Facial asymmetry: causes, how to fix. Photo disease and treatment

A slight asymmetry of the body (virtually imperceptible differences in the structure of the right and left halves) is a normal ubiquitous phenomenon, due to genetic characteristics and the dominance of the functions of the right or left limbs. Facial asymmetry is also found in all people, but in this case, the phenomenon can cause complexes, discomfort and even nervous disorders. In some cases, even what is considered the norm among specialists, the owner of a non-standard face may seem like a pathological deviation. The causes of the condition can be varied. In some cases, the formation of inconsistencies can be avoided, it is only necessary to eliminate the effect on the body of certain factors.

The difference between normal and abnormal

Distinguishing physiological asymmetry from pathology is quite simple. Under normal conditions, the difference is not obvious, only small differences are noted when comparing the two halves of the face. Most often, the left half of the face is characterized by more feminine and smoothed features, slightly elongated vertically. At the same time, the right half is slightly wider, more masculine and sharper. Experts even set specific indicators to facilitate the process of making a diagnosis - the difference in proportions should not exceed 3-5 ° or 2-3 mm.

In particularly difficult cases - for example, with damage to the facial nerve - facial asymmetry is accompanied by severe symptoms.

1. On the affected half, facial muscles weaken, which leads to sagging of the cheeks, drooping of the corner of the mouth.
2. The affected part of the face becomes like a mask due to the impossibility of performing traditional movements.
3. Natural frontal and nasolabial folds are smoothed out.
4. The palpebral fissure is noticeably widened.
5. Unlike the healthy half, a pained expression appears on the affected part.
6. Mimicry suffers greatly: the ability to close the eye, lift the lip, wrinkle the nose or forehead disappears. All this applies only to the sick side.
7. Over time, signs of speech impairment appear, and the risk of nutritional problems is high.
8. In some cases, external signs are accompanied by severe pain.

In the event of a violation of the muscles on one side of the neck, the formation of specific symptoms is possible, for example, a strong tilt of the head to one side, an obvious predominance of the volume of one cheek, smoothing the shape of the head.

Causes of asymmetry

The causes of asymmetry of the body and face are divided into congenital and acquired. The degree of development of the pathology and the method of its elimination depend on the type of provoking factor.

Congenital asymmetry of the face may be a consequence of the following conditions caused by a violation of intrauterine development or a genetic predisposition:

• pathology of the development of the bones of the skull;
• violation of the process of formation of the joint that attaches the lower jaw to the temple;
• connective and muscle tissue defects;
• slow development of the lower jaw.

Acquired pathology usually results from injuries, previous diseases and improper care of the jaws and muscular apparatus. There are many such reasons.

• Prolonged lying on one side of the body or a consequence of torticollis in children.
• Violation of the visual function of the eyeballs with the formation of strabismus.
• Inflammatory and infectious processes (for example, a breakthrough of a boil), leading to damage or pinching of the facial nerve.
• Absence of teeth on one side of the face, severe malocclusion.
• Fractures of the facial bones with displacement and incorrect fusion of the edges.
• Systemic diseases of the muscle or connective tissue.
• Wrong lifestyle (regular squinting of one eye, using only one part of the jaws while chewing, sleeping on one side, constant use of chewing gum).

Often, facial asymmetry is a side effect of a stroke and occurs as a result of permanent paralysis of the facial muscles.

Diagnosis and treatment

Often, a visual examination of the patient, taking an anamnesis, identifying injuries and inflammatory processes is sufficient to make a diagnosis. In addition, facial proportions can be measured using special devices.

To clarify the degree of damage to the facial nerve and identify the area of ​​influence, it is necessary to additionally go through the following steps:

1. get a consultation with a neurologist;
2. undergo a complete neurological examination;
3. make an x-ray of the skull;
4. get advice from specialized specialists (oculist, dentist or neurosurgeon);
5. perform an MRI of the face.

