Surgery for drooping mouth?
A photo of the mouth at rest and one smiling would GREATLY ease our job and increase the accuracy and relevancy of the answers.
Besides the NATURAL facial asymmetry we all have, there are several reasons why one side of the mouth and "THE" solution would greatly depend on the reason for the droop.
Age related drooping associated with a deepening nose to mouth (Nasolabial) fold would be improved with a mid-facelift as well as with fillers in the fold.
Sometimes the drooping is seen on the NORMAL side because the nerve supplying the muscle pulling the corner of the mouth down (DEPRESSOR ANGULI ORIS) , has been damaged. (Such a birth injury related to a forceps injury (A famous example is Sylvester Stallone), the same injury can also happen during a neck lift when a branch to that muscle is damaged). Such drooping can be made symmetrical and nicely improved by weakening the muscle which pulls the corner of the mouth with a few units of Botox.
Peter A Aldea, MD
Asymmetric face or drooping mouth
There are many options and the choices depend on the severity:
1) Botox to the other side
2) Subcutaneous Fillers
3) Corner lift
4) Asymmetric Lip lift (Bull-horn or gull wing)
5) Cheek lift
6) Face lift
It is not uncommon to see asymmetry of the face including the corners of the mouth, cheek folds and facial lines. Without a photograph we will have to assume a few things. First of all the surgeon would want to access your smile and facial expression. He or she would want to know about the motor function of the face, balance of the lower third of the face, amount of vermillion or lip show, your dental occlusion, and assessment of your face in a lateral position. If you are young and all the other assessment are normal maybe the first thing to consider if a dermal filler to push up the corner of the mouth and address the shadowing. Sometimes Botox can be added to block the depressor muscles at the corner of the mouth. Finally there are several ways a lip lift is performed. The scars are quite acceptable to most patients.
The procedure that best treats drooping at the corner of the mouth is a corner lip lift. In very early, minimal instances, botox can be used to paralyze the corner depressors of the mouth to help elevate this area. However, a facelift, cheek lift or fillers will have no significant effect.
This is a common problem as you age. Many times this is done in conjunction with a facelift. This is a separate procedure and can be done alone. The scars are placed in facial lines, as not to be noticed.
Facial Asymmetry responds well to Botox
Drooping of one side of your mouth may respond well to having some Botox placed in the DAO, (depressor anguli oris), muscle on the side of the droop. As this muscle "pulls down" the corner of your mouth, weakening it with Botox may correct the asymmetry. Make sure you have somebody with experience in lower face Botox therapy, as, if it is done incorrectly, the lower lip, (and not just the corner), will be distorted.
A Corner of the Mouth Lift is What You Need
When the corners of the mouth turn down, there is other solution than to treat it directly. Many people mistakenly believe that a face or cheek lift will turn the corners up to a level position, but this will not result from those procedures. A simple corner of the mouth lift removes a very small triangle of skin at the mouth corners and creates an immediate and permanent change in the smile line. It does result in a very small scar but this area heals well and scar revision of it is usually not needed.
Direct solutions to the problem should be avoided. Any corner of the mouth lift will leave you with a very visible and unnatural scar.....for that mater any visible scar in the area of the mouth is unsightly and to be avoided at all cost (either surgical or traumatic.). My suggestion is to try either a filler in the area or for a more permanent longer lasting result get a preauricular facelift (essentially a gentle small pull under local anest. 20 min. near the tragus that may elevate the area. As assymetries are common and not necessarily a problem, you could simply ignore it
Sometimes a midface lift can lift the upper lid and cheek. The surgeon probably thought you had a facial nerve palsy from an accident. The midface lift can give you a good result from this.
Everybody's face is asymmetrical to some degree. Some more than others. If the underlying bony architecture is very different from one side to the other, soft tissue work alone may not correct the problem sufficiently. A photo of you would help here enormously.