Facial Asymmetry - Is it something serious? Would filler help? (Photos)

Question

My facial drooping in my right side just gotten worse over the years. It’s always been uneven but with age I notice it more. One side of my face is actually getting smaller it seems. Does this look like Parry-Romberg Syndrome or just typical facial droop to you? Could facial exercises help? Or is the only answer to get dermal filler/plastic surgery? I already get Botox in my forehead and brows. (Ps. I did have a dog bit and stitches on the side that droops about five years ago, could this trauma have something to do with it?)

Anna Chacon, MD, FAAD · Answer

Facial asymmetry can arise from various factors, including natural aging, previous trauma, or underlying medical conditions. In your case, the history of a dog bite and subsequent stitches on the affected side may have contributed to changes in facial symmetry.

Potential Causes:

Natural Aging: As we age, changes in skin elasticity and muscle tone can lead to asymmetry.
Previous Trauma: Injuries such as a dog bite can alter facial structure and symmetry.
Underlying Conditions: Conditions like Parry-Romberg Syndrome, a rare disorder characterized by progressive facial atrophy, can cause asymmetry. A thorough evaluation by a specialist is essential to confirm or rule out such conditions.
Treatment Options:

Dermal Fillers: These non-surgical treatments can add volume to specific areas, potentially improving symmetry. They offer temporary results and are a popular choice for those seeking less invasive options.

Plastic Surgery: For more significant asymmetry, surgical interventions can provide permanent solutions. However, they involve longer recovery times and higher costs.

Facial Exercises: While beneficial for muscle tone, facial exercises are unlikely to significantly alter structural asymmetry.

Given your current use of Botox, you may already be familiar with non-surgical cosmetic procedures. Consulting with a dermatologist or plastic surgeon can provide a comprehensive assessment of your situation. They can evaluate whether the trauma from the dog bite has contributed to the asymmetry and discuss potential interventions tailored to your needs.

Jeffrey H. Spiegel, MD · Answer

My rule of thumb is if you're trying to correct facial assymetry it's best to be examined by a trusted plastic surgeon before moving forward with any treatment. Dermal fillers are often a first good choice of treatment as they are reversible and can easily correct facial asymmetry, especially if you're young and one or two filler syringes can go a long way. Good luck, from Boston!

Darryl J. Blinski, MD · Answer

Based on your series of post facial photos, I would recommend nano and micro fat grafting under ultrasound. Fee $10,000-$12,000. Best of virtual consult with.

Camille Cash, MD · Answer

We all have facial asymmetry to some degree and yours is within normal limits.  It may be more noticeable to you since you see it every day.  Fillers are a great option to help add volume and balance to the face.  See an expert injector near you to discuss your concerns and learn more about your options.

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