Nicholas C. Lam, MD

Hi Intellectual887601,

The short answer to your question is that your "sad mouth" appearance can be helped with injecting fillers to help provide support to the oral commissure. However, in some cases, a certain style of lip filler injections may make it harder to achieve that. Typically, when performing lip filler injections, the injector looks at your entire perioral area and have a discussion with you including the positioning of your corners of your mouth or your oral commissure. 

Depending on your basal tone which is usually assessed during dynamic movement, a muscle that can pull the corner of your mouth down known as the Depressor Anguli Oris or DAO can contribute to the down turn appearance. However, when injected inappropriately, it can give you an asymmetrical smile or a smile that seems to reduce the show of your lower teeth which will look quite abnormal. 

Always choose a physician injector in your area that has performed a lot of Botox and Filler for the problem you want to resolve.




Thanks,

Nicholas Lam, M.D.

Hi Sibby,

Thank you for your question. Fillers injected in the nose is the second most common area for blindness. Even though the risk of blindness is small, it is a usually a permanent consequence. Botox can be used to reduce the movement of the muscle that causes the line. However, if performed incorrectly, it can lead to droopy eyelids (lid ptosis). Always choose a physician injector who has done the most Botox injections in your area.

Thanks,

Nicholas Lam, M.D.

Hi Hbicmatty,

Thank you for your pictures and question.

Voluma is most likely the best choice for you. However, your photos are taken with your eye closed and there is subtle nasojugal groove depression extending into your suborbital hollow. An more accurate assessment must be made with watching your tissues move in animation and palpating your tissue in person.

What is more important is who is injecting, how they are injecting and where they are injecting it. We are among the TOP 50 account in the country with Allergan, the makers of the Juvederm portfolio of fillers (which includes Voluma). Look for such an account in your area. 





Good luck!

Hi Teeeam,

Thank you for your question. Asymmetry is common. New asymmetry should be evaluated by a qualified aesthetic physician. You have a lower lid and smaller lid crease on your left eye which could be due to your lower brow position in your left eye. The lower brow position can be due to different basal muscle tone on your face and/or bony (orbital rim) structure. Botox can help improve symmetry and is easy and affordable. However, it can worsen the situation if done incorrectly. You should look for a physician injector who does a lot of Botox in your area. One way is to use the physician finder on the Botox website which ranks the practice based on the volume of Botox that they use. For example, in our state, we are ranked number 1 because we are the number provider of Botox in the state and TOP 50 in the country. Hope this helps.

Nicholas Lam, M.D.

TOP 50 APP 

Hey Kate,

It is not uncommon to use Botox to treat the neck band that stick out when you are smiling. It is in a region that has a lot of vital structures. Potential rare but serious complications can interfere with pharyngeal nerves, superior laryngeal nerve and recurrent laryngeal nerve in that area that can cause phonation or airway problems not to mention swallowing and aspiration.

We are the TOP 50 account of the makers of Botox in the U.S.A. and do these injections very often. Be sure you are assessed and treated by someone who does a lot of these injections to maximized your results and minimize your risk. You had mentioned that you had a gland removed and an assessment on the impact of the surgery on your anatomy and any nerve damage in that area is vital before any treatment.

Thanks!

Nicholas Lam, M.D.

TOP 50 Allergan Partner Privileges