Follow-up question - Botox/Surgical options to fix crooked mouth due to weak left DLI muscle? (photos)

Hi. I posted this problem before but with a non-surgery question. Now I am seeking consultation about surgery. My left lower lip does not pull down like the right; probably a weakness in the left depressor labii inferiosis. My mouth moves oddly when I talk (left corner does not curl or pull down like right). No problem shows when mouth is closed. I've had this problem since birth, and have no history of jaw surgery/nerve damage. I've heard about right DLI resection. Is this suggested over Botox?

To see previous question, please click here. 

Doctor Answers 4

Correction of a crooked smile

.  Thank you for your question.  I have treated a large number of patients who have asymmetry of their smile due to weakness of the DLI muscle.  I have found that Botox is the best solution for this.  A very small amount of product is required and patient satisfaction is extremely high afterwards.


Nashville Oculoplastic Surgeon
4.8 out of 5 stars 41 reviews

Reshaping the jawline with fillers and botox versus surgery

Fillers and botox can be used to improve this area. I recommend this over surgery, because they are non-permanent and non-invasive, and can be adjusted as your face changes with age. I suggest seeing a facial sculpting expert. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

DLI resection vs Botox

I wouldn't do surgery. It will almost certainly not work and probably cause additional problems. I would try the Botox to correct. If not happy, I wouldn't pursue surgery and just live with the issue. Sometimes in pursuit of a correction, the treatments can cause a problem that is worse.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.6 out of 5 stars 26 reviews

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Follow-up question - Botox/Surgical options to fix crooked mouth due to weak left DLI muscle?

Thank you for sharing your question.  The less invasive, but nonpermanent solution would be to pursue Botox into your right side in order to better balance your left side appearance.  This would not only be a reversible correction but can allow for adjustments over time over muscle resection.  best wishes. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

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