Lip asymmetry: causes, types and methods of correction

Facial asymmetry refers to different distances or angles of inclination of individual parts of the right and left halves in relation to the central plane. Plastic surgeons say that there are no perfectly symmetrical proportions. Visually, only a specialist can determine small deviations in the shape of the oval, nose, and outline of the lips. For some people, distinctive features of appearance are a memorable “highlight”. Not in all cases they need to be eradicated. Treatment of facial asymmetry is required if a person has psychological and aesthetic problems.

Facial asymmetry in the concept of physiognomy

Physiognomy as a science that connects facial expression and its structure with certain character traits and thoughts of a person, attaches great importance to symmetry. Any deviations from the balance of the left and right halves are considered as signs of personality disharmony. Supporters of this trend believe that people with predominantly symmetrical features are distinguished by honesty, and with broken symmetry they have the ability to hide their thoughts and lies.

One of the popular authors of works on physiognomy, Simon Brown, emphasizes that the right half of the face represents the main emotions, personal characteristics, and is associated with the inheritance of creative abilities through the mother. The left side reflects logical thinking and personality, passed down from male relatives.

There are several classic standards for “reading” a face:

• If there is asymmetry in the width of the oval, a shift towards the left half indicates more developed mental abilities (in mathematics, exact sciences, philosophy); if the right side of the skeleton is more developed, then the person is credited with creative professions (art, acting).
• The length of the face is assessed by the shape of the chin - if there is a slant to the right or left, then the balance of the processes of tension and relaxation suffers, this is expressed in unexpected irritability, “outbursts” of anger, and sudden changes in mood.
• Irregularities in the “intellectual zone” (forehead, wrinkles on the bridge of the nose, different shapes and depths of the eyes, raised eyebrows) are considered depending on the degree of deviation. With moderate asymmetry, it imparts confidence to facial features and a desire for a goal; if pronounced, it is recognized as a sign of a contradictory personality.

Modern computer programs make it possible to take into account many deviations from the mirror arrangement of different sides. Physiognomy bases its conclusions on an accurate 3-D description of a personality portrait and psychoanalysis of a specific case.

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Reasons why facial asymmetry occurs

The physiological norm is considered to be a deviation in the location of parts of the face by 2–3 mm or an angle of up to 5 degrees. If the imbalance is more pronounced, then facial asymmetry is recorded. The causes are divided into 3 groups: congenital, acquired and mixed. In addition, it is important for plastic surgeons to distinguish between static and dynamic asymmetry. The first type is visible in the absence of muscle contractions when the face is at rest. The dynamic type is characterized by manifestation only during actions (smiling, chewing, wrinkling the forehead).

Congenital causes

Anomalies of intrauterine development are influenced by the correct course of the mother's pregnancy, nutritional balance, stress experienced, and genetic mutations. As a result, the formation of the osteochondral skeleton of the fetal face is disrupted, and the muscular system develops unequally. The most significant:

• asymmetrically developed bones of the facial part of the skull;
• sharply reduced (underdeveloped) lower jaw;
• the influence of impaired formation of the articulations of the temporal and lower jaws on the width of the face;
• abnormalities of muscles and connective tissue responsible for facial expressions and eye movements (strabismus).

The development of the child’s bone skeleton continues until adulthood, so subtle changes can be compensated independently. Hereditary predisposition includes an imbalance that arose due to increased plasticity of nasal cartilage and lack of progesterone synthesis during pregnancy.

Acquired reasons

Throughout life, a person encounters various factors that can change the symmetry of the face. These include:

• injuries to the facial bones (especially the nose, jaw);
• inflammatory diseases in the area of ​​the mandibular joints, nasal sinuses, teeth;
• pathology of chewing and facial muscles;
• violation of bite formation;
• improper growth of teeth;
• consequences and signs of neurological pathology;
• general severe diseases accompanied by a decrease in immunity and metabolic disorders.

Injury to the facial skeleton can occur during childbirth due to incorrect presentation of the fetus or careless actions of medical workers. Inflammation of the mandibular joints is caused by a child suffering from mumps, otitis media, and frequent runny nose complicated by sinusitis.

