I have an uneven smile - surgery/botox suggestions. (photos)

I have had braces which fixed my teeth as well as jaw reconscruction surgery that fixed my underbite (moved the top teeth over the bottom). I am happy with my teeth but unhappen with the uneven smile. I also have a slight lisp which i am unuse if this is from the positioning of my mouth? I have attached photos and am wondering what surgery/botox can be done to fix the uneven smile.

Doctor Answers 9

Uneven smile after surgery

Thank you for your question rhirhi1234. I am sorry to hear about your situation. Botox is a purified protein used to address wrinkles associated with facial expression. It is always useful to compare after photographs with before photographs. This will help determine what is going on. I would speak with your surgeon first.

Please consult with a doctor for specific recommendations. Good luck!


Encino Physician
5.0 out of 5 stars 3 reviews

Uneven smile

Botox can be used to even out your smile but I am not sure that it would fix your lisp. Make sure to seek for an experienced provider whose expertise is face symmetry. However, Botox is not permanent solution if that is what you are looking for. Good luck!

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 44 reviews

I have an uneven smile - surgery/botox suggestions

Injecting Botox or any other neurotoxin to weaken the muscles on the side where the lower lip moves more will make the smile look more even but I cannot guarantee you that the lisp problem will go away

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Uneven smile after Facial/Oral Surgery

It's difficult to tell without seeing pictures of your smile before your surgery, but it's possible that you may have some weakness of the nerve/muscle which is able to pull down your lower lip on the left after the surgery.

Conservative use of Botox on your right side could potentially balance this out, and I tend to start small and build my way up until we've found the perfect dosing. I suspect that if an experienced cosmetic physician with lots of experience using medications in the class of Botox in the lower face were to relax your right side to approximate your left, that fillers would be unnecessary and would potentially result in added cost and an unnatural result. Just make sure that your physician does have experience with lower face asymmetry as this is not an area to be managed by people without significant training.

Rebecca Gelber, MD
Incline Village Physician
5.0 out of 5 stars 2 reviews

Uneven smile

Thank you for your question.  I appears that a small amount of Botox in the DAO muscle on the side of the mouth that is being pulled lower may help with the symmetry.  To be sure, consult with a board certified physician experienced in facial surgery and injections.  Best wishes!

Nicholas Tarola, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 56 reviews

Smile Asymmetry--Fillers and Botox in Combination

Botox in combination with fillers can be used to improve symmetry in this area. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Left marginal nerve weakness correction

This is a tough fix. It was probably either congenital or related to the jaw surgery. Weakening the right side DLI is possible but not recommended. It will lead to problems moving the food around in your mouth. Best to probably leave alone.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Botox for asymmetric smile

It appears that the marginal mandibular nerve may have been injured on the left resulting in paralysis of the lip depressor muscles on that side. Botox on the contralateral side could help even your smile. Of course, before any decision is made, your surgical history and face would need to be further evaluated. See an expert injector as the treatment will require advanced knowledge of facial anatomy.

Shaun Patel, MD
Miami Physician
5.0 out of 5 stars 55 reviews

I have an uneven smile - surgery/botox suggestions.

Thank you for sharing your question and photographs.  Unfortunately without knowing a bit more information such as how long its been from your surgery and if anything was done to your lower jaw or teeth it is difficult to offer definite advice.  At first glance the portion of your lip that is not dropping when you smile is similar to those patients who have a nerve that is not working correctly, affecting the muscles of their lower lip.  This can be corrected by well-placed botox into the other side of the mouth to achieve improved balance.  I would definitely see an ASPS board certified plastic surgeon to discuss your full history in order to maximize results. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 63 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.