Are lip fillers the best way to fix my asymmetrical lips? (Photo)

Question

I have a small mouth with the top lip being a lot smaller than the bottom lip. Also my top lip is very asymmetrical, which im really self concious about. I would like a permanent solution to this, but it seems that lip injections may be the only answer. What should I do?

Nima Shemirani, MD · Answer

Hi @SunflowerBays! I recommend 1 syringe of filler into you lips to help with asymmetry and volume.  I hope this was helpful!

Jonathan Kulbersh, MD · Answer

Thank you for submitting your question and photos. Dermal fillers are an excellent choice for adding volume to the top lip while creating a more symmetrical appearance, with results that may last for a year or more depending on the formula used. 
For a longer-lasting result, a lip lift is a surgical procedure that can reveal more of your upper lip and make it look fuller while addressing asymmetry. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or injector. They will be able to assess your concern and suggest the best approach for you.

Jason Emer, MD · Answer

Most doctors will start with one-syringe to avoid overfilling. These fillers, (Volbella, Restylane, Juvederm) are good to create a symmetrical and full lip. PDO NovaThreads can also be used to improve shape and also provide lift. Fat or implants are a permanent alternative. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Cory Bovenzi, MD · Answer

Hi and thanks for your question! While there are more permanent procedures that can be done on the lips re: types of lip lifts and fat injections, I would recommend starting with lip fillers to determine the shape that you like before doing anything more permanent.
Best of luck!

Daniel Barrett, MD · Answer

Dear SunflowerBays,
I perform a lot of lip injections with fillers such as juvederm and it works great. Many times I need to put more in one side than the other to attempt to even out the vermillion border (The red line of the lip). This helps provide more symmetry at times.For patients looking for a more long lasting result, I recommend fat grafting. That is, using your own bodies fat to make your lips naturally look more shapely. The bonus is that the results last many many years.
In general, I avoid using permanent prosthesis because I find that the lips are such dynamic and sensitive structures, the end result is not natural.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Afternoon! Thanks for the questions and photos. Fat transfer is an option. This is where fat is harvested from around the abdomen and injected into the lips. It's a natural filler which can last 5-10 years. The lips can be tricky with fat transfer though as the metabolism of the fat tends to be much higher than other areas of the face. Fillers are a great option. They are easy to inject with fast results and minimal downtime. Asymmetries are a big reason why many of my patients choose lip filler (not just for more volume). I would avoid any form of lip implant. Hope this is useful!

Camille Cash, MD · Answer

Lip fillers are a great way to add volume and improve symmetry for the lips.  The results are temporary, but the big benefit is that you can go slowly and build up to the look that you want.  HA fillers can be dissolved if you are unhappy with the results.  See an experienced injector near you to learn more.

Sheryl D. Clark, MD, FAAD · Answer

Hello Sunflower Bays!
Unfortunately, perhaps, fillers are the only solution to the asymmetry of your lips, and should never be fillers of the more permanent type. You will probably only need to have this done every 9 to 12 months, but I think you will be very happy with the results.  
Correcting assymetry in lips can be a challenge but the keys are understanding lip anatomy, starting with a very small amount, and placing it only in the areas that are lacking in volume or structure. Your lips have great “bones” in that you have a beautiful philrum and the vermillion border is quite defined and lovely, with luscious pillows of the lower lip. All they need to be even more beautiful is a small amount of filler to the medial pillows and lateral areas of the upper lip to correct your “M-shaped” upper lip. All the best from NYC, Sheryl Clark MD, FAAD

Mats Hagstrom, MD (license on probation) · Answer

The great majority of people at least 95+ percent have a lower lip that’s larger than the upper lip. in your case the positions of the upper and lower lip and the relationship between the two is also different because of how your mandible and Maxilla were formed during embryological development.
The position of the lip is based on dentition or where your teeth sit. if the teeth sit forward so does the lip.
To make an assessment on any part of the face we need to see full facial pictures. The reason for this is that everything is related to the areas next to them and things in terms of facial aesthetics are a little more complex than just the area of concern. Lip a symmetry is almost always do to facial schedule a symmetry and soft tissue coverage is typically very consistent. The two sides of the face develop independently of each other during embryological development and I are not the same and are not equal. no one has facial symmetry. This is true for both to face the body and extremities. All internal organs are asymmetrically placed and the concept that the human body is supposed to be symmetrical is simply not accurate or a correct way of thinking.
Striving for symmetry is often a mistake because in attempting to obtain symmetry patience usually end up with two asymmetries.
Your lip asymmetry is not a result of a lack of volume on one side.
If you try to compensate for a skeletal asymmetry by adding a volume you’ll now simply have two asymmetries.
The human brain is accustomed to seeing facial asymmetry as completely normal and then a purely symmetrical face such as a computer generated image tends to look less attractive and has an unfamiliar odd or strange look to it. The Internet has lots of examples of computer generated symmetrical faces and it can be an interesting thing to learn about.
There may be plenty of opportunities for Aesthetic improvement if you would like but recognize that facial aesthetics starts with skeletal structure and soft tissues are usually not what makes people look the way they do because soft tissues tend to be very consistent.
Oral surgeons tend to see things from a skeletal or bone perspective but plastic surgeons often see things from a soft tissue perspective. there is some overlap within the two specialties and there are certainly plastic surgeons who do cranial facial surgery and oral surgeons who work with soft tissues.
I’ve simply found that oral surgeons tend to see things more from a primary cause-and-effect relationship in a more accurate manner than us plastic surgeons.
Regardless you can consult with anyone you’d like and you’ll find lots of plastic surgeons who believe that facial symmetry is an aesthetic ideal that should be the end goal. I am not one of them.
My view on symmetry and asymmetry comes from years of doing surgery and examining thousands of people.
Early in my career I also believed symmetry was the ideal and should be strived to accomplish as an aesthetic idealism.
The exception were symmetry is probably worth trying to obtain is in women’s breast surgery where asymmetry typically is distracting. 
obviously gross asymmetry outside of the boundary of normal is clearly undesirable.
Best,
Mats Hagstrom MD

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!From your photos, I note that you appear to demonstrate a paucity of upper lip tissue when compared to the lower lip. Hyaluronic acid tissue filler injections will provide temporary lip fullness which may last for 6 months or so.Fat grafting to the lips is an alternative treatment, but may require several touch up injections to reach your goal (and the result may fade over time). Tendon or fascial grafts can be used to permanently augment the lips. The "Permalip" is a silicone filled implant which can be inserted into the lips for a permanent result.Visit a board certified plastic surgeon for evaluation and discussion of your options.Best wishes

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