Asymmetrical Faces: What Causes Them and How to Treat Them

An asymmetrical face can give a person a special charm. Therefore, it should only be treated if it causes functional or psychosocial problems.
Asymmetrical Faces: What Causes Them and How to Treat Them

Last update: 22 August, 2021

Asymmetrical faces, or “facial asymmetry”, is a condition in which there’s disharmony between both sides of the face. When we say both sides, we refer to the sections that arise from drawing an imaginary vertical line down the middle of the face.

Generally speaking, asymmetrical faces appear in two modalities. One is when the disharmony is in the jaw or maxilla; the other is when several bones are involved. In the latter case, the cheekbones, eye sockets, nose, and forehead, etc., may be affected.

Sometimes the asymmetry originates from a disharmony of muscles, skin, or nerves. Whatever the case may be, an asymmetrical face only merits an intervention if it’s very evident, to the point of causing psychological or social consequences to the affected person.

What can cause it?

A boy scratching his face
An asymmetrical face implies the presence of facial disharmonies.

There are several reasons that can lead to the asymmetrical face configuration. The most important are the following.

Congenital torticollis

Congenital torticollis is a contracture of the sternocleidomastoid muscle which is located in the neck and allows rotation of the head. This problem is caused by a bad position of the fetus inside the uterus or by a vacuum or forceps extraction during delivery.

In this case, what occurs is a deviation of the head to the affected side. This causes the baby to bring the ear toward the shoulder and the chin toward the other side. This disharmony is relatively easy to correct.

Dental and jaw problems

In this case, the jaw or maxilla doesn’t develop correctly and this gives rise to an asymmetrical face. Therefore, a bite defect, or “malocclusion” arises. This can occur in the vertical, transverse, or anteroposterior plane. Quite often it not only affects the appearance, but also produces problems in eating, speaking, and even breathing.

Craniosynostosis

This is a congenital condition in which one or more sutures in the baby’s head close earlier than normal. In the baby’s skull, there are plates of bones that are still growing. The edges where these plates cross are the sutures.

Under normal conditions, the sutures should only close when the child is between 2 and 3 years old. If this occurs earlier, it leads to an abnormally shaped head and, as a result, an asymmetrical face.

Growth spurts

Growth spurts are sudden and accelerated increases in growth. They’re periodic and frequent until the age of 4. Then the process slows down until puberty, when one of these “growth spurts” occurs again.

Asymmetrical faces may be configured during the growth spurt that corresponds to puberty. In that condition, one side of the jaw may grow faster than the other.

Hemifacial microsomia

Hemifacial microsomia is a disorder in which one side of the face isn’t fully developed. In some cases, both sides of the face are affected or the deformity also involves the skull as a whole.

This anomaly can range from mild to severe. It may affect the shape of the face, but also the ear, teeth, jaws, cheeks and nerves. The cause of this problem is believed to be genetic.

Other causes

There are other factors that can affect the shape of an asymmetrical face. Among them are the following:

  • Aging. Cartilage continues to grow after puberty and this can cause asymmetry in the face over the years.
  • Dental work. Teeth extraction, as well as the use of dental prostheses, affect the shape of the face.
  • Tobacco consumption. A study revealed a link between smoking and an asymmetrical face.
  • Injury. Trauma can change the shape of the face.
  • Stroke. This condition causes numbness in part of the face or facial drooping.
  • Bell’s palsy. This is a sudden facial paralysis that’s almost always temporary.
  • Lifestyle. Recurrent bad posture can lead to facial deformity.

How to detect if there’s facial asymmetry

Sometimes you can detect facial asymmetry with the naked eye, sometimes not. If it isn’t noticeable, it may not be relevant to detect it either. However, if someone wants to check if they have an asymmetrical face, there’s a simple method to do so.

The best thing to do is to take a picture with the head straight and the face in the foreground. Then do the following:

  • Draw a vertical line from the forehead to the chin.
  • Draw a horizontal line from one crease of the eye to the crease of the other.
  • Then draw a horizontal line joining the two ends of the lips.
  • After that, draw a line joining the two opposite points at the widest part of the face.
  • Finally, draw a line between both nostrils.

If, in the end, the straight line coincides with the disposition of the face, the person has a symmetrical face. If, on the contrary, if it doesn’t match, then we’re talking about facial asymmetry. From a medical point of view, this is of no importance.

When is treatment necessary?

Asymmetrical faces should only be treated if they cause significant functional or aesthetic problems. That is, when it doesn’t allow the person to perform certain activities or hinders them significantly. Also when the appearance generates psychosocial difficulties.

The issue of appearance is very subjective. A person may feel that some asymmetry in their face is very prominent, even though it isn’t really so. If that’s the case, however, they wouldn’t be a candidate for medical treatment.

Treatments available for asymmetrical faces

A man getting surgery on his face
Maxillofacial surgeries can correct an asymmetrical face.

Most commonly, the most notorious cases of asymmetrical faces can be corrected with maxillofacial surgery. This usually achieves the desired functional and aesthetic effects. In essence, there are three modalities of this surgical procedure:

  • Maxillary orthognathic surgery. Only one of the jaws is operated on.
  • Bimaxillary orthognathic surgery. Both jaws are operated on.
  • Bimaxillary or monomaxillary surgery. It can be accompanied by other aesthetic surgeries. It’s used when there’s generalized asymmetry.

This last option can be accompanied by rhinoplasty, blepharoplasty, implants, or facial fillers, depending on the case. In general, these are low-risk procedures that rarely generate complications.

An asymmetrical face can also be attractive

There’s no scientific evidence that facial exercises have any impact on an asymmetrical face. What is certain is that if the asymmetry is due to muscle weakness or irregularity in muscle tone, there are facial exercises that can help correct this.

Keep in mind that perfect symmetry isn’t always more aesthetically pleasing. Imperfections can give great personality and attractiveness to a face. So, it’s only worth trying a change if the anomaly generates negative effects.

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