All That You Wanted To Know About Facial Asymmetry

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It just means that there is no equal balance between the two sides of your face. It is the common scenario in the overall population and is often seen subclinically. But also on a few occasions, a significant amount of facial asymmetry is seen. This not only results in functional problems but also leads to esthetic issues.

Most of the patients who we have seen with the problem of facial asymmetry open up saying that they are suffering social disturbance due to aesthetic reasons.

Most of our human parts are mechanized to develop symmetry that is our right and left side to grow out to be mirror images.

But few inherent and environmental factors influence the growth process and always there will always be slight asymmetry in the body parts. So the perfect bilateral symmetry is rarely found.

This mild degree of asymmetry is rarely perceived by others and the person himself.

How to know if you have facial asymmetry?

In front of the mirror divide your face into two halves by a line drawn passing through your mid-face or an imaginary line.

Use a marker that you can wash later. The midline should divide your forehead and then passing through the middle of your nose touching the tip and then the middle of your lips, later joining the mid chin.

So this line should be a straight line and then compare both halves of your face. If both are half correlating equalling then you have a bilaterally symmetrical face. If not it is called facial asymmetry. The slightest asymmetry which is usually not perceived is not at all a problem. But if it is causing esthetic and functional problems then you should be reaching out to a facial surgeon.

The most common facial asymmetry seen is deviated lower jaws, Swollen cheeks on one side, depressed cheeks or malar bones, elongated lower jaw on one side, improper jawlines,  lip deformities, etc.

You know this now. do not worry we are there. Continue reading to know more about it.

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Why jaw deformities or facial asymmetry is caused?

Congenital changes: inborn changes present from your birth.

  1. Facial Clefts: it is a condition in which a gap will be created in the face. It’s a kind of malformation due to improper or underdevelopment of structures like bone, soft tissue, skin, etc. they are a rare form of congenital anomalies. they are usually found in the lip and palate region. if left untreated in the infant age, this leads to facial asymmetry in the adult age due to improper facial development that was hindered by clefts present.
  2. Hemifacial Microsomia: the lower half of the face development is affected in which ears, mouth, and lower jaws are mostly underdeveloped and are affected. This is caused due to poor blood supply in the development of the face when the baby is in the womb.
  3. Neurofibromatosis
  4. Congenital Muscular Torticollis: this is a condition formed due to contraction of the sternocleidomastoid muscle (a muscle found in the neck region). it is usually found in infants. the head of the child will be tilted on one side. this condition leads to craniofacial deformities.
  5. Positional Plagiocephaly
  6. Craniosynostosis: it is a birth defect in which the bones in a baby’s skull join together too early. This happens before the baby’s brain is fully formed. As the baby’s brain grows, the skull can become more misshapen. The spaces between a typical baby’s skullbones are filled with flexible material and called sutures.

