Asymmetrical cheekbone structure and mid face descent, can anything be done to even the appearance? (photos)

Can anything be done to even the appearance of my cheeks? I've always had an asymmetrical face, with a cheekbone which is more anterior, but lower on the left, and higher but less developed on the right. As I've aged I've developed quite pronounced nasojugal folds, which are asymmetrical. I suspect much of the mid face descent is consequent to the fact that neither of the cheekbones is particularly well developed, giving a neutral/ negative vector. The orbicularis is quite loose on the right.

Doctor Answers 5

Can anything be done to even the appearance of my cheeks?

 Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years. Following the beauty principles outlined in my book on face and body beauty, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  From the photos, your cheeks are flat anteriorly (in the front), the chin is weak as are the mandibular angles and there is evidence of "malar bags" on both cheeks.  These combine to create an elongated rectangularly shaped face.  The following procedures would create a more ruggedly handsome face.

  • Cheek augmentation with cheek implants to add angularity to the cheeks and mid face. 
  • Chin augmentation, using a chin implant, to add projection to the chin creating harmony and balance to the lower face.  I have performed many Chin Augmentations using chin implants for over 30 years.  From the photos, your chin is weak.  A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.
  • Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line.

Hope this helps.


Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Cheek Asymmetry

The first question about your cheekbone asymmetry is which side do you like better? i suspect it is the higher right side even though it is less developed. (full) Cheek implants would work the best but would have to be custom made from a 3D CT scan to get the most symmetric result afterward. The use of standard cheek implants, no matter how they are adjusted for the differences between the two cheeks, will still end up with some visible asymmetry or could even make it more apparent.

Asymmetric face and cheeks

It appears from your photos that you have mild cheek bone hypoplasia. "Midface descend" and asymmetry is most likely result of underlying bone structure. Correction of bone deficiency with implants or fat grafting, even filler would help; most likely a combination of cheek implants and fat grafts. A small chin should be considered for correction as well. In-person evaluation would help to evaluate your clinical condition, expectations and to discuss your options. Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 15 reviews

Asymmetrical cheekbone structure and mid face descent, can anything be done to even the appearance?

Facial asymmetry is common to everyone. One side of the face is slightly less developed than the other side. When there are focal areas of asymmetry paired with volume loss, the differences are magnified.

Facial contours can be improved with fillers, fat, or implants. I recommend consulting with a surgeon so she/he may examine you and take photographs. I like to use 3D computer simulation software to get on the same page as my patient regarding their aesthetic goals. The surgeon can then outline a treatment plan appropriate for your face for a safe and happy outcome. Safety comes first.

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Asymmetrical Solution with cheek augmentation and fillers (juvederm, radiesse)

Facial fullness and symmetry can be improved with well-placed fillers (Voluma, Radiesse, Perlane, Bellafill): Sculptra, implants or fat. I recommend getting a consultation with a facial contouring expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 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.