19 years old and I have a very "lop sided smile". How should I go about treating this? (photo)

how do I go about getting this fixed?? orthodontist? or Botox (I understand Botox wont last though!) I have provided photos below. thank you very much for any help! Which i am sure that it is related to my teeth more than anything though im not 100 percent sure.?

Doctor Answers 10


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Thank you for posting your question. Even though slightly asymmetrical facial features are natural and expected, your picture does show one side's muscle pulling harder than the other side. A combination of Botox and filler can help improve your situation. I recommend meeting with an experienced, board certified  physician for an in-person consultation to determine the best treatment for you. Best of luck.

Asymmetrical Smile

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I believe this is due to the muscle around the mouth pulling unequally. It can be fixed with Botox or fillers. I suggest you have in person consultation with an expert to discuss your concerns and desires. 

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 47 reviews

Correcting an uneven smile

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Thank you for your question. On careful assessment of your photo, your natural smile appears to be very so slight more raised on the right side compared to the left. This occurs because your Levator labii superiors alaeque nasi muscle appears to be slight more active on the right side compared to the left side. (See diagram below):

Historically this muscle is known as Otto's muscle. It acts to dilate the nostril and elevates the upper lip, enabling a person to snarl. Elvis Presley is famous for his use of this expression, earning the muscle's nickname "The Elvis muscle" (See diagram below):

If this uneven smile bothers you, I would suggest a small dose of anti-wrinkle injection such as Botox or Dysport near the right border junction where your right naso-labial fold meets the right lateral border of your nose. The exact dose need would optimally require optimally require a face-to-face consultation. I would also advise small incremental doses possibly over 2 treatment sessions to begin with to ensure an initial over-treatment of the area is avoided.

19 years old and I have a very "lop sided smile". How should I go about treating this?

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If you actually study everyones smile there will always be some minor asymmetry. I personally think this can add to ones character and be quite endearing. A consultation with a Specialist Plastic Surgeon or Orthodontist is a good start to discuss your concerns or what options are available to you. The crown height of the teeth can be adjusted with fixed appliances on only veneers/crowns. The inclination of the maxillary occlusal plane can be adjusted with orthognathic surgery. Alternatively the soft tissue levels can be adjusted with surgical elevation or botox to lower one side. All options have their pros and cons. Good luck with your search.


Dr Guy Watts

Consult a Cosmetic Dentist

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Botox is not something that is good to commence at your age. It is also not exact nor will be able to perfectly balance a lip or smile.  A Cosmetic Dentist may be able to recommend change in position of teeth.  But realize that no one has a perfect smile.  The entire face is not symmetrical.  

19 years old and I have a very lop sided smile". How should I go about treating this?

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Hi Sarah,
Botox is a temporary fix and will drop the right side of your smile if done properly in the apex of your nasal labial fold.  Ultimately, I do feel that you should visit an orthodontist for a more permanent fix.  Additionally, you may want to start taking calcium supplements. I would double check what your needs are with your own internal medicine doctor.
Good luck,
Dr. Downie

Jeanine B. Downie, MD
Montclair Dermatologic Surgeon

Lopsided smile

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The strength of the pull of the muscle on one side is stronger than the other side. some botox and fillers can help but to a limited extent and only in hands of an experienced practitioner.

Firas Al-Niaimi, MSc
London Dermatologist

Asymmetrical Smile Solution with fillers and botox

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A combination of fillers and botox can be used to improve this area. I suggest seeing a facial sculpting expert. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 203 reviews

Asymmetric smile

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I think this is related to the muscle around the mouth pulling unequally. I think the correction with Botox/fillers is probably not going to improve you to the extent that you are satisfied, and might make things worse. I'd live with the minor asymmetry. It's what differentiates you from everyone else.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.8 out of 5 stars 53 reviews

Lopsided smile

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I think it is not your smile that is lopsided but there is unevenness in the nasolabial folds from your nose down and can be treated with filling material such as Radiesse.  Be sure you see a board certified dermatologist or plastic surgeon

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