The chin is shifted to the side
The chin deviates from the middle of the face. Among patients with asymmetry in the examination of 1,460 people, the chin was displaced in 74%.
CONDITION / JAWS, MOUTH AND NECK
Asymmetry of the face and jaws.
Asymmetry of the face and jaws is a noticeable difference between the left and right halves of the face when the jaws, teeth, or soft tissues are misaligned. Slight asymmetry is common and considered normal; treatment is considered when it is noticeable, increases or interferes with chewing.
CONCEPTUAL VISUALIZATION- What it is
- A noticeable difference between the halves of the face due to jaws, teeth, joints or soft tissues.
- When is this the norm?
- Slight asymmetry is common and considered normal.
- How common
- Among 1,460 patients of the maxillofacial deformities clinic, 34% had noticeable asymmetry.
- Who treats it
- Maxillofacial surgeon together with an orthodontist; first they look for a reason.
01 / WHAT IS ITWhat is
What is
jaw asymmetry
A completely symmetrical face is rare: a slight difference between the halves is common and often imperceptible. Asymmetry is considered a problem when the difference is noticeable to the eye, interferes with chewing or closing the teeth, or gradually increases.
The difference can come from bones (lower or upper jaw, condyle, which connects the jaw to the skull), from teeth and bite, or from soft tissues - fat, muscles, skin. Often there are several components at once: the teeth close with a shift, the line between the front teeth is shifted, and the plane along which the teeth close is inclined.
First, they find out the cause, because the treatment is primarily aimed at it. If the asymmetry is combined with an incorrect bite, the jaws are rearranged during orthognathic surgery; the volume of bones and soft tissues on one or both sides is sometimes additionally increased or decreased.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow
How
asymmetry presents.
Soft tissues, teeth and bones are evaluated separately. People do not notice asymmetry in the same way: according to a review of studies, the difference in the position of the eyelids is visible from 2 mm, the corner of the mouth - from 3 mm, and the shift of the chin - from about 6 mm.
The teeth close with a shift
The line between the front teeth does not coincide with the middle of the face, on one side the teeth close differently than on the other.
Mesial biteSloping line of teeth
The plane on which the teeth close is inclined: in a smile, more teeth or gums are visible on one side. 41% of patients with asymmetry in the same examination had this inclination.
Halves of different volume
One cheek or the corner of the jaw is fuller, the other half seems sunken - this is how soft tissue or bone asymmetry manifests itself.
The joint
Clicking, pain or limited mouth opening on one side. According to a meta-analysis of 7 studies, unilateral temporomandibular joint disease is associated with chin asymmetry, although the evidence is low.
Dysfunction of the joint03 / REASONSWhere does it come from?
Where does it come from?
asymmetry
The causes are congenital, acquired, post-traumatic and growth-related. The treatment plan also depends on the cause.
Congenital underdevelopment
One half of the face — jaw, ear, soft tissues — is underdeveloped from birth.
Hemifacial microsomiaExcessive growth of the condyle
The condylar process of the lower jaw on one side grows more than it should, and the jaw shifts or lengthens. Deformation can grow even after 20 years. In Germany, 2.4–9.6 cases per 100,000 people are diagnosed or treated.
Injury
Displaced fractures of the jaws or cheekbones change the contour of the face and bite.
Deformations after injuriesThe joint
Fusion or destruction of the temporomandibular joint on one side changes the growth and position of the jaw.
Ankylosis of the jointSoft tissues
With progressive hemiatrophy (Parry-Romberg disease), the subcutaneous layer of one half of the face gradually thins. Asymmetry is also caused by paralysis of the facial nerve.
Paralysis of the facial nerveThe reason is unknown
The reasons for many cases of asymmetry formed during growth cannot be clarified.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
The asymmetry, which has been forming for years, does not need urgent help. But if the face is suddenly crooked, it could be a stroke - call 103.
103 immediately if:
- the corner of the mouth or eyelid suddenly dropped on one side, it became difficult to smile;
- a person cannot raise both hands and hold them;
- speech became slurred or confused;
- such signs were present during the last day, even if they have already passed;
- after surgery on the jaws, the swelling in the mouth or on the neck grows quickly and prevents breathing or swallowing;
- it is very difficult to breathe, the person suffocates or cannot utter words;
- bleeding from the mouth or wound does not stop;
- blood gushes, bright red, it is difficult to stop;
- very frequent breathing;
- confusion, the person speaks illogically;
- the skin or lips are pale, bluish or marbled;
- the body is very hot or cold to the touch, shakes a lot.
Other levels of urgency:
Immediately - to the surgeon who operated, and if it does not work - to the waiting room: after surgery, the pain or swelling of the face is severe or increases, and painkillers do not help. On the same day - call the surgeon: after surgery, pus comes out of the wound or mouth, the suture has come apart, you have a fever, or you feel generally unwell. Scheduled, without delay: asymmetry noticeably increases - especially in a teenager or young person - the teeth began to close differently, clicking or joint pain appeared. Early diagnosis of excessive growth of the condyle makes it possible to stop the progression. A long-standing stable asymmetry is a reason for a regular planning consultation.
