Upper vermillion border is lower on the left side, how to fix lip asymmetry? (Photo)

Question

My upper vermillion border is lower on the left side causing a natural "smirk" appearance and a bad case of RBF. What can I do to fix this? Open to all options surgical or otherwise. Thanks!

Steve Laverson, MD, FACS · Answer

To me, your upper lip asymmetry does not communicate a "smirk" expression, but if you want to symmetrize and/or show more vermilion on the left side (your left in the photo), the best treatment depends on the position of your lips relative to underlying maxilla and teeth.  If you have 3mm or more upper incisor show at rest with lips gently parted, my first choice would be a V to Y plasty vermilion advancement on that side.  If you don't have much incisor show, consider asymmetric upper lip lift, perhaps extended upper lip lift on the left side to really lift that corner of your upper lip out to the labial commissure so the vermilion will be adequately everted.  These treatments all have their risks, chiefly that minor adjustments over time will be desired.  The lips are so dynamic and moving all the time.  How you feel about the results of any procedure cannot be predicted.  For complete satisfaction, more than one procedure is often indicated and required.

Jacob Tower, MD · Answer

Hello, hope you are well. Thanks for submitting your question! I can appreciate some asymmetry in the photo just as you describe. The best thing to do is set up a consult with an experienced lip lift surgeon and take measurements from the base of your nose to the vermilion border at standard points along the upper lip. This allows us to measure the exact location and magnitude of the asymmetry and then design a lip lift to even it out. From the photo alone, that would probably be a type of corner lip lift, but we would want to confirm with measurements. 
Best,Dr. Tower

Upper vermillion border is lower on the left side, how to fix lip asymmetry? (Photo)

Answers (2)

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