36, Female, Facial Asymmetry — what are my options? (Photos)

Question

Hi, I am a 36 year old female and for some time now I have noticed the right side of my face appears to be ‘lazy’ and wondering what could be causing this or if it is just part of the aging process? The left side of my face is still quite youthful and tight even though I have always slept on my left side. It is particularly noticeable when I smile and you will see in the photos my right eyelid is lazy and my right lip and cheek droop down which causes a puckering of the skin around my mouth on that side. Wondering what surgical options could help with this? Or should I wait until my 40’s and have it corrected once I am ready for a full facelift? Thank you

Semih Yildiz, MD, FEPOBRAS · Answer

The photos show more asymmetry around the right eyelid, cheek, and mouth corner, especially with expression, but photos alone cannot tell whether this is aging, eyelid/brow position, muscle imbalance, volume difference, or a nerve-related issue. Because you describe one side as lazy, an in-person exam is important; if this is new, worsening, or associated with weakness, numbness, headaches, or speech/vision symptoms, it should be assessed medically rather than treated as cosmetic aging.

At 36, a full facelift is usually not the first answer for this pattern. Depending on the exam, options may include careful eyelid or brow evaluation, small-volume filler or fat grafting, selective neuromodulator treatment, skin tightening, or a more targeted lower-face plan. Start with a board-certified plastic surgeon, and sometimes an oculoplastic surgeon or neurologist, before deciding on any surgery.

36, Female, Facial Asymmetry — what are my options? (Photos)

Answers (1)

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