I have an Uneven Jaw. Is this something Botox or fillers can help, or do I need surgery/ shaving the jaw bone?

Question

I have a very asymmetric jaw line. I judged to have very bad TMJ & jaw clicking for years after my braces. While my teeth appear to be straight, my lips, chin & jaw seem to be very off centered. Any advice would be appreciated.

George Yang, MD · Answer

Hi Katelyn,Just looking at the bottom half of your face, you have an attractive face and I think this assymetry of the chin and jaw is not apparent to the casual observer.  Everyone's face is assymmetric to some degree.  It is considered that the more symmetric the face, the more attractive it is.  I think this is an over-simplification.  If someone is not attractive, and their face is perfectly symmetric, it doesn't make it any more attractive.  Another person with beautiful features although not perfectly symmetric will still be considered attractive.Symmetry is a simple way for people when looking for "mates" to choose someone who most likely does not have any genetic problems or diseases.  If you are mostly symmetric and attractive, the increase in symmetry will unlikely do very much when it comes to attracting a "mate."  Only in "mug shots" which plastic surgeons and DMVs take, do you really see the assymetry, since we ask you to look straight into the camera.  Most people have a "better side."  For me, my right side is better, so I will try to show my right side (my part side) more when I take photos.  Come to think of it, I think my chin is crooked, too (I also wore braces in high school and had minor TMJ because of it.)  I think I may have noticed it once, but let it go.  I will go look in the mirror after I finish this post.Of the 4 photos, you posted, only in the 3rd photo, is it barely noticeable.  If you posted the other 3 photos and asked different question, no one would have noticed that your chin is not symmetric unless you pointed it out to them.Your questions are valid, and I will help answer the first two.  Botox to the masseter muscle helps to reduce the side and bulk of the large muscle on the outside of your jaw bone/jaw angle.  You can google masseter muscle to see a diagram of this muscle.  If your masseter muscle is particularly bulky on one side, botoxing the masseter muscle may help narrow the overall width of the jawline, and perhaps help with the assymetry.  Fillers to the jawline, can help to smooth any indentations or transitions between the pointier chin area to the remainder of the jawline.  If you think a narrower width to the jaw and smoother transition will help achieve the result you are looking for then, the non-surgical route may be an option.The best type of surgeon to ask about bony jaw/chin surgery are oral maxillofacial surgeons who are both MD's and dentists.  So they have excellent training to deal with both the dental aspect as well as the bony aspect. They could offer bone shaving or perhaps a genioplasty where they cut the lower edge of the chin bone and make modification and screw the two parts back together with a plate and screws..  These are not surgeries that I offer in my practice, although I did assist on several during my facial plastic and reconstructive fellowship.  We performed these cases with the oral maxillofacial surgeons.  The chin surgery is relatively small compared to a double jaw surgery (orthognathic surgery), which can be life changing for someone with a significant deformities which will help them look more normal.  These are big surgeries to consider and if a friend or family member really wanted to have it done, I would want to at least play devil's advocate during their decision making.Best,Dr. YangP.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.

Ira Shapira, DDS · Answer

You have a narrow underdeveloped maxilla, dark buccal corridors and deeep labial grooves.  I would recommend starting with a DNA Appliance to expand maxilla and give freedom for the mandible to reposition.  Possibly start with a diagnostic orthotic if you have lot of  pain.  The displace chin is often a jaw shift to accomodate occlusion.A physiologic approach is far superior to just dumping in fillers and neurotoxins.Check out TMJ patients treated with a physiologic approach at web reference.The physiologic approach includes ULF-TENS, SPG Blocks, Trigger point injections and neuromuscular orthotic. Other helpful approaches is treating sleep disordered breathing common in narrow maxillas, oral myofunctional therapy, trigger point myotherapy and Cranio work.Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Past Chair, Alliance of TMD Organizations
Diplomat,  Academy of Integrative Pain Management
Diplomat, American Board of Dental Sleep Medicine
Regent & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal
Member, American Equilibration Society
Member, Academy of Applied Myofunctional SciencesMember, Academy of Cosmetic Dentistry

Bahman Guyuron, MD · Answer

It seems that you have a slightly longer upper and lower jaw on the left side pushing your chin to the right. The ideal result will come from orthodontic preparation to be followed with an upper jaw, lower jaw and chin surgery to straighten your smile and even out your chin position. This is complicated and may require a year to 18 months process. If this is to cumbersome for you, an alternative procedure would be a chin surgery alone which can make the chin symmetric but will not change your smile. The chin surgery alone is a simple procedure and usually takes about 30 minutes as an outpatient surgery. The chin bone is cut through in incision inside the lip and repositioned and fixed new position using a small plate and 4 titanium screws. Bahman Guyuron, MD

Vicki J. Levine, MD · Answer

I do not know if the average person looking at your face notice the difference between right and left jaw. Whatever a filler would help this in all likelihood

Gerald Wittenberg, MSc, DMD (retired) · Answer

IF the bite fits together, you could consider a genioplasty and jawline augmentation to 'even it out'. This works if you do not want a bite change. Asymmetries are masked by this approach and can look good.

I have an Uneven Jaw. Is this something Botox or fillers can help, or do I need surgery/ shaving the jaw bone?

Answers (5)

Answer: Not so obvious

Answer: Not so obvious

Answer: Asymmetry of the jawline

Answer: Asymmetry of the jawline

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I have an Uneven Jaw. Is this something Botox or fillers can help, or do I need surgery/ shaving the jaw bone?

Answers (5)

Answer: Not so obvious

Answer: Not so obvious

Answer: Asymmetry of the jawline

Answer: Asymmetry of the jawline

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Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.