What procedure would best correct my facial asymmetry? I have misaligned teeth and jaw after braces. (photos)

20 years old now, but I had braces from 12-16 and my orthodontist took out 4 teeth to correct slight bucked teeth and crooked bottom teeth. I think the braces made my bottom teeth shift to the right and become misaligned with my top teeth, slanting my jawline. The difference is especially prominent in my chin when I smile. I noticed when I got my braces off but didn't speak up. Is there anything that will reduce or fix the problem? Thanks so much in advance.

Doctor Answers 1

Facial Asymmetry following orthodontic manipulation

Dear Clairre94,

It appears from the photos that there may be some lower facial skeletal, or bony, asymmetry involving your maxilla and your mandible. Prior to embarking on any other form of aesthetic intervention, it is important you return back to your orthodontist and seek their advice as to the alignment of your teeth and the relationship between your upper jaw, called the maxilla, and your lower jaw, called the mandible. It is very, very common to have maxilla-mandibular skeletal dysplasia. Once you have had your teeth aligned with orthodontic work, you may then be a candidate for a longer-term corrective procedure called orthognathic surgery, where the upper bone of your jawline, called the maxilla, and the lower bone, called the mandible, may be broken and then realigned into a more aesthetically pleasing position, with or without movement of the chin point. This kind of aesthetic orthognathic surgery can be an excellent way to provide long-term stability for jawline asymmetries, jawline tilts (also called a cant) and chin/cheek asymmetries.

In the interim, if there is more orthodontic work that is required, soft tissue fillers can be extremely effective in correcting lower facial and upper facial asymmetries by performing a procedure called the Voluma™ lift, using Juvederm® Voluma™ to restore craniofacial/cheek/jawline facial aesthetics for many years. The use of the soft tissue fillers is a very low-risk way to achieve aesthetic contour improvement and also a way to assess, in your own mind, the kind of results you may want to achieve with orthognathic surgery. The Voluma™ lift, using Juvederm® Voluma™ or other products such as Radiesse®, Sculptra®, Restylane® and Perlane® can be a nice injectable soft tissue alternative to surgery, especially if further orthodontic procedures are required to migrate the teeth more.

To find out more about the injectable soft tissue option, please check out the link below provided on my website.
Seek the consultation of your orthodontist to ensure that your dental corrections provide normal occlusal surfaces and normal bite and then seek non-surgical or surgical consultations for any resulting bony asymmetry that may exist.

I trust that this helps.

R. Stephen Mulholland, M.D., Certified Plastic Surgeon, Yorkville, Toronto

Toronto Plastic Surgeon
4.6 out of 5 stars 93 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.