Jay Shayevitz, MD

You may very well have a problem with your facial nerve on the left side. This can be either central in origin, or peripheral. If central, then you should not be able to raise your left eyebrow or wrinkle the left side of your forehead, in addition to your asymmetric smile. If peripheral, the issue is usually restricted only to the lower facial muscles.

Also if peripheral, the likely triggering event was perhaps some kind of birth-related trauma. In the old days, compression injury from forceps use during delivery was the usual culprit. Not so common any more with less forceps use.

Defining your problem with the asymmetric smile may require a few diagnostic interventions first, including imaging with MRI and CT and electromyography and nerve conduction studies. For this consultation with a neurologist or neurosurgeon would be your best bet. Once the problem is defined more thoroughly, it may be possible to get some ideas about how to manage it, which can be surgical, non-surgical, or a combination.

O-shot will likely help your situation (possibly lichen sclerosus et atophicus, or LSA) by improving the ability of your vulva to lubricate and by decreasing vaginal dryness. O-shot by itself won't enhance the volume of your labia. It is possible to inject filler or platelet-rich fibrin as part of the O-shot procedure. This is colloquially called a "wing lift."

The O-shot procedure usually requires at least 2 sessions, with perhaps yearly "boosters" after that to be truly effective.

The diagnosis of LSA can be made only with a physical examination.

Although it's difficult t make a diagnosis without a face-to-face exam, I would theorize that that these lumps are likely hypertrophied corrugator muscles, since they are symmetric. Botulinum neurotoxin may be helpful in reducing the muscle bulk and smoothing out your forehead.