It is facial skeletal structure that gives each unique person, their unique facial appearance, whether attractive or not so much. Soft tissue coverage seems to be much more consistent from person to person and it is bone structure that gives each person their unique individual look. Changing facial, skeletal structure can be done, but is often quite involved and people often look for a Softer gentler approach. It is however important to recognize that When we apply soft tissue solutions to problems, which are primarily based on skeletal structure, the best we can hope for is a partial improvement.All people have facial asymmetry. Primary facial asymmetry is almost always based on skeletal structure. During embryological development, the two sides of the face develop independently from each other and eventually fuse in the midline. The human brain is an accustomed to seeing facial asymmetry as being normal because everybody has it. We usually don’t think of immediate friends and family as having asymmetrical faces, even though all of them do.Facial aesthetics is primarily based on balance and the relationship between an anatomic structures rather than symmetry. Because facial asymmetry is based on bone structure attempts at soft tissue solutions typically only create a second asymmetry. In your case, your left orbit does sit off-balance and is placed closer to the midline than the right side. This does Change your facial balance to the point where it may be noticeable to others. People typically don’t bring things like that up because it can be a sensitive subject. You may have better insight of this your self. Do people do a second look? Moving the orbit is probably more than most people want to undergo. If you want to get a formal assessment, then consult with craniofacial surgeons who do complex craniofacial surgery. surgeons to do this kind of work can either come from an oral surgery background or plastic surgery background. A lot of this type of surgery are done on children but it can be considered at any age, I’m not saying that you should or should not consider this kind of surgery. I’m only saying that if you want a quality assessment then get that by those who do this type of work. There may be easier options, focused on emphasizing projection and size of your right midface. As I mentioned earlier, I typically stay away from a asymmetry treatment, but in your case, it may be justified.Midface filler could be an attractive option, and this could potentially be done with a slight greater emphasis on the right side to create slightly better balance. Doing this kind of work well is a real art that not all providers are good at. I often refer people to the website 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 on your own. David is a facial plastic surgeon whose practice is devoted exclusively to facial enhancement only using fillers. His work is the best I’ve ever seen, and I consider his results the gold standard. His website has incredible collection of before, and after pictures. I’m not suggesting people fly to San Francisco to get fillers But seeing his results can be a powerful educational tool to understand what can be achieved using only this non-surgical treatment When doing a facial assessment, we often divide the face into an upper third, and mid third and a lower 1/3. The mid third is related to the size and shape of the maxilla while the lower third of the face is related to the shape and size of the mandible. In your case, the mid third is slightly dominant in relationship to the lower 1/3. In your profile picture your mandible is slightly lacking in projection in relationship to the Maxilla. Your upper lip has slightly more projection than your lower lip, even though the lower lip is larger. I’m guessing you have at least a slight overbite dental occlusion. Your upper lip is also slightly short so you have a lot of tooth show when you smile. There are procedures that can lower the upper lip which may be something to consider. Augmenting the chin and giving better definition to the mentalis region with fillers could also be an improvement.Your chin could use slightly more projection in a forward and downward direction, giving both vertical and horizontal advancement this can be done with fillers, a sliding genioplasty or potentially an implant You already have a labiomental sulcus so forward projection needs to be done cautiously, if considered. All of this work is without question complex. Expect providers to have a variety of different ideas and recommendations. Recognize that providers are going to give recommendations based on their background and what they have available at their disposal. A nurse injector at a med spa is not going to recommend training facial surgery. An oral surgeon likewise may not recommend that you stick with fillers. If major operations are out of the question, then you can probably hold off on getting an assessment, though personally, I do believe getting the most comprehensive assessment of fundamental primary variables is the best place to start. Even if you opted for nonsurgical options having the best understanding of your facial dynamics can help make decisions of lesser treatments. Always recognize the treatments that don’t address primary underlying ideologies are going to give partial improvements at most. Keep expectations real and always try to find the most talented providers. In the end, provider selection is probably the most important variable, regardless of treatment option. For that reason, I recommend you consider having in person consultations exclusively (avoid virtual consultations) with multiple providers. Anytime there is no straightforward solution and the problem is complex expect people to have it very different opinions. If there was an easy straightforward solution than everybody would be doing the same thing. Best, Mats Hagstrom MD