Asymmetrical Smile from Filler Injections on Nasolabial Folds

The Aysmmetry can be caused by several different factors:The injection techniqueThe filler's propertiesDepending on how much bruising/bleeding/swelling you experienced from the injection itself, this can affect or distort your smile. However, this should generally resolve withing one week. If the injection was directly into a muscle or nerve this can take longer but most fillers tend to resorb and you would see an improvement over timeDepending on the properties of the filler, you may observe several different results.For example is it a permanent or temporary/longterm filler?What is the chemical composition?What layer if the face is it recommended?Permanent fillers can have permanent effects and despite the obvious benefits, this is one of the reasons that doctors are reluctant to use them.Collagen products are mixed with an anesthetic that can make a muscle weak but this generally dissapates after 2-3 hours and should be injected more superficially. Evolence is a newer porcine collagen product which causes little bruising but can cause some firmness which may be felt but not necessarily visible. It also should be more superficial and not necessarily interfere with your smile unless alot was injected.Radiesse is a product composed of two primary materials, one of which takes about 3 months to absorb. This can cause some distortion which wil resolve at that point in time.Hyaluronic products (Restylane, Juvederm, Perlane, Hylaform, Captique, Prevelle, etc) are water attracting substances (hydrophilic) which can intially feel firm but generally soften over several days as they draw in water; think of a sponge soaking up water. If any of these have been injected in excess of your desires, they can be diminished using an enzyme hyaluronidase (skin test recommended).So it really depends.........I hope this helped

Thank you for your question. In my opinion, it takes about 1-2 weeks for the product to settle down. First few day is still early to tell. Most of the times the asymmetry will improve by itself. Make sure to follow up with your surgeon as they can always perform touch up if needed.
I hope this helps. Best wishes. Dr. Salameh (Plastic surgeon - Bowling Green, KY)

There are two explanations for assymetry immediately after facial filler injections:  These can occur from the numbing medication used or from localized swelling post injection.  Both should resolve with time as there are very few, and rare, causes of permanent deformity.