What can be done to treat my asymmetrical face?

Question

Hi there. My face is pretty assymetrical and I'm not sure if there is maybe one cause, or do I need to fix all asymmetry by itself. 1. My nose is tilted slightly right, sort of like a deviated septum. 2.My mouth is also slightly more on the same side as the nose. 3. I have straight teeth, my smile closes more on one side, which makes me think I may have a jaw issue or asymmetry 4. My lips are closed a bit more on left side when I smile. 5. My left eye and eyebrows are slightly higher Thank

David Bell, DDS, MD · Answer

Good morning. The surgical correction of facial asymmetry is a common problem that I treat.
You stated that "I'm not sure if there is maybe one cause" and indeed, the cause is almost always related primarily to the growth of the lower jaw. As a consequence, the growth of the upper jaw follows in almost all cases, the growth of the lower jaw. However, the asymmetry does not manifest itself only in one axis of rotation, but almost always creates asymmetries in the X, Y, and Z axes. The terms associated with these rotations are pitch (clockwise versus counterclockwise rotation when viewing a person's profile), roll (otherwise known as "cant"), and yaw (think of rotating your head to the left or your right). For a visual representation of what I am describing, please see the supporting link below from Wikipedia. 
Because of the inevitable complexity of facial asymmetries, you are able to see the consequences, namely, the "tilting of your nose to the right", your "mouth also slightly more on the same side as the nose", and your "smile closing more on one side". 
The visual appearance of having your left eye and eyebrow slightly higher may be related to the asymmetry also manifesting higher up in your face in the structure of your "cranium" rather than your facial bones, or it may be simply the consequence of the relative positions of your eye and eyebrow to structures in your lower face, thereby creating something of an optical illusion. Only an expert surgeon will be able to diagnose the problem. With the correct diagnosis, what one can one can achieve, is in almost all cases for greater than most people can imagine. With the wrong diagnosis and the wrong surgeon, your outcome will be a coin toss.
Thank you for your detailed description of your asymmetry and for your question.
Sincerely,
David David Bell, D.D.S., M.D.Diplomate of the American Board of Oral and Maxillofacial Surgery

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