Thank you for your question. You submitted a photo with your face relaxed and smiling,
and you described that you wore braces as an adult for several years and that you have
a challenge because of an issue with the difference on one side of the other in terms of your
jawbone anatomy. You’ve seen a plastic surgeon regarding to the desire to improve symmetry,
and the doctor suggested to address the line you describe from your nose to the outer part
of your mouth that he could put some Juvederm. That certainly it seems to encapsulate the
question, but you are asking how do you make your face more symmetric.
Well I can certainly give you a perspective on this. I'm a Board-certified cosmetic surgeon
and facial rejuvenation is a big part of my practice. I've been practicing in Manhattan
and Long Island for over 20 years, and certainly this type of challenge is something that we
deal with a lot in our practice. With the understanding that the human face is naturally
asymmetric, I will say that we are beautifully imperfect, and many people tried to address
asymmetries.
So with that being said, understanding that Juvederm, at this point, with the way your
doctor is suggesting, is being used as a dermal filler. A dermal filler means that it's being
placed in the level of skin called the dermis. Now the dermis has only certain amount of
thickness and it can be placed in that area and soften that line. Now it is something
that is very common that doctors consider looking at the face based on patient's concerns.
Patients typically, or people in general, focus on lines. Well there's another way to
also look at your face, and that is to look at the volume. So you said that one side of
your face has a larger bone structure compared to the other.
Well, we have an approach in our practice, which we refer to as “structural volumizing”,
and this is derived from a method called the Y Lift. Now, the Y Lift is a way to help rejuvenate
the face using a filler, a hyaluronic acid filler, such as Juvederm and Voluma. But as
opposed to only focusing on the lines, I'll would say the lines are only part of the picture,
they're part of the reality that there is a difference in volume.
So, there've been many patients who come to us who are focused on the same lines, and
they referred to frequently as nasolabial fold lines or parentheses lines, people will
often come with that concern, but I can tell you doing this type of work for over 20 years
that, you can make an improvement and you can make someone happy and satisfied. But
when we do structural volumizing, such as restoration of volume or balancing volume
in the cheek, the jawline, the chin, the angle of the jaw, or the angle of the mandible,
then consistently people look in the mirror and they are very impressed. What's particularly
worth noting is that they will not think of the line as being as significant as it did
before, and the reason is, is that in the context of the restoration of proportion and
that's probably what's really bothering you is that there is something called the Golden
Ratio.
The Golden Ratio is derived from the Greek culture about balance in nature and balance
in aesthetics, and it's a ratio of 1.6 : 1. A lot of times people walk around the city,
in New York City and Long Island, and the faces are all bloated because they've so much
filler and there's no angularity or balance, or they have very large facial implants, or
too much filler in their cheeks, and their balance is off. But when you see natural balance,
it looks really nice and so something to think about is, in addition to the strategy of filling
the lines, is look at your face and think of structural volumizing as I described. With
the Y Lift, what we're doing is we're putting Juvederm at a deeper level, on the bone structure,
below the muscles, and having this structure expand and balance out the face. You can actually
put many syringes of Juvederm and paradoxically you won't look swollen ,you actually look
thinner, you look like you have more structure.
So I think that in addition to the nasolabial fold suggestion, is not that we don't do that,
we do that as well, but it is certainly a perspective that you may want to think about
when you understand that it's not the fold so much as it may be the rest of the face,
and how to balance it out so it looks more like in proportion—again, thinking of the
Golden Ratio. Of course, injection in the nasolabial fold will soften that line, but
I'm not sure it'll be as good as you hoped, but that's more about the communication between
you and your doctor. It's very important to understand what your expectations are and
whether the doctor can fulfill those expectations. With that being said I hope that was helpful
I wish you the best of luck. Thank you for your question.