Treatment of pathology depends on the cause and can be conservative. Massage and gymnastics of the muscular frame with increased stimulation of problem areas help well. In some cases, physiotherapy procedures are prescribed. It is important to consider that the treatment of the condition at home without the recommendation and regular supervision of a doctor is prohibited!
If the face is not severely disfigured, then correctly applied cosmetics, a certain form of hairstyle, the use of a beard or mustache (for men) are enough.

If the asymmetry of the face leads to its disfigurement, radical methods are used: treatment by an orthodontist, surgical correction of the maxillofacial apparatus, plastic surgery.

Negative consequences and preventive measures

If the pathology is not treated, there is a high risk of deterioration of the condition, which can lead to nutritional problems, hearing loss, pain as a result of constant muscle tension. Do not forget about the deterioration of the mental state of the patient. Neuroses, aggressiveness, pathological isolation and chronic depression are possible. After an unsuccessful surgical intervention, facial expressions often change, a nervous tic appears, and a tendency to inflammatory processes is formed.

The development of such an unpleasant condition as facial asymmetry can be prevented. It is only necessary to lead a healthy lifestyle, regularly visit a dentist and, if necessary, an orthodontist, give up bad habits, consult a doctor in a timely manner when risk factors form.

If a person is unable to come to terms with his external data, a harmonious existence is impossible. Even with a slight asymmetry that confuses the patient, he is shown conservative and even radical therapy at the discretion of the specialist.

Immediately after your baby is born, his head will be slightly deformed. it can even frighten mothers who did not devote time to reading special literature before giving birth. You should not be afraid: during the passage of the birth canal, the bones, which are connected by soft cartilage, folded like a bud to make it easier for a child to be born. As a rule, the head becomes round a few days after childbirth. But if the baby has an asymmetrical face, this is a reason to visit a specialist. Let's try to figure out why there is asymmetry of the face in a newborn and what to do about it.

Natural asymmetry

It is not surprising that young mothers who have recently returned from the hospital can look at the baby for hours. Very often they notice that the baby's face is a little asymmetrical. One eye is slightly larger than the other, the right eyebrow is raised higher than the left ... Should such symptoms be alarming? The answer to this question will be negative. The face of each person has a slight natural asymmetry. Scientists have even proven that perfectly symmetrical faces are perceived as less attractive and even repulsive. Therefore, a slight asymmetry, which can only be noticed by carefully examining the baby, should not cause alarm.

A noticeable asymmetry that catches the eye is the reason for a visit to a specialist

The main causes of asymmetry

The main causes of facial asymmetry in newborns include:

• uneven development of the bones of the facial skull, caused by intrauterine trauma. In infants, asymmetry can be caused by incorrect presentation, entanglement with the umbilical cord, etc .;
• muscular dystonia, that is, a change in the tone of facial muscles;
• damage to the facial nerve, which was caused by compression with obstetric forceps;
• the passage of the birth canal in the breech or transverse presentation. In this case, during childbirth, the head is flattened too much, and the lower jaw is deformed;
• fractures of the temporal bone during the passage of the birth canal;
• epilepsy. This disease often causes facial asymmetry in newborns. At the same time, diagnosing epilepsy is quite difficult: for this you need to find an experienced specialist.

Often the cause of asymmetry is a disease such as torticollis. It is not difficult to notice this pathology and distinguish it from others: with torticollis, the entire body of the baby bends in one direction. Unfortunately, if the treatment of torticollis is not started in time, the muscles will be fixed in a deformed state, that is, the location of the facial tissues will change. As a result, one eye remains slightly dilated, the corners of the mouth move, and the mouth itself curves.

Below, the reasons for which facial asymmetry occurs in a newborn will be discussed in more detail.

Epilepsy of the newborn

Epilepsy in newborns, which can cause facial asymmetry, is difficult to diagnose. After all, the baby is not yet able to report his condition, and a convulsive seizure is easy to confuse with uncoordinated movements characteristic of any baby.

Seizures in a child can develop due to local brain damage during childbirth, hemorrhages, and even strokes. Epilepsy also affects the symmetry of the child's face. For example, you may notice that one nasolabial fold is smoother than the other, one eye opens wider than the other, and so on.