05 / DIAGNOSTICSHow to determine
How to determine
the reason
- Conversation and photo
When asymmetry was noticed, whether it is growing, whether there were injuries and operations. Photos from different years help.
- Review
The doctor separately evaluates soft tissues, bite and bones, checks movements and sounds in the joint.
- Panoramic shot and CT
The pictures show which bone is displaced and how much; CT gives a three-dimensional picture.
- Growth check
If excessive growth of the condyle is suspected, scintigraphy (SPECT) is performed - it shows whether the bone is still growing.
- 3D model
They build a model of the face and jaws based on the CT scan and plan what to move on it.
06 / TREATMENTHow to fix
How to fix
asymmetry
Treatment depends on age, cause and severity of asymmetry — from orthodontics to jaw surgery. The goal is a noticeably flatter face and proper teeth closure, not complete mirror symmetry.
01
First, the reason
Treatment is primarily aimed at the disorder that caused the asymmetry.
- Only the teeth
- If only the dental arches are asymmetric, sometimes orthodontic treatment is sufficient.
- Excessive growth of the condyle
- Treatment is mainly surgical: partial removal of the condyle (condylectomy) and/or orthognathic surgery. If growth still continues, proportional reduction of the condyle stops it. Most of the studies are small series, the evidence is low.
- The joint
- When the cause is joint fusion, asymmetry is corrected by surgery on the joint, sometimes by lengthening the jaw with a device (distraction).
02
Jaw surgery
If the asymmetry is combined with an incorrect bite.
- What are they doing?
- The jaws are dissected in the planned places, rearranged in a symmetrical position and fixed with plates. An orthodontist aligns teeth before and after surgery.
- 3D planning
- In a review of studies of patients with asymmetry, the average soft tissue prediction error was less than 2 mm; the lower third of the face is least accurately predicted. Errors of printed patterns are less than 2 mm.
- Quality of life
- In a meta-analysis of 7 studies, jaw surgery had a positive effect on the quality of life of people with jaw and bite deformities.
- Numbness
- If the lower jaw is split (sagittal osteotomy), the sensitivity of the lip and chin may decrease. According to a meta-analysis of 47 studies (5,406 patients), 21% of sensitivity disorders remained after one year; the risk was higher in older patients and with greater forward jaw protrusion.
03
Contour and soft tissues
Bone surgery is supplemented or asymmetry is corrected without changing the bite.
- Individual implants
- Titanium or PEEK implants according to the 3D model. In a meta-analysis of 29 studies of contoured facial implants (392 patients), complications were 6.94% with PEEK and 4.77% with titanium; advantages of one material were not revealed.
- Lipofilling
- Own fat adds volume where it is lacking. With mild hemiatrophy, it is sufficient, with medium and severe adipose tissue on its own vessels (flap) is needed for a long-term result.
- Risks of lipofilling
- The true frequency of complications is unknown. Among the described adverse events, 13.4% were serious — fat getting into a vessel or its migration — and can have serious consequences.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Asymmetry of the face and jaws at Dr. Valikhnovskyi's Institute of Surgery is treated in the direction of "New face" - together with deformities after injuries and reconstruction of the jaws. Whether an operation on the jaws or on the joint is required, the surgeon decides after the CT scan; an orthodontist takes care of the teeth before and after the operation.
CLINIC SERVICE
A new face
Form, symmetry, facial expressions and functions after injuries, wounds, burns, removal of tumors and congenital changes.
View service
What we do for this condition
- Virtual planning and 3D printing — they build a three-dimensional model based on the CT scan and plan the movement of the bones in advance.
- Mirror CT modeling — the healthy half of the face is mirrored on the changed one to get a plan of the contour and bones.
- Surgical templates — printed guides, along which the bone is sawn at a given angle.
- Osteotomy — bones that have fused with displacement are dissected, rearranged and fixed with titanium plates.
- Individual implants made of titanium or PEEK — plates or fragments of the jaw based on a 3D model, repeating the anatomy of the patient.
- Joint implant — when the joint of the lower jaw is destroyed.
- Lipofilling — own fat is injected with thin cannulas into the asymmetry zones.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend a full-face, profile and smiling photo, as well as a CT or panoramic shot, if available.
- ConsultationExamination of the face, bite and joint; if necessary — CT.
- PlanThe reason for the asymmetry, the 3D model, what to move, whether an orthodontist is needed and how many stages.
- TreatmentBone surgery, contour correction or their combination.
- RecoverySwelling is greatest in the first days and passes in a few weeks; after surgery on the jaws, food is only soft or liquid for a while.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
Is it normal to have a slightly asymmetrical face?
Yes. Slight asymmetry is common and considered normal. According to a review of studies, the displacement of the chin begins to be noticed from about 6 mm.
