If the Face (Cheekbones) Is Asymmetrical, Can It Be Corrected with Cheekbone Reduction Surgery?

Hello. I’m Dr. Jo Hyun-woo of 입체성형외과.

The weather has now fully moved into spring. COVID-19 is still occurring in large numbers, but proactively, not only I but also the hospital staff have been vaccinated, and we are doing our best to provide safe medical care.

We will continue to work to help you receive treatment as safely as possible.^^

Today, I’d like to talk about facial asymmetry, which many patients worry about.

In some of my previous posts, I explained how facial asymmetry can be addressed through contouring surgery.

There are many cases where relatively simple problems can be improved with contouring surgery.

However, in fundamental terms, there is actually no way to correct facial asymmetry 100% through surgery.

Let me show you one CT image.

This is the CT scan of a patient with a typical facial skeleton. Can you see the asymmetry?

In fact, our face is formed during the fetal development process, when the left and right sides differentiate from different cells and the bones join together on both sides.

If you think of it in terms of twins, it would be like the left and right sides of identical twins’ faces.

Just as twins can look slightly different when examined closely, the left and right sides of our face are inevitably different.

Looking at the CT image above:

1. First, you can see asymmetry in the cheekbones. The right cheekbone is positioned higher than the left cheekbone.
2. The shape of the eye sockets is also quite different on the left and right, right? The reason one eye appears higher or lower is also because the position of the eye sockets is different.
3. In addition, if you look at the lower jaw bone, it is slightly rotated toward the left, and the degree to which the outer cortex protrudes is also different.

If we examine it in detail, there are too many differences, but for now, if we summarize it like this, how could surgery be performed to address this asymmetry?

First, the shape of the eye sockets would need to be made the same, right? Since the upper and lower parts are different, surgery can be performed to cut the eye socket into a rectangular shape and move it upward.

Yes, of course, this is surgery for children with congenital deformities. Such surgery cannot be performed for cosmetic purposes.

As for the difference in cheekbone height, it is of course possible to fix one side upward through 3D cheekbone surgery.

However, the important point is that the cheekbone position on the skull remains the same, so this cannot be corrected 100%.

There are many surgeries that can be done in theory, but as of 2021, it should be considered impossible to correct cheekbone asymmetry 100%.

But! That does not mean you need to be disappointed. If it is not 100%, there are of course ways to improve it.

I will explain cases where correction is possible by showing a few examples.

A case in which left-right asymmetry was not corrected and 230-degree cheekbone surgery was performed

This patient had a particularly prominent left cheekbone.

When I first consulted with the patient, I recommended surgery on only one cheekbone or 3D cheekbone surgery in order to correct the left-right asymmetry.

However, the patient wanted both sides reduced with a simple procedure.

This is the patient’s photo after surgery. Overall, the face has become slimmer, but the left side still feels larger.

Because the procedure was performed as 230-degree cheekbone surgery, both sides moved inward by the same amount as the patient’s own bone thickness.

Still, compared with before surgery, you can see that the asymmetry looks less noticeable.

When the degree of projection decreases, asymmetry appears much less obvious, so even cheekbone surgery alone can make asymmetry look reduced.

The second case is one in which only one cheekbone was operated on because one side was larger.

A case in which 230-degree cheekbone surgery was performed on only one side

This is the preoperative photo. As you can see from the photo, there are cases where only one side appears more prominent.

In such cases, surgery may be performed on only one side.

Looking at the postoperative photo:

You can see that the left-right asymmetry has improved significantly.

That is why I explain that if one side seems too large, operating on only that side can also be a good option.

The third case is one in which left-right asymmetry was corrected through 3D cheekbone surgery.

When performing 3D cheekbone surgery, if one cheekbone is larger, the amount of bone removed at the 45-degree area can be increased slightly, and the amount pushed inward can be made different on the left and right sides, allowing for more efficient correction.

A case in which left-right asymmetry was corrected through 3D cheekbone surgery

Looking at the preoperative photo, this patient’s right 45-degree cheekbone protrudes more, making the side cheekbone appear larger.

In such a case, when planning the surgery, the amount of cheekbone bone to be resected at the 45-degree area can be made slightly larger, and the amount pushed inward from the 45-degree area can be adjusted differently on the left and right sides.

Therefore, by making the amount of inward movement different, asymmetry can be corrected to some extent.

Looking at the postoperative photo:

You can see that the difference between the right and left sides has been greatly reduced.

It is very difficult to correct differences in the vertical height of the cheekbones, but because the larger side can be reduced and moved inward more, this level of correction is certainly possible.

So far, I have explained how cheekbone asymmetry can be corrected through various cases.

As I mentioned at the beginning, there is no surgical method that can make both sides exactly the same 100%.

However, depending on each patient’s individual case, it is possible to correct asymmetry to a degree that can be improved sufficiently.

Therefore, if you are worried about facial asymmetry, do not worry too much, and if you come in for a consultation, you may be able to get a good result.

Thank you.