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Perfect symmetry between the left and right sides of the face is uncommon.

It is more common for humans to have facial asymmetry, where there are slight differences between the two halves of the face than to have a face that is perfectly symmetrical.

Even people who are thought to be aesthetically attractive may have slightly asymmetrical faces. Minor facial asymmetry is usually not noticeable and in most normal individuals, there is no need for treatment.

Facial asymmetry usually involves the lower half of the face, and it is very common to find that the right side of the face is slightly wider than the left, with the chin deviating to the left. There are many possible causes of facial asymmetry, including congenital, developmental, traumatic and pathological causes.

One of the most common birth defects involving the face is hemifacial microsomia, where the lower half of one side of your face, including the ear and jaw, appears underdeveloped. Severity of the condition varies and the cheek, eye and neck on the same side may be affected. People with hemifacial microsomia may have ear tags, small ear, reduced facial muscles, delayed tooth development, deafness, and other associated abnormalities on one side of the face. The cause is unknown, but genetic factors may play a role.

Treatment of Facial Asymmetry

Management of facial asymmetry may involve a combination of dental, skeletal and soft tissue treatments, depending on the involved parts of the face (teeth, facial bones and muscles). Proper surgical evaluation and planning is necessary. Aside from these, genetic counseling may be necessary for patients who have congenital conditions such as hemifacial microsomia, as well as management of other associated problems like deafness, speech impediments, feeding and respiratory problems.

For simple, mildly asymmetrical faces, facial implants may be used to augment various facial regions. The goal of surgery is to achieve balance and proportion. Facial implants may be performed alone, or in combination with other facial contouring procedures.

For some patients, dental consultation is required to improve problems with underdeveloped teeth and problems with malocclusion. Surgery may not be accomplished in a single stage for people with severe facial asymmetry. Surgical stages may involve work on the lower jaw, facial bone contouring, muscle contouring, facial implants, bone reduction, fat injections, and liposuction. Plastic surgeons must first assess a patient's expectations because the success of surgery ultimately depends on the patient's perception of facial symmetry.

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