Can asymmetry be corrected without surgery?
If only the teeth are asymmetric, sometimes orthodontics is enough. Bone asymmetry with an incorrect bite is corrected by surgery on the jaws, and the lack of volume is corrected with an implant or lipofilling.
Why does chin asymmetry grow?
One of the reasons is the excessive growth of the condylar process: the deformation can increase even after 20 years. Early diagnosis makes it possible to stop the progression.
Will an implant help instead of jaw surgery?
The implant aligns the contour, but does not change the bite. If the teeth do not close properly, jaw surgery is usually required, and an implant only complements it.
Will there be numbness after the operation?
This is possible. After sagittal osteotomy of the lower jaw, sensitivity of the lip and chin may decrease; according to a meta-analysis of 47 studies, 21% of patients remained impaired after a year.
Why 3D planning?
To see in advance on the model where and how much to move the bones, and to print templates for the operation. The average soft tissue prediction error in the review of studies was less than 2 mm.
What to do if the face is crooked suddenly?
Call 103: it could be a stroke. Sudden asymmetry is not the planned jaw asymmetry that this page is about.
Sources
20 sources · reviews, guidelines and researchshowCollapse
- Clinical Practice Guideline: Condylar Hyperplasia of the Mandible—Diagnosis and TreatmentDeutsches Ärzteblatt International, 2024doi:10.3238/arztebl.m2024.0210 ↗
- Condylar hyperplasia: current thinkingBritish Journal of Oral and Maxillofacial Surgery, 2018doi:10.1016/j.bjoms.2018.07.017 ↗
- Facial asymmetry: etiology, evaluation, and managementChang Gung Medical Journal, 2011pubmed.ncbi.nlm.nih.gov/21880188 ↗
- Facial asymmetry: a current reviewDental Press Journal of Orthodontics, 2015doi:10.1590/2177-6709.20.6.110-125.sar ↗
- Facial Asymmetry-Demystifying the EntityJournal of Maxillofacial and Oral Surgery, 2023doi:10.1007/s12663-023-02053-9 ↗
- The prevalence of facial asymmetry in the dentofacial deformities population at the University of North CarolinaInternational Journal of Adult Orthodontics and Orthognathic Surgery, 1997pubmed.ncbi.nlm.nih.gov/9511487 ↗
- Discriminative Thresholds in Facial Asymmetry: A Review of the LiteratureAesthetic Surgery Journal, 2017doi:10.1093/asj/sjw271 ↗
- Are temporomandibular disorders associated with facial asymmetry? A systematic review and meta-analysisOrthodontics & Craniofacial Research, 2021doi:10.1111/ocr.12404 ↗
- The accuracy of soft tissue movement using virtual planning for non-syndromic facial asymmetry cases — a systematic reviewOral and Maxillofacial Surgery, 2023doi:10.1007/s10006-022-01059-w ↗
- What is the accuracy of the surgical guide in the planning of orthognathic surgeries? A systematic reviewMedicina Oral, Patología Oral y Cirugía Bucal, 2022doi:10.4317/medoral.25042 ↗
- Persistent Neurosensory Disturbance Following Sagittal Split Osteotomy: A Systematic Review and Meta-Analysis of One-Year Outcomes and Risk FactorsJournal of Oral and Maxillofacial Surgery, 2026doi:10.1016/j.joms.2025.08.014 ↗
- Impact of orthognathic surgery on quality of life of patients with dentofacial deformity: a systematic review and meta-analysisBritish Journal of Oral and Maxillofacial Surgery, 2021doi:10.1016/j.bjoms.2020.08.014 ↗
- Esthetic restoration in progressive hemifacial atrophy (Romberg disease): structural fat grafting versus local/free flapsJournal of Craniofacial Surgery, 2014doi:10.1097/SCS.0000000000000831 ↗
- Facial Fat Grafting (FFG): Worth the Risk? A Systematic Review of Complications and Critical AppraisalJournal of Clinical Medicine, 2022doi:10.3390/jcm11164708 ↗
- Complications After Patient-specific Implants for Facial Contouring and Augmentation: A Systematic Review and Meta-analysisPlastic and Reconstructive Surgery Global Open, 2026doi:10.1097/GOX.0000000000007911 ↗
- Symptoms of a strokeNHS, 2024nhs.uk/conditions/stroke/symptoms ↗
- Bell’s palsyNHS, 2023nhs.uk/conditions/bells-palsy ↗
- Cuts and grazesNHS, 2026nhs.uk/conditions/cuts-and-grazes ↗
- Shortness of breathNHS, 2024nhs.uk/symptoms/shortness-of-breath ↗
- SepsisNHS, 2026nhs.uk/conditions/sepsis ↗
The figures on the page are from these sources.
The face became
asymmetrical?
Submit full-face and profile photos and headshots, if available. The doctor will tell what causes the asymmetry and what can be changed.