The whole right side of my face is lower than the left; even my ear, eyes and jaw. How can I fix it? (Photos)

Unfortunately as we get older the face falls and looses fat. A facelift will reposition the tissue that has fallen. You may need filler as well depending on your goals. See an experienced facelift surgeon who does natural facelifts. 

Real Self Answers 7-4-14

What is the length of time for a hematoma from nicked vein caused by Juvederm Voluma XC injection?
Most bruising following an injection of any kind is gone within a few days to a couple of weeks. There are however instances where a larger hematoma with bruising lasting longer which may change colors from the usual blue to green and even yellow as the hemoglobin breaks down. Usually these are not dangerous of grave concern but they may add extra swelling which is noticeable for a while. These can be treated with arnica montana, bromelain, warm compresses and massage. They can be aggravated by a person taking aspirin or other blood thinners prior to the injection.

Droopy the face or eyelids. What treatment would you recommend?
The photographs are of a young man with a beard who is thin and would appear to have a skin. There is mild lagophthalmos of a congenital nature bilaterally with some scleral show. Unless the patient more having symptoms of the eye exposure I would not recommend any surgery. The beard adequately covers any sagging and the eyelid exposure is probably well-tolerated by the patient.

How bad is my ptosis? Would correctional surgery be a good idea for me?
This young patient with Asian eyelids has mild hooding. If the patient desired a more Western block it would be appropriate to do an upper blepharoplasty with tacking of the eyelid skin to the insertion of the levator muscle to produce an upper eyelid crease. This would make the eyes appear more open. Attempting to correct ptosis without skin excision is not advisable as it probably would aggravate the hooding.

Is a too early to tell if I need a revision or not?
The patient relates having had initial eyelid ptosis surgery approximately 4 months ago which was revised approximately 2 weeks ago. No photograph is available. The patient notes one eyelid is lower than the other. A surgeon with 30 years experience doing blepharoplasties probably can predict if additional surgery might be needed. I would certainly encourage another opinion since the surgeon has done two surgeries already. Normally I would suggest waiting 6 weeks or longer following a surgery however to make a judgment.

Sutures showing below eye corner on upper cheek area after facelift and fat transfer. Is this normal?
The patient had a facelift and fat transfer approximately 2 months prior. She notes a suture showing by the eye and puffiness in the area of that transfer but no photographs are offered. Certainly the surgeon should know if the suture will absorb. There could even be some swelling around the fat transfer which subsequently will resolve. Although treatment of these areas is not complex I would suggest trusting your surgeon and giving it more time, perhaps another two months.

Can I get my lids like this without removing skin. Only doing a mini eye brow lift?
Two comparative photographs are given, one with the hair in a ponytail which the patient likes. Certainly the browlift would approximate the effect of the ponytail lift of the eyebrows. Photographs however indicate that the patient has a mild eyelid ptosis. The brows are only mildly ptotic, therefore the patient may want to do a ptosis correction on the upper lids rather than a browlift. Some medical conditions can cause eyelid ptosis and should be checked out.

Can a stitch on lateral canthus reduce or resolve my scleral show?
The various photographs show the patient in a slight upward gaze which naturally exaggerates any scleral show. A true frontal close-up picture of the eyelids would help assess the situation. If the patient has a true lagophthalmos of sufficient magnitude and especially if it is causing symptoms then a canthopexy would be appropriate. An alternative for some patients would be a lateral tarsorrhaphy or tacking attachment of the upper and lower eyelids but this would narrow the eyes somewhat. You should go to an experienced plastic surgeon for proper assessment and recommendations.

Could you tell me if I am a candidate for a neck/jowl liposuction or a mini lift?
The patient states that she is in her early 30s and expects a “no” response in regard to the possibility of a lift. Photograph shows there is mild asymmetry with perhaps some slight sagging on the right side in the area of the jaw line. Generally speaking the rest of the face is excellent. This provides an interesting insight into patient's expectations. It is not for the plastic surgeon to interpret the effect of a problem on a patient's self-esteem. While the occasional observer may feel a defect to be slight, and unimportant nevertheless the patient may feel considerable loss of self confidence because of it. Most people appreciate that virtually everyone has some mild asymmetry. There arefew people who are so affected by a rather minor difference as most would see at that it affects their self-confidence, ability to function or creates other problems. If the patient has a significant psychological problem associated with an insignificant defect counseling may be more appropriate. However in this instance I think a slight mini lift would probably help the patient. The patient would have to weigh the disadvantages, cost, recovery and other considerations against the possible benefit. Unless this were a severe handicap to the patient I probably would not recommend surgery. Liposuction, and perhaps even the new Thermitight could help improve without being overly aggressive.

The whole right side of my face is lower than the left; even my ear, eyes and jaw. How cane I fix it
Photographs demonstrate a significant developmental asymmetry in the face with the right face being smaller than the left. This would include both bone and soft tissue asymmetry. In severe instances of congenital asymmetry early craniofacial surgery might be indicated. That is the course extensive and somewhat hazardous surgery and generally is not done for any but the most severe defects. In an adult who has asymmetry (most of us have some) it may be possible to camouflage but not correct the difference. Sometimes fillers such s fat or Voluma can compensate for differences and occasionally minor corrective surgery may be indicated. Although never perfect the results can be very close.