The relationship of neurology to the causes of imbalances

Emotional experiences (joy, interest, crying, fear, grief) are reflected on a person’s face. Each is characterized by a certain “mask”, which is formed by contractions of facial muscles. The signal comes from the cerebral hemispheres along the nerve trunks. Anatomical structures cause the same actions on both sides.

If on the one hand there is a focus of inflammation, a tumor, or traumatic disorders in the path of impulse transmission, then the muscles contract differently. Sensitive endings react with pain, and an adaptation appears in muscle groups that reduces pain. This is reflected in the symmetry of the face. Based on the sign, the neurologist diagnoses the level of damage.

When choosing a method for eliminating asymmetry, cosmetologists and plastic surgeons take into account that the static (morphological) option is often caused by anomalies in the development of the bones of the facial skull, injuries, and the consequences of diseases of the muscular system.

To identify functional changes, the patient is asked to smile, stretch out his lips, and raise his eyebrows. Only with “provocation” are signs of unequal contraction of muscle groups revealed. The pathology is characteristic of neuritis of the facial nerve, the consequences of cerebrovascular accident (stroke).

Among the most common lesions of the nervous system leading to facial asymmetry are:

• injuries to the facial nerve resulting from a bruise or complications of surgery;
• neuropathy of the facial nerve (Bell's palsy);
• consequences of unilateral paralysis (due to significant relaxation of muscle tone on one side and high muscle tone on the other);
• unilateral pain syndrome in the face area;
• a sign of damage to the facial nerve due to a viral disease (herpes);
• myasthenic syndrome.

Neurologists take into account a group of synkinesis. This is an abnormal joint contraction of certain muscles. For example, when the eyelid droops and the forehead wrinkles, the corner of the mouth rises on the same side. A similar dependence is formed with neuritis of the facial nerve due to the connection of the fibers with other impulse pathways. In children, the condition is reflected in the development of speech and the pronunciation of individual sounds.

Further care and prevention

When asymmetrical lips are corrected, care must be taken to ensure that the operation is not wasted. Cold compresses and doctor-approved moisturizing creams and balms are necessary for two weeks. Refusal of lipstick, solarium and sauna during this time will be the right decision.

If there is no asymmetry, and there is also a desire to fight it, a healthy lifestyle, visits to the dentist, and regular medical supervision will reduce the risk of diseases that lead to problems with facial beauty. Exercises to improve facial expressions will help keep your facial muscles and skin toned.

The article has been verified by the editors

Stages of development of facial asymmetry

The stages of formation of facial asymmetry depend on the degree of dysfunction of the facial nerve responsible for facial expressions. It is proposed to take into account static and dynamic changes:

• I — despite the pain, the motor functions of the facial nerve are not impaired;
• II - when smiling, moderate asymmetry is revealed, closing the eye requires effort;
• III - the signs are clearly expressed, it is impossible to raise an eyebrow, limited mobility or spasm of the facial muscles is detected;
• IV - asymmetry is determined at rest in the form of an incompletely closed eye, sagging of the corner of the mouth;
• V - muscle contraction on the affected side is impossible, but there is no pronounced spasm (contracture);
• VI - the tone drops sharply, movements are completely paralyzed.

Types of asymmetry

Asymmetry on the lips appears along a vertical line (if you draw a line across the mouth) and horizontally.

• Drooping of the corner of the mouth. Age-related changes associated with deterioration of the nasolabial muscles.
• A tilt of the mouth to one side is a “crooked smile.” May be a symptom of a stroke or associated with inflammation of the facial nerve.
• Different lip volumes. Except for differences due to birth defects, this is normal.
• Uneven lip line. The acquired habit of smiling on only one side can lead to permanent curvature.

How to correct facial asymmetry?

The choice of treatment method depends on clarifying the cause of the asymmetry. It is strictly not recommended to use folk remedies. Their use can worsen the situation. Conservative therapy includes facial exercises, means to increase or decrease muscle tone (electrical stimulation). If there is no effect, injection and surgical methods are indicated.

