Correction of asymmetric facial deformity by contouring: indications and outcomes.

Abstract

Facial asymmetry is usually due to unbalanced development of the lower jaw and zygoma and often results in esthetically unpleasant appearance. However, reasonable and systematic treatment of such an asymmetric face is rarely reported in the literature. This article aims to evaluate the effectiveness of surgical correction of asymmetric facial deformity and discuss their indications. From July 2006 to November 2010, a total of 52 patients received contour reshaping procedures to correct their asymmetric faces. Those patients in whom the asymmetric facial deformities were initiated by hypertrophy of the mandible and zygoma without occlusion and temporomandibular joint problem were chosen for this study. The authors performed a modified reduction malarplasty to correct asymmetric middle face and mandibular outer cortex splitting ostectomy, mandibular "V-line" ostectomy, and rotation genioplasty to improve asymmetric lower face depending on individual asymmetric facial characteristics. The effectiveness was then evaluated through cephalometric radiographs, three-dimensional computed tomography, and presurgical and postsurgical standard facial photographs. The postoperative results of all 52 cases showed that the asymmetric face was effectively corrected without serious complications and the harmonious facial contour improved significantly. The final esthetic outcomes were quite satisfactory for both surgeons and patients. The results indicate that a variety of contouring techniques for facial asymmetric deformity could be carried out based on characteristics of asymmetric face, so as to acquire a symmetric and harmonious face in accordance with facial esthetics.