Torticollis: manifestations and treatment

In children, torticollis, which is a congenital pathology of soft and bone tissues, usually manifests itself two to three weeks after birth. Torticollis occurs in about 2% of children, with girls suffering from this disease much more often than boys.

The main cause of torticollis is the pathology of the sternocleidomastoid muscle, which for some reason loses its elasticity.

During childbirth, the sternocleidomastoid muscle is injured during the passage of the birth canal, as a result of which a scar is formed in place of the muscle tissue, holding the head of the baby in a certain position.

The pathology of the sternocleidomastoid muscle can occur due to intrauterine infection or due to the fact that the child is uncomfortable in the uterus. Also, torticollis can develop due to entanglement with the umbilical cord or with breech presentation.

Torticollis can form because parents hang toys on only one side of the crib. The baby is forced to constantly keep his head in one position, as a result of which the muscles of the neck and face are deformed.

birth trauma

Unfortunately, birth trauma often causes young parents to treat their baby for a long time after he is born.

The causes of birth trauma can be not only the inept actions of midwives, but also a number of other factors, for example, a too narrow pelvis, diseases of a pregnant woman, and a post-term pregnancy. Also, breech presentation of the fetus and its too large size, intrauterine hypoxia, abnormal labor activity (too fast or too long labor), etc., lead to birth injuries.

The reason for the development of facial asymmetry in a newborn is usually the improper use of obstetric instruments, such as forceps, a vacuum extractor, and others.

The result of birth trauma may be damage to the facial nerves, which causes asymmetry. This is a serious complication that can stay with the child for a very long time, so you should immediately consult a doctor with a similar problem.

How to deal with asymmetry?

Treatment of asymmetry of the face of a newborn depends on what factor caused this manifestation.

With torticollis, the child is shown special preparations, as well as regular massage sessions and electrophoresis. A good result gives the correct laying of the child. In particular, the child should lie with the healthy side against the wall. The baby will want to see what is happening in the room and will try to turn the head in the opposite direction, while the short muscle will be stretched.

With torticollis, pediatricians recommend using a special bagel instead of a pillow, which can be made independently from sterile bandages and cotton wool. You can also put bags of cereal on both sides of the head. Keep the child in this position for 2 hours daily.

Wearing a collar helps correct torticollis, which is a foam construction with a notch for the chin.

Massage and physiotherapy exercises help to achieve excellent results with torticollis.

After the sternocleidomastoid muscle is stretched, the asymmetry of the face of the newborn will also disappear. It is important to start treatment as early as possible, otherwise irreversible changes may occur in the mimic muscles.

With epilepsy and birth trauma, treatment is prescribed individually. As a rule, if the baby suffers from epileptic seizures, the asymmetry of his face is one of the least problems of parents. To stop seizures, special drugs are prescribed, modern physiotherapy helps to achieve good results. Birth injuries that led to the asymmetry of the face can be corrected with regular massage of the baby's face. How to perform this massage? You will learn about this in the next section.

Newborn face massage

An experienced massage therapist can easily determine the asymmetry of the baby's face: on the one hand, the muscles are always more trained, on the other, they are sluggish and relaxed. On the side on which the muscles are weaker, the exercises should be repeated three times more than on the more “strong” one. Usually on the more “trained” side of the eye, the eyes are slightly smaller in size. This means that the impact will be less on this side.

Hands before the massage should be washed with warm water and wiped dry. The child should be placed on your knees. Massage should be performed after the child has eaten

The main method of facial massage in newborns is gentle stroking, which is performed with three fingers tightly pressed against each other. When touching, do not put too much pressure on the fingers: the baby should experience pleasure from touching. In addition, it is very important not to damage the delicate skin of the child.

First you need to make stroking movements along the hairline from the forehead to the temples. After making 5-7 movements, you can move to the forehead, running your fingers between the hairline and eyebrows towards the temporal zone.

Particular attention should be paid to the eyebrows. Eyebrows should be stroked with light pressure, moving from the bridge of the nose to the temples.

In the same way, you need to “process” all areas of the face: the wings of the nose, cheeks, the dimple above the upper lip. You need to finish the massage with light strokes of the child's neck.

