What can I do to treat my crooked smile? (Photo)

Question

I was just curious as to why I can activate the muscles above my lip on the lefts ide but not the right. I noticed when I smile, my upper left lip raises but not the right.

Anna Chacon, MD, FAAD · Answer

As a board-certified dermatologist, what you’re describing is actually quite common and usually not something dangerous.

Most “crooked” smiles come down to normal asymmetry in facial muscles. The muscles that lift your upper lip (like the levator labii superioris and zygomaticus muscles) are not always equally strong or equally coordinated on both sides. So when you smile, one side may lift more than the other, which is exactly what you’re noticing.

The fact that you can consciously activate the left side more than the right suggests either slightly stronger muscle function on the left or milder activation/coordination on the right. In many people, this is something they’ve had for years but only recently noticed in photos.

This is different from conditions like Bell’s palsy, which typically affect the entire side of the face, including the eye and forehead.

In terms of treatment, the most common and effective option is Botox to the stronger side to create better symmetry. In select cases, a small amount of filler or neuromodulator adjustment can help refine the smile further.

If it’s subtle and not bothersome, no treatment is needed at all.

The key takeaway is that mild smile asymmetry is very common—and very treatable if desired.

Glenn Lyle, MD · Answer

Our bodies are simply not symmetric, think of them as cousins not twins. One side is always going to be stronger or higher. One side will be weaker and lower. Typically, it goes along with your dominate hand, left handed vs right handed. You can use a neurotoxin to help with symmetry whether it’s working to raise one side or soften the other, it is not a permanent fix but it most definitely can help. Hope this helps.

Camille Cash, MD · Answer

A small dose of Botox can be used to help even out your smile a bit.  Just know there's no exact symmetry formula, so consider starting conservatively and adjust based on the results. See an expert injector for treatment.

Amanda Maloney, MD, FRCSC · Answer

Hello and thank you for your question. Of course it is always best to have an in person assessment so that the facial muscles can be properly examined at rest and in animation, however, some patients do have more power on one side of the face than the other. From your photo, it looks like the right sided muscles that are lip and corner of mouth elevators are stronger on the right compared to the left so the right side pulls less opposed so to speak. Oftentimes a very small amount of Botox or other Neuromodulator injected about 1 cm lateral to the nose on the strong side weakens things a little and allows for more symmetry. An experienced injector will know how to determine the precise spot and dose. I hope this helps and thanks for asking!
Dr. Amanda Maloney, FRSC(C)

What can I do to treat my crooked smile? (Photo)

Answers (4)

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