Facial asymmetry is a condition in which the length and area of the left and right sides of the face differ, and the lips are not parallel.
Causes of facial asymmetry
There are many causes of facial asymmetry. There are quite a few people with a mild degree of facial asymmetry. If the facial asymmetry is severe, it can be corrected surgically. To find out if it is a surgical target, it is necessary to first distinguish whether the cause of the asymmetry is a soft tissue problem or a hard tissue problem such as bone. If the soft tissue is the cause, there are diseases such as Parry-Romberg Syndrome (PRS). PRS usually begins around the 20’s, and the soft tissue gradually shrinks, causing the face to become smaller, and progression stops on its own and can be corrected to some extent by surgery such as fat transplantation or flap surgery. There are congenital and acquired cases of skeletal asymmetry.
In the case of diseases such as semi-facial dwarfism (craniofacial dwarfism), which results in congenital facial asymmetry, one ear may be small or absent in severe cases, and may be accompanied by asymmetry of the jaw, nerve paralysis, etc. Acquired facial asymmetry is often caused by abnormal growth of the jaw, and when the young jawbone or jaw joint is injured, the jaw asymmetry may develop as it grows.
Symptoms of facial asymmetry
The features of facial asymmetry are:
- The shape of eyes, nose, and mouth is crooked.
- The center of the forehead and the tip of the chin do not coincide, and the centerline of the face does not fit overall.
- The tail of one mouth goes up when laughing.
- The cheekbones are out of balance.
- The centers of the upper and lower teeth do not coincide and there is malocclusion.
- Food is chewed well with only one molar.
- The head is tilted obliquely.
Diagnosis of facial asymmetry
Facial bone X-ray and CT scans, computer analysis, tooth modeling, and dental examinations. Once surgery is determined, additional tests are needed to perform surgery, anesthesia, and orthodontics.
Treatment of facial asymmetry
Treatment of patients with semifacial dwarfism with bone asymmetry is complex and takes a long time. Orthodontics, bone surgery, skin and soft tissue surgery, etc. should be performed in several stages over a long period of time. If the severity is severe, the shape of the lips is corrected at the age of 1 to 2 years, the jaw joint is reconstructed in childhood, and bone extension is performed if necessary. Ear surgery is performed in the lower grades of elementary school and may require multiple stages of surgery if the ear is not at all or very small. After becoming an adult, a jawbone surgery is performed and the shape of the face is finally refined.
On the other hand, in case of progressive semi-facial atrophy of soft tissue, improvement of appearance through fat transplantation is the main treatment method. Recently, attempts have been made to increase the engraftment rate of fat by including the stromal vascular fraction (SVF) in fat transplantation.
Progress of facial asymmetric surgery
After surgery, swelling and bruising are most severe on the 1st to 3rd day and last for 3 weeks. Everyday life is possible after about a week, but it takes months to reach the final appearance of the face.
Precautions for facial asymmetric surgery
Facial asymmetry that causes facial bones can be corrected by facial contour surgery. Facial contouring is not just correcting asymmetry, but it can change the entire face to the desired shape of the patient and make a small face as a whole. The operation is difficult, but the patient’s satisfaction is high. Therefore, the experience of the surgeon is important, and it is safe to operate in a hospital where the anesthesia and post-surgical management can be well managed as it is a highly difficult operation. Facial contour surgery is an operation that moves both the upper and lower jaw bones, so dental correction is required months before and after surgery. Depending on the condition and condition of the patient, correction may be performed before surgery, and correction may be performed after surgery. After 2-3 days after facial contour surgery, discharge is possible and daily life is possible after 3-4 weeks.