I know the best way to determine is through a visit with my plastic surgeon but is there any advice on what procedures (preferably non-surgical) can minimize this? My jaw is very asymmetrical and bulges out on one side. It also creates strange lines around my mouth. Is this a problem with my teeth or bone? I know the creases are not from aging as I'm 21 but it makes me very self-conscious and I feel that my entire face shape is odd and uneven. I have TMJ too if that's relevant. Thanks!
Wide, Uneven Jaw with Creases Around Mouth - How Can It Be Fixed / Minimized?
Doctor Answers 8
You are correct in that it is difficult to evaluate your condition without being seen in person. It would be important to view your facial contour from different angles while your muscles are at rest, and during animation. In some photos it appears that one nostril is slightly higher than the other but other photographs don't reflect this. There does appear to be in one photograph a significant asymmetry of the chin and in another photograph the left cheek near the jaw appears more convex than the other side. Before anyone does Botox on hypertrophic masseter (cheek chewing muscle enlargement) muscle or inject filler to bulk up a flatter side, I would suggest a consultation with an oral maxillofacial surgeon. Certain x-rays may be done to provide an analysis of your bony framework which will help a team approach offer you the best result. An ENT specialist may focus on the TMJ, a plastic surgeon or dermatologic surgeon can discuss fillers after they learn of the findings from the oral maxillofacial surgeon.
Soem facial asymmetry is common in most patients. If it bothers you, you should get it evaluated. More than likley a CT will be performed and perhaps cephaolmetrics will be required to assess your upper and lower dentition alignment and mandible to maxilla relationship.
Jaw asymmetry and bulging non-surgical treatment
Given that you have TMJ your jaw asymmetry may be caused by masseter (chewing muscle) hypertrophy (abnormal growth). One of the newer uses of Botox is to make this muscle smaller. Fillers like Radiesse, Juvederm, Restylane and Sculptra can help correct minor chin and jawline asymmetries as well. I have done microfat transfer to correct asymmetric chins and jawlines with great success. Some amount of chin and jawline asymmetry is perfectly within the normal range. You would really need a physical exam to determine what, if any, treatment would work best.
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As others have stated, most people have some degree of facial asymmetry. In face, the more you look in the mirror or the more you look at someone else, you will start to notice areas that appear asymmetry. That is jus that way we are. In your pictures, you do appear to have a rotate jaw, but the extent of this asymmetry can only be determined with an examination and possibly a CT scan to look at the underlying bones. In the asymmetry is minor, it may be masked through a combination of facial implants or injectables. If more is needed then you may need more invasive surgery.
Jaw asymmetry and TMJ
The photos appear to show a jaw that is rotated forward on your left and backward on your right. However the photos are not clearly straight on in the frontal views so this is hard to assess. I would be more concerned about how this possible asymmetry is related to your TMJ. You do not say how you know you have TMJ or if you have seen any doctor or oral surgeon for it. If in fact you do have TMJ you need to be examined to see if there is a click on mouth opening/closing, if the jaw moves to the sides as you open instead of straight down and what the cant of the teeth is. Then you will need xrays to asses bone alignment and relative sizes. If most of the asymmetry is because one side of jaw is sliding out of the joint you should not just cut out some bone or inject some filler to try and achieve symmetry.
The best thing for you to do is see a plastic surgeon who does jaw work or an oral surgeon for a full evaluation. Early TMJ can be treated without surgery in some patients.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
You have an adorable mouth!
As others point out, we all have issues.
Here is my question for you: How self-conscious do you feel about these issues? Occasionally we find that people are literally crippled by minor issues. If you spend hours a day thinking about this problem, avoid social situations because you think others are aware of this issue or are making fun of you because of this, these are feelings that might be consistent with body dysmorphic disorder.
The punishment should fit the crime. If you are crippled by these feelings, you need a psychotherapist not a cosmetic surgeon. If you have mild concerns about this and are not obsessed by these issues, then sure, some filler might help. Avoid being coerced to have major surgery for this. There will always be someone who wants to do chin surgery or implants for this sort of thing. Avoid fillers that can be adjusted. Perlane and Restylane are best. Cosmetic dermatologists are less likely to push you to have a surgery. Please be safe out there.
Facial asymmetry is very common
Based on the pictures that you have attached, you have minimal facial asymmetry . This is very common and you should not focus on them . You have very beautiful facial features and rather than focusing on the asymmetry, you should look at the whole face. I would not recommend any surgical options . You may consider fillers like Juvederm or Restylane.
What to do about uneven jawline?
We are all asymmetrical. In fact if you take a human face and divide it in half and make a composite of one half and its mirror image, the composite image does not usually look like the original face.
What I see in your photos is probably different than what you see. I do see the cheek asymmetry and a slightly uneven nose and chin, but primarily I see a young face with great volume and skin texture and a nice heart shape. You did not include a side view of your face which may help with the assessment as well.
The unevenness of the chin can be corrected with a filler such as Radiesse.
Interesting that you mention TMJ. That often involves teeth clenching which can enlarge the masseter muscle. The enlargement of the masseter muscle will make the jawline appear wider. The wider jawline can be addressed with Botox injections into the masseter muscle.
Consult with a board certified dermatologist or plastic surgeon with proper training and experience with these procedures.