There are various causes for an asymmetric face (also called “unequal face”). The commonest reason is congenital asymmetric facial development (50%), followed by acquired teeth malocclusion (35%). Some rare reasons are trauma or side sleeping (15%). The incidence in women is higher than that in men, and usually, the right face is smaller than the left. Because an asymmetric face does not cause any functional disorder, many patients do not think that it is necessary to undergo any corrective plastic surgery. Clinically, Dr. Chuang finds that most people will not even notice that they have slightly unequal faces. Whether patients need to undergo corrective surgeries is dependent on the severity of asymmetry or the willingness and expectation of patients.
The most common reason for an unequal face is caused by asymmetric facial bone structures; the next most common reason is the difference in the thickness of skin and soft tissue on both sides. Surgical options should vary depending on different indications. If patients show only mild asymmetry and the differences are mostly caused by skin and soft tissues but not bone structures, the problem can be simply corrected by unilateral facial liposuction or buccal fat pad removal; however if the asymmetric face is caused by variation in bone development, such as an awry facial diagonal (namely unilateral cheek protrusion with contralateral jaw hypertrophy), it will have to be esthetically corrected by unilateral zygomatic reduction and contralateral mandible reduction. The procedures are very similar to regular facial bone surgery; however, Dr. Chuang will have to precisely estimate the difference between the bones on both sides and focus more on bone adjustment and fixation during the procedure. He will perform unilateral zygomatic arch/body reduction, mandible angle resection/splitting osteotomy, or both in the contralateral side. The ultimate goal of the surgeries is adjusting bone structures as much as possible to make the facial asymmetry unperceivable.
To correct the asymmetric facial contour, patients can also choose Medpor implants to augment the facial bone defects. These permanent implants have highly biocompatibility with human bodies and rarely cause tissue reaction or rejection. Dr. Chuang can also choose various sizes and types of cheekbone or mandible implants to create a symmetric result for each individual patient. Besides bone cutting, Medpor implant augmentation is an alternative for patients who do not want to undergo extensive bone reduction.