What can be done to correct lips from appearing asymmetrical when I speak?

Question

I had noticed my left lip and face becoming increasingly asymmetrical over 5 months. Botox and Dysport were tried for TMJ, with Dysport being successful. Fillers at a med spa helped overall, but my left lip still lifts higher on one side when I speak. Prednisone was prescribed for possible facial weakness but did not work. Despite filler correction, my lip remains uneven when I speak. Any suggestions to fix this? Thank You.

Gary M. Horndeski, MD · Answer

A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. After your lip filler and not speaking, you still have asymmetry. This can be improved on with a lip lift. However, it will not necessarily correct the asymmetry when you are speaking.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Anna Chacon, MD, FAAD · Answer

Asymmetry in the lips, especially when speaking, can be a challenging issue to address, but there are several potential approaches that might help improve the situation:

Neuromodulators: Since you have had success with Dysport for TMJ, a similar approach could be considered for the asymmetry. Precise injections of Botox or Dysport could help relax the muscles that are causing the asymmetry. An experienced injector can assess which muscles are contributing to the uneven movement and target them specifically.

Fillers: While you've already had fillers, sometimes asymmetry can be due to volume loss or differences in muscle movement. A highly skilled injector might be able to use fillers more strategically to balance the appearance of your lips when in motion.

Physical Therapy: Sometimes, facial asymmetry can be due to muscle weakness or imbalance. Working with a physical therapist who specializes in facial muscles could help strengthen the weaker side and improve symmetry over time.

Surgical Options: In more severe cases, surgical interventions such as a lip lift or other corrective procedures might be considered. Consulting with a plastic surgeon who specializes in facial anatomy could provide more insight into whether this is a viable option for you.

Neurological Evaluation: Given that prednisone was prescribed for possible facial weakness, it might be worth exploring further neurological evaluation to rule out any underlying conditions that could be contributing to the asymmetry.

It's important to consult with a board-certified dermatologist or plastic surgeon who can evaluate your specific situation in detail and recommend the best course of action tailored to your needs.

Connie Hiers, MD, FACS · Answer

You have lost some movement on that side so Botox can be used on the opposite side to weaken the lip and look more even.

What can be done to correct lips from appearing asymmetrical when I speak?

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