Objectively why is my face slightly twisted/asymmetrical? What could I do to improve? How much would it cost? (Photo)

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.

None of us are completely symmetrical. If you look the most beautiful people in the world they are not symmetrical. If you do a split face and mirror image anyone they would no longer look like themselves. You can however correct some of the asymmetry with fillers and botox, but I suggest you concentrate on enhancing the parts that bother you rather than  trying to get perfect symmetry. 

It is typical to have about a half inch of asymmetry in the face and on our bodies.  As we age it becomes more obvious.  There are heat treatments like Pelleve, which is radio frequency heat that will bring up the temperature of the skin below the surface to a temperature that causes inflammation and wound healing to begin.  It is a non-surgical, non-invasive, no downtime, and can present instant results.  Another great way is the use of dermal fillers like Juvederm, Restylane, or Radiesse.  These are injected into the area, determined by your Dr. and instantly add volume to the area that is drooping, giving the face a more symmetry.Hope this helps and good luck on your journey to great skin.Dr. Ahmed