From the Guidelines
To improve facial asymmetry, a systematic approach based on individualized analysis is crucial, and camouflage techniques, such as non-surgical options like targeted Botox injections or dermal fillers, can be a more conservative and predictable alternative to realignment techniques. When evaluating facial asymmetry, it's essential to consider the facial centerpoint, lying halfway between the medial canthi on the nose with the head in the Frankfurt position, as a reference point 1. Facial asymmetry can be categorized into different types, including left-right differences in facial width, orbital level, rotation displacement of the upper jaw, isolated lateral placement of the piriform aperture, non-horizontal alar base, and more pronounced facial asymmetry associated with cheek flattening and slanting of the midface 1.
To address facial asymmetry, a combination of exercises, skincare, and lifestyle adjustments can be beneficial. This includes:
- Facial exercises like cheek puffs, jaw releases, and eyebrow raises to strengthen facial muscles evenly
- A consistent skincare routine with gentle cleansing, moisturizing, and sun protection to prevent uneven skin aging
- Practicing good posture to avoid chronic tilting that can contribute to asymmetry over time
- Ensuring adequate sleep and staying well-hydrated to maintain overall facial health. For persistent asymmetry concerns, non-surgical options like targeted Botox injections (typically 10-25 units per treatment area) or dermal fillers can help balance facial features, as suggested by the study 1.
It's also important to note that facial asymmetry can be influenced by both genetic factors and environmental influences, with muscle development, skin health, and habitual positioning all playing roles in how symmetrical the face appears 1. Therefore, a comprehensive approach that takes into account individual factors and preferences is necessary to improve facial asymmetry.
From the FDA Drug Label
Caution should be used when JEUVEAU treatment is used in patients who have marked facial asymmetry, ptosis, excessive dermatochalasis, deep dermal scarring, thick sebaceous skin, or when subjects do not respond to 20 Units of botulinum toxin (e.g., the inability to substantially lessen glabellar lines even by physically spreading them apart).
Facial asymmetry can be improved with caution when using botulinum toxin (IM) treatment, such as JEUVEAU. However, the treatment should be used with caution in patients with marked facial asymmetry. The label does not provide specific guidance on how to improve facial asymmetry, only that caution should be used in these cases 2.
From the Research
Improvement of Facial Asymmetry
Facial asymmetry can be improved through various methods, including:
- Surgical procedures: Orthognathic surgery can be performed to correct facial asymmetry combined with dental occlusal problems, as stated in the study by 3. Additionally, surgical procedures such as gap arthroplasty or distraction osteogenesis can be utilized to improve facial asymmetry, as mentioned in the study by 4.
- Botulinum toxin injections: Botulinum toxin can be used to improve facial symmetry in patients with facial palsy or synkinesis, as shown in the studies by 5 and 6. This method can reduce facial asymmetry and improve facial aesthetics.
- Soft tissue fillers: Soft tissue fillers, such as hyaluronic acid-based fillers, can be used to correct facial asymmetries and loss of volume, as reported in the study by 6.
- Three-dimensional imaging: The use of 3D imaging can aid in the diagnosis and treatment planning of facial asymmetry, as discussed in the studies by 7 and 4.
Treatment Planning
Treatment planning for facial asymmetry involves:
- Evaluation of the underlying cause of the asymmetry, as stated in the study by 3.
- Assessment of the patient's problems using latest diagnostic methods, such as 3-dimensional imaging, as mentioned in the study by 4.
- Correction of the underlying disorder, as stated in the study by 3.
- Rehabilitation of functional components of the orofacial complex, such as speech, deglutition, and phonation, as mentioned in the study by 4.