When I smile, the center of my top lip pulls down while the rest pulls up.

It would be helpful to have photos of you with and without a smile. The extra "pulling" that you see when you smile may be treated with Botox or Dysport. For volume loss, a dermal filler, like Restylane, can be added. Best wishes, Dr. ALDO

Thank you for sharing your question.  Unfortunately without a series of pictures it is difficult to offer definite advice but improvement can likely be had with a combination of Botox and/or dermal fillers.  The Botox can be used to treat hyperactive muscles, while dermal fillers can help add volume and smooth results.  Hope this helps.

This is tough to answer without pictures. Smile symmetry may be improved with well-placed Botox in combination with fillers (Voluma, Restylane, Volbella). I recommend getting a formal evaluation with a facial contouring expert. Best, Dr. Emer

Hi.  You need to post a pic without smiling and one with smiling for us to see.  But from the sounds of it, you would need a small amount of Botox to the top lip laterally to decrease the elevation and thinning of the tip lip laterally as well as fillers to the lateral top lip leaving the central lip untouched so that they blend better and balance better.  But without a few pictures its hard to tell.  Just know that Botox does have a role in lip beautification and its not just fillers

Hello,

You can obtain a balanced appearance in the lips with the use of hyaluronic acid based lip fillers towards the center towards the corners of the lips and the Botox/Dysport injections to the upper part of your lips which weakens over time, giving it a lifted appearance. 

I recommend booking an in-person consultation with a certified cosmetic facial cosmetic surgeon. When you are exploring the options of a facial procedure, make sure that you also explore the right type of cosmetic surgeon to perform your procedure. A facial plastic surgeon is a cosmetic doctor that is an expert strictly in the head and neck. 

Hi, I have used Botox and some of the other neuro-modulators for over 30 years. Precise placement of Botox or Xeomin to the upper lip can selectively weaken the muscles that are over-thinning your upper lip.Hope this helps.