Facial asymmetry in a newborn may be a completely normal individual sign, or it may indicate the presence of a fairly serious neurological disease that requires urgent treatment. Therefore, you should definitely talk to your pediatrician and discuss your concerns with him.

Slight asymmetry of the face is present in every person, small children are no exception.

Studies show that such a disproportion is considered more pleasing than the symmetry of a person's face.

With natural asymmetry, the difference in sides is invisible to the naked eye. In the early days, mothers look at their baby for a long time.

And the observed differences in the sides of the baby's face can cause some concern. In this case, it is best to consult a doctor to exclude the possibility of pathological disproportion of the face.

The natural asymmetry of the child's face can be found in a slight difference in the size of the eyes, just above the planted eyebrow.

Scientists have proven that normally the difference between the sides of the face should not exceed 2-3 mm or 3-5 degrees. As a rule, the left side is more feminine, the features are smoothed and elongated vertically.

The right side is wider, with well-defined features and is considered more masculine.

Therefore, such a slight disproportion should not cause excitement in mommy. In children under one year, mild asymmetry is considered the norm.

If the disproportion of the face is clearly noticeable, manifests itself even in a calm state, is expressed in the difference in the placement of the eyebrows, the size of the eyes, a noticeable difference in muscle tone, sagging of one side of the face, then this is considered a pathological change. It is urgent to consult a doctor to find out the cause and prescribe adequate treatment.

The main causes of asymmetry

In the modern world, scientists identify more than 20 causes of facial asymmetry. But all of them can be divided into two groups: congenital and acquired.

Congenital include:

• uneven development of the facial bones of the skull, resulting from intrauterine trauma. In newborns, disproportionality of the face may be caused by incorrect presentation or entanglement of the umbilical cord;
• spasmodic contractions of mimic muscles;
• trauma to the facial nerve caused by compression of obstetric forceps;
• breech or transverse presentation and subsequent passage of the birth canal. In this case, the child's head is strongly compressed, and the lower jaw is deformed;
• damage to the temporal bone during the passage of the birth canal;
• epilepsy - very often causes asymmetry of the face of newborns. It is problematic due to the fact that the child cannot yet tell about his condition, and convulsions can be mistaken for poorly coordinated movements characteristic of infants. Seizures can be the result of brain damage during childbirth, hemorrhages and strokes. In epilepsy, asymmetry is expressed in a greater smoothness of one nasolabial fold, a wider opening of one eye in relation to the other.

The acquired causes of asymmetry in children at an early age include. You can detect this pathology yourself. With this disease, the baby's body is tilted to one side. This is a pathology of bones and soft tissues, which usually manifests itself 2–3 weeks after birth. This disease is not so common, girls are more susceptible to it than boys.

Wryneck in a baby

The causes of torticollis can be an injury to the sternocleidomastoid muscle during childbirth, as a result of which the muscle tissue is replaced by scar tissue, giving the baby's head a tilt to one side. Another cause of torticollis may be intrauterine infection or an inadequate position of the fetus in the uterus.

In the postpartum period, torticollis may appear due to the fact that toys were hung in a crib or stroller on only one side. And the child had to constantly keep his head in one position, which caused deformation of the muscles of the face and neck.

Also, birth injuries are among the acquired causes of facial disproportion. The causes of such injuries are negligent actions of midwives, as well as illness during pregnancy. Causes include overstaying, too large a fetus, intrauterine hypoxia, a narrow pelvis of a woman in labor, or an abnormal birth process (too fast or prolonged labor).

Birth injuries can damage the facial nerve, which in turn can lead to facial asymmetry.

Acquired causes include trauma to the jaw and facial bones, inflammation of the nerve processes, malocclusion, and the absence of one or more teeth (in older children).

How to deal with asymmetry?

The choice of treatment depends on the cause of the disease.

If the reason is low tone, then facial gymnastics, myostimulation and massage give a good effect.

