My smile is crooked. What's causing it and how do I fix it? (photos)
Doctor Answers 2
Yup, your smile is a bit crooked, and it appears as if there is slight weakness not only in the left upper lip, but more so in the depressors of the left lower lip. I would want to see how your face animates, and would also want to ask you if this has always been this way, or if it is recent.
Assuming that your lip has always looked this way when you smile, it is congenital facial nerve weakness in the marginal mandibular branch and possibly one of the buccal branches on the left side of your face. Microsurgical cross-face nerve grafts have been done (Dr. Julia Terzis has done pioneering work in congenital and post-traumatic nerve palsy patients), but this is big-deal surgery done most commonly for complete paralysis patients, not partial and minimal as your appears to be.
I think asymmetry like this is not unatrractive at all and should not be considered a problem, especially since the "cure" is WAY worse than the problem. Be peaceful about this--this does not make you ugly or weird-looking, just someone with a unique smile! Botox can weaken the other side, but I'd not recommend weakening normal function to (try to) match slightly decreased function. Best wishes! Dr. Tholen
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You look young, but botox can be injected into the muscles on the right side so they don't pull down as much, which will make your smile a little more symmetric. Best of luck.
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