Facial Asymmetry: Etiology, Evaluation, and Management

Facial asymmetry is common in humans. Significantfacial asymmetry causes both functional as well as estheticproblems. When patients complain of facial asymmetry, theu n d e r l y i n g c a u s e s h o u l d b e i n v e s t i g a t e d . T h e e t i o l o g yincludes congenital disorders, acquired diseases, and traumatic and developmental deformities. The causes of many casesof developmental facial asymmetry are indistinct. Assessmentof facial asymmetry consists of a patient history, physicalexamination, and medical imaging. Medical imaging is helpful for objective diagnosis and measurement of the asymmetry, as well as for treatment planning. Components of soft tissue, dental and skeletal differences contributing to facialasymmetry are evaluated. Frequently dental malocclusion,canting of the occlusal level and midline shift are found.Management of facial asymmetry first aims at correcting theunderlying disorder. Orthognathic surgery is performed for the treatment of facial asymmetry combined with dental occlusal problems. A symmetrical facial midline, harmoniousfacial profile and dental occlusion are obtained from treatment. Additional surgical procedures may be required to increase or reduce the volume of skeletal and soft tissue components on both sides to achieve better symmetry