Acquired condition

  1. Trauma: it is caused mainly due to accidents. tissue loss and fracture of bones are the main reason for facial asymmetry. sometimes due to improper suturing during the primary treatment of the wounds and the tension created during suturing leads to improper planes of skin and tissues brought together. the wound heals in the improper planes leading to defective planes and the formation of scars.
  2. Fracture: the facial bones are quite thick, but a few are very fragile too.due to road traffic accidents or by accidental hit by sharp instruments or while playing games, high chances of fracture of craniofacial bones are present. this leads to facial symmetry. these fractures when treated earliest are best. but sometimes patients come late due to personal reasons or if the primary treatment did not go well. these types of facial deformities can also be treated.
  3. Arthritis: like other joints, the temporomandibular joint – the joint that allows your lower jaw to move; is also affected by arthritis. this leads to improper movement of jaws, again causing a significant amount of facial asymmetry.
  4. Infection of TMJ: it is also known as the septic arthritis of TMJ. this is a kind of bacterial infection. this condition leads to a lot of pain and swelling near the TMJ. as mentioned earlier, TMJ is the joint that allows your lower jaw movement.
  5. Tumors: tumors are the lumps that develop in our body due to various reasons. it is an abnormal growth in our tissues. not all tumors are neoplasms, that is. not all tumors are called cancer tumors. benign tumors are non- cancerous tumors that are developing in our bodies. facial tumors cause gross facial deformity.few tumors occur bilaterally. whereas few tumors are unilateral. diagnosis of this done mainly through scans and laboratory investigations.
  6. Hyperplasia of the condyle:  hyperplasia means increased growth. condyle in the bony part of your lower jaw that fixes in the TMJ. hyperplasia of condyle means abnormal extra growth of condyle that leads to facial asymmetry when it occurs unilaterally. this condition leads to deviation of your chin and whole lower jaw to one side.
  7. Hypoplasia of condyle: similar to the above-mentioned condition, hypoplasia means decreased growth of condyle on one side of your mandible than the normal development. this again leads to the same condition that is the deviation of chin and mouth to one side.
  8. Ankylosis of TMJ: ankylosis means immobility or stiffness that is caused by a particular joint. when there is ankylosis of TMJ on one or both sides, the movement of jaws gets hindered. this again leads to abnormals development of mandible or lower jaws. after the growth period, it leads to a deviated jaw causing gross facial asymmetry.

Many times the exact reason for facial asymmetry remains unknown and you need not worry much about it sometimes. In such cases, we call it developmental asymmetry.

These unknown asymmetries are found during your growing age.

The reasons for this might be by

  • The habit of chewing food on one side always
  • Sleeping on one side which puts on a lot of pressure on that side
  • Deleterious oral habits

After knowing about this now, you will be redirected to a facial hospital where it can be corrected. Worried much? You need not be. We are there. Leave the rest to us.

To know what we do when you first come to us, continue reading.

DIAGNOSIS

At first, the facial asymmetry is assessed with a thorough examination and judicious analysis.

With a good interactive session your problems, complaints, and expectations will be assessed. Later Upon examination of your external facial and intraoral examination, the dental and bony features will be assessed. Your old medical history, allergic reactions will be asked about.

For further information, scanning will be done (CBCT) for the complete evaluation of your facial structure where the 3D images will be obtained.

Then our doctor will explain the diagnosis. After some meticulous examinations, the treatment plan will be explained in a simple and clear understandable way by showing you all the scan slides on the computer screen.

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Treatment

Final facial profile with balancing the dental and surgical treatment plan, which includes proper occlusion correction and coinciding midline will be done.

A combination of orthognathic, orthomorphic surgeries along with orthodontics procedure will be done in severe cases of facial asymmetry.orthognathicsurgeries involve correction of the jaw by making cuts in the jawbones according to the treatment plan and fixation using plates. The majority of skeletal deformities are corrected using this method.

Orthomorphic Surgeries: this is a very rare type of orthognathic surgery where the entire jaw can be moved and fixed without involving the dentition of teeth.jaw sculpting: jaw sculpting is done to give the required shape for the jaws. the extra or undesired bony shape is trimmed and proper jawlines and chin shapes are given to correct the defect.

Tumor Removal: tumors on the face are removed surgically and the soft tissue defect it has caused will be corrected. even the hard tissue defects are equal care and maximum care is taken to bring back the original form of the face.

Fracture Fixation: after assessing the level of fracture, various approaches will be planned. after selecting the best approach, the fracture end will be fixed using titanium plates and screws. since the access to the fracture spot will be done intraorally, no scars or sutures will be present on the face. so you need not worry about the presence of surgical wounds after surgery.

TMJ Related Problems: based on the issue and the diagnosis, surgery will be planned. all the surgeries involve an intraoral approach and no scars will be seen after the surgery.

Even though it’s a major challenge for our team to correct the patient’s smile and esthetics, we are proven efficient now.

We at Richardson dentofacial hospital, are performing enormously well. Already2000+ such surgeries have been performed and with excellent results.

With fine details, we offer you excellent results.

So for your problems, we are here.

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