Uneven upper lip -- Right side higher than left side. What kind of procedure could fix this issue? (Photo)

Question

I like how full my bottom lip is -- but my upper lip has always bothered me because it's uneven on the right side. When my mouth is closed and relaxed, there is a slight gap on the right side -- it's always driven me crazy. I've been trying to do research to figure out the kind of procedure I could get to fix this issue, but I haven't really found any cases out there that are similar to mine. Any guidance/advice would be appreciated. Thanks!

Sean R. Weiss, MD, FACS · Answer

There are several options for patients wanting to change the shape of their lips.  Whether its to achieve a fuller lip or correct asymmetry, both surgical and non-surgical options exist.  The non-surgical approach centers around injectable filling agents.  Most common of these are Hyaluronic acid (HA) fillers such as restylane and Juvederm.  These fillers are safe and reversible with the use of hyaluronidase.  More permanent filling can be achieved with minimally invasive fat transfer to the lips.There are also several more invasive surgical options that you may want to consider.  A dermal graft is one option, and this can be done using your own skin or cadaveric dermal graft material.  You could also use other tissue, such as SMAS, to achieve the filling or recontouring that you desire.  With many options to chose from, you must be certain that you consult with a board certified Facial Plastic Surgeon or plastic surgeon that has experience in both surgical and non-surgical treatment of the lips.  After a detailed evaluation, the appropriate treatment plan will become clear.  Best regards.

Audrey A. Klenke, MD, FACS · Answer

Cosmetic surgery offers many options for shaping your lips in a way that helps you look and feel your best. As far as in-office treatments are concerned, there are many fillers on the market today, allowing your plastic surgeon to choose the best product for achieving your goals. Fillers can be injected in the pink part of the lip for plumping. Fat grafting is a more permanent, but perhaps less predictable option. Another option for achieving more fullness of the lips is the placement of a permanent soft, silicone lip implant... however, I caution against this in patients who are asymmetric at baseline because the implant can actually accentuate asymmetries. There are still other, more advanced procedures that can help perfect your pout. Various forms of a lip lift, similar to other cosmetic lifts you may be familiar with, can help decrease the distance between the base of the nose and the pink portion of the upper lip. Advancing the inside portion of the lip is yet another surgical option for balancing.

Michael H. Gold, MD · Answer

We are all asymmetric in some of our facial features, so you are not alone. You need to be careful here, so make sure you are being evaluated by a board-certified dermatologist or plastic surgeon who can look at your lips closely and determine with you the proper ratios of the upper lip to the lower lip to give you the best possible results. And the injector must know how to create the perfect lip with the skill of an artist.Fillers such as Restylane, Juvederm and Belotero will all work here. A new filler, called Restylane Silk, has just received FDA clearance for lip treatments and may turn out to be a great option here. But to me, the skill of the injector is key to make you have the lips you have always wanted.

Barry L. Eppley, MD, DMD · Answer

A V-Y mucosal advancement will roll out tissue from the inside to lower the lip on the higher side for a more even upper lip line.

Gregory Park, MD - Account Suspended · Answer

There are several treatment options to improve the asymmetry in your upper lip. A temporary solution would be the use of dermal fillers such as Juvederm or Restylane. Fat transfer could be a permanent solution to fill the gap seen in your photo. Thank you for sharing your question and photos. Best wishes.

Uneven upper lip -- Right side higher than left side. What kind of procedure could fix this issue? (Photo)

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