Dermal fillers are often associated with simply adding volume to areas such as the lips or cheeks. At Oriah, however, we use them very differently.

When carefully planned and precisely placed, dermal fillers can be used as a powerful tool to improve facial balance, proportion and overall harmony.

Farzana has kindly allowed us to document her treatment journey to demonstrate how a highly tailored approach to facial rejuvenation can be used in a more complex case of congenital maxillofacial asymmetry.

Farzana’s History

Farzana was born with significant maxillofacial asymmetry and had previously undergone surgery to realign her jaw.

Prior to visiting Oriah, she had not undergone any non-surgical aesthetic treatment specifically intended to address her facial asymmetry.

Her history included:

• Congenital maxillofacial asymmetry
• Previous surgery to realign the jaw
• No previous non-surgical aesthetic treatment to address her facial asymmetry

Assessment and Treatment Planning

Cases involving significant facial asymmetry require a comprehensive facial assessment and particularly detailed treatment planning.

While every dermal filler treatment should be bespoke to the individual, conventional approaches to facial enhancement are often unsuitable when significant asymmetry is present.

Rather than treating predetermined areas with equal quantities of product, we assess each side of the face independently, considering differences in structure, projection, volume and proportion.

This allows us to create a treatment plan designed specifically around the individual face, with the aim of improving overall facial harmony rather than pursuing perfect symmetry.

During Farzana’s assessment, we identified several key differences between the two sides of her face:

• Significantly greater volume through the left cheek and jaw compared with the right
• A chin that appeared off-centre, with a visible shift towards the right
• Reduced structure and projection through the right mandibular angle

With these differences identified, we developed a treatment plan that would strategically address each area while respecting Farzana’s existing facial anatomy.

The Treatment Plan

Bilateral Midface and Cheek Augmentation

Although both sides of the midface were treated, they could not be approached in the same way.

Different volumes and carefully tailored placement were required on each side to account for Farzana’s existing asymmetry.

Rather than simply adding equal amounts of filler bilaterally, treatment was adapted to the structural requirements of each side, helping us work towards greater balance across the midface.

Pyriform Fossa

A small amount of carefully placed product was used within the pyriform region.

Although a relatively subtle part of the overall treatment, this placement was used strategically to provide additional support and contribute to improved projection and balance through the midface.

Chin and Pre-jowl Sulcus

The chin and pre-jowl region were pivotal to Farzana’s treatment.

Her existing chin asymmetry meant that treating both sides equally would have reinforced, rather than improved, the imbalance.

Significantly different volumes were therefore required between the two sides, allowing us to build and reshape the chin strategically while improving its relationship with the rest of the lower face.

Right Mandibular Angle

Farzana’s right mandibular angle displayed considerably less structure and volume than the left, creating a more concave appearance through this side of the jawline.

We therefore treated the right mandibular angle unilaterally, using structural augmentation to improve projection and create greater balance between the two sides of the lower face.

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A Tailored Approach to Facial Balance

Complex cases such as Farzana’s demonstrate why dermal filler treatment should never be reduced to simply adding volume or treating isolated features.

The objective was not to make both sides of Farzana’s face identical. Perfect facial symmetry is neither realistic nor necessarily desirable.

Instead, every decision was made according to her individual anatomy, with different areas, volumes and placements selected to improve the relationship between the two sides of her face.

This is the principle behind our approach to Tailored Facial Rejuvenation: treating the face as a whole, respecting the individual’s natural anatomy and using dermal filler strategically to create a result that feels balanced, refined and unmistakably their own.

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