Facial nerve injury is treated in a hospital by physiotherapy, electromyography and myostimulation

With a more severe pathology, methods such as:

• orthodontic treatment;
• jaw surgery;
• plastic surgery.

With birth trauma or epilepsy, the appointment of treatment is always individual. With epilepsy, facial asymmetry is not the biggest concern of parents. To stop seizures, medication is prescribed, but physiotherapy helps to remove asymmetry quite well. Birth trauma will help cure baby's facial massage.

If the cause is torticollis, then the child is prescribed special medications, physiotherapy (electrophoresis) and mandatory massage courses. In addition, at home, the correct laying of the child helps well - it is necessary to put the child with the healthy side against the wall. Due to curiosity, the baby will want to see what is happening around him, and will turn his head in the opposite direction, thereby stretching the short muscle.

Pediatricians advise making a special fixative for the baby's head - a bagel made of sterile cotton wool and a bandage. You can also put bags of cereal on both sides of the baby's head. It is worth fixing the head in this position for 2 hours a day.

In some cases, a Shants collar is used to correct torticollis. Massage and physiotherapy exercises help a lot.

Newborn face massage

The purpose of the massage is to stimulate the neuromuscular fibers, as a result of which they must grow and change their configuration, smoothing out the pathology.

Before proceeding with the massage, it should be remembered that it should be done only with clean hands on previously cleansed skin.

It is also necessary to use a special massage cream or gel so as not to damage the delicate skin of the baby. The usual children's greasy cream is also suitable.

Movements should be light, stroking. It is necessary to do massage over the entire surface of the face, focusing on the problem area.

According to the general rules, you should start with stroking movements, then you need to apply light rubbing movements in order to warm up the muscles. The next set of actions is stretching movements with gentle pressure. It is also worth stroking to complete the massage.

All movements are made along massage lines, from the center to the periphery.

It is always worth remembering that actions should be neat and associated with pleasure and positive emotions, without causing pain.

The massage begins from the hairline, from the forehead to the temples. And gradually descends. After repeating the movements 5-7 times, you can go to the forehead.

With gentle stretching movements, draw your fingers between the eyebrows and the hairline towards the temples.

It is worth carefully working out the eyebrows, acting with a slight pressure from the bridge of the nose to the temporal zone.

With the same stretching movements with slight pressure, it is necessary to walk through all other areas: nose, cheeks, dimple above the lip. The massage ends with stroking movements of the neck.

The disproportion of the baby's face can be quite natural and go away on its own by the end of the first year. But it can also be a sign of a serious neurological disease, which should be treated as soon as possible. This means that parents should definitely contact a specialist as soon as they notice even slight changes in the appearance of their child.

The shape and symmetry of the face are determined by the structure and volume of its muscles, nerves, blood vessels, fatty tissue and ligaments. It is the anomalies in the development of the facial part of the skull or the consequences of injuries, pathological processes affecting the bone structures, as well as the pathology of the facial muscles, that are the main reasons for the development of facial asymmetry. Thus, facial asymmetry can be due to both individual morpho-anatomical features (physiological facial asymmetry) and any pathology, incl. a combination of these factors (in addition to the type of asymmetry, it is important to consider its degree: this is a more accurate characteristic that can be measured [see below]).

When communicating, the first thing a neurologist pays attention to is a person’s face. A slight unevenness of the eyebrows, eyelids, corners of the mouth, different sizes and positions of the wings of the nose, ears, bulge of the cheeks are quite common. From the point of view of neurology, mimic asymmetry, the nature of which is quite complex, is of particular importance in this aspect. First of all, mimic asymmetry is determined by interhemispheric asymmetry. We know that different hemispheres of the brain regulate the motility and sensory of the two halves of the body in different ways, and therefore the mimic activity of different sides of the face is somewhat different. But it turns out that the perception of facial expressions also depends on the state of interhemispheric interaction in a particular person. Therefore, if we, looking at the face of patient a, consider it asymmetric, then we may be mistaken: another person, looking at the same face, sees a different picture due to the peculiarities of his interhemispheric interaction (remember: face perception is subjective). Thus, it is possible to distinguish static and dynamic asymmetry of the face:

