What to Know About Facial Asymmetry

Medically Reviewed by Dany Paul Baby, MD on November 14, 2022
4 min read

Many people have asymmetrical faces, and the asymmetry can range from very mild to severe. On an asymmetrical face, the features don’t line up exactly or create a mirror image on both sides of your face. In some cases, it is more noticeable and may be linked to injury, aging, or other conditions.

What is facial asymmetry? It’s a condition found in most people to some degree. When facial asymmetry is more pronounced, it can affect your day-to-day life or be a sign of a more serious underlying condition. Facial asymmetry can affect your physical appearance and limit how your nose, mouth, and eyes function. It can look like:

  • Cheek retrusion
  • Eye displacement
  • Eyebrow lowering
  • Brown bone and forehead protrusion
  • Nasal deviations

If you think you have facial asymmetry, which is affecting your health or the functions of your face, you should reach out to a healthcare provider for a more detailed diagnosis. It might be visually obvious that you have facial asymmetry, but it could also be a sign of something more serious.

Subjective and objective tests coupled with quick, specific analysis of your genes can give your healthcare provider the information they need to help you decide on a plan for treatment.

There are a variety of facial asymmetry causes — from natural phenomena to serious conditions.


A study on 200 people using 3D digital imaging technology found a strong correlation between age and facial asymmetry — here, the faces of older participants were much more asymmetrical than those of younger participants. Although any part of the face could become asymmetrical, researchers found that age-related changes in facial symmetry typically affected the bottom two-thirds of your face — from your eyebrows to your chin. These changes, however, did not have negative effects on the participants’ health.

Craniofacial Microsomia

This is a congenital condition — that is, it develops starting from birth. Craniofacial microsomia prevents half of the face from developing completely during fetal growth.

In craniofacial microsomia, facial asymmetry symptoms are physical and usually affect the following areas of the head and face:

  • Ears — This could look like a minor difference in ear shape or the absence of an entire ear.
  • Ear canals — They might be underdeveloped or missing, which may affect hearing.
  • Lower jaw (or mandible) — It could be malformed, with the chin pointed to one side or with an irregular bite.
  • Facial nerves — Each facial nerve has multiple branches that allow facial movements. You could have a single affected nerve or a group of affected nerves, which might stop you from moving a part of your face.
  • Eyes or eye sockets — They might be smaller than normal or completely absent.

A person with craniofacial microsomia is generally treated by a team of healthcare providers including an orthodontist, dentist, ENT surgeon, speech therapist, and plastic surgeon.

Congenital Facial Nerve Palsy

This is a congenital condition that affects one or both of the main facial nerves you have on your face. These facial nerves control many muscles of your face and help you move it. When both sides of the face are affected by congenital muscle paralysis, Moebius syndrome may develop.

Congenital facial nerve palsy can happen as a result of birth trauma or developmental issues:

When it happens due to developmental complications, the affected person might have difficulty raising their eyebrows, closing their eyes, eating, smiling on half of their face, and performing other similar facial movements. Difficulty in closing the eyes can lead to eye irritation or even ulcers. 

When this happens due to birth trauma, it goes away 90% of the time. If it persists, the child may need surgery to stitch up nerve endings or a nerve graft to bring nerve function back.

Congenital facial nerve palsy can be treated in a few ways:

  • A tiny weight may be surgically placed on the upper eyelid to help close it and, as a result, protect the cornea from infection.
  • A muscle from the face or somewhere else on the body may be moved to the corner of the mouth. If transplanted properly, the mover nerves, muscles, veins, and arteries will help restore an affected person’s smile.

Acquired Facial Nerve Palsy

This is not a congenital condition. You might develop weakness or paralysis in your facial nerves as a result of tumors, trauma, or Bell’s palsy. Bell’s palsy is usually a side effect of a viral infection that damages the facial nerve and often paralyzes one side of the face. Over time, the affected side may regain its function. If the paralysis persists, surgery may be needed.

Other Possible Causes

Facial asymmetry can be a result of other causes like:

  • Trauma
  • Injury
  • Lifestyle choices, like smoking or prolonged sun exposure
  • Genetics
  • Medical or health conditions, like a cleft palate
  • Rare disease

In addition to the treatments mentioned above, plastic surgery is a common kind of facial asymmetry surgery. It may be right for those who want the appearance of symmetry but are otherwise unaffected by the condition.

In cases of age-related asymmetry, soft-tissue implants and volumizers can be used to support facial structures and bring back a youthful appearance.

After any of these surgical procedures, you may or may not need to spend a few nights in the hospital, depending on what your healthcare provider recommends. You’ll probably have pain and swelling for a few days after the procedures, but they should go away on their own after a few weeks. If they don’t, reach out to your healthcare provider soon.