Surgical Correction of Facial Asymmetry

Facial asymmetry is the noticeable difference between the right and left sides of the face. It may become apparent only during certain actions like smiling, eating, or talking, but can also be present even when the face is at rest. To make surgical correction of facial asymmetry, it’s crucial to first identify the underlying causes and determine the area to be treated. Generally, the causes of facial asymmetry include:

• Neck and head traumas at birth
• Variations in soft tissues
• Dental problems
• Factors like chewing, sleep, posture, etc.

Understanding the source of the problem is critical for treatment. For instance, if the asymmetry is due solely to differences in soft tissues, it can usually be treated with botox and fillers. However, if it stems from jaw misalignment or dental issues, it falls under the scope of orthognathic surgery procedures and can be treated by dental interventions.

Once the cause of the asymmetry is identified, the appropriate specialist or specialists to handle the treatment can be determined. In some cases, intervention by both dentists and cosmetic surgeons may be necessary. For example, issues arising from dental problems are initially addressed by oral and maxillofacial surgery. If there is a deformity in the lips as a result, cosmetic surgery can improve appearance with filler treatments.

Different types of surgery are available for the surgical correction of facial asymmetry. The first step is to understand the cause of the asymmetry and make a diagnosis. This determines which specialist will intervene. Finally, a decision is made on the necessary surgical operation. If the asymmetry is not minor, simpler treatment methods may not be sufficient.

Asymmetry in the lower face region can be a dental, skeletal, or combined problem. If the symmetry issue is only in the teeth, it can be eliminated with orthodontic treatment alone. In skeletal cases, treatment continues with chin implants and asymmetry applications.

Orthodontic treatment removes the right and left teeth misalignment. However, it’s important to note that aligning the upper and lower midlines is not always possible. A few millimeters of midline deviation due to the size and misalignment of teeth is considered normal.

Skeletal asymmetry involves the upper, lower, or both jaw bones and is evaluated in three dimensions. While some problems can be camouflaged with orthodontic treatment alone, others require surgical intervention. Decisions on treatment progression depend on clinical and radiological examinations, patient requests, and the amount of asymmetry.

Facial reconstruction techniques are applied in cases of function loss, congenital soft tissue masses, and tissue losses due to injury. They are also preferred in situations where there is a noticeable difference between the right and left sides of the face. Reconstructive surgery is applied in the following cases:

• Lip and palate clefts
• Rare facial clefts
• Jaw surgery
• Facial soft tissue injuries
• Eyelid ptosis
• Congenital absence of the ear
• Congenital cranial bone anomalies
• Facial deformities and asymmetry

These operations do not result in a completely symmetrical facial appearance but significantly reduce noticeable differences.

Rhinoplasty for facial balance is also performed in cases where it is necessary. Differences in the mouth and jaw region are minimized through various interventions. Some patients also opt for aesthetic procedures like rhinoplasty, fillers, and botox to achieve a more aesthetic appearance.

Before surgery, an initial assessment of the patient’s facial bone grafting is conducted. Observations are made on the midline of the teeth and the midline of the face. Other factors evaluated during the preparation stage include:

1. Symmetry between the bilateral gonial angles
2. Lower border of the mandibular bone
3. Visibility of the gums; upper, lower, right, and left
4. Occlusion defect and symmetry
5. Closure of the anterior teeth
6. Gap and closure between the front teeth
7. Mandibular curvature
8. Temporomandibular joint

To evaluate facial symmetry, frontal, right, and left lateral cephalogram X-rays are taken. The cephalogram helps in determining the midline and comparing other findings. The following steps are then undertaken:

• Assessment of the symmetry of specific aesthetic areas.
• Symmetric analysis using numerical measurements and evaluations.
• Symmetry evaluation using computer-assisted programs.

Before the surgery, the asymmetry in the patient’s face is precisely determined, and the course of the surgery is decided. Depending on the procedure to be performed, facial asymmetry braces may be used, or an incision inside the mouth may be made to secure the integrity of the bone by positioning two bone plates in the new position with screws. The patient is thoroughly informed by the doctor about what to pay attention to before the surgery.

The jaw surgery recovery time depends on correcting facial asymmetry and varies depending on the extent of the surgical procedure. Typically, post-operative care includes painkillers, antibiotics, and treatments to prevent swelling of the face. If deemed necessary, supportive treatments with serums are also administered.

The patient can start eating liquid foods on the same day of the surgery. While general recovery takes about 2-4 days, the bones take approximately 1-3 weeks to heal, during which time the mouth is closed with elastics passed through the teeth. During the recovery process, it is important to avoid products that can harm the teeth, such as cigarettes, alcohol, tea, and coffee. Additionally, the patient should rest, avoid heavy lifting, and not exert themselves excessively.

There are multiple procedures for the surgical correction of facial asymmetry. If the procedure is performed to correct asymmetry in the mouth and jaw area, the risk of complications is relatively low. Assuming the patient does not have any specific unknown risk factors, there is no risk of death associated with this procedure. To prevent nerve damage, nerves are monitored at every stage to check if they have been affected. Although it’s rare, if a nerve is compressed or damaged, it can be repaired using microsurgical techniques. This attention to nerve integrity is crucial to ensure a safe and effective surgical outcome.

When cosmetic surgery for facial harmony is performed, a completely symmetrical appearance is not achieved. It’s normal for there to be slight differences in facial features. However, if there is noticeable asymmetry in the mouth and jaw area, an orthodontic intervention can achieve an aesthetic appearance. The majority of patients who undergo surgery for facial asymmetry receive successful results.

At HospitaPrime clinic, we use equipment with the latest technology and establish personalized treatment processes. Our expert in this field, Dr. Eren PERA, and our team are available 24/7 for facial contouring surgery.