Why is my jaw so crooked? (photo)

Question

Hello, despite what people tell me I know my face (particularly my jaw) is crooked. When I smile my jaw tends to point towards the left. My eyes are also completely uneven as one seems to be much higher then the other. My bite is completely fine so I don't know what it could be? When I look in the mirror my face looks asymmetric but not drastically but in pictures it looks much worse Could this be fixed? Thank you!

Mike Majmundar, MD · Answer

You do have some asymmetry in your jaw.  Actually, you also have some mild asymmetries in your face.  It appears the left side of your face is slightly smaller than your right (lower brow, smaller cheekbone, and shorter jaw on left).  I would say greater than 95% of patients have asymmetry so it isn't unusual.  If it bothers you, adding volume to simulate the bony deficiency would be one way to acheive some symmetry.  There are many different ways of doing this including fat transfer, implants or fillers.  Fillers are a good place to start.

William Portuese, MD · Answer

There appears to be significant facial and bony mandible asymmetry. This is accentuated when you smile due to the soft tissues. One option would be to have sliding  genioplasty by an oral surgeon to fix this, especially so if the teeth are significantly out of  alignment. A custom carved chin implant performed under local anesthesia may be able to significantly improve this asymmetry,  as long as you are teeth are in good alignment. For more information about chin implants and many before and after chin implant examples,  please see the link and the video below

Kapil Saigal, MD, FACS · Answer

Many, and maybe all of us have some features that are asymmetric. They are what make us unique. The name for asymmetric cheekbones is mid-facial hypoplasia and in some cases can be helped with corrective surgery and/or filler treatments in certain cases. But for many of us, it's great to embrace these minor 'imperfections' and understand that they are very common. Discuss your case with a  specialist and good luck!

Barry L. Eppley, MD, DMD · Answer

If you look carefully at your face, the entire left side is slightly underdeveloped or hypoplastic. This is seen by a lower eyebrow, inferiorly positioned eyeball, smaller cheek, thinner soft tissues and shorter jaw from chin back to the jaw angles. The jaw asymmetry in particular is magnified when you smile as the soft tissue of the chin is pulled back and deviates to the weaker or less developed side. There are a variety of facial asymmetry procedures that can be done from the eyebrow down to the jawline/chin. What you would do depends on how much of the facial asymmetry bothers you and what asymmetry location is most disturbing. The chin/jawline is the most obvious to you and this can be treated by a sliding genioplasty to move the bony chin over to the midline possibly combined with a small jaw angle implant in the back.

John Frodel, MD · Answer

Yes, your face is asymmetric, but many faces are.  Ideally, you would have both upper and lower jaws moved into proper position.  A maxillofacial surgeon could discuss this option with you.  An alternative would be to build up the left side of your face (particularly the cheekbone and outer lower jaw areas) to try to match the more normal right side.  Some manipulations with your eyelids and eyebrow on the left could also be considered.  Please consult with a surgeon experienced with the treatment of facial asymmetries.

Gerald Wittenberg, MSc, DMD (retired) · Answer

You do have a growth pattern whereby the right side of the face is 'longer' than the left so that when you smile; and activate muscles, it becomes more apparent. Generally, it would involve the 'orbits' down to the lower jaw. An orthodontist and Maxillofacial surgeon can provide you with more information, if it concerns you, But it should not cause difficulties. Occasionally the TMJ area on the 'weaker side' can have symptoms, but it is variable.

David Alessi, MD - Account Suspended · Answer

Without an in-person exam, it is not possible to say what exactly is the issue.  The eyes seem to be at slightly different levels but most noticeable is the left brow being lower and the chin tilting to the left with smiling.  At rest, it appears symmetric.  You may have mainly an issue with your facial nerve.  Has your appearance gotten progressively more apparent?  Imaging should be done to evaluate you further before treatment is done.  If it is mainly a facial nerve issue, then Botox may help.  If it is indeed a boney asymmetry, then grafting or repositioning the bones may be required.  Best wishes.

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