One side of my face is more droopy than the other. Is it slight bells palsy? (Photo)

Question

I noticed this drooping about a year ago. I'm having acupuncture at the moment. I've had 5 sessions but I'm losing hope. In certain lights and on photos it looks terrible. Is it slight bells palsy? The corner of my mouth turns down too on the effected side. My face works fine. I have no other problems.

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. I suggest that you move forward and consult with a board certified facial plastic surgeon or a board certified neurologist to review the effects of the Botox procedure. 
Best wishes,

David Chappell, MD · Answer

Bell's palsy is not uncommon. It occurs more often in the 20-60-year-old age group and is more common in diabetics. It is usually thought to be a viral-triggered inflammation to the facial nerve, usually on one side and usually affecting both the upper and lower facial muscles. If your muscles move well, the asymmetry in your face might not be due to facial nerve paralysis. A neurologist could help establish or exclude the diagnosis by doing a test called an electromyography (EMG), which measures the electrical activity of the nerve. Bell's palsy usually goes away even without treatment. If you have stable asymmetry for months it is possible that carefully placed Botox injections could reduce it.

Rita Rakus, MBBS - Account Suspended · Answer

Hello and thanks for your question. Without a face to face assessment of your facial muscles it its very difficult to assess this. Please visit your primary care physician for a full assessment. Always go to a qualified and experienced practitioner, best wishes

F. Victor Rueckl, MD (in memoriam) · Answer

It's very hard to tell from your photo. It's best to schedule a visit with a neurologist. There's testing specifically for Bells Palsy that will show if you do or do not have it, or if some other neurological issue is occurring. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

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