Cosmetologists consider possibilities only after unsuccessful treatment with neurological drugs. To correct the oval of the face, the shape of the nose and lips, use:

Physiotherapeutic treatment of certain muscle groups - in the first 2 weeks of the disease, the anti-inflammatory effect of blue light, magnetic therapy apparatus, ultrasound with “Hydrocortisone” (phonophoresis), and infrared laser waves are suitable. On days 10–14, it is necessary to examine the electrical excitability of the nerve trunk. If it remains reduced or lost, electrical stimulation is prescribed.

The duration of the procedure is 5–7 minutes, 10 manipulations are required per course. Proserina electrophoresis is performed as prescribed by a doctor. To relieve increased tone, paraffin and mud applications are used.

Injections of drugs based on botulinum toxin (Botox, Dysport, Lantox). To equalize symmetry, injections are given on the healthy half of the face to relieve reflex muscle spasm. If the affected muscle groups causing synkinesis or contractures are accurately identified, then the drugs are administered specifically at certain points. With the help of several courses, it is possible to restore symmetry in 4–6 months.

Botox or hyaluronic acid injection

The introduction of fillers with hyaluronic acid - this method allows not only to perform contouring, lift the corner of the mouth, eyelid, but also to normalize blood circulation in the affected area. Injections are carried out along certain lines, a grid or points (multipuncture method). When choosing a drug, the concentration of hyaluronic acid is taken into account.

The patient will have to maintain the effect obtained after 8–12 months, since the medicine is gradually absorbed. To fill the tissue defect and increase the volume, lipofilling with autologous fat tissue is used.

Surgical correction and thread lifting are the only option for severe unilateral deviation of the anatomical structures of the face. Fillers and botulinum toxin do not correct bone abnormalities.

Thread lifting and surgical treatment

If the defect in the arrangement of paired areas of the face is 50 mm or more, surgical techniques can help restore the aesthetic appearance. Thread lifting is carried out by plastic surgeons by introducing special thread-like preparations made of gold, platinum and polymer materials. They fix sagging muscles and eliminate imbalances.

The operation involves correction of bone defects and persistent contractures. It is performed under anesthesia through a micro-incision using endoscopic technique or with open access. Autoplastic materials and endotins are used. To lift the corner of the mouth, part of the skin and muscles is excised, and the shortened stretched ends are sewn together.

Gymnastics for facial asymmetry

In any case, gymnastics and facial massage help improve microcirculation in tissues and stimulate muscle tone. It is especially indicated for impaired functioning of the lower jaw joint, stretching of the surrounding muscles. It is recommended to carry out the exercises daily in a course of 2–3 months, gradually increasing the number of repetitions from 20 to 50. An approximate complex:

• close your eyes and sharply open your eyes as much as possible;
• form your lips into a tube and pronounce the sound “i”;
• with your nose pinched, imitate a deep breath;
• carry out rotational movements with the tongue in one direction and the other;
• alternately contract the corners of the mouth.

Lip asymmetry - six ways to get “bows”

Asymmetry of the contours of the lips has the same reasons as the rest of the face. But you should pay attention to the dangerous consequences of introducing fillers at home to increase volume. Incorrect calculation of the need for the drug and violation of technology lead to unexpected results.

If asymmetry is associated with individual characteristics, cosmetologists use additional injection of filler on one side or a destructive drug with the enzyme hyaluronidase. Sometimes you have to resort to surgical removal of biogel.

To achieve the effect of “Parisian” lips or a “bow,” fillers with hyaluronic acid are injected into the upper lip. By increasing the volume, one achieves the creation of an O-shape. Usually 1 ml of filler is enough. The technique of administration depends on the original form. Options are possible if the lower lip is thick enough, injections are carried out:

• in the central toe on both sides equally;
• into arcuate elevations;
• in the middle part of the internal mucosa;
• evenly “fan” along the contour;
• while simultaneously raising the corners (a diamond shape is created).

Correction of lip asymmetry does not equally cover the contours on both sides. The amount of filler consumed depends on the damaged shape. If the lower lip is thin, it is chipped at the same time, without affecting the corners of the mouth.