Procedure for asymmetrical cheekbones? (photo)

Question

I have noticed my upper cheeks or cheekbones are very asymmetric. My left side looks lower and more prominent than my right. My upper lip is also crooked. Is there a procedure that could minimize this.

Houtan Chaboki, MD · Answer

Asymmetry of the face is normal and expected to various degrees. Cosmetic surgery and treatments can help improve asymmetry, however, some asymmetry will still persist. Cheek augmentation options include non-surgical facial fillers such as Radiesse or Sculptra. Silicone cheek implants provide a permanent solution for cheek improvement. Only after a comprehensive evaluation can a plastic surgeon help determine appropriate options for you. Your surgeon can give more filler or place a larger implant on the smaller cheek. Best of luck.

	Dr. Chaboki

Carey Nease, MD · Answer

Subtle differences in the left and right side of the face are very normal in all people. When the asymmetry is very noticeable or bothersome, injectable fillers or fat transfer can be used to balance out the difference. Sometimes cheek implants are also appropriate when both sides need more volume, which is commonly lost with age. The lips shown in the photos look fine, but hyaluronic acid fillers are often used for minor corrections or enhancement.

David Shafer, MD, FACS · Answer

Most patients have some asymmetry if you look hard enough.  A very effective and minimally invasive way to help with facial asymmetry is with dermal fillers.  You can use products such as Juvederm, Restylane, Radiesse or Sculptra depending on the area treated and the volume required.  I would suggest setting up a consultation with an experienced injector.

	 

	Good Luck.

Dara Liotta, MD, FACS · Answer

Most of us have natural asymmetries in our faces. Many people (myself included) have one side of the face that is flatter and broader, and one that is fuller and more narrow. The most common place to observe this asymmetry is in the area of the cheekbones. In my experience, women tend to notice it in themselves more than men, because women tend to notice as they put their blush on, that one side requires a bit more than the other to achieve the same highlighting effect.

	Just as you can camouflage asymmetries in the cheeks and lips with makeup, you can also camouflage them in a more semi-permanent way with injectable facial fillers such as Perlane, Juvaderm, or Restylane.

	The advantage of the hyaluronic acid facial fillers mentioned above is that they are easy to do, and are not permanent if you DON'T love the results. The disadvantage is that they are not permanent if you DO love the results. The hyaluronic acid fillers last about 5-6 months in the lips and 9-12 months in the cheeks.  The more mobile an area is, the quicker the filler is absorbed.  The most permanent solution is a custom designed implant. 

	I would recommend consultation with an experienced injector and/or surgeon.  Good luck!

Pablo Prichard, MD · Answer

Dear Cvb,

	thank you for your question and photos.  It appears you have a very mild asymmetry which most people have.  Cheek augmentation would be over-kill for you.  Fillers will provide temporary improvement, as they will dissolve and go away.  I would recommend fat grafting to the face as a permanent way to even out this asymmetry.

	Best Wishes,

	Pablo Prichard, MD

Mohsen Tavoussi, MD, DO · Answer

Facial asymmetry is the rule in everyone and may be more prominent in some. The fillers, whether temporary or permanent can correct these mild to moderate deformities. Surgical correction will include custom made precise cheek and jaw implants to fit your facial structure.

Darryl J. Blinski, MD · Answer

Very minor genetic/anatomic asymmetry is noted in the posted photos. Try fillers to cheek area on the right or even fat grafts. As for lips I would not attempt any correction.

Michael A. Carron, MD · Answer

It is quite a matter of fact that no one person possesses a perfectly symmetric right and left side of the face. In fact, if you closely examine the face of every person there is one side that is slightly "shorter", slightly "flatter" and the chin on that side is slightly elevated. The lip on this side is also slightly elevated and retracted. The reason for this is that there is less bone on the entire facial skeleton on this side of the face. When the asymmetry becomes quite evident to the casual observer "the grocery store test" then one may consider the situation to be more amenable to correction. Custom implants, injections with various fillers and even surgery to re-position the bone are all available. However, in your case the asymmetry is in the realm of what we are to expect just by the nature of being human and I would not suggest the pursuit of correction.

Michael Bowman, MD · Answer

When you analyze faces everyday, you get an appreciation for how common asymmetries truly are.  All of use have asymmetries in our appearance, ranging from small and subtle to more prominent.  I would urge you to keep in mind that you are a beautiful woman, with very nice features.  I do appreciate the asymmetry that you describe, but I can assure you that most everyone does not notice those things about you.  We are certainly our own worst critics.  Therefore, I usually stress to patients that perfect symmetry is not attainable, but we can often improve these findings without much difficulty.

	Seek consultation with a local physician who is appropriately boarded and get his/her recommendations.  A HA filler will be effective at balancing your lips and can be used in the cheeks as well.   Other options for the cheeks including Sculptra, fat transfer, Radiesse, etc.  Your local MD will discuss the risks and benefits of these different treatments in detail and help you find the best one.  Best wishes.

Richard W. Fleming, MD (retired) · Answer

Facial asymmetries are usually treated with implants or injectables such as fat or fillers. Consult with an experienced surgeon who uses all techniques to discuss the options and the advantages and disadvantages of each.

Procedure for asymmetrical cheekbones? (photo)

Answers (11)

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