What do you suggest for my wonky, uneven mouth? (Photo)

Question

I hate my face when I smile, my nose is quite large and I get crows feet as i have to force a smile as I cannot move the lower left hand side of my lower lip.. what do you suggest would even my face up as it is wonky when i smile

Adam J. Oppenheimer, MD, FACS · Answer

The smile shown above appears natural, with a mild asymmetry. As you suggest, this is due to idiopathic (unknown cause) congenital (from birth) paralysis of the marginal mandibular nerve on the left side. The treatment for this would be to paralyze the NORMAL right side DAO (depressor anguli oris) muscle. This can be done with Botox and will require repeat treatments (Botox lasts around 3 to 6 months).It may take a few treatments to get the dosage correct. I would start with a smaller amount (5-10 units) and move forward from there with close follow up.With regard to the size of your nose, a rhinoplasty could be performed whereby the size and shape of the nasal bones and cartilage could be altered. In most cases, this involves a small incision across the columella of the nose to access the nasal structures. Make sure to seek out an experienced rhinoplasty surgeon with good before and after photos for you to review.

Samir Shureih, MD · Answer

There is no actual treatment for crocked smile. This is due to hyperactive muscles on one side more than the other.You can try very slowly to use botox on the depressor labii inferioris and depressor anguli oris muscles. Used on the hyperactive side, one muscle at a time and see the results.

What do you suggest for my wonky, uneven mouth? (Photo)

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