What can I do about my lip? It makes my smile unattractive (Photo)

Question

My whole life my smile has been ugly so when I turned 15 I decided to get braces after my smile was still not the best I think it’s because of my lip when I smile my lower right side of my lip isn’t as full as the left side and pulls down more. What do I do?

Nikesh K. Patel, MD · Answer

You're not alone! Many men and women come to our office looking for something that'll plump up their lips, help enhance the shape of their mouths, reduce fine lines and wrinkles at the edges of their lips, repair irregularities in shape and size, and lift corners of their mouths that droop.  The good news is that lip augmentation is a common procedure in our practice and can be done in just a few minutes with minimal to no downtime.  It sounds like you may have an asymmetric smile, or asymmetries of your lips, which is common in a lot of people.  When people come to my office to treat asymmetries, I like to point them out and then place fillers so we can adjust them.  Just an FYI: If you try this, you probably wont see complete correction on the first attempt, but it may be likely on your second or third attempt if you're looking for perfection.  Find someone who is experienced and will point out your asymmetries without you prompting.  Best wishes.

Robert M. Tornambe, MD · Answer

taylorhand11.  Your asymmetry is only apparent when you smile, so correction must be done with great care because your lips are quite attractive when in repose. I recommend correction with a filler like Juvederm Ultra plus by an experienced injector very conservatively because over correction will cause another asymmetry. If you like the result, then you can consider fat transfer for a longer lasting result. Seek out a board certified plastic surgeon or dermatologist with lots of experience treating lips. Good luck!

Jonathan Kulbersh, MD · Answer

Lip augmentations with fillers is a great option to improve the fullness, suppleness and symmetry of the lips. I prefer to use a micro cannula to inject the lips to prevent bruising. Look for a cosmetic dermatologist or plastic surgeon who is an expert in fillers. 
I hope this helps.

Jason Emer, MD · Answer

You would get a nice improvement with lip fillers (Volbella, Restylane, Juvederm). Nova threads can be used to improve lift and shape. Implants or fat are alternatives. I recommend getting a formal evaluation with a facial sculpting expert to go over your desired results. Best, Dr. Emer

Monika Soni, MD · Answer

Thank you for your question. A non-permanent way to add volume to the lips is with hyaluronic acid fillers such as Juvederm or Restylane and results typically last 6-12 months. I do not advise having more than 1 syringe injected at a time as to avoid overcorrecting. You can always add more filler later if needed. Also, if you are not happy with your results the filler can be dissolved with and an enzyme known as hyaluronidase. I recommend having a consultation with an expert injector to determine the best treatment plan for you. Best of Luck!

Richard A. Zoumalan, MD · Answer

Fillers are an excellent treatment to enhance the shape of your lips. This is a non-surgical procedure that can create fullness, as well as symmetry. I recommend consulting with a physician who specializes in cosmetic procedures.

Vibha Gambhir, MD · Answer

Thanks for your question. We would recommend a lip filler such as Vollure to add volume to the right upper lip and right lower lip that way your teeth and gums will be less visible on the right side. Once the filler is in place we would consider strategically placing a tiny amount of Botox so that there is less muscle pull when smiling on the right side. However, symmetry can be improved, but never perfect. Good luck with your treatment!

Amiya Prasad, MD - Account Suspended · Answer

Thank you for your question. You describe a concern about the attractiveness of your smile as you’ve undergone orthodontics and gotten braces, but are still concerned about asymmetry in your smile. In particular, it appears to be a pulling down of the lip in the right side, and you want to know what you can possibly do.
I can share with you how I would approach a situation like yours, without the benefit of a full physical examination, and by just reviewing your photos. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Helping people improve the appearance of their lips is a process we do in our practice everyday, and it is an area of focus that is very important for a lot of people to have confidence. 
I think it is important to pursue appearance, but at the same time it is important to recognize that nobody is 100% symmetric. I always tell my patients who are naturally very focused on maximizing symmetry that we are beautifully imperfect, and everybody has a little difference from one side to the other. I think we can get a little understanding of some basic principles I apply when evaluating patients for lip enhancement. 
One issue you raised in your question has to do with volume. When you look at someone who is relatively young, we naturally understand that this is a genetic appearance. When we look at someone who is aging and there’s volume loss, that’s an age-related change, so the approach is more about correction. When we’re looking at someone who is younger, we’re looking at an augmentation, and it depends on the degree of volume that can be beneficial, and the art is being very strategic. Often, a little  goes a long way. I’m not saying that’s the right thing for you, but it’s important to understand the distinction of where volume may play a role.
When we look at lips, there’s a Golden Ratio we often apply to the aesthetics of the lip. If there is volume imbalance which could be enhanced to achieve something closer to the Golden Ratio, that’s where volume augmentation has a role. 
The other part of the equation which is more relevant in your situation is with the action of certain muscles on the lips. There’s a particular muscle relevant in this situation called the depressor anguli oris muscle. This is the muscle that in the dynamics of lip movement pulls  the lips down like a pulley. When I ask someone to show me the strength of that muscle, I ask them to show me their lower teeth. What happens is they bring the corners of their mouth down, and show me their lower teeth. 
It is not unusual for people to have an imbalance between the two sides. To help patients to improve the balance as well as change the downward appearance of the corners of the lip to a more upward appearance, we do something called a Botox® lip lift. That means applying this principle of relaxing certain muscles like the depressor anguli oris to allow the lip to travel upward, and it can have a very nice impact. The benefits of trying an approach like this is you can see if you like the results, and with a drug or neurotoxin like Botox®, it wears off. If for any reason you’re not happy with that outcome, it wears off. This is an opportunity to do something minimally invasive, and seeing if a little can help you feel a bit better about the outcome. 
I always stress to my patients that when people look at themselves, they see things they don't like, and tend to magnify them, while the rest of the world sees the big picture and sees the whole face. Although I think it is important to do things for yourself to feel more confident, it is also important to have a perspective to ask some of your closest friends if they ever noticed this particular attribute, they probably would not consider it significant. Some may notice it, but I would assert that most often, people would not notice, and that’s just human nature. 
If you are interested, meet with qualified and experienced doctors who can offer you some options. Try to be conservative first. I think the use of Botox® strategically is probably a conservative first step to help you achieve this goal. Understanding of course that Botox® does wear off, therefore you will need to do this in an ongoing basis for maintenance if you are so inspired. I hope that was helpful, I wish you the best of luck, and thank you for your question.

P. Alexander Ataii, MD- Account Suspended · Answer

Hello and thank you for your question.  A lip augmentation is a cosmetic procedure that uses an injectable dermal filler to enhance the appearance of your lips. The procedure is designed for anyone who is not satisfied with the appearance of the lips, and for patients who want more appealing, plumper lips.  From the picture you sent it looks like you are a good candidate for Lip Augmentation.  
Hyaluronic acid filers such as Juvederm and Restylane are the two most common dermal fillers that are used to create fuller lips. Hyaluronic acid is a naturally occurring sugar that gives the skin its natural elasticity and volume. Like collagen, hyaluronic acid decreases over time, and skin begins to lose its volume. An ultra-fine needle is used to inject the material into the lips and along the edge of the lips to make your lips fuller and plumper. Although the results are not permanent, you can expect your lips to retain the plump fullness for up to six months.  I recommend scheduling a consultation with an experienced physician to discuss your options.
  
Best of luck to you
  P. Alexander Ataii M.D.

What can I do about my lip? It makes my smile unattractive (Photo)

Answers (9)

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