How can I treat facial asymmetry, bulbous eyes and a long, bulbous nose? (Photo)

Question

I'm 46, I haven't been the best looking person in the past and now I look hideous, in the past 3 years my face has went from an oval quite symmetrical face to a droopy Asymmetrical mess, my eyes have become bulbous and I think I have ptosis, my face is very oblong and looks longer with a big jaw and chin, my nose is longer and has a very bulbous tip, my face just looks like an old hags, I thought I had acromegaly as my features do look enlarged and irregular, the tests came back neg

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.

Mats Hagstrom, MD (license on probation) · Answer

Facial aesthetics, and the ability to make accurate assessment is complex. 
You’re fine there is significant difference in skills and ability when it comes to not only for me treatment, but also when it comes to making assessment or having a clear understanding of why someones appearance looks the way it does.
Facial aesthetics is primarily determined by bone structure. Soft tissue covering tends to be far more consistent from person to person and what differentiates each individual person’s facial characteristics is fundamentally based on their skeletal structure.
For this reason, oral surgeons or surgeons with craniofacial background sometimes have an upper edge and having an understanding of primary principles regarding facial aesthetics.
Facial feminization surgery can be accomplished, and there are a lot of treatment options, depending on what somebody is willing to go through. I recommend getting the most thorough consultation possible including a cephalometric assessment. Once you have a good understanding of the various facial components, and what helps create more attractive facial features you can begin formulating a treatment plan together with appropriate providers.
Getting an assessment on someone with a craniofacial background as well as somebody from plastic surgery can both be useful. Plastic surgeons, soft tissue oriented because of our training. Oral surgeons tend to see if things more from a facial skeletal perspective.
In the end both skeletal and soft tissue manipulation, maybe indicated to get you a better aesthetic appearance.
Recognize this type of work is complex and to some degree subjective. You may get very different opinions from different providers. As providers to show you numerous before and after pictures of any proposed option. Look carefully for previous patients who have similar facial characteristics to your own, to get a good idea of what anyone the procedure can, or cannot accomplish.
Best,
Mats Hagstrom, MD

How can I treat facial asymmetry, bulbous eyes and a long, bulbous nose? (Photo)

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How can I treat facial asymmetry, bulbous eyes and a long, bulbous nose? (Photo)

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