Why is only one half of my face doing this? Help? How do I fix this?

Question

This asymmetrical situation going on here is literally about to drive me up the wall…. Why. And how do I fix my one eye and cheek!? I don’t even know what to call this or what to ask for besides half my face looks like it gave up on life lol.

Anna Chacon, MD, FAAD · Answer

Thank you for your question — I understand how distressing it can be when one side of your face doesn’t appear to match the other. Facial asymmetry is actually more common than most people realize, but when it becomes noticeable or changes over time, there may be underlying causes worth evaluating and treating.

Why Is One Side of Your Face Doing This?
Here are some common reasons why only one half of your face may appear droopier, puffier, or less defined:

Natural Asymmetry: Everyone has slight differences between the right and left sides of their face. Genetics, bone structure, and fat distribution can make one eye or cheek look different.

Volume Loss or Aging: Fat pads, muscle tone, and collagen break down over time — and sometimes unevenly. If one side of your face is aging faster, it may appear flatter or more sunken, especially in the midface/cheek area.

Sleeping Position or Habitual Movements: If you sleep predominantly on one side, it can compress facial structures over time. Similarly, uneven facial expressions or chewing on one side can affect muscle tone and skin texture.

Previous Treatments: Any past filler, Botox, or surgical interventions — even years ago — can affect current symmetry, especially if one side absorbed product faster or was treated more aggressively.

Lymphatic Drainage Issues: Puffiness or fluid retention on one side may be related to how your body drains fluid in the facial tissues, which can worsen with inflammation or posture.

Neuromuscular Conditions (Less Common): In rare cases, underlying nerve conditions can cause muscle weakness or asymmetry. If you’ve noticed a sudden, sharp change, it may be worth checking with a neurologist or facial nerve specialist.

How to Fix It
The solution depends on the specific cause, but here are some general and effective options:

Facial Balancing with Filler: Hyaluronic acid filler can restore volume where it’s deficient, such as in the cheek or tear trough, creating a more symmetrical appearance.

Botox for Muscle Rebalancing: Sometimes one side of the face is more active — Botox can help weaken overactive muscles or elevate weaker areas to match the other side.

Skin Tightening Treatments: Radiofrequency (RF), ultrasound (Ultherapy), or microneedling with RF can help firm and lift skin that appears looser or more aged on one side.

Lymphatic Drainage Massage: If puffiness or fluid retention is a factor, facial massage and proper hydration can improve symmetry.

Laser Resurfacing or Collagen-Stimulating Procedures: These treatments help even skin tone, texture, and support underlying collagen structure — beneficial if asymmetry is related to skin quality.

Final Thoughts
You’re not alone in noticing this — many people experience visible changes to one side of the face with time. The good news is, most cases are manageable with non-surgical approaches that balance out features and improve confidence. A facial assessment in person or via detailed imaging can help determine where volume or muscle imbalance is occurring and guide personalized treatment.

Camille Cash, MD · Answer

We have many tools to address facial asymmetry.  Botox and fillers are a great starting point.  Botox can soften lines from dynamic muscles, give a conservative brow lift, and improve hypertrophic jaw muscles.  Fillers can improve contours and asymmetries.  Other treatments such as Morpheus8 can improve overall skin tone and texture.  We also recommend using medical grade skin care products like Transform MD and wearing sunscreen every day.

Why is only one half of my face doing this? Help? How do I fix this?

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