Is Botox or Filler Better for Correcting Lip Asymmetry?

I have a genetic condition the has resulted in one side of my face growing shorter than the other. I've had jaw realignment, which has drastically improved things, but I still have asymmetry in my lips that bothers me. I had juvederm 6 months ago, and while it plumped them, one side still appeared to droop. I've also had fat transfe, but the results didn't last. Can botox correct this? Is it better for asymmetries than fillers?

Doctor Answers 10

Lip Droop

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Fillers work well for asymmetry when resting. If you have asymmetry when smiling we can correct that with botox. We use it all the time for what we call "gummy smile" when patients raise their lips to high we can inject to lower them. With paralysis patients I often inject one side to equalize their smile. You can also inject near the jawline to release the pull on the side of the face that is being pulled down too much which may help in your case

Boynton Beach Dermatologist

Botox or Filler for Lip Asymmetry

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Botox would work if you want to weaken the over-active side but you may not like the inability to raise that side.  The best lip augmentation products, IMHO are Alloderm or silastic lip implants.  If after lip augmentation, asymmetries still exist in the front red sections (mucosa) of the upper lip...a localised V to Y advancement flap will roll some of the red from the inside, of the lip, to even things out.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Which product is best to correct lip asymmetry

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The best product depends on your smile.  If your lips appear uneven in repose, then some sort of filler will be your best option.  HA fillers are ideal, and they last about a year or so.  There are some more permanent fillers available as well.


If your smile is asymmetric when speaking and smiling, Botox will be the best product to selectively weaken the muscles which are pulling too much.  This can be done safely and with great and predictable results, but be sure you are working with an experienced injector as an over-injection around the mouth can leave you with difficulty speaking, smiling, chewing, etc.




Michael Bowman, MD
Roanoke Facial Plastic Surgeon

Lip Asymmetry - botox or filler?

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Hi Rayel. Botox and fillers work by different mechanisms. Botox acts to weaken or paralyze treated muscles, the contractions of which may contribute to asymmetry. If muscle contraction is contributing to your lip asymmetry, then there may be a role of botox. Fillers act to restore or add volume to a particular area. If asymmetric volume distribution of the soft tissues of your lips or perioral area are contributing to your assymetric appearance, then there may be a role for fillers. Which method of treament may be best for you depends upon your particular findings. Your question is best answered by an experienced doctor after having examined you. Good luck.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 137 reviews

Botox can be wonderful but it isn't for everyone.

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Your photo shows very minor asymmetry so I'd suggest you do nothing. If you must try something, please give us photos that are directly face forward and with you in repose with the lips slightly separated and also a photo with a modest (not overly strong) smile. This way we can try to sort out the asymmetry better because you will be showing us neutral as well as dynamic action of your lips.

Harlow Hollis, MD
Victoria Plastic Surgeon

Lip assymetry

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I think your lips have a great overall shape and and definition but if you want to correct the left sided drooping a combination of both Botox and a hyaluronic filler can give you the best results. The reason being is that when treating the area around the mouth with Botox one has to be careful to not over treat since musculature movement here is essential to retain as opposed to treating the frown lines which is something we don't want (except in those circumstances when we went to express our concern or displeasure). So when treating the lips or mouth we strive for subtle changes that can soften imperfections. Since fillers don't affect the facial movements we have a bit more leeway in what can be accomplished. The best results in your case can be achieved with use of both products some Botox into the depressors muscle on the left side along with a small amount of filler to lift up the left side.

Ted Brezel, MD
Long Island Dermatologic Surgeon

Crooked lip, treat with botox not filler

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As your photograph indicates, your lip is significantly lower on the left and increasing fullness with filler, even if only on one side, will make the lip appear unusual.  Your mouth is partially open in this photograph, so the muscles are slightly contracted on the left.  If a couple of units of Botox are injected into the depressor muscle of the left side of the lower lip, you might have some upward displacement making it look more symmetric.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Lip Asymmetries Are Best Corrected With Juvederm

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Asymmetries of the lips are always best to correct with Juvederm. I do not believe that Botox is safe or really effective in this area. "Fine tuning" is usually a simple thing in this area with Juvederm.


Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Asymmetry of lips

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Your lips are qute beautiful as is. Botox has been used around the mouth to soften rhytids and to elevate the corners of the mouth. This a very tricky area because of the risk of over paralysis causing drooping of the corner of the mouth. I find carefully placed filler eithe Restylane or Juvederm are best. Radiesse is contraindicated in the lip.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

Your lips are beautiful!

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BOTOX for lips is used for vertical lines and not lip shaping.  Personally, I think BOTOX which weakens muscles is not the right approach for treating lip lines.  You do not have lip lines.  In fact, there is really nothing, nothing wrong with your lips.  None of us are perfectly symmetric.  If you want to play with your lip shape, a really good injector can help shape the lip with Restylane.  You do not need very much volume for this purpose.  However, you need to go to someone who is absolutely great at this.  Your lips are already so good that it is very easy to make them look worse not better.  Do not get more than 0.4 ml of Restylane.  And do not get BOTOX for this.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.