Congenital Hemifacial Asymmetry

Although the definition of an attractive and beautiful face is subjective and influenced by different factors, such as ethnicity, age, gender, culture etc., the beauty of the person’s face is determined by the harmony of proportions and symmetry.

In fact, studies have shown that behind our common definition of a beautiful face there is an actual mathematical symmetry algorithm that underlies our perception of attractiveness. This is called the Golden Ratio of Beauty and was first used by Leonardo Da Vinci, who realised that the closer a face or object gets to this number, the higher the level of its perceived beauty. It is also known as Phi, or the Fibonacci number.

All faces have some degree of asymmetry. However, more pronounced asymmetry may become bothersome and in severe cases, are indicative of an underlying syndrome.

What is Hemifacial Asymmetry

Hemifacial asymmetry (or hemifacial microsomia in medical terms) is a common congenital facial asymmetry that causes an abnormal development of the face. This condition may affect all structures of the face, but most commonly causes asymmetry of the eyes, jaws, ears, muscles/nerves that allow a patient to smile, and the soft tissues of the face.

What Causes Hemifacial Asymmetry

Asymmetry is most commonly a result of volume loss, volume excess or lack of nervous sensation. Volume loss can occur due to lack of development, after injury or inflammatory conditions of the skin and fatty tissues, or even in children after a problematic birth.

However, researchers are still unsure of what exactly causes hemifacial asymmetry. Most cases are not genetic or inherited, but seem to result from congenital problems, trauma, or a prior surgery or treatment gone wrong.

Facial asymmetry can be mild, moderate or severe. The condition may affect both sides of the face (bilateral hemifacial microsomia), but typically one side is more severely affected than the other.

What Are the Symptoms?

The most common abnormality in hemifacial microsomia is asymmetry of the jaw and in the lower face. Other asymmetries of the face may be caused by the presence of less fat in the tissues of the cheeks and asymmetries of the muscles and nerves that move the face.

How is Hemifacial Asymmetry Treated?

Dr Nina at Facial Sculpting uses the Golden Ratio of Beauty, together with her own personal assessment, to analyse her client’s face and devise a specific treatment plan to transform a face aesthetically within minutes.

While most severe cases of facial asymmetry may require invasive surgery, mildest cases can be successfully treated with less invasive aesthetic procedures, such as dermal fillers and Botulinum Toxin A injections.

Dermal Fillers

Dermal fillers represent an effective, non-invasive option to improve facial symmetry and work particularly well for asymmetry that results from tissue imbalance or muscle weakness.

They are made from biocompatible materials that are injected under the skin in precise sequences at specific locations. Results are seen instantly, although for some treatments the optimal effects may be seen after a course of treatments. Over time the fillers are slowly but naturally absorbed by the body. This generally occurs over a period of 9-24 months, depending on the area treated and the type of filler.

Example of dermal fillers performed by Dr Nina to restore symmetry in the face include:

• Cheek fillers, which can bring the face into balance by making the cheekbones more prominent.
• Chin sculpting, which involves injecting hyaluronic acid into the skin to improve projection, volume or definition in the chin. This can also change the contour of the face by balancing the facial features.
• Eyebrow lift

Injections with Botulinum Toxin A

Botulinum toxin is a protein produced by the bacterium Clostridium botulinum which blocks the electrical impulses that make the facial muscles contract. Sometimes injections may be placed just in the affected side, just in the unaffected side or in both sides.

The treatment works by restoring symmetry and balance of movement across both sides of the face. When the affected side of the face is weaker, the muscles of the unaffected side must work harder and get stronger. This can increase the imbalance and asymmetry in the face. Botulinum Toxin injections in specific areas of the unaffected side can restore better balance and enhance a patient’s facial appearance.

The effect of the toxin may last for three to four months and should be repeated after this time to maintain the results.

Treatments of hemifacial asymmetry with dermal fillers and botulinum toxin A are available at Dr Nina Facial Sculpting clinics. Potential side effects are mainly minor and temporary, and they will be discussed in detail with you at your consultation before any treatment takes place.