First, one should know that having one’s face be symmetrical would be very rare. After all, our liver is on the right, the heart is on the left, pancreas on the left, and so forth. Usually, one leg is a little longer than the other, the hairline is not even, etc. 

Very commonly a patient will visit a plastic surgeon regarding asymmetry of the face. Depending on the location and degree, most asymmetries can be diminished, but not all. 

For instance, virtually all human skulls are smaller on one side, and usually it’s the right side (for reasons unknown). Possibly it’s because our heart is on the left and, in utero, the left side receives more blood supply and thus grows slightly larger. 

This can be noticed by looking at the eyes to assess which one is lower than the other. Also, the lower eye will then be closer to the mouth.   

What types of asymmetry can be treated, and how? 

If one side of the brow sags more than the other, a brow lift can be done on that side. An alternative treatment would be using lifting PDO (polydioxanone) threads, a biodegradable polyester suture. Inserting these threads takes only a few minutes, and the result will last about two years. These threads last about six months, but they stimulate production of collagen, hyaluronic acid, and most importantly, elastin, causing the longevity of the results.

If the lips are uneven (often noticeable in the upper lip) the treatment might be an asymmetrical lip lift, called a “buckhorn” lift. The result is permanent. Or a filler on the side that is thinner can be used. Each patient must be carefully assessed.

Fillers such as Juvederm or Restylane products are usually used for other asymmetries of the face, such as a cheek that is smaller than the opposite cheek. This also applies to the jawline or any part of the face on the deficient side.  

Surgery may be indicated, such as a facelift or non-surgical PDO lifting threads and/or fat grafts. Again, each patient must be assessed and treated appropriately.  

Eyes are a common request for more symmetry. As mentioned, the right eye is usually lower than the left, and this cannot be corrected. However, the appearance of more evenness can often be achieved by removing more skin from the upper eyelid. Again, if indicated, elevating the lowest brow may be another solution. Fat grafts or even a cheek implant may be used if there is a deficient bony rim below the lower eye. 

Asymmetrical noses usually require a surgical rhinoplasty, but amazing results can be achieved in many cases with properly placed fillers. In fact, humps can be minimized, noses shortened and even tilted more upwards non-surgically as well. 

Although most people are unaware of the asymmetry of their faces, others have noticeable asymmetries which can easily be corrected with minimal (if any) downtime.  

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton.