Would filler and lip blushing help the appearance of asymmetrical off-centered lips? Should I consider another option? (photos)

Question

My lips have always been uneven - off-centered and one side looks longer and thinner than the other. I recently had 0.5ml filler injected and it did improve their shape, but they're still rather wonky. I'm considering getting more filler, the cosmetologist also suggesting getting lip blush. Which option would be better, or should I look into something more surgical altogether?

Jason Emer, MD · Answer

I would highly recommend getting a formal evaluation with and treatment from a board-certified cosmetic dermatologist and expert in facial sculpting. Technique is the key to a successful lip augmentation with fillers, so you'll want to see someone meticulous. An experienced physician will be able to determine which filler, how much filler, and which technique will give you the subtle result you're looking for. See an expert. Best, Dr. Emer

Ian MacArthur, MD, FRCSC · Answer

Thanks for your question. Additional lip filler would be able to help further balance out the asymmetry in your lips. A more permanent option would be facial fat grafting, although that would require a surgery. I wouldn't recommend lip blush in your case as it will only be masking the volume difference. Take care.

Mats Hagstrom, MD (license on probation) · Answer

Most people have some asymmetry of their lips. The main reason for that is facial asymmetry which everybody has. most people have substantial degrees of asymmetry. During embryological development the two sides of the face develop independently of each other and eventually fused in the midline. failure of complete fusion during embryological development results in conditions like a cleft lip. The shape size and position of each half of your lips is dependent on a multitude of structures throughout your face. muscles that determine movement in the position of the corner of your mouth start around your cheekbone and work your way down to your chin. Rarely is the problem but one side requires more volume than the other.
The true cause of asymmetry is usually based on skeletal structure which inevitably has baseline asymmetry on all people. 
For this reason volume and manipulation is unlikely to make things better because it isn’t addressing the primary problem.
Facial asymmetry is normal and the human brain is accustomed to seeing peoples faces as it being asymmetrical. In fact computer generated true symmetrical faces have an odd unfamiliar strange appearance since the human brain is not accustomed to seeing anyone with perfect facial symmetry.
Great artists throughout time have understood that the human face is not symmetrical and facial asymmetry is incorporated into almost all classic works of art regardless of what time period. 
Attempts at soft tissue middle relation using lip volume is probably not going to correct the asymmetry very well. well done lip filler treatments can look great and many people and you may want to consider having lip fillers if you’d like the effect but lower your expectations for correcting asymmetry. 
You probably don’t notice the facial asymmetry of all the people you see on a daily basis. if you were to analyze their faces like you had your own you would see that they all have a symmetry just like you do.
Facial asymmetry is best left alone and excepted as being appropriate normal and aesthetically correct.
There are exceptions when asymmetry is so strong that it becomes obvious causing peoples gaze to notice it. We’ve all seen people with birth defect or the result of trauma who have gross asymmetry. when is severe enough that people notice it and first glance it should always be considered for treatment.
If it’s not noticed by most other people it’s probably better to leave it alone since asymmetry is by its nature difficult to treat. Most people have fairly symmetrical and consistent soft tissues. The baseline asymmetry tends to be based on facial skeletal structure.
Best,
Mats Hagstrom MD

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