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Mandibular Asymmetry

A condition we regularly treat, mandibular asymmetry is highly correctable with outcomes that improve symmetry, alignment, and overall facial balance.

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What Is Mandibular Asymmetry

Understanding Mandibular Asymmetry

Mandibular asymmetry is a condition in which one side of the lower jaw differs in size, shape, or position from the other, and is commonly associated with mandibular prognathia. This imbalance can affect facial symmetry, bite alignment, jaw function, and joint mechanics, and may also influence the position and development of the maxilla. Treatment focuses on correcting uneven mandibular structure or positioning to restore facial balance, functional occlusion, and coordinated jaw movement.

Close-up of woman's face showing mandibular asymmetry.

Clinical Presentation

Clinical presentation of mandibular asymmetry, profile view.
Side View

Profile Analysis

Profile analysis shows asymmetry with differences in projection between both sides of the mandible, often associated with mandibular prognathia.

Key Assessments:

Asymmetric mandibular projection
Uneven jaw contours
Chin point deviation
Prognathic profile tendency
Clinical presentation of mandibular asymmetry, frontal view.
Frontal View

Frontal Analysis

Mandibular asymmetry involves uneven positioning of the lower jaw, resulting in visible facial imbalance and chin deviation, often with a prognathic appearance.

Key Assessments:

Chin deviation to one side
Lower facial asymmetry
Prognathic appearance tendency
Midline discrepancy
Clinical presentation of mandibular asymmetry, occlusal view.
Bite View

Occlusal Relationship

An uneven bite relationship is demonstrated between the left and right sides, commonly with a prognathic tendency, and may lead to compensatory changes in the maxillary arch.

Key Assessments:

Asymmetric occlusion pattern
Midline deviation
Possible upper jaw canting
Crossbite tendency

Mandibular Asymmetry

Common Functional Issues

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Eating

Jaw asymmetry, sometimes combined with a more prominent lower jaw, can make biting and chewing uneven or inefficient.

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Speech

Changes in jaw position and alignment may affect tongue placement and airflow, contributing to mild articulation differences.

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TMJ

The uneven jaw position, with or without forward prominence, can place added strain on the joints, increasing the risk of discomfort or dysfunction.

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Mouth Breathing

Altered jaw structure may contribute to an open mouth posture, especially at rest.

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Nasal Congestion

Skeletal imbalance can be associated with reduced nasal airflow and a sense of congestion.

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Psychosocial Effects

Visible asymmetry, sometimes with a more prominent lower jaw, can affect facial balance and impact confidence in social settings.

Before & After Gallery

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Mandibular Asymmetry

Jaw Surgery Procedures

Orthognathic surgery corrects mandibular asymmetry by repositioning the lower jaw and, when necessary, leveling the upper jaw to correct cant and improve facial symmetry. Most commonly, double jaw surgery is performed, combining BSSO and Le Fort I osteotomy to create a more even, balanced appearance.

BSSO

BSSO Result Illustration

BILATERAL SAGITTAL SPLIT OSTEOTOMY

Allows asymmetric repositioning of the lower jaw to correct deviation and restore alignment.

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Le Fort I

Le Fort I Osteotomy Result Illustration

LE FORT I OSTEOTOMY

Upper jaw repositioning, including cant correction and rotation, may help achieve facial symmetry.

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Double Jaw

Double Jaw Surgery Result Illustration

DOUBLE JAW SURGERY

Repositions both jaws to correct asymmetry, including leveling maxillary cant and adjusting the occlusal plane to restore balance and alignment.

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Life-Changing Benefits

Correcting asymmetry improves function, joint balance, and facial harmony.

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Improved bite balance
Reduced joint strain
Enhanced facial symmetry
Improved chewing function
Better functional stability
Increased confidence

Surgical Management of Mandibular Asymmetry

Lower Jaw

Bilateral sagittal split osteotomy corrects mandibular asymmetry by separating the mandible on both sides behind the last molar, allowing differential positioning of each side to level the chin and restore facial symmetry. This single-jaw procedure corrects the deviated chin position and rebalances the bite. The jaw is secured with titanium plates and screws, improving chewing, speech, and facial symmetry. Each case is planned with advanced imaging and surgical simulation.

