What do you recommend for severe facial asymmetry? (Photo)

Thank you for your question and for the photo.
First, we are all asymmetric to an extent-- and my personal philosophy is not to chase perfect symmetry but to minimize asymmetries and create balance and harmony.
Nose: your nose is deviated from the nasal bones (possible prior trauma?) and septum. A septorhinoplasty with osteotomies, septoplasty, possible spreader graft will certainly help improve the deviation of the nose, and likely your breathing (if that is a problem. If you have other aesthetic concerns with your nose, those can be addressed at the same time.
Nasolabial Folds: you have some volume depletion of the midface (cheek area), and this contributes to the appearance of NLF. I would recommend filler in the midface to help improve the volume depletion and this will likely improve the NLF; if not enough, you can use filler in the NLF as well, however, I prefer to correct the cheeks first-- it gives a more natural appearance.
Brows: you can use botox/dysport to decrease wrinkles and I commonly use this re-shape brows.
I would recommend consulting with a Facial Plastic Surgeon or Plastic Surgeon that specializes in Rhinoplasty for more specific recommendations.
I hope this was helpful.
Best,Rosa B Lipin, MD

You have a congenital facial asymmetry in which the left side of your face is smaller. This affects all the features of your face on that side from the lower eyebrow/brow bone to the smaller and higher jawline on that side. (and every feature in between) To 'untwist' this type of facial asymmetry the key elements are raising the eyebrow/brow bone superiorly and building out the jawline with chin straightening inferiorly. The nose need to be realigned/reduced and the cheek built out on the left side. A preoperative 3D CT scan is needed for treatment planning purposes.