What could be done to make the top lip turn more upwards & the bottom to not be crooked? (Photos)

Question

As you can see my smile is crooked, what could be done to make the top lip turn more upwards and the bottom to not be crooked, I just want it to look normal

Anna Chacon, MD, FAAD · Answer

Thank you for your question, and I completely understand your desire to achieve a more balanced, symmetrical smile—it’s a common concern, and thankfully, there are several treatment options depending on the underlying cause.

A crooked smile or uneven lips can result from a number of factors, including muscle asymmetry, volume loss, prior trauma, dental or skeletal structure, or previous filler placement. Here are some potential solutions:

Botox (Neuromodulators):
Small, targeted Botox injections can help relax overactive muscles that are pulling one side of the mouth more than the other. This is often effective for lifting the upper lip slightly and balancing a crooked lower lip due to muscle asymmetry.

Dermal Fillers:
Hyaluronic acid-based fillers like Juvederm or Restylane can be strategically placed to lift the upper lip (particularly the central portion) and provide volume or structure where needed. They can also correct uneven volume or definition in the bottom lip.

Lip Flip:
A subtle Botox treatment into the orbicularis oris muscle around the upper lip can help evert (flip) the lip slightly upward, giving it more visible height without adding volume.

Lip Lift Surgery:
For a more permanent solution, especially if the philtrum is long or the upper lip doesn’t expose enough pink tissue, a surgical lip lift can reposition and reshape the upper lip. This option requires a more in-depth consultation.

Assessment of Dental or Structural Factors:
Sometimes asymmetry comes from the teeth or jaw alignment. In such cases, working with a multidisciplinary team including dental professionals may be helpful.

My recommendation:
Start with a consultation to evaluate your smile at rest and while moving. A combination of subtle neuromodulator treatment and filler may be all that’s needed for a natural, harmonious result. I’d be happy to evaluate you further via virtual consult and customize a plan for your goals.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. To address a crooked smile and achieve a more symmetrical appearance, several options can be considered. One effective approach is to use Botox strategically to relax certain muscles around the mouth, which can help lift the corners of your upper lip. This can create a more even smile by allowing the lip to turn upwards more naturally. Additionally, dermal fillers may be used to enhance the shape of your lips, providing volume where needed. For instance, a small amount of filler can be injected into the upper lip to create more definition and lift, helping to balance the overall appearance. I hope this helps and best of luck!

Dallas Buchanan, MD · Answer

Thank you for your question. Some better photos would be very helpful. Close up photos of your mouth/lips at rest, with a light smile, and then with a full smile. This would help to assess baseline anatomy, and changes with movement and animation. Until that can be better evaluated, it is hard to know what options are available to you in regards to non-surgical (botox/fillers) vs surgical (lip lift) options. Reach out to a local board certified (ABPS) plastic surgeon. Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Zoran Potparic, MD · Answer

Unfortunately, based on these photos it is impossible to give good advice about lips. In general, lip lift, with incision (scar) placed underneath and inside the nostrils, would be the best procedure to achieve lip up-turn. In person evaluation with a board certified plastic surgeon with experience in this procedure would provide better information.

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. This could help correct your asymmetry.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Joe Gryskiewicz, MD, FACS · Answer

Hello,
You may try a lip flip to the upper lip to help it have a little more volume and not downturn when you smile. That would use a few units of a neurotoxin product such as Botox. For the crookedness to the bottom I may recommend lip filler such as Restylane Kysse.  
All the best,
Dr. Joe

Camille Cash, MD · Answer

A combination of Botox and fillers will likely give you the best results.  A Botox lip flip can be used to "flip" the upper lip to give a fuller appearance.  Filler can be used to add volume and correct asymmetry.  See an expert injector near you for treatment.

Mats Hagstrom, MD (license on probation) · Answer

All people have facial asymmetry.
Your lips being uneven has very little to do with your lips and everything to do with the rest of your face, especially skeletal structure, which is the underlying reason for normal facial asymmetry.
Attempts at soft tissue Solutions for problems which are based on skeletal structure are unlikely to give good outcomes.
Best,
Mats Hagstrom MD

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