My smile has progressively gotten more crooked, can this be fixed?

While neuromodulators in these areas can help, when used around the mouth they can be a bit unpredictable. The doses utilized here can vary considerably, especially when trying to treat smile asymmetry. No matter the injector you choose, I would be willing to work with them long term and change doses and possibly injection patterns a bit until you find a style of injecting that works for you.

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. I recommend injecting the DAO muscles with Botox. DAO (Depressor Anguli Oris) Botox is a cosmetic procedure aimed at correcting a crooked smile by targeting specific facial muscles. The DAO muscles, located at the corners of the mouth, can pull them downward, causing a frown or a downturned appearance even when not expressing sadness. During the procedure, a small amount of botulinum toxin (Botox) is injected into the DAO muscles. This temporarily weakens their activity, allowing the muscles that lift the corners of the mouth to regain balance. As a result, the smile can appear more symmetrical and natural. The effects of DAO Botox typically begin to be noticeable within a few days and can last for several months. I hope this helps and best of luck!

I'm sorry to hear about the concerns with your smile. A progressively crooked smile can be distressing, and it's understandable that you want to find a solution. There are several potential causes for this issue, and addressing it effectively will depend on identifying the underlying cause. Here are some possibilities and steps you can take:

Potential Causes
1. Dental Issues:
- Misalignment of teeth or jaw.
- Dental work that might have changed the balance of your smile.

2. Muscular or Nerve Issues:
- Facial nerve issues, such as Bell's palsy or other nerve damage.
- Muscle imbalances or weakness on one side of the face.

3. Genetic Factors:
- Natural asymmetry that has become more pronounced over time.

4. Other Medical Conditions:
- Conditions affecting the nervous system or muscles.

Steps to Take
1. Consult a Dentist:
- A dentist can evaluate if there are any dental or orthodontic issues contributing to the asymmetry. They might recommend braces, aligners, or other dental treatments if misalignment is found.

2. See a Neurologist:
- If you suspect nerve or muscle issues, a neurologist can perform tests to determine if there is any nerve damage or other neurological conditions affecting your facial muscles.

3. Visit a Facial Plastic Surgeon:
- They can assess if surgical or non-surgical options might help improve symmetry. This could include procedures that address muscle or structural issues.

4. Physical Therapy:
- If muscle imbalance is the cause, a physical therapist specializing in facial muscles might be able to provide exercises to improve muscle function and symmetry.

5. Botox Consultation:
- While the nurse mentioned that Botox might not help much, it can sometimes be used to address muscle imbalances. Consulting with a specialist who has experience in using Botox for facial asymmetry might provide more insight.

Treatment Options
- Orthodontic Treatment: Braces or clear aligners to correct dental misalignment.
- Surgical Interventions: Procedures to correct structural issues.
- Physical Therapy: Exercises to strengthen and balance facial muscles.
- Botox or Fillers: To relax overactive muscles or add volume to areas that need it.

It's important to start with a thorough evaluation from healthcare professionals, including a dentist, neurologist, and possibly a facial plastic surgeon. Each specialist can provide insights into whether the issue is dental, neurological, or structural, and recommend appropriate treatments. With the right diagnosis and treatment plan, there is a good chance that the asymmetry can be improved.

As you mentioned a crooked smile could be related to your genetics/bone structure. It could also be muscle related. Some people find improvement with braces or similar treatments. Botox can be used to help even out your smile somewhat, though the effects would be temporary lasting approximately three to four months. I encourage you to visit with an expert injector to learn more.