Would a genioplasty help me achieve a more balanced appearance? (photos)

Question

As you can see, I have slight facial asymmetry which I know is normal but it bothers me. My right side has a bigger cheek and the bottom of the cheek looks pre hollow. And my left cheek is flatter but led of a nasolabial fold. It looks like my jaw is less big on my right side than my left. I want to get the least invasive kind of surgery to try and balance out my face. In the 2/3 views we can see the differences in chin and jaw on each side.

Mats Hagstrom, MD (license on probation) · Answer

Facial aesthetics, especially when assessed in young people is completely determined by facial skeletal structure.
It is facial skeletal structure that gives each unique person, their unique facial appearance, including the ability for computers to recognize us.
This is true whether the outcome is desirable or not so much.
 For this reason at improving facial aesthetics with soft tissue manipulation is inherently going to be limited.
It is also facial skeletal structure that determines our degree of asymmetry which, as you know, all of us have.
Attempting to correct skeletal asymmetry with soft tissue manipulation will simply only create two different asymmetries.
addressing this on Fundamental level treating the primary underlying ideology requires craniofacial surgery.
Simplistic approaches aren’t going to deliver quality outcomes.
Because facial asymmetry is normal and the human brain as accustomed to seeing it as normal it is better left alone, impaired
I’m not saying there aren’t individual cases where someone may glance a second look but generally speaking of the human brain as a custom to seeing substantial degrees of facial asymmetry to the point where it normally is not recognized.
 For example you probably don’t see your immediate friends and family as having significant facial asymmetry even though every single one of them does.
Degree of a symmetry is slightly more than most.
Your chin, however, is not contributing to the asymmetry and is balanced in both vertical and horizontal projection.
For that reason, I don’t see a good indication for a genioplasty.
 The most simplistic approach at addressing facial symmetry is by filler enhancement.
You can try that and see where it takes you.
If you want to go that route, then with it almost every single plastic surgery procedure I urge you to focus your efforts on finding the best provider.
 Injecting fillers may seem fairly simple and straightforward, but getting consistent outcomes as far from it.
To see what can be accomplished using facial fillers, perhaps not directed at treating a symmetry I consider you look at the work of Dr. David Mabrie MD in San Francisco.
Real self will not allow me to include a website link so you’ll have to look up his website.
David is a facial plastic surgeon whose practice is devoted exclusively to working with facial fillers.
His work is the best I’ve ever seen and his work represents what I believe is the gold standard for this type of treatment.
I’m not suggesting people fly to San Francisco to get fillers, but I do believe that looking at his work serves as an important educational tool for people to understand what fillers can accomplish in the hands of the right provider.
 Once people know what fillers can accomplish, they can look for local providers who have similar levels of skill, though I think it’ll be difficult to find anyone whose work is comparable to David’s. 
Flat grafting may seem like a desirable alternative.
I highly recommend avoiding fat grafting specifically for the purpose of treating a symmetry.
Grafting fat in the face is bites very nature unpredictable, imprecise, and potentially unforgiving if you don’t like the outcome.
Definitely start with fillers first because fillers unlike grafting fat is Precise, predictable and forgiving if you don’t like the outcome.
I don’t really see any good treatment options and for the issues you bring forward the treatment is really either correcting the underlying Ideology which is highly invasive and involved or leaving it alone.
I recommend you learn to accept your face for being what it is, which is attractive, balanced, and slightly asymmetric.
When it comes to, judging our own, a symmetry intends to lead some people down as slippery slope of focusing on it more and more.
A better option is to stop looking for treatments because in doing so it reinforces the belief that something needs to be done.
 Nothing needs to be done and nothing should be done.
Best,
Mats Hagstrom MD

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