■ static (morphological) asymmetry is characterized by the presence of differences in the structure, size, proportions and shape of individual elements of the face that are revealed at rest; they are due to individual developmental features or pathology of the facial skeleton, muscles, the consequences of injuries and diseases; so, for example, a patient (see photo 1) has a slight degree of asymmetry, which is revealed only with a detailed study of certain areas of the face: there is asymmetry of the frontal bone, the position of the eyebrows, orbits, the right palpebral fissure is slightly narrower than the left one, the width and bending of the bones in the cheekbone area. The back and wings of the nose are also asymmetrical; muscles work synchronously and friendly, however, with facial expressions, asymmetry slightly increases (see middle photo 1);

■ dynamic (functional) asymmetry associated with non-synchronous facial motility, manifested in facial expressions; dynamic asymmetry is a consequence of the pathology of the mimic muscles of a congenital or acquired nature or residual phenomena of peripheral (Bell's palsy) or central (stroke) pathology of the facial nerve (in this case, the severity of neuropathy determines the degree of asymmetry); for example, the patient (see photo 2) has a dynamic facial asymmetry due to paresis of the facial muscles innervated by the buccal branch of the facial nerve on the right. The asymmetry present at rest is greatly enhanced by smiling.

The main block of problems when considering mimic asymmetry of the face, from the point of view of a neurologist, are neurological diseases - damage to the facial nerve, hyperkinesia, pain in the face. Let's look at some examples. Romberg hemiatrophy is a disease of unknown etiology, which leads to the development of atrophy of all tissues of one half of the face - bone, cartilage, muscle, fat, skin. The affected part of the face decreases in size, the skin is stretched, dyschromia, graying and hair loss are observed, sweating and sebum secretion is often reduced (but sometimes increased). Sometimes dystrophy and loss of teeth are noted, in severe cases - atrophy of the zygomatic bone and lower jaw. This condition is not associated with the pathology of the facial nerve, but, possibly, with some processes in the opposite hemisphere of the brain. Unfortunately, this disease is not treated, there is only the possibility of symptomatic correction, for example, by volumization methods. A tumor of the parotid gland and the consequences of its compressive effect on the trunk of the facial nerve can also lead to the development of pronounced asymmetry. Therefore, cases of gradually developing hemiatrophy of the face, neuropathy, asymmetry of one half of the face require special attention. Ptosis in myasthenic syndrome is often asymmetrical. This disease is characterized by the dynamics of muscle weakness during the day with aggravation in the evening. Traumatic, including postoperative, damage to the facial nerve often leads to muscle paresis and the development of facial asymmetry. However, the most common cause of facial asymmetry is facial nerve neuropathy or Bell's palsy (including its consequences in the form of post-paralytic contractures and pathological synkinesis of facial muscles, which are not detected at rest, but only during facial movements). According to the WHO, Bell's palsy occurs in 13-25 cases per 100,000 population.

House-Brackman scale for determining the degree of dysfunction of the facial nerve (1985):

The most common types of pathological synkinesis:

Considering the problem of “facial asymmetry”, it is impossible not to touch upon such a component as “wrinkles” (mimic), which can be associated not only with the aging process, but also with a “neurological background”. The nature of facial wrinkles from the standpoint of neurology consists of several components. Firstly, these are genetically determined characterological features of the personality, which predetermine the methods and intensity of mimic emotional expression. Secondly, these are various environmental factors (cold, atmospheric phenomena), in response to the action of which muscle hypertonicity can develop. After all, any impact on the sensitive link activates the motor link of the physiological sensory-motor reflex. This can also include pain effects that provoke spasm of both facial and masticatory muscles (for example, in young patients who suffer from a headache, a characteristic pattern of early static wrinkles is often revealed - horizontal in the forehead and vertical in the interbrow area). In the form of mimic wrinkles, violent movements in the face area can manifest - facial hyperkinesis (the so-called "tics"). The asymmetric nature of the location and depth of wrinkles and folds on the face may be the result of (mentioned above) neuropathy of the facial nerve, both primary and after plastic surgery or trauma.

