Can Facial Imbalance from Childhood Injury Be Corrected with Surgery?

When laughing, there is a dent on the side of the face?

Hello, doctor: My face has a slight asymmetry.
It's not noticeable when I'm not smiling, but when I laugh heartily (the flesh on my face compresses), a dent appears on the right cheek.
My mother said I fell and hit my face when I was three years old, so I would like to ask if it is possible to undergo cosmetic surgery to correct this and prevent the dent from appearing when I laugh.
Are there any side effects? What would the cost be? Thank you! I have searched online for information, and since this is due to an injury, could it be that I have a peripheral facial nerve injury? Is there still hope for recovery? However, it has been over twenty years… Thank you!

Bu xiang lian wai de ren, 20~29 year old female. Ask Date: 2005/03/24

Dr. Lu Daokuan reply Plastic Surgery

Facial nerve rupture can result in one side being immobile, and the indentation when smiling may be a consequence of tissue adhesion following trauma.
Improvement options would likely require an in-person examination.

Reply Date: 2005/03/24

More Info

Facial imbalance resulting from a childhood injury can indeed be addressed through surgical intervention, depending on the specific nature and extent of the injury. In your case, it sounds like the asymmetry in your face, particularly the noticeable indentation on the right cheek when you smile, may be related to the trauma you experienced at the age of three. This could potentially involve damage to the underlying structures of the face, including muscles, fat pads, or even the bone itself.

Surgical Options
1. Assessment by a Specialist: The first step is to consult with a board-certified plastic surgeon or a facial reconstructive surgeon who specializes in facial asymmetry. They will conduct a thorough examination, which may include imaging studies, to assess the underlying causes of your facial imbalance.

2. Types of Surgery: Depending on the findings, surgical options may include:
- Fat Grafting: This involves transferring fat from another part of your body to the area of concern to fill in the indentation.

- Facial Implants: In some cases, implants can be used to enhance the volume of the affected area.

- Muscle Repair: If there is evidence of muscle damage or atrophy, surgical repair or repositioning of the muscles may be necessary.

- Bone Reshaping: If the underlying bone structure is involved, procedures to reshape or augment the bone may be considered.

Risks and Considerations
As with any surgical procedure, there are inherent risks, including:
- Infection: This is a risk with any surgical intervention.

- Scarring: While surgeons strive to minimize visible scars, some scarring is inevitable.

- Anesthesia Risks: Depending on the type of anesthesia used, there are risks associated with both local and general anesthesia.

- Dissatisfaction with Results: There is always a possibility that the results may not meet your expectations, which could lead to further procedures.

Cost
The cost of facial reconstructive surgery can vary widely based on the complexity of the procedure, the surgeon's experience, and the geographic location of the practice. On average, you might expect to pay anywhere from $3,000 to $15,000 or more. It's essential to discuss the financial aspects during your consultation, as many surgeons offer payment plans or financing options.

Neurological Considerations
Regarding your concern about potential nerve damage, particularly if you suspect peripheral facial nerve injury, this would typically present with additional symptoms such as weakness or paralysis on one side of the face. If you have not experienced these symptoms, it is less likely that you have a significant nerve injury. However, a thorough evaluation by a neurologist or a facial plastic surgeon can provide clarity on this matter.

Conclusion
In summary, surgical correction of facial imbalance due to childhood injury is possible, but it requires careful evaluation and planning. Consulting with a qualified specialist is crucial to determine the best course of action tailored to your specific needs. They will help you understand the potential outcomes, risks, and costs involved, ensuring you make an informed decision about your treatment options.

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