Facial asymmetry in adults - causes, symptoms, treatment, prevention

In nature, symmetry of face and body is rare. An example of ideal symmetry are actresses - P. Andreeva, S. Khodchenkova, E. Varnava, N. Samburskaya, K. Asmus, A. Chipovskaya, singers - O. Skryabina, P. Gagarina, O. Buzova. The proportions of the facial part of the skull of these beauties correspond to the rule of the “golden ratio”.

Rice. 1 Examples of perfect symmetry

Most people have an asymmetrical facial skull. Scientists believe the cause of the disproportion is the different degrees of development of the halves of the brain. Normally, for right-handers, the left half of the face is more harmonious, and for left-handers, the right half is more harmonious. Slight physiological asymmetry gives a person’s appearance individuality, charm and does not require correction.

Intervention is necessary/desirable when there is a pathological deformity in which the difference in linear measurements is 2-3 mm, and in angular measurements - 3-5°. The study of asymmetries of the torso, skull, and its facial part relates to current problems of theoretical and practical medicine - physiology, psychology, psychiatry, speech therapy, pediatrics, pedagogy, gerontology, dentistry, general and plastic surgery.

Violation of symmetry is caused by congenital/acquired external influences, internal anomalies and pathologies. The cause of the defect can be the natural processes of aging and age-related diseases. Indications for asymmetry correction are functional disorders, psychological discomfort, and aesthetic reasons.

Types of facial symmetry disorders

The symmetry of the face depends on the structure, volume:

• muscles;
• fatty tissue;
• nerves and blood vessels;
• joints, skull bones;
• cartilage and connective tissue;
• ligaments

The cause of asymmetry can be individual anatomical and morphological structural features (physiological disproportion) or pathological (diseases, injuries) and a combination of these factors.

In addition, asymmetry of the facial part of the skull is divided into:

• morphological (static) – deformation is caused by a violation of the location, shape, volume of individual elements of bone and soft tissue, noticeable at rest;
• functional (facial) - caused by a violation of the coordination of the work of individual facial muscles or damage to the facial nerve, the anomaly intensifies during facial movements.

Severe facial asymmetry, the causes of which are varied, requires professional treatment.

Possible complications

The consequences depend entirely on the underlying cause of the anomaly and the timeliness of contacting a doctor. In some cases, the problem can be eliminated without a trace with a quick cosmetic procedure or a light bite correction.

In others, if the problem is ignored for a long time, it can result in significant destruction of the temporomandibular joint, with no guaranteed hope for a complete restoration of its function.

Thirdly, create a serious threat to life itself (in case of malignant tumors).

Only a doctor can give an accurate answer to the question about the consequences of pathology after a thorough examination. In any case, the only correct action for the patient will be to consult a doctor as quickly as possible when a pathology is first detected.

Causes of facial asymmetry

Disproportion of the articular bones of the skull can be congenital or acquired. Congenital anomalies may occur:

• in the prenatal period due to intoxication, infectious diseases suffered by the mother, abnormal position of the fetus, multiple pregnancies, delayed development of individual parts or tissues;
• genetic aberrations.

The consequences of birth defects are:

• disruption of the development of joints and bones of the skull, facial muscles, connective tissue;
• underdevelopment of the lower jaw;
• torticollis;
• strabismus;
• violation of the formation of the temporomandibular joint.

Genetic pathologies accompanied by disproportion of traits include the following microdeletion syndromes:

• monosomy 1p36;
• Wolf-Hirschhorn;
• Sotos;
• Setre-Chotzena;

The deformity can be a consequence of obstetric complications or birth trauma. An example is the famous actor Sylvester Stallone. Damage to the facial nerve led to speech defects and noticeable deformation of the left half of the face.

Rice. 2 Severe asymmetry due to neuritis of the facial nerve

Acquired pathology occurs as a result of:

• tumors in bone tissue - osteomas, osteochondromas, the tumor is localized in the nose, frontal and ethmoid cavities, in the joints and bones of the lower jaw;
• infectious and inflammatory diseases of the ENT organs;
• deviated nasal septum, polyps and cysts;
• trauma and inflammation of the maxillofacial apparatus;
• disruption of the formation or loss of individual units of the dentition, malocclusion;
• pathology of the muscular frame of the face - facial and chewing muscles;
• Cheiloschisis - cleft palate and lip.

