Jaw Surgery for Face Symmetry: Considerations and Scope

A face is symmetrical when the right and left sides bear a similar skeletal and dental structure. Research reveals that only 2% of the world's population has proper facial symmetry. Others have a near facial balance or a facial asymmetry, ranging from mild to severe in intensity. While symmetry in the face is regarded as attractive and often desired, it can take a lot of effort to obtain it. Read on to learn about face symmetry and the scope of corrective jaw surgeries.

Facial asymmetry – how to recognize it:

Gross disharmony of the facial structures is often apparent to the common eye. In contrast, your eye can miss out the minor asymmetries, and it's best to consult a cosmetic surgeon to clear out any confusion. Moreover, if the misalignment affects the functioning of the facial structures, including the jaw and facial muscles, it needs prompt, professional attention.

Often esthetic and maxillofacial surgeons use the golden ratio as a guide to achieving facial symmetry. A perfectly symmetrical face follows the golden ratio. Your surgeon may discuss some of the proportions that the golden ratio suggests, such as:

• An optically balanced face is around 1.618 times longer than its breadth.
• The distance from the center of the lips to the chin should be approximately 1.618 times the distance from the top of the nose to the center of the lips.
• The distance from the hairline to the upper eyelid is customarily 1.618 times longer than the distance from the top of the upper brow to the lower eyelid.

Causes of facial asymmetry

There are three major categories define the origins of face asymmetry:

• Congenital. Occurring before birth.
• Acquired. Brought on by trauma or illness. Trauma, fractures, arthritis, infections of the temporomandibular joint (TMJ), facial pathologies and tumors, hyperplasia or hypoplasia of the condyle, and ankylosis (fusion) of the temporomandibular joint are a few acquired disorders that can cause facial asymmetry.
• Developmental. Occurring throughout development and with no known explanation. One of the reasons for developmental disharmony is bad oral habits or a unilateral crossbite. Dental and jaw malalignment can offer uneven support for the soft tissues of the face and lip.

Before deciding on the surgery, a maxillofacial surgeon looks into all dental, skeletal, soft tissue, and functional features that characterize face asymmetry. The final decision is often taken by an expert team, made up of a cosmetic surgeon, a maxillofacial surgeon, and an orthodontist.

Do you need to correct facial asymmetry?

There are some standard factors that a dentist will check before deciding on what therapy is needed to correct any existing asymmetry:

• Evaluate. An orthodontist will evaluate the asymmetry of your face by comparing the face midline to the dental midline; the line that runs between the top left and right central incisors. If they are not coincidental, therapy may involve braces for a mild midline shift, or surgery for a more pronounced facial deviation.
• Your goals. One of the things dentists take into account before advising jaw surgery is your individual goals. While some individuals undergoing orthognathic surgery are only concerned with altering their facial appearance, others might want to enhance their bite. Regardless of the purpose, a treatment plan must consider facial characteristics and dental occlusion.
• Your health. They also take into account your general health. If you suffer from co-morbid health conditions, the dentist can refer you to specialists to check your current status.
• Dental bite. People with severe facial asymmetry often suffer from a malaligned bite, resulting in chewing problems, temporomandibular joint disorders, and chronic headaches. A dentist will try to help you overcome these health issues and plan your jaw surgery accordingly.

Orthognathic surgery for face symmetry

Jaw surgery, also known as orthognathic surgery, involves having your upper jaw (maxilla) or lower jaw (mandible) fixed and re-aligned to attain functional and aesthetic improvements. Given that 12% to 37% of the population reporting facial asymmetry end up being diagnosed with misaligned jaws, corrective jaw surgeries are emerging to be an effective therapy for facial asymmetry.

The majority of asymmetry problems call for double jaw surgery. Upper jaw surgery is frequently required to rectify a deviated facial angle. Lower jaw surgery is often necessary to create a good bite against the upper jaw and bring the chin point back to the center.

Sometimes, contouring surgery may be required to minimize the uneven facial protrusion after the jaws have been moved into the proper place.

Tests before an orthognathic surgery

The teeth alignment must be considered while planning orthognathic surgery. Dentists often recommend a thorough intraoral and extraoral(facial) examination to arrive at a conclusion.

Intraoral X-rays, orthopantomograms/OPGs (an X-ray image of the hard tissues of the oral cavity and surrounding skeletal structures), CT scans( computed tomography images of your jaw and teeth), and dental impressions (to build a dental model), are often advised to explore the skeletal and dental issues of a patient.

A cephalogram enables the dentist to capture a complete radiographic image of the side of the face and measure the hard and soft tissue relations (for pre and post-surgical analysis). It is an important prognostic tool that dentists use during planning.

Facial asymmetry can range from mild to severe. It comes with a varying set of aesthetic and functional limitations. If you are worried about your facial deviation, it's best to consult a maxillofacial surgeon. Jaw surgeries are an often-opted therapy to correct facial asymmetry. However, an expert opinion is recommended on whether you are the right candidate for the surgery and what you can expect after the surgery.