Chewing muscles are directly related to the activity of facial muscles. Hypertonicity of masticatory muscles occurs not only as a result of a disease (bruxism, oromandibular dystonia), but also as a reactive condition after inadequate or prolonged dental intervention (it should be remembered that the appearance of the lower half of the face reflects a close relationship with the state of the dentoalveolar system). Analyzing the horizontal wrinkles of the frontal zone, one should bear in mind the possible compensatory activation of the frontalis muscle in some variants of ptosis, primarily in myasthenia gravis. However, healthy people also try to raise their eyebrows and upper eyelids by tension of the frontal muscle, thus expanding the field of view (this fact must be taken into account when prescribing botulinum therapy).

Incorrect bite, the structure of the jaws and cranial bones play a significant role in the appearance of a person. Problems such as a heavy chin, thin lips, hollow cheeks are the consequences of improper tooth growth. The appearance of early signs of aging: deep wrinkles, a blurred oval of the face are also a consequence of an abnormal bite.

Facial asymmetry due to malocclusion

Malocclusion is one of the most common problems in orthodontics. Often, parents do not pay attention to how the child's teeth grow, meanwhile, incorrect closing of the teeth entails a lot of unpleasant, and sometimes dangerous consequences. With a crossbite, asymmetry can be quite pronounced (we recommend reading: crossbite: photos before and after treatment). If the asymmetry is enhanced by the displacement of the lower jaw relative to the fixed part of the skull, then the visual effect is even more noticeable.

Norms and pathologies

Normally, a person has slight differences between the right and left sides of the face. At first glance, they are not so noticeable, upon closer inspection, you can see the difference. In numerical terms, the norm is characterized by a violation of proportions by 2-3 millimeters or 3-5 degrees. Parameters that go beyond these figures can be attributed to pathologies. As a rule, they are noticeable immediately.

Pathology can be manifested by the following defects in appearance:

• sagging cheeks, a crooked line and lowered corners of the mouth as a result of atrophy of the facial muscles;
• complete smoothing of the nasolabial and frontal folds;
• enlarged slit of the eye;
• the upper eyelid is not completely in contact with the lower eyelid, the eye does not close completely;
• the face has a tortured, suffering look;
• lack or insufficiency of facial abilities: a person cannot wrinkle his forehead, nose, move his lip.

Pathologies caused by abnormal bite entail not only aesthetic problems. A person cannot chew food normally, as a result of which diseases of the gastrointestinal tract occur. Dictionary disturbances may also be observed. Sometimes bite defects cause pain in a person.

Reasons for the appearance of asymmetry

The causes of the appearance can be external, when the pathology occurs as a result of mechanical damage to the face. In some cases, this problem may be congenital. Congenital and acquired defects, in addition to aesthetic problems, cause various difficulties and diseases, so treatment is the elimination of the root causes of pathology.

Diagnostics

Diagnosis of this pathology is not difficult. A visual examination is enough for the doctor. Special measuring devices have been developed, with the help of which it is possible to determine the degree of severity of the defect. The doctor collects data on facial injuries, inflammatory processes, and dental diseases. If there is a suspicion of neuralgia, then additional studies are carried out with the involvement of a neurologist. Also, diagnosis can be carried out on the basis of the X-ray data of the skull.

Types of defect

To understand what a defect is, you first need to define what a norm is. In a normal bite, the jaws are compressed naturally, while the molars should fall on each other clearly, and the front upper row should protrude about a third above the lower one. If you draw an imaginary vertical line along the face, then it will pass between the two central teeth.

Also, the characteristics of the correct bite include the absence of significant gaps between the teeth. Deviation from the norm may be the result of genetic or acquired changes.

Natural and pathological origin

The natural types of bite are: orthognathic, bioprognathic, straight, progenic and opistognostic. An abnormal bite causes significant distortion and asymmetry of the face, as well as disturbances in the functioning of the dentition.

Pathological bite can be of the following types: open, distal, mesial, deep and cross (more in the article: deep bite: correction methods and photos after the procedure). All of them contribute to the development of complications, therefore, they need to be corrected.

