What can I do to improve my facial asymmetry? Doctor is recommending a facial fat transfer, looking for other opinions

Question

I’ve done a bimaxilliary osteotomy and I’m not too happy with my results. My face looks wider than it is long and my face is still quite asymmetrical. My doctor is now telling me to do a facial fat transfer. What do you think? What can I do to get a more symmetrical face?

Zoran Potparic, MD · Answer

Most patients have very mild form of facial asymmetry; facial fillers and fat grafting are procedures that can be used in most cases. However, it takes significant experience and extensive discussion with the patient to make decision what type of treatment is best suited for that particular face. Only on the basis of in person consultation with an experienced plastic surgeon with excellent reputation in facial surgery/rejuvenation you may find some answers. Keep searching. Good luck.

Mats Hagstrom, MD (license on probation) · Answer

You seem to be of the understanding that human face is supposed to be symmetrical.
It is not.
No one has a symmetrical face and the degree of asymmetry in the human face, torso and extremities is quite significant.
The human brain is accustomed to seeing peoples faces as a symmetrical. For that reason seeing a computer generated perfectly symmetrical face looks odd and less attractive than a normal asymmetrical face.
Each side of the face develops independent of each other during embryology eventually fusing in the midline.
The degree of asymmetry in your face is completely normal.
Most of the asymmetry is from skeletal structure.
If you graft fat to 1/2 of your face then you’ll have an asymmetrical bone structure and an asymmetrical fat distribution
The two don’t balance each other and have different appearances.
The first asymmetry is natural, normal while the other is created.
Grafting half of your face is a bad idea.
When you look around you don’t notice other people have the same degree of asymmetry all around you.
Likewise all the people who look at you don’t see someone who has an asymmetrical face.
The human mind is it custom to seeing a symmetrical faces as being completely normal.
Treating a symmetry that is within normal limits is a big mistake.
The results will not turn out the way you anticipate and there’s no indication for the treatment in the first place.
Asymmetry can be grotesque and severe. In those cases it’s treatable and in those cases everyone recognizes The person is abnormal.
The single exception for treating asymmetry is in women’s breast. Women tend to have highly asymmetrical breast.
For breast surgery we typically try to aim for improved symmetry.
Even with breast the left breast on both men and women typically sits 1/2 inch higher on the left side then on the right.
You can even check that yourself. If you put your finger in the inframammary fold on both sides you’ll see that most likely the left side is one finger breath higher than the right.
Treating a symmetry for the purpose of treating a symmetry does not lead to aesthetic improvements.
A substantial number of providers still are under the belief that symmetry is some kind of aesthetic goal.
I think it’s a bad idea to graft fat and half of your face.
Your face is attractive, looks normal and you don’t need surgical intervention in regards to aesthetics.
Best,
Mats Hagstrom MD

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