Smile asymmetry - How can I fix this? (Photos)

Question

Hi I'm 22F, and however long I can remember, I've had a slightly asymmetric smile more than normal (photos attached). I feel very very uncomfortable with injectables but I really want to get this fixed - I was told Botox could be an option but I really don't want to do that / other injectables at this age. Can you please tell me some options I can approach?

Anna Chacon, MD, FAAD · Answer

Hi! Thank you for sharing your photos and explaining your concerns. I completely understand how frustrating it can feel to notice a smile that feels uneven, especially when you want a natural result and aren’t comfortable with injectables.

Smile asymmetry can come from natural facial anatomy, muscle activity, or previous habits, and the good news is there are a few approaches beyond injectables:

1. Targeted Facial Exercises / Therapy

Working with a facial physical therapist or practicing guided exercises can sometimes help improve muscle balance over time.

This is non-invasive, safe, and can subtly enhance symmetry if done consistently.

2. Orthodontic or Dental Considerations

Sometimes bite alignment or jaw positioning contributes to asymmetry.

A consultation with a dentist or orthodontist can help determine if minor adjustments could improve your smile naturally.

3. Minimally Invasive Procedures

While you mentioned you’re hesitant about Botox or fillers, subtle procedures like thread lifts in the smile or cheek area can offer gentle lift and improve symmetry without adding volume or freezing movement.

4. Lifestyle & Awareness

Being mindful of chewing habits, posture, or repetitive facial movements can reduce further asymmetry.

At 22, your face is still naturally resilient, so the changes that are made can be subtle but effective over time. True “permanent” corrections often require surgical approaches, but for mild asymmetry, non-invasive strategies usually provide satisfying improvement without affecting your natural expressions.

It’s entirely reasonable to approach this gradually and explore non-injectable options first, especially since your comfort is a priority.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. Smile asymmetry is usually caused by uneven muscle activity, volume differences, or habits like favoring one side while speaking or chewing, and the best approach depends on the underlying cause. If the asymmetry is due to overactive muscles on one side, I recommend treating the area with Botox. I hope this helps!

Camille Cash, MD · Answer

We are all asymmetrical to some degree.  For smile asymmetry the options include Botox and fillers.  If this isn't something you are ready to explore yet, just know the option is available when you are.  Botox can give a conservative lip flip which shows more of the pink part of the lip.  It can also be used to treat gummy smile.  Fillers can be used to address volume discrepancies and to help shape the lips.  Both are temporary.

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