Congenital and acquired asymmetry

Congenital asymmetry develops due to genetic abnormalities, abnormal intrauterine formation and development of the skull, underdevelopment of the lower jaw, abnormal growth of the joint that attaches the jaw to the temporal bone. Also, congenital pathologies can be associated with impaired growth of soft and connective tissues on the bones.

Acquired defects appear as a result of mechanical damage, inflammatory processes and infectious diseases. They can also be caused by unhealthy habits and improper care of the maxillo-muscular apparatus. The reasons causing the development of acquired asymmetry include:

• the habit of sleeping on one side, the development of torticollis in children;
• development of strabismus;
• incorrectly formed bite, lack of teeth;
• inflammation and infection, furunculosis;
• bone fractures and their incorrect fusion;
• autoimmune diseases of muscle or connective tissues;
• bad facial habits: regular squinting, chewing mainly on one side, constant use of chewing gum.

In some cases, the symmetry is broken sharply and is the result of paresis or complete paralysis of the facial muscles. Such pathologies are characteristic of a stroke.

How to treat?

Treatment directly depends on the causes that caused the development of pathology. Minor defects are easily masked with the help of cosmetics, corrective makeup. To correct small defects, massage, exercises for the development and strengthening of facial muscles are used. In some cases, these measures are supplemented by physiotherapy.

For serious problems, when the pathology is very pronounced and disfigures the appearance, more radical decisions can be made. Modern medicine has a large number of methods for correcting appearance. A patient with severe asymmetry may be recommended plastic surgery, treatment by an orthodontist. In cases where facial asymmetry is caused by infringement of the facial nerve, a consultation and treatment with a neurologist is prescribed.

Massage

Massage increases blood flow in the muscles of the face. As a result of intense exposure, atrophied facial muscles begin to grow and change their configuration, which leads to smoothing out defects and positive changes in appearance. Massage should be carried out only by a specialist.

To achieve the best effect, myostimulation is also used. This is a massage using special devices that additionally stimulate the muscles of the face with weak electrical impulses. Such procedures synchronize the work of the facial muscles, make it work more intensively.

Cosmetic procedures

Cosmetology offers many ways to correct facial defects. Most often resort to the so-called contour plastic. Various materials are injected under the skin to smooth or add volume to problem areas. To date, cosmetologists have at their disposal substances synthesized from the natural structural elements of the dermis. Their use is safe, and the body does not reject them.

Fillers with hyaluronic acid are used. In some cases, the beautician may recommend the introduction of Botox. This drug eliminates the ability of the facial muscles to contract, as a result, they relax and do not emphasize defects so much.

Plastic surgery

With the help of plastic surgery, pathological changes in the face can be completely corrected. There are various types of plastics aimed at eliminating certain problems. These include:

• lipofilling (transplantation of fatty tissues on the face from other parts of the body);
• blepharoplasty (eyelid correction);
• mandibuloplasty (correction of the curve of the lower jaw);
• rhinoplasty (nose correction).

Complications due to lack of treatment

Ignoring the problem can lead to the development of various complications:

• uneven grinding of teeth and enamel due to incorrect distribution of chewing load;
• jaw asymmetry;
• early loss of teeth;
• disruption of the gastrointestinal tract;
• respiratory and diction disorders;
• increased traumatism of the oral cavity;
• development of ENT diseases;
• bruxism (we recommend reading: Dr. Komarovsky's opinion about bruxism in children);
• periodontal disease;
• gum recession (more in the article: gum prolapse: causes and treatment).

How to prevent the development of pathology?

Prevention is to closely monitor the condition of the child's teeth. Do not think that milk teeth will be replaced by permanent ones, and they will grow normal. Permanent teeth grow in the same way as milk teeth, so the correct formation of the dentition should occur as soon as they appear.

Make sure that the child breathes through the nose, does not hold foreign objects in the mouth, include solid foods in the diet, do not allow picking your mouth and touching growing teeth. You need to have regular check-ups with your dentist and orthodontist.