmetry of the upper lip. The bleph and facelift will not address this area. I see a lot of patients with this variation though where the lip is not aligned to the nose. I have used lip lift to improve this feature with some success.

Nerva damage thirty years ago caused asymmetry - Can my asymmetry be corrected during a facelift? (Photos)

Answers (3)

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