What is a more permanent solution to my uneven smile? (Photo)

I can understand how frustrating it must feel to notice an uneven smile, especially after investing time and effort into surgical rejuvenation. Given that it’s been more than five years since your facelift and lip procedure, the asymmetry you’re seeing is likely due to a combination of muscle imbalance, nerve recovery patterns, and soft tissue changes rather than anything structurally wrong with your facelift itself.

Since Botox has helped temporarily, that suggests your asymmetry is at least partly muscular. For a more lasting solution, here are a few considerations:

Targeted neuromodulator adjustment: A highly skilled injector—often a dermatologist or facial plastic surgeon—can sometimes refine the balance between the muscles around the mouth to create a more symmetrical resting and smiling position. This may involve micro-dosing Botox differently than before.

Facial retraining or physical therapy: Specialized facial therapy can help improve coordination and strength between the two sides of your mouth, particularly if there’s any mild residual nerve imbalance.

Surgical options: In more persistent cases, a minor revision procedure or fat grafting can subtly even out tissue volume or restore balance between the muscles.

You’ve already identified that the Botox lip flip helps, which is a great sign—it means your issue is likely correctable with the right tailored approach. A facial plastic surgeon or dermatologist experienced in post-surgical asymmetry correction would be the most suitable type of specialist to assess your options in detail.