Botox for uneven smile? (photo)

Question

I genetically have more mobility on my right cheek than left. After completing orthodontics, my smile isn't what I expected. Would Botox help? If so, into which muscle exactly and how many units?

Ella Fedonenko, MD · Answer

The right upper lip could be lowered to even the smile by injecting 3-5 units of Botox into the Levator labii superioris muscle.

Anna Chacon, MD, FAAD · Answer

Botox can be an effective treatment for addressing asymmetry in your smile due to uneven muscle activity. In cases where one side of the face has more mobility than the other, Botox can be used to relax the overactive muscles, helping to create a more balanced appearance.

For an uneven smile, Botox is often injected into the muscles responsible for the asymmetry. Typically, these muscles could include the zygomaticus major and minor, which are involved in elevating the corners of the mouth. However, the exact muscle and dosage can vary based on individual anatomy and the specific asymmetry.

A typical starting dosage might be around 2-4 units of Botox for mild cases, but this can vary. It is crucial to have a thorough consultation with a qualified healthcare professional, such as a dermatologist or a plastic surgeon, who can assess your specific facial anatomy and recommend the appropriate treatment plan.

I recommend scheduling a consultation with a specialist to discuss your concerns and explore the best treatment options for your needs. They can evaluate your smile and provide a tailored approach to help achieve the symmetry you desire.

Ran Y. Rubinstein, MD · Answer

Hello and thank you for your question. Natural facial asymmetries are not uncommon. Based on your photo, it appears that your right LLSAN muscle is slightly hyperdynamic compared to your left. This muscle is responsible for elevating the upper lip and flaring of the nostril. You can see that there is more visible teeth showing on your right as a result of this muscle pulling upward. This can be improved by just a small amount of Botox in the right LLSAN muscle. 2 units should be sufficient to lower the right upper lip to match the left. If there was something else bothering you about your smile, happy to discuss further during a consultation. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Rajaie Hazboun, MD, MBA · Answer

Thank you for posting your question here,My answer will be based on the limited information and pictures provided , for a more detailed and bespoke plan please consult with your plastic surgeon in person.
The answer will depend on the cause of the asymmetry , if it is an injury to the nerve or muscle then you can potentially inject botox in the muscles on the un affected side , to gain that symmetry.I hope this helps , best of luck!

Leonard Grossman, MD · Answer

Every single individual on this planet has a slightly crooked smile. The reason for that is that both sides of the skull as well as the muscles are not created symmetrically. By trying to manipulate the muscles with Botox may only create more asymmetry and dissatisfaction with the way you look. My advice to you is leave yourself alone and don’t fix anything. That’s not broken. I hope this helps and good luck from Leonard Grossman MD organic Plastic Surgery

Camille Cash, MD · Answer

Yes Botox can be used to help smile asymmetry.  But be aware that it is important to progress slowly as you don't want untoward results.  See an expert injector near you for an evaluation.

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