I have a crooked smile and my right lower lip does not move, how can I fix my smile? (Photo)

Question

I have had a crooked smile since birth. (photos to prove) When I smile, my right lower lip does not sag down showing the rest of my teeth, like my lower left one does. If I put my finger and pull my right lower lip down, I now have a normal smile.

Nima Shemirani, MD · Answer

Dear Ralphiel65,Thank you for your question and photo. My recommendation as the other doctors have mentioned is to do Botox on the opposite side to give symmetry back to your smile. Fillers can also be done to balance out the smile depending on the examination. When you are ready, please look at before and after photos on my website and we can set up a complimentary in-person consultation to address your concerns and answer all of your questions.Best regards,Nima Shemirani

Jason Emer, MD · Answer

You would get a nice improvement with lip fillers. These fillers, (Volbella, Restylane, Juvederm) are good to create a symmetrical lip. Nova threads can be used to improve lift and shape. Implants or fat are alternatives. Technique will be important here, so you'll want to see someone meticulous. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Daniel Barrett, MD · Answer

Dear ralphiel65,based on your photo, Botox might be the right choice for you.  I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Stephen Weber MD, FACS · Answer

This is a common problem. I have the same issue. There is unfortunately no treatment that will animate the side of the lip that rises too high with smiling. But, as my colleagues suggest, Botox to the opposite side can improve symmetry with minimal risk. Best.

Johnson C. Lee, MD · Answer

Thank you for your photo. It appears that you may have difficulty activating your right lower lip depressors. These muscles are the ones that pull the right corner of your mouth down when you smile. Generally speaking, to improve the symmetry of your smile, some people would like the left side treated with botox to relax the left muscles to better match the right. It is best to have an in-office examination to determine the exact cause of your asymmetry and best treatment plan to achieve your goals. Hope this helps!Johnson C. Lee, MD Plastic Surgery@drjohnsonlee

Lily Lee, MD · Answer

it looks like you were born with a paralyzed marginal mandibular nerve. There could be a hundred reasons for this and therefore a lot of options to treat depending on your appetite for dealing with it. The simplest would be to Botox the unaffected side. Using Botox to temporarily paralyze the opposite side is quick and easy, but will only last 3-4 months at a time. If you would rather try to figure out how to innervate the side that does not move when you smile, it becomes a lot more complicated, but could give you a more permanent option (nerve and muscle transfers). Best to see a board certified plastic surgeon in person for a consultation.

I have a crooked smile and my right lower lip does not move, how can I fix my smile? (Photo)

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