Both Jaws

When mandibular asymmetry is accompanied by a maxillary cant or additional skeletal discrepancies, double jaw surgery is recommended. A Le Fort I osteotomy corrects the upper jaw cant through differential impaction while a bilateral sagittal split osteotomy simultaneously repositions the lower jaw to align the chin and level the bite. The combination of cant correction and mandibular repositioning achieves comprehensive facial symmetry and balance. Both jaws are secured with titanium plates and screws, improving chewing, speech, breathing, and facial harmony.

Presurgical Considerations

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Growth Completion

Key Assessment Points:

Bone scan if indicated
Facial asymmetry stabilized
Chin deviation unchanged
Serial ceph X-rays stable
Female wearing braces.

Orthodontic Preparation

Key Assessment Points:

Dental compensations removed
Midlines intentionally unchanged
Arch coordination balanced
Occlusal cant preserved 
Clinical jaw evaluation with a patient.

TMJ & Asymmetry Analysis

Key Assessment Points:

TMJ function evaluation
Condylar position comparison
Joint pathology excluded
Functional shift assessed

Timeline for Mandibular Asymmetry

Month 0

Initial Consultation

Comprehensive history, clinical evaluation, 3D scans, X-rays, photographs, and impressions to assess jaw position and bite.

2–4 weeks after initial consultation

Treatment Planning Visit

Once your records are reviewed and the doctor has coordinated with your orthodontist, you’ll return either in person or via telemedicine to review your treatment plan, see prediction images, and go over the steps and timeline ahead.

6–12 months

Orthodontic Preparation (if necessary)

Braces or aligners gradually guide the teeth into proper positions to prepare the jaws for surgical
correction. In select cases, a surgery-first approach may be possible.

3-6 weeks prior to surgery

Final Surgical Planning

Virtual surgical planning determines precise bone movements for optimal symmetry, stability,
and facial balance.

2–4 weeks prior to surgery

Pre-Op Medical Clearance

Medical exams, lab testing, and final instructions ensure the body is fully prepared for surgery.

Typically a one-night hospital stay

Surgery Day

Corrective jaw surgery is performed to reposition the jaws, improve bite function, and enhance facial balance.

3–9 months after surgery

Post-Surgical Orthodontics

Final orthodontic treatment fine-tunes tooth position and bite, optimizing aesthetics, function, and long-term stability.

Experience Matters

“We personally plan your care, perform your surgery, and guide your recovery. No residents, no fellows, no handoffs.“

Choosing the right surgical team matters. You should feel informed, comfortable, and confident in every step of the process. At our practice, your care is provided by one of the most highly trained and experienced jaw surgery teams in the country.

When you come to our office, you meet directly with your surgeons. We are the ones who plan your treatment, perform your surgery, see you after surgery, and remain personally available to you throughout your recovery. Unlike larger institutions, your care is not delegated to residents, fellows, or doctors in training. Every critical aspect of your treatment is handled by your surgeons.

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Founding Members of the American Society of Orthognathic Surgery

What Our Patients Are Saying

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★★★★★

Dr Lee and the team at Northeast Facial are incredible. I was very nervous about my procedure but Dr Lee walked me through it step by step, never once making me feel rushed. Silvanna at the front desk went above and beyond to help me schedule an appointment that worked for me. I would highly recommend NEFOSS!

Stephanie Brown

★★★★★

“I had double jaw surgery done with Dr. Jacob in June 2021. I am extremely happy with my results. No more jaw pain and chewing problems. I also feel much more confident with my new smile. The surgery was definitely well worth it, thanks to Dr. Jacob and his team!”

Amelia Chen

★★★★★

“I would definitely recommend Dr. Jacob and his team at NEFOSS! Dr. Jacob and the team of doctors are very knowledgeable about all aspects of the TMJ process. They are such a nice group of doctors! The office staff is also very helpful and very friendly.”

Tiffany Puopolo

Frequently Asked Questions

Here are some common questions about mandibular asymmetry and its treatment.

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