What is the Best Way to Enhance my Facial Aesthetics, Get Rid of Asymetry and when Should I Commit to It (photo)

Question

I am a male, 19 years old, 6'1", 190 lbs, in shape and healthy. Mild kyphosis and scoliosis. My teeth are at a noticeable slant now. Ortho said I could revisit this when I turn 21 or 22 if I wanted to fix it with orthognathic surgery. If I decided to have a rhinoplasty and chin advancement and other cosmetic surgeries to help balance my asymmetry and enhance profile would I have to wait until after I had jaw surgery and would I even need it or would jaw surgery fix most of my problems?

	What is the Best Way to Enhance my Facial Aesthetics, Get Rid of Asymetry and when Should I Commit to It?

Toby Mayer, MD · Answer

Jaw surgery for facial balance would be the best place to start and you can always see how it turns out and have other surgery if you still feel unsatisfied.

William Portuese, MD · Answer

Orthognathic surgery should probably be performed first to address facial asymmetry. The nose can be performed 6 months after the orthognathic surgery. Asymmetries of the nose will need to be addressed by straightening the columella, osteotomies, asymmetrical alarplasty incisions to address the asymmetrical tip.

Alexander Ovchinsky, MD · Answer

It seems that your main problem is asymmetric lower jaw, which is shorter on the left side. This is called hemifacial microsomia, and many people have it to some extend. There are ways to correct this problem: orthognathic surgery, which is a true correction of size discrepancy, or lower jaw implants, which will camouflage it. Your nose has some dorsal hump and slightly droopy tip which may be corrected with routine rhinoplasty. If you decide to go with orthognathic surgery, then do it before rhinoplasty as it may affect the nose. On the other hand, lower jaw implant placement can be combined with rhinoplasty in one setting. Good luck.

Francis R. Palmer, III, MD (retired) · Answer

These are very good questions. Aesthetically speaking, your cheeks are quite flat and the chin is a bit weak. The nose has a slight hump and the nasal tip is a bit wide. If you want to correct your bite, this is best done prior to any Rhinoplasty as this will most likely change the shape of your nose. I do not use bone cuts (sliding genioplasty) for chin augmentation but prefer using chin implants made of silastic. The cheek implants would also be silastic. The goal is to make your face more angular and naturally attractive, not merely more symmetrical as people's faces can be quite symmetric, yet still not really attractive.

What is the Best Way to Enhance my Facial Aesthetics, Get Rid of Asymetry and when Should I Commit to It (photo)

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