A common cause of disproportion of the facial part of the skull is neuropathies:

• Bell's palsy;
• muscle contracture after surgery and paralysis;
• muscle synkinesis;
• unilateral myasthenia;
• injuries and iatrogenic lesions of the facial nerve;
• pain in certain areas of the face;
• dyskinesia and spasm of facial muscles.

Facial asymmetry, neurology considers it from the perspective of a violation of muscle innervation, can be caused by a disease of unknown etiology. Romberg's hemiatrophy leads to multiple facial anomalies, which are caused by degenerative processes, impaired nerve function, and pathology in the opposite hemisphere of the brain.

The causes of the anomaly are also:

• traumatic brain injuries;
• cerebrovascular accident;
• spinal injuries or diseases;
• strabismus and other ophthalmological diseases;
• tissue damage due to violation of the technique of performing cosmetic procedures and surgical interventions;

soft tissue neoplasms.

Figure 3. Deformation caused by crossbite

The deformity can also be caused by a disruption in communication between the hemispheres of the brain. Facial asymmetry, the causes of which are diverse, requires correction, as it leads to complications.

General information

Jaw asymmetry is a pathology expressed in visually visible asymmetry of the lower third of the face. Displacement away from the midline of the entire upper or lower jaw, their segments or individual areas of the face - lips, chin, branches of the upper and lower jaw.

In addition to the above features, pathology can manifest itself as drooping corners of the lips, disruption of the oval of the face, widening or narrowing of the eyes, smoothed lip folds, and some specific features, for example, a pained expression.

To see whether there are deviations or not, you need to imaginarily draw the central line of the face - a vertical straight line passing strictly along the space between the central incisors of the upper and lower jaw. A wide smile makes asymmetry more pronounced.

Strictly speaking, there is no complete correspondence between the left and right parts of the face (ideal symmetry). A certain disproportion of them is present in all people.

The physiological norm is considered to be a position in which the asymmetry in the linear value does not exceed 2-3 mm, in the angular value - 3-5°. If these values ​​are exceeded, they talk about pathology and look for the reasons for its occurrence.

To a greater extent, asymmetry is characteristic of the lower jaw. This is explained by the fact that it is located movably relative to the skull, and has more factors influencing its position than the upper jaw. This is the type of bite, the condition of the TMJ, habitual postures, manner of chewing food, etc.

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Diagnostics and examination

To confirm the primary diagnosis and establish the cause of the lesion, it is necessary to conduct visual and hardware diagnostics. The doctor measures axial and angular distances, performs tests at rest and in motion, takes a medical history, and interviews the patient. Hardware diagnostics include:

• radiography;
• MRI;
• electroneuromyography.

Radiography is used for anomalies in the symmetry of the head bones and damage to the sutures of the skull. MRI or CT is used to diagnose soft tissues and brain structures. Muscle tone and strength of the facial nerve are examined using electroneuromyography. Facial parameters are measured using a special device.

If infectious tissue damage or neuroinfection is suspected, laboratory tests are prescribed.

Diagnosis must be comprehensive, since the causes of the lesion can be different. If a patient has severe facial asymmetry, then to establish an accurate diagnosis, consultation with doctors of different specialties may be necessary - a neurologist, an ophthalmologist, an ENT doctor, a neurosurgeon, a psychiatrist, a dentist. They also carry out diagnostics using their own methods. The diagnosis is established after all studies.

Depending on the severity of facial asymmetry, surgery or conservative treatment is prescribed after a joint discussion by a commission of specialists.

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Facial asymmetry in adults - how to treat

Treatment depends on the causes of the disease and the severity of the changes. When a diagnosis of facial asymmetry is made, one or more doctors decide how to correct the anomaly. For mild asymmetry, conservative correction methods are sufficient:

• An asymmetrical bite is corrected using splinting, braces and other orthodontic aids.
• When muscles are damaged, drug therapy, physiotherapy, and massage are used. With reduced muscle tone, myostimulation and gymnastics are necessary. Massage relaxes/tones muscles, eliminates pain.
• For neuritis of the facial nerve, treatment is carried out in a hospital. The doctor prescribes medication and physiotherapeutic treatment.

Surgery is required when the structure and function of the jaw joint changes.

Craniosacral manual therapy and massage help correct the asymmetrical skull in children and alleviate the condition of adult patients. In case of significant defects in the articular bones, the neurosurgeon prescribes prosthetic surgery.

At the Clinic of Manual Medicine “Galia Ignatieva MD”, correction of soft tissue lesions is performed using cosmetic minimally invasive methods:

• Botox injections;
• thread lifting;
• hardware massage;
• lipofilling;
• injection of fillers.

Rice. 4. The result of conservative treatment - before and after.

If the asymmetry is severe and does not respond to conservative treatment methods, then a surgical solution to the problem is indicated. It could be plastic surgery.

If there is an abnormal development of the joint of the jaw bones, maxillofacial surgery is prescribed. The neurosurgeon performs surgical treatment of complications of innervation and pathology of the facial nerve.

Facial asymmetry, the treatment of which may require a whole range of measures, is difficult to eliminate if the patient consults a doctor late. Early diagnosis, the professionalism of the doctors at the Manual Medicine Clinic “Galia Ignatieva MD” and compliance with their recommendations in half the cases lead to an improvement in the condition.

Treatment

The etiology of facial asymmetry is very diverse. Many diseases accompanied by this symptom can pose a serious threat to the patient’s health, especially if treatment is started late. Self-medication in such cases is unacceptable; the appearance of this symptom should be considered as a reason to immediately seek medical help.

Conservative therapy

The treatment plan varies depending on the characteristics of the pathology. In many cases, a special diet is recommended. For dental diseases, treatment of caries, pulpitis, and periodontitis can be carried out. Patients with facial asymmetry are prescribed medications of the following groups:

• Analgesics
  . Indicated for severe pain syndrome. Intramuscular injections or tablet forms are possible.
• NSAIDs
  . Required to reduce the severity of inflammation, swelling, and pain. General action drugs are taken in short courses to reduce the risk of side effects from the liver and gastrointestinal tract.
• Antibiotics
  . Necessary for general bacterial infections and local inflammatory processes. First, broad-spectrum drugs are used; after receiving the results of microbiological analysis, the antibiotic treatment regimen is adjusted taking into account the sensitivity of the pathogen.
• Antiseptics
  . Local medications are used in the form of rinses. Recommended in the presence of inflammation, wounds on the mucous membrane, after surgery.

In some cases, drug therapy is supplemented with physical therapy. When treating diseases that cause facial asymmetry, electrical stimulation, UHF, medicinal electrophoresis, and other methods may be prescribed. For oncological pathologies, chemotherapy and radiation therapy are performed.

Habit of chewing on one side

Most often, this is again a consequence of the loss of a tooth (or teeth). We chew on one side of our mouth because there is simply nothing to chew on the other. As a result, the facial muscles on the one hand, not receiving the proper load, weaken, while on the other they become hypertonic. Overstrained muscles literally pull on facial tissues, creating creases and visible asymmetry. It should be noted that the risk of developing an aesthetic defect is especially high if you like chewing gum. In this case, the chewing muscles experience uneven load for a long time.

Habit of sleeping on one side

Sleep, as you know, is a necessary condition for beauty. However, if you are used to sleeping on one side, you risk losing your beauty while sleeping. The fact is that the tissue on the side of your face, with which you press against the pillow, slowly but inevitably deforms. The oval gradually changes, a network of small wrinkles forms around the eye, deeper folds lie between the eyebrows, and vertical lines form on the cheeks and chin. As cosmetologists say, if you prefer to sleep on one side, then it will quickly become clear which one. The best way to avoid asymmetry and wrinkles while sleeping is to eliminate any contact between your face and your pillow. You can do this by training yourself to fall asleep lying on your back. This way you will not only avoid prolonged pressure on the muscles and skin, but also maintain normal fluid flow throughout the night.

Preventive measures

Prevention of any dental diseases consists of following a number of rules that are relevant for almost every person. And although, unfortunately, they do not provide a complete guarantee of preventing dental diseases, they reduce the risk of their development. And if they have already appeared, they speed up and facilitate treatment.

This is the fight against bad habits of children, teaching them proper oral care. Quitting smoking and foods that are harmful to teeth. Using mouthguards when playing sports. And, perhaps most importantly, regular visits to the dentist for preventive purposes.

In the video, experts talk about the causes of